Securian Dental Plans
Underwritten by Securian Life Insurance Company and administered by DeCare Dental Health International, LLC

Forms and Literature

For your convenience, Securian provides web site access to forms needed by group administrators below. Check back in the future as we add additional forms, brochures, applications and more.

General Information

Securian Dental At A Glance

What Is A Dental Plan? Q & A

Reference Manual for Group Administrators - all states except VT, ME, NH

Reference Manual for Group Administrators — VT, ME, NH

Exclusions and Limitations

Escalating Maximum Sheet

Membership Enrollment and Maintenance

Membership Enrollment Form (for all states except the following)

Membership Enrollment Form - Spanish 

Membership Maintenance Form (for all states except the following)

New Group Enrollment Checklist (VT, ME, NH)

Census Enrollment Spreadsheet

Disabled Dependent/Michelle's Law Application

Online Enrollment User Request Form

Online Enrollment Highlights

Enrollment Meeting Poster

Enrollment Meeting Stuffer

Billing

Automated Clearinghouse (ACH) Authorization Agreement

Billing Reports Highlights

Billing Reports Online User Request Form

Billing Reports Online Change Request Form

Group Premium Billing Schedule

International/Expatriate Emergency Dental Programs

International Emergency Dental Program Brochure 

International Expatriate Dental Program Brochure

Frequently Asked Questions

International Dentist Listing 

Claim Form and Instructions for Members

International Dentist Nomination Form

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