Two ways your employees can enroll:
Complete an enrollment form online PDF, print it and sign it. Then, submit it to your company's human resources department for review and submission to Delta Dental for processing.
Download an enrollment form PDF, print it, manually complete and sign the form. Then submit the form to your company's Human Resources department for review and submission to Delta Dental for processing.
Once you have reviewed the enrollment form, please mail or fax it to the attention of your assigned Delta Dental group accounts representative.
Delta Dental of Missouri
c/o Group Accounts
P.O. Box 8690
St. Louis, MO 63126-0690
If you don't have the fax number of your assigned group accounts representative, you may fax the enrollment form to the number below.