Email and password do not match our records NOTE: This site is not the ADA.org member site. Passwords may be different.
Remember my User Name
On the next page you'll be asked to provide the amount you wish to pay as well as select the Plan to which your payment should apply. If you wish to pay premiums for multiple plans, you'll need to repeat the process for each plan.
One application will be created for you that incorporates all necessary questions for your chosen Plans. You can save your application anytime and return when it is convenient.
Once submitted, your application will be securely transmitted to ADA Members Insurance Plans. Please remember to print your completed application for your records.
If you have any questions about completing the online application or the application process in general, please call an Insurance Plan Specialist at 866-607-5338.