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Welcome to American Public Life Insurance Company's Group Dental
Proposal request site. Please review the following Dental Plan Details
and Underwriting Guidelines prior to completing the request for proposal.
Instructions for completing the Request for Proposal
- Completion is required for all items with an asterisk (*).
- In Section IV, up to two plan(s) may be chosen.
- If takeover credit is requested, Section V must be completed and all required
documents are to be submitted to be eligible for review.
- You may complete the Request for Proposal form from within your web browser using Adobe Acrobat
Reader.
- Once you are satisfied with the information you have provided we recommend you save the PDF document
to your hard drive.
- You may submit your RFP by:
- Printing the completed PDF and faxing it to (601) 939-0655 OR...
- Send an e-mail to dental@ampublic.com and
attach the completed PDF to the e-mail.
- After submitting the request for proposal, please contact the Group Dental Underwriting
Department at 1-800-256-6736 regarding items which are not completed.
Any questions you may have pertaining to the plans or completion of the Request
for Proposal, please contact the Group Dental Underwriting Department at
1-800-256-6736 or send an e-mail to dental@ampublic.com.
>> Download the Request for Proposal <<
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