Delta Dental of Minnesota provides several forms and resources to help you manage your employer group. Choose from the options below! Have questions? Visit our Frequently Asked Questions section or contact us.
- NEW Group Master Vision Applications
- DeltaVision® Group Master Application
- DeltaVision® Enrollment and Eligibility update form
- DeltaVision® Enrollment and Eligibility update form – Spanish
- Employer Services Portal Access Forms
- Employer Services Portal – Client Access
- Employer Services Portal – Broker Access
- Group Master Applications
- MN Group Master Application (Small Group Pooled)
- MN Master Application for Health Care Reform – Certified Group Products
- ND Group Master Application (Small Group Pooled)
- ND Master Application for Health Care Reform – Certified Group Products
- Enrollment and Maintenance Forms
- Direct Debit Authorization (ACH) Form
- MN/ND Eligibility Enrollment/Update Form
- MN Membership Enrollment Form – Spanish (Small Group Pooled)
- MN/ ND Enrollment Form for Health Care Reform – Certified Group
- ND Membership Enrollment Form – Spanish (Small Group Pooled)
- Disabled Dependent/Michelle’s Law Application
- HIPAA Designated Contact Form
- Employer Request and Claim Forms
- Attending Dentists Statement Claim Form
- Additional Resources
- Health Care Reform Resources