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Employers

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.

Group DHMO Benefit Administrators

If you offer a SafeGuard DHMO plan, click here to log in.

Group Vision Benefit Administrators

If you offer a SafeGuard Vision HMO or PPO plan, click here to log in.

Group SmileSaver Administrators

If you offer a SmileSaver plan, click here to log in.

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 1-800-880-1800. 

GRIEVANCE FORM 

California Grievance Form1 

California Formulario para Quejas1

加州申诉表1 

Florida Grievance Form 

Florida Formulario para Quejas 

New Jersey Grievance Form 

New York Grievance Form 

Texas Grievance Form 

Texas Formulario para Quejas

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.

Need More Information
Contact Customer Service 1-800-880-1800