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Delta Dental of WisconsinEnrollment/Change/Waiver Form Television PLEASE NOTE THAT COMPLETING THIS FORM DOES NOT GUARANTEE COVERAGE.EMPLOYER USE ONLY43429 GROUP NUMBER ___EFFECTIVE DATE ___COMPLETE

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Visit the Delta Dental of Illinois website

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What is delta dental of illinois?

Delta Dental of Illinois is a dental insurance company that provides dental insurance coverage to individuals and groups in Illinois.

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Employers and individuals who have purchased dental insurance coverage from Delta Dental of Illinois are required to file.

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The purpose of Delta Dental of Illinois is to provide dental insurance coverage to individuals and groups in Illinois to help them afford dental care.

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Information such as dental expenses, covered dental procedures, and any updates to personal information must be reported on Delta Dental of Illinois forms.

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