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Enroll Now

To enroll in our dental plans, you have several options:

FOR EMPLOYER GROUPS:

Option 1: Online Registration
Complete the information below and one of our enrollment specialists will call you to discuss your company’s specific needs and how you would like to tailor your company’s dental plan.

*FIRST NAME
 *LAST NAME
*TITLE
*NAME OF COMPANY
*ADDRESS 1
ADDRESS 2
*CITY
 *STATE
 *ZIP
*WORK PHONE
 *EMAIL
*NUMBER OF EMPLOYEES

HOW DID YOU HEAR ABOUT US?



Option 2: Over the phone
You can contact one of our enrollment specialists at 609-951-0150 and follow the prompts for our enrollment department.

FOR INDIVIDUALS & FAMILIES:

Option 1: Online Registration
Complete the information below and one of our enrollment specialists will contact you. Yes, we still believe in the “personal touch!”

*FIRST NAME
 *LAST NAME
*ADDRESS 1
ADDRESS 2
*CITY
 *STATE
 *ZIP
*HOME PHONE
 CELL PHONE
WORK PHONE
 *EMAIL
*PLAN TYPE (select one)
INDIVIDUAL HUSBAND/WIFE FAMILY PLAN(unlimited children)
*WHERE WOULD YOU LIKE TO BE CONTACTED (select one)
HOME WORK CELL EMAIL

HOW DID YOU HEAR ABOUT US?


Option 2: Over the phone
You can contact one of our enrollment specialists at 609-951-0150 and follow the prompts for our enrollment department.



Option 3: Download our Application
You can download our application by clicking the button below. After completing, you can fax back to 609-951-0030 or you can scan and email the completed application to enrollment@qualityhealthcaregroup.net.

If you are unable to download the application, please contact us via phone 609-951-0150 or at enrollment@qualityhealthcaregroup.net and an application will be forwarded to you.

 

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