Welcome to the DeltaCare Enrollment Information page. 
When you are done reviewing the following infromation please go back to the form and complete the enrollment.

DeltaCare enrollment needs to be received by the 15th of the month prior to the requested effective date. 

If the form is received after the 15th of the month prior to the requested effective date we will assign the effective date to the first of the month following the requested effective month.

Providers:  Please indicate in the memo section of the enrollment the Providers Name and six digit Facility ID.  If a provider is not selected, a provider will be assigned by DeltaCare.

Delta Care has contracted with a network of dental offices.  Please follow this link to search for DeltaCare Providers.  Make sure you select ONLY the DeltaCare USA Network. 

When you enroll in DeltaCare, you select a DeltaCare Provider to take care of the dental needs for you and your family.  After you have enrolled, you will receive a Combined Evidence of Coverage and Disclosure Form that fully describes the benefits of your dental program, and a DeltaCare membership card.  This card will have the address and telephone number of your participating network dentist and will be sent directly by DeltaCare near to the effective date of the coverage.  To receive all necessary dental care covered by the program, simply call your selected dental office to make an appointment.

Remember to always contact your network dentist.  Dental services which are not performed by this dentist or are not authorized in advance by DeltaCare will not be covered under the DeltaCare program.

If you were previously enrolled in a DeltaCare Plan, you have to wait 13 months from your last date of coverage before you can re-enroll.

Wolfpack Insurance Services Group # 01675-0001, Plan: 11B