Join the Team
Becoming a Delta Dental producer is quick and easy. To start, determine whether you should sign the Agency/Agent agreement as an individual agent
or as an agency
If you’re an individual agent (not associated with an agency):
Please complete and sign the Agent Agreement Packet, and also include:
IRS Form W-9
A copy of your individual producer’s license
Your Social Security number (required by the state)
A check in the amount of $20.00 made payable to Delta Dental of New Mexico
If you’re signing the agreement on behalf of your agency:
First, check with Delta Dental to see if your agency already has an active agreement on file.
If your agency has an active agreement with Delta Dental, a company officer will need to update the current Agent Agreement Addendum to reflect all brokers (existing and new) appointed for their agency.
If your agency does not have an active agreement with Delta Dental, please have an officer (or another employee with the authority to bind the agency) complete the Agency Agreement Packet, IRS Form W-9, and the Agent Agreement Addendum. The agreement is with the agency rather than individual agents, which is why an authorized person must sign it.
For all new producer appointments, please include:
A copy of your agency’s license
Copies of all the producers’ licenses
All the producers’ Social Security numbers (required by the state)
A check in the amount of $20.00 made payable to Delta Dental of New Mexico for each producer's appointment
All completed forms may be faxed to (505) 883-7444 or emailed to Ellen Herrera
Checks should be mailed to:
Delta Dental of New Mexico
Attn: Ellen Herrera
2500 Louisiana Blvd NE, Suite 600
Albuquerque, NM 87110