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Dental Provider:

Lincoln Financialwww.lfg.com1-800-423-2765

 

2016 rates

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Dental Enrollment Form

If you are enrolling in Dental dental for the first time , or adding children under 3 years, be sure to download and complete the enrollment form. 

Complete the following sections : (Product Selection, Dependent and Other Insurance Information, Request for Coverage, ) and sign and date the form. 

View file
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nameDental insurance - Lincoln Enrollment Form - current year.pdf
pageAll Forms
spaceFMHOME
height250

2016 Monthly Premium Rates

Coverage levelCost
Employee$37.12
Employee + One$73.15
Family$112.98

Other plan documents

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