Member Forms and Downloads

Quick Access to Common Resources

Member Forms
Submit A Claim
Existing members may submit a claim using the form below:
Dental Claim Form
Enrollment Change Form
Use these forms to request changes to your existing coverage:
MN Individual and Family℠ – Elite 3500, Elite 1000 Enrolment Change Form
MN Individual and Family℠ – Plan A, Plan B, Plan C, Plan D Enrollment Change Form
2019 MN Health Care reform Individual & Family Change Form
2018 MN Health Care Reform Individual & Family Enrollment Change Form
ND Individual and Family℠ – Plan A, Plan B, Plan C Enrollment Change Form
2019 ND Health Care Reform Individual & Family Enrollment Change Form
2018 ND Health Care Reform Individual and Family℠ Enrollment Change Form
Helpful Tools for Members

Cost Estimator

Our Dental Care Cost Estimator tool provides estimated cost ranges for common dental care needs.

Learn More

Recent Blog Posts

November 30th, 2018

Asthma and your oral health

If you have asthma, you probably already know that winter = colder weather = thriving viruses = upper respiratory infections = asthma attacks. What you may not know is that those asthma symptoms can have an impact on your smile.

November 28th, 2018

Answers to your frequently asked questions about senior dental benefits

Do you have a question about dental insurance for seniors? You’re not the only one! Our support team put together the most commonly asked questions they receive – and their answers! – below.

November 26th, 2018

My Tricare Retiree Dental Program ended. What are my options?

If you’re a military retiree looking for alternatives to replace your Tricare Retiree Dental Program (TRDP), you’re not alone. The government announced an end to the program beginning Dec. 31, which has a lot of people wondering what their options are.