Notice
Change Healthcare announced a breach of HIPAA privacy and is reaching out to individuals whose personal information may have been compromised. Although this incident does not involve Delta Dental of New Jersey or Connecticut, Change Healthcare is a vendor we used and we are providing this information to help our members who might be affected.
Broker Forms for Individual & Family Plans
Easily access and download all the forms you need
Producer Appointment Forms (pdf, 26 pages, 789KB)
Use this packet to get appointed to sell Individual & Family Plans and earn commission.
Delta Dental of Connecticut is a part of Delta Dental Plans Association. Through our national network of Delta Dental companies, we offer dental coverage in all 50 states, Puerto Rico and other U.S. territories.
