Dental Provider:

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

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. 

2016 Monthly Premium Rates

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

Other plan documents