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  Downloadable Forms & Literature  
 
 

Now you can download and print SmileSaver Plan Summaries, Contracts and Applications online.

Please note:
Most of the files in the following sections are stored in Adobe Acrobat Format (pdf). You must have Adobe Acrobat installed on your computer to download and print the forms. If you don't already have this program installed on your computer, please click here:

Member Forms:

Forms

Description

SM400 and SM600 Comparison

Individual Plan Comparisons

SM400 and SM600 Area 1 Disclosure

Disclosure of Benfits for Individual Plans SM400 and SM600 Area 1 (Southern CA)

SM400 and SM600 Area 2 Disclosure

Disclosure of Benfits for Individual Plans SM400 and SM600 Area 1 (Northern/Central CA)

SM400 and SM600 Enrollment Form

Enrollment Form for Individual Plans SM400 and SM600

Cancellation Letter

Cancellation Letter

Individal Dental Plan SM400 EOC

Explanation of Coverage for Individual Dental Plan SM400

Individal Dental Plan SM600 EOC

Explanation of Coverage for Individual Dental Plan SM600

 

 
       
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