Dental Insurance - Employer Request Form

Employer & Group Dental Request

Would your employees like to have a dental plan, but the benefits from dental insurance don't seem to justify the premiums you must pay?

Does your current group dental insurance limit your benefits or exclude work that you need to have done?

Would you like to start a dental plan, but don't want to wait a year with dental insurance to get braces for your kids?

Take a look at the advantages that the CAREINGTON Discount Dental Plan offers versus traditional group dental insurance.

One of the first to offer quality dental coverage at a discount beginning in 1979. Currently over 3 million members.
Provider network of over 54,000 credentialed dentists nationwide
Only 3 Participants Required regardless of group size
Orthodontics (Braces) Included
Vision Plan Included
Free Rx Discount Plan Included

If you are interested in offering our dental plans to your employees or group members, please complete this request form. One of our administrators will contact you with a group solution. Depending on your group size, we have list bill options and we can create a benefit plan that best fits your group needs.

NOTE: The CAREINGTON $10 enrollment fee will be waived for groups of 10 or more.

GROUP REQUEST FORM - LTCC, Inc.

Company Name:
Contact Name:
Address:
City:
State:
Zip Code:
Phone Number:
Email Address:
Number in Group:
Type of Benefits:
How did you find us:
Please include the specific type of information you would like us to send you so we can respond in a timely manner.

For immediate assistance, Please call
LTCC, Inc.
Toll Free at 1-800-544-9505

We understand the importance of protecting your privacy. Any personal information you provide will be considered strictly confidential and will not be shared with any third party organizations.

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LTCC is a trademark of LTCC, Inc. All other products mentioned are registered trademarks of their respective companies.