You must submit a written request to cancel by letter, fax or email. Please send all cancellation requests to:
Attn: Eligibility Department
5373 S. Green Street, Suite 400
Salt Lake City, UT, 84123
Fax: (888) 998-8711
Submit an Individual Plan Bank Draft Form. This form can be found under the Forms section of this page. Mail, fax or email the completed form to:
Your provider can call Dental Select to verify services that are covered. You will want to provide your dentist with a copy of your id card.
Attn: Claims Administration