Plan document library

Plan summaries and rates, and group application forms in downloadable .PDF format.

2024 small business plans

2024 plan summaries

Application form

Enrollment change form

Make changes to your group's enrollment roster of primary members and dependents.

Enrollment form [.pdf]

Qualifying event form

Notify us of a change in coverage status for an an enrolled primary member or dependent.

Qualifying event form

Electronic Funds Transfer form

Set up an automatic funds transfer to auto-pay your monthly invoice.

EFT signup form

2024 plan summaries

Enrollment form

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Individual & family plans

Enrollment form

Fillable enrollment form for all 2024 individual and family plans [1031, 1041, 1051]

2024 plan summaries

Application form

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SD Retailers Association plans

Group application form

Fillable group application form for all SDRA group plans [8010, 8012, 8013 & 8015]

Enrollment change form

Make changes to your group's enrollment roster of primary members and dependents.

Enrollment form [.pdf]

Qualifying event form

Notify us of a change in coverage status for an an enrolled primary member or dependent.

Qualifying event form

Electronic Funds Transfer form

Set up an automatic funds transfer to auto-pay your monthly invoice.

EFT signup form
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Plan features & options

Top 10 advantages

The top 10 reasons to choose a plan from Delta Dental of South Dakota

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Plan features & options

Prevention Pays flyer for employers

A flyer for employers, group plan administrators, and human resources managers describing the Prevention Pays plan feature.

2025 plan summaries

Application form

Enrollment change form

Make changes to your group's enrollment roster of primary members and dependents.

Enrollment form [.pdf]

Qualifying event form

Notify us of a change in coverage status for an an enrolled primary member or dependent.

Qualifying event form

Electronic Funds Transfer form

Set up an automatic funds transfer to auto-pay your monthly invoice.

EFT signup form

2025 plan summaries

Enrollment form

icon-document.png

Individual & family plans

Enrollment form

Fillable enrollment form for all 2025 individual and family plans [1031, 1041, 1051]

2025 plan summaries

Application form

icon-document.png

SD Retailers Association plans

Group application form

Fillable group application form for all SDRA group plans [8010, 8012, 8013 & 8015]

Enrollment change form

Make changes to your group's enrollment roster of primary members and dependents.

Enrollment form [.pdf]

Qualifying event form

Notify us of a change in coverage status for an an enrolled primary member or dependent.

Qualifying event form

Electronic Funds Transfer form

Set up an automatic funds transfer to auto-pay your monthly invoice.

EFT signup form