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Below you will find a list of commonly used forms for groups with Delta Dental and Vision available for download.  While we do the best we can to keep everything up to date, sometimes carrier websites change without our knowledge, which may mean step by step instructions may be out of date.  If you notice anything doesn't work as intended, please bring it to our attention and we will correct it. 
 
Please submit all completed forms to Shannon Herr:
 
Email:     Shannon.Herr@hia-wi.com

Fax:        262-786-6731

Mail:  Health Insurance Associates, Inc
           Attn:  Shannon Herr
           19525 Janacek Ct STE 101
           Brookfield, WI 53045
Type
Description
Form

Delta Dental Enroll/Change/Term Form

Can be used for any existing dental or vision group to enroll and terminate members, and make any information changes.

WIBT Delta Dental Enroll/Change/Term Form

Can be used for any existing WIBT dental or vision group to enroll and terminate members, and make any information changes.

ID Cards

This is a link to the Delta Dental website for employees to register and
print their ID cards.

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