Tools and Resources
Broker Forms
Member Forms
Employer Forms
- ADA Claim Form
- FCL Change Delete Form
- FCL Dental and VIsion Enrollment Application 2 Tier
- FCL Dental and VIsion Enrollment Application 3 Tier
- FCL Dental and VIsion Enrollment Application 4 Tier
- FCL Dental Enrollment Application 2 Tier
- FCL Dental Enrollment Application 3 Tier
- FCL Dental Enrollment Application 4 Tier
- FCL Dental Enrollment Application- Multi Plan Option
- ACH / Bank Draft Authorization Form
- Credit Card Authorization Form
- Itransact Access Request Form
- Wellcard RX Discount Program
- FCL - Application for Group Dental Service