PROFESSIONAL BENEFIT
 ADMINISTRATORS

1130 Hurricane Shoals Road NE
Suite 2300
Lawrenceville, GA 30043

Phone: (770) 963-3939
 (800) 578-2082
Fax: (770) 963-6126
 (888) 264-6975
 
ENROLL NOW!
Click and print the two forms below, and mail or fax to:
Professional Benefit Administrators

Enrollment Forms

Enrollment Form
Method of Payment

Agent Forms
B4 Form
PDA2 Form
B4BD Form
1199A Form

AFLAC Agent Forms
B4 DED Federal
B4 Split Allotment

 
PROVIDER LOCATOR
 1.  CompBenefits

www.compbenefits.com

CompBenefits for New Mexico Only

 6. AIG VISION

AIG VISION 
PROVIDER LOCATOR

 2.  Delta Care

www.deltadentalins.com

 7. AIG Dental

AIG DENTAL
PROVIDER LOCATOR

 3. Dominion

www.dominiondental.com

 8. Humana Vision

Humana Vision
PROVIDER LOCATOR

4. DIAMOND 1500

  DENTEMAX
PROVIDER LOCATOR
www.Dentemax.com

 

9. Dental Plus

Dental Plus
PROVIDER LOCATOR

 

5. Dina Dental

  

www.dinadental.com

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