Dental Claim Form (all dental plans) |
Member Termination Form |
Transition of Dental Care Form |
Reinstatement Request Form For members who purchased their plan directly through CareFirst and not through a state Exchange. |
Coordination of Benefits Form |
Please be advised, the Employer Portal will undergo maintenance from 3 pm Friday 4/19th to 4 am Monday 4/22nd. The application will be inaccessible during this time.
Dental & Vision Forms
Dental