GEHA will be closed in observance of Thanksgiving on Thursday, November 22, and Friday, November 23. We will reopen at 7 a.m. Central time on Monday, November 26.

Dental Coordination of Benefits Form

If you or any other family member has other coverage that pays for your dental expenses in addition to GEHA, please complete the information below and select Submit to send this secure form electronically to GEHA.

    Employee or Annuitant Identification Data

    To help us identify your account, please provide the following information.








    Other Group Coverage Information







    Signature