Ameritas Dental Insurance
Forms Page

Dental Claim Form
http://www.ameritasgroup.com/forms/gc140.pdf

Change or Waiver Form
http://www.ameritasgroup.com/forms/gr303.pdf

Election of Continuation Form
http://www.ameritasgroup.com/forms/gr82.pdf

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In Partnership
 With:

EDUCATIONAL
BENEFIT PLANS, INC.

2307 Robinhood Road
P.O. Box 70059 •  Albany, GA 31708
229-435-2141 • 800-833-9620 • fax:229-888-8900
info@benefitssouth.com   • Disclaimer
 

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