This is a dental plan only available to BCBS Service Benefit Plan Basic or Standard Option enrollees.
Please complete all items on this application. Any information missing may delay processing your application.
To enroll in Alabama Federal DentalBlue you must reside in the service area of Blue Cross and Blue Shield of Alabama. If you enroll in the FEHB Basic Option, you will automatically be enrolled in Alabama Federal DentalBlue Basic Option. The same is true for
Your Federal DentalBlue coverage election should reflect the same plan option (i.e. Standard or Basic) and type of enrollment (i.e. Self Only, Self Plus One or Self and Family) as your BCBS Federal Employee Health Benefit (FEHB) Plan.