Enrollment Kit - reliance standard (dental)
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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 Reliance Standard’s case submission requirements.
- Completed SmartChoice Request for Participation and Enrollment Form (2-19 lives).
- Copy of sold proposal premium summary page(s) as presented to the employer (2+ lives).
- SmartChoice Employee Enrollment Forms.
- To write a (2) employee dental group, two additional lines of coverage must also be sold.
If applicable:
- Notification of Waiver Form(s) (2-19 lives)
- Quarterly State Wage Reports may be requested at the discretion of Reliance Standard (2-19 lives)
- Prior carrier information required for Dental, STD and LTD coverage takeover (2+ lives)
- Evidence of Insurability Applications for Life benefits exceeding Non-Medical Issue (Guaranteed Issue Amount) Limits (2+ lives).
NOTE: If any of the above items are missing or incomplete, processing of case may be delayed.
- Broker Licensing: Agent Appointment Application and Commission Schedule and copy of license (if applicable).
- Authorization Agreement for Automatic Deposits of Commission
- EFT Recurring Payment Authorization
| 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.