Forms and Resources

We've included some of the standard forms you'll need to manage benefits for your employees. Please download the necessary form(s) and return to:

Delta Dental of Rhode Island
PO Box 1517
Providence, RI 02901-1517

Online Enrollment System User Guide

Dental Automatic Payment Form
Online Access Administrator Role
Direct Electronic Access Agreement * (Return completed form to your Account Executive)
Student Certification Form (Use this form to certify dependents as college students)
Group Data Form
Authorization To Release Protected Health Information
Certificate Of Coverage For Small Businesses

* Please note: It takes approximately two weeks to process a complete Direct Electronic Access Agreement. Until you receive your username and password, please forward subscriber changes and additions directly to the enrollment department via fax at 401-752-6040.