If you already offer benefits, through this portal you can access eligibility, billing, plan, enrollment information and download forms. Just click on the link that applies to you.
Forms
Administrative Form
Change Form
Grievance Form
You may print and mail in your grievance according to the instructions included in the forms below, or you may call Customer Service at (800) 880-1800.
Enrollment Forms
These forms are NOT interchangeable. Please
use the form that corresponds to the plan your employee has chosen.
California Enrollment Forms:
Dental HMO
Vision PPO
Managed Vision Care
Florida Enrollment Forms:
Dental HMO Plan
Vision PPO
Texas Enrollment Forms:
Dental HMO
Vision PPO
If you have trouble accessing your benefit plan information or forms online, please contact Customer Service at 1-800-880-1800.
1In the event of urgent grievance, which involves an imminent and serious threat to your health, including, but not limited to, severe pain, potential loss of life, limb or major bodily function, you are not required to participate in Safeguard's grievance process and may directly contact the California Department of Managed Health Care, as referenced above, for review of the urgent grievance. You may reach the department at 1-888-HMO-2219, TDD: 1-877-688-9891, or http://www.hmohelp.ca.gov
Dental benefits provided by SafeGuard Health Plans, Inc., a MetLife company. Vision benefits are provided by SafeHealth Life Insurance Company for VPPO and SafeGuard Health Plans, Inc. for VHMO, only in California, both of which are MetLife companies. Individual Dental HMO plans are available in CA, FL and TX only, through a domestic company in the applicable state named SafeGuard Health Plans, Inc.
"Dental HMO" is used to refer to products that may differ by state of residence of the enrollee, including but not limited to: "Specialized Health Care Service Plans" in California; "Prepaid Limited Health Service Organizations" as described in Chapter 636 of the Florida statutes in Florida; and "Single Service Health Maintenance Organizations" in Texas.
Like most benefit programs, benefit programs offered by MetLife and its affiliates contain certain exclusions, exceptions, waiting periods, reductions, limitations and terms for keeping them in force. Please contact MetLife for complete details.
Need More Information
Contact Customer Service1-800-880-1800
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