DentalandVisionIns.com
Request a list of active members and dependents
Please provide your email address for confirmation of this request
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Please provide the Client ID number shown on your invoice. Example: 123456-0
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Please provide the name of the group:
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Do you wish us to include what we have for the member's address?
Yes
No
How should we send the ledger copy
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Member list to be emailed to the above email address
Member list to be mailed to the address of record for the group
The listing will not include birth dates or identification numbers
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