Broker Appointment Application

Are you an Arizona licensed broker interested in working with Delta Dental? We make it easy to partner with us, allowing you to sell Delta Dental of Arizona benefits to groups and individuals from our diverse family of plans. Use the form to get started.

Important Information

Be sure to review these docs:

Are you an AZ licensed broker?
Only licensed brokers with an insurance license number issued by the Arizona Department of Insurance are eligible for appointment. Note: Out-of-state license numbers will not be accepted for the "insurance license number" on the application.

After you submit your application:
We'll have additional documentation and information for you to review and complete. Keep an eye out for an email from our sales team⁠—you'll usually receive it within 2 business days.

Have questions?
We can help! Call our toll-free broker line at 888.651.3080.