Where To Send Claims

Please select the state for which you need to submit a claim form.

If you have group dental coverage provided by your employer, choose the state in which the company's headquarters are located.

If you have individual or family coverage, chose the state where you live.

Please click on a state within the map. This will display the claim form address for the selected state.

Alabama Alaska Arizona Arkansas California Colorado Connecticut Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Illinois Individual Indiana Iowa Kansas Kentucky Louisiana Maine Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York New York No Surprises No Surprises Classic North Carolina North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Virginia Washington West Virginia Wisconsin Wyoming