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Delta Dental Plan for Rhode Island Students

PPO PLUS PREMIER PLAN
2024-2025 Policy Year
Spring Enrollment Form


The deadline to enroll for coverage from January 1, 2025 through August 31, 2025 is December 15. 2024.

If you purchase the plan now, your enrollment will be processed AFTER the deadline and once processed, coverage will be effective January 1, 2025 through August 31, 2025. 


PLEASE FILL OUT THE REQUIRED FIELDS BELOW TO CONTINUE THE ENROLLMENT PROCESS:

Asterisk (*) denotes required field

STUDENT INFORMATION

 (MM/DD/YYYY)