Enrollment Kit - principal (dental)
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This checklist is provided as a guide. The carrier may require additional items and documentation. Please refer to the carrier's underwriting guidelines for a complete list of requirements. Please use the latest version of forms.
Our goal is to process your new group enrollment easily and efficiently in order to provide you and your client with a quick approval. The following list outlines Principal's case submission requirements.
**Forms are generated based on coverages sold and by state. Please contact your Word & Brown Sales Representative**
Employer Application
Group Policy Installation Form
Enrollment Spreadsheet
Employee Enrollment & Waiver
E-Service Election Form for groups electing paperless administration.
Copy of the Principal quote.
Broker: must be licensed with Principal Life. If not licensed, licensing paperwork must be submitted with the case.
Group Plans: Minimum of 3 participating employees for standalone as long as Employer Contribution is a minimum of 50%. Minimum of 3 participating employees if multiple lines of coverage are sold. Minimum 10 enrolling when quoting Ortho.
Voluntary Dental: Minimum of 10 eligible employees (available through the local Principal Financial sales office).
Employee Benefit Choice: Minimum 10 enrolled employees. At least one employee must be enrolled in each benefit offering.
No prior carrier bill needed.
Waivers are needed on Employer-paid dental. Valid waivers do not reduce participation. Invalid waivers reduce a group’s participation rate. Please contact your Word & Brown representative for more details. Not applicable to Voluntary dental.
Health Statement required for all employees electing over the Voluntary Term Life guarantee issue amount of $50,000.
Vision Claim: Employees can submit a vision claim simply by taking a photo of their receipt.
Broker Licensing: Must be licensed with Principal Life. If not licensed, licensing paperwork must be submitted with the case. Consumer Report Authorization, Agent Appointment Information Sheet and copy of license (if applicable).
Authorization Agreement for Direct Deposit
| After approval, prior carrier termination letter must be submitted by the employer or broker. |
For other useful or older documents, please refer to the Forms database.