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Contracting and Appointments

Thank you for considering Delta Dental. To receive a quote for your client, you must first be contracted with Delta Dental of Missouri and appointed by our carrier(s) with the Department of Insurance. Follow the simple steps below to get started. 

1. Download and complete the applicable toolkit(s).

*The Producer Agreement(s) and Contact Form must be signed by an officer or similar individual with the authority to bind the agency. As a contracted producer, it is expected that you will maintain errors and omissions (E&O) insurance and submit proof.

Notice To Producers Regarding Appointment Requirements And Commission Payments Policy

• Group Product Package

• Individual Product Package

2. Email the completed documents to Broker-Relations@DeltaDentalMO.com or fax them to 314-656-2942. If you fax these documents, please include your email address on the cover sheet.

3. Upon receipt of all the necessary forms, Delta Dental of Missouri will initiate steps for your appointment. Please allow up to 14 business days for the appointment to be processed. Once this is complete, the counter-signed agreement will be returned. 

Individual Product
Once you complete and return the Individual Product package shown above, you will be assigned a producer number which will be supplied to you at the email address provided. Your producer number must be submitted on the individual plan application through our website to receive a commission of a one-time, per-policy amount of $25. Please visit our Individual and Family plan website at Individual.DeltaDentalMO.com for information on plan designs and networks.

Updating your Information
If you have previously applied to sell Delta Dental of Missouri insurance and wish to update your information on file, please update the applicable forms and submit the request to Broker-Relations@DeltaDentalMO.com or fax them to 314-656-2942.

•  Change of 1099 address
•  Change of physical or commission address – Contact Form
•  New producer in office – Appointment Request Form
•  Mergers and acquisitions – please contact us directly