Benefits Connection applications for Highmark Blue Cross Blue Shield, Aetna, United Concordia Dental, Dominion Dental and Delta Dental, Vision and HSA Forms are available by clicking on the links below.
These forms may be printed (PDF files), completed forms can be faxed to
302-654-8836 or scanned & emailed to BenefitsConnection@AllenInsurance.com
You may also call our office (302-654-8823) and we will be happy to provide these forms to you.
Highmark BCBS Employee Enrollment/Change/Waiver Form
Highmark BCBS Group Application
Aetna Employee Enrollment/Change/Waiver Form
Aetna Group Enrollment Form
United Concordia Enrollment Application 
Dominion Dental Enrollment Application
Delta Dental Enrollment Application
Vision Application for VSP Vision
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| Toll Free: 800.486.1244 | ||
| Local: 302.654.8823 | ||
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| Broker since 1980 | ||
| 302-654-8823 | ||
| Wilmington, DE 19801 | ||
| Allen@AllenInsurance.com | ||
