Appointment with Delta Dental of Illinois

To sell an Illinois group plan or individual policy, you must have a broker contract on file with Delta Dental of Illinois. You can now complete and submit an application to become contracted with Delta Dental of Illinois on our broker portal. Once you register for an account, follow these steps to complete your broker agreement. 

If you're not able to complete your broker agreement on the broker portal, you can download and complete the broker agreement and send the agreement along with the items listed below to askdelta@deltadentalil.com. 

• Broker Agreement
• W-9
• Copy of Illinois Producer License
• Copy of Illinois Business Entity License, if applicable