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INDIVIDUAL PLAN FORMS
High Option - Enrollment and Rate Booklet Click Here
Low Option - Enrollment and Rate Booklet  Click Here

How to Enroll
  1. Decide which plan you want to purchase (High Option or Low Option). Call our Customer Service Department if you need assistance.
  3. Download and complete all sections of the Enrollment and Agreement Form.
  5. Select a dental office and enter the Provider Number or Name on the Enrollment and Agreement. (To select a dental provider you may use the current Directory of Participating General Dentists and Specialist located in the forms section under member or go to Provider Search under member)
  7. Select a payment option (annually or monthly) on the front of the form.

    1. To avoid delays in processing, return the Enrollment and Agreement Form with the correct premium for your enrollment type. Please see the “Plan Highlights and Rates” sheet for premium information.

 

Mail your request to:
Global Benefits Group 3104 E. Camelback Rd  #302  Phoenix,  Az   85016 (602) 299-9785
       

By submitting this information, I request that insurance companies and    (DesignMyHealthInsurance.com) partners contact me to provide quotes and/or obtain additional information for the purposes of providing a quote. I certify that the information I am providing is accurate to the best of my knowledge.

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Design My Health Insurance, offers: Affordable Health Insurance, Great Customer Care, The Top-Rated Health Insurance Carriers in the US, Assurant, Humana, Aetna, Blue Cross and UnitedHealth Care Plus many more. Life Insurance and Annuities are Available. All Providers Available in your area with Coverage you can Afford. Rated the Best low Cost Insurance Agency with Help Buying Insurance available.