Get Ar Delta Dental Request For Appointment Application 2020-2025

Filling out the AR Delta Dental Request For Appointment Application online is a vital step for agents looking to partner with Delta Dental of Arkansas. This comprehensive guide will provide you with clear, step-by-step instructions to ensure your application is completed thoroughly and accurately.

Follow the steps to complete the application process seamlessly.

1. Click the ‘Get Form’ button to access the form and open it in your preferred online editor.
2. Begin by entering the agent information, which includes last name, first name, middle initial, date of birth, social security number, and national producer number.
3. Complete the business address section by providing the street address, city, state, and ZIP code. Ensure that the business telephone and mobile telephone information is accurate.
4. Indicate whether you have an Arkansas Accident & Health producer license and whether this is your first appointment in Arkansas.
5. Provide detailed responses to questions regarding previous license suspensions, legal convictions, or business relationships with insurance companies.
6. If applicable, complete the agency information section by providing the agency name, tax ID number, and details about agency contact.
7. Attach any required documents, such as a copy of your Medicare Learning Network training certificate if certified to sell ACA dental plans.
8. Review all information provided for accuracy before submitting your application.
9. Submit your completed forms to the Sales & Account Management Department via email, fax, or mail as indicated in the instructions.
10. After submission, wait for a confirmation packet that will include further information on conducting business with Delta Dental.

Start completing your documents online today for a smooth application process.