Get Caldent/calvision Employee Application

This guide provides a step-by-step approach to filling out the CalDent/CalVision Employee Application online. Each section is outlined to help users accurately complete their enrollment forms for dental and vision coverage.

Follow the steps to successfully complete the application.

1. Click the ‘Get Form’ button to obtain the application and access it in the editor.
2. Begin by selecting your preferred dental plans. Mark your choice from the group dental plans — Silver, Gold, or Platinum. Also, choose any voluntary plans you wish to enroll in, either Standard, Deluxe, or Deluxe Plus.
3. Move on to the vision plan selection. Indicate your choice of vision coverage, ensuring you include the policy details as required, under Vision Policy Form GHA-1157.
4. Fill out your personal information, including your name, address, social security number, date of birth, and date of hire. Make sure to enter your phone number and select your marital status.
5. If you have dependents, provide their information in the designated section. Include their names, genders, dates of birth, relationships to you, and any applicable social security numbers. Indicate if any enrolling child is currently married.
6. In the other insurance section, list any additional coverage you or your dependents may have. This includes information about the insurance carrier, group number, ID number, and contact phone number.
7. Review the acknowledgment section carefully. It outlines important information regarding your coverage elections and authorizations. Please ensure you understand this content before proceeding.
8. Sign and date the application where indicated. Make sure your signature represents your understanding that all provided information is accurate.
9. After completing the form, you may choose to save the changes, download a copy, print it for your records, or share it as needed.

Complete your CalDent/CalVision Employee Application online today for seamless enrollment.