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Comment: changed order of dental enrollment form & premium rates (to match format on medical page)

Dental Provider:

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

2016 Monthly Premium Rates

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

 

Dental Enrollment Form

 

If you are enrolling in 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
nameDental insurance - Lincoln Enrollment Form - current year.pdf
pageAll Forms
spaceFMHOME
height250

2016 Monthly Premium Rates

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Other plan documents

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