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Help and Resources

Downloadable Forms



Dental Deductible Carry-Over Credit Report for NY and PA (2576)

Dental Service Report (Claim Form) for NY and PA (1248)

Employee Dental Application for Enrollment or Change for NY (4518)

Employee Dental Application for Enrollment or Change for PA (8646B)

Rayant Dental Discount Plan Application for NY/PA (2764)

Transmittal of Deletions form for NY and PA (2933)

New York Application for Employer Dental Benefits Policy (8923)

Application for a Small Employer Dental Benefits Policy for PA (8758PA)
FAQs

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In New York, products are underwritten by Rayant Insurance Company of New York. In Pennsylvania, products are underwritten by Rayant Insurance Company of Pennsylvania.
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