To enroll in the Argus Freedom Plan, please fill out the form below.If you have any questions please contact our Enrollment Team at (844) 641-5156.Click here for information on the Argus Freedom Plan. For Provider Search please click here.Freedom Plan Vision Available!Check out our affordable vision rider, only available to Freedom Plan Dental members!Step 1 of 3 - Member Information33%Enrollment Instructions Complete the entire application which begins below and be sure to include all eligible dependents (family members you wish to include under your coverage)Gender*MaleFemaleDate of Birth*Year2022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Month123456789101112Day12345678910111213141516171819202122232425262728293031First Name*Last Name*Street Address*Apartment #City*State*This plan is available to Florida Residents only.FloridaZip Code*Email* Home Phone*Dentist NameHow did you hear about us ?*Select OneAgentDentistE-HealthEmailGoogle AdsLinkedInSearch Engine (Google, Bing, Yahoo, etc.)FacebookTwitterReferralOtherOther*AgentsAccount HouseAcevedo MarisolAdam SaheedAdcock MichaelAdelusi HenryAgency LLC Mai InsuranceAgreda JhonnyAgudelo Guerra OscarAhern KeriAhlers ChristopherAlexander DawnAlexandre BedlieAlford AnthonyAli FazalAlmonte RitaAlvarez LuzAlvarez GriseldaAmador FelixAnderson KristenAnderson ShireeAnderson RobertAndre DavidAnthony TonyAntonneau HeatherArana MariluAraque MarisolArata SilArbolaez JospehArias DonnaArriaga AdelfaArteaga GiomarArteaga GiomarAssociates PNRAtwood SusanAvital-Cohen AyeletAwad MohammedAxe StephenAyers RandyBabcock VincentBahr JasonBaird JeremyBaker GlenBaker SherriBaker VondolynBalakrishnan Girija SarikaBaldwin LowryBall TimothyBallard DanielBandy-Alms BarbaraBanks GeorgeBarbone MichaelBarnes SteveBaron RonBarreto CharlesBarrineau ThomasBarrlentos JoseBarrow ValerieBartlein RandallBartley DavidBarton MichaelBastardo RafaelBaste JorgeBateman WilliamBauer MaryBean AnnBeckman BarbaraBedsole SidneyBeebe KennethBelcher StevenBell MarieBell RuthBellinger JeffreyBenavides DianaBendtsen GeorgeBendtsen GeorgeBenson AlanBentley DanielleBenton GwendollenBerg BrianBerrios ManuelBerry ThomasBerry GeraldBetz- Bender JaniceBeyerlein BradleyBhatt SaurabhBielak JarekBiltis JackBlanco AngelicaBlizman DonnaBlizman DonnaBlocker II AnthonyBlunt DavidBoer GeraldBoice JasaenBonaparte BarbaraBooth NeilBowen NicoleBowen RichardBozanich SamBradley GeoffreyBraun MitchellBraun JayBrent A. J.Bress AllenBress AllenBridges AngelaBrooks LouisBrown JesseBrown DonaldBrown CatherineBrown ChantelleBrowne CarolineBrowning BrettBruce RobertBruckman AdamBrunet MigdaliaBuffano PhilipBullerman LindaBurke Bridges ToniBurkett JamesBurnett DemarcusBurns CynthiaBurrows JamesBurton MichelleBushey RichardBushko HeidiBustinza JessicaButler BrianCadet CarlCallahan DanaCallan JamesCalvin MicheleCampbell JayCannella JosephCapehart GeorgeCariglio PaulCarmenate JeannieCarr WilliamCarrasquillo JavierCarroll CharlesCarter JulieCarter Jr CharlesCasimir JeanCastrillo AliCastro CarlosCavin DennyCedeno YusetCelestin DaraChacon CesarChaffin HollieChalmers JohnChang LeilaChang FredCharles EnocChecca MathewCherry CarolChickk KennethChristianson JasonCiko JohnClark JeffreyCleveland JohnClifton SteffanieCode BrianCode JordanCoggins BarbaraCohen CathyColey EsmieCollazo VirmarieCollins Peggycom Dentalinsurance.Condon AngelaConnelly JohnCook DawnCooley DustinCoradin GraceCorcoran JulieCorominas WandaCostello RichardCoursey JessicaCova Figueroa JesusCovert DougCox AndrewCraig RebeccaCram NormanCrawford OliviaCretella ElizabethCrews BryanCrews BryanCrook SandraCross TimothyCurrier ClaytonCuster JohnDacre PaulDahlquist AmyDaidone FrancisDanco ThomasDarnell BenjaminDaugherty ScottDaul KellyDavis LoNeaseDavis LarrieDavis LarrieDaza LuisDe Alba FelipeDe Moya AngelicaDedmon LarryDee ScottDeegan DarleneDega BridgettDeitemeyer TimDelahanty MartaDelatorre CaraDenHouter JoyDeSouza AnthiaDeters RobertDetweiler JoniDeVoe AshlyDiaz HectorDiaz AdrianaDickinson GeannineDilling GregDillow DavidDiRaimo RobertDissault DanDMD Dr WelchDO NOT USE DO NOT USEDoerges DavidDoering RobertDoherty FrankDonnelly TimothyDonovan StevenDoran RobertDoss KarenDr Angelov Dentique DentalDr Bivens DA Sun CityDr Burchell - Dr Weinstock DHSDr Carter DA Plant CityDr Cohrn and Pellosie Heritage DentalDr Cowan Cosmetic DentistryDr Duvart & Desinor Bright NowDr Fellner Lake Wales DentistryDr Fox Palm Tree DentalDr Georgy Ideal DentistryDr Mueller DA TampaDr Parasher Caring DentistDr Phelps Caring DentistDr Ruiz Crown DentalDr Walker - Hsu DHS NorthdaleDr Weber Family Dent HernandoDr Weiner DA New TampaDr. Almerico Woodside DentalDr. Kulangara Smile Design LithiaDr. Monticciolo Family DentistryDr. Monticciolo & Fares Family DentistryDr. Parikshak Premier DentalDr. Walker and Vu DHS WestshoreDuczak GeorgeDuever JamesDuff KassandraDuffy TimothyDuke LoydDunne LaurenDuperval VeroniqueDuque LuzDurango ElsimarDurrell NatashaDuval NadineDzurick CarrieEarp JeremyEck GregoryEdouard StevensEdwards CarolynElder PhilipElliott BrandonEmery KarenEmery TimothyEmpert RichardEnnis EthanEpstein PeterErd LisaErnest CynthiaEscudero GinetteEvers ChristianeFalcon MichaelFebres GuillermoFeliciano LuisFeliciano CarlosFernandez LizetFerris AllynFessler CaseFinkbeiner DennisFinnestad MatthewFiorella JohnFisher JohnFlores HelenFloyd SheilaFolb PaulitaFoldenaur JohnFord JeffreyForeman StevenFoster TiffanieFraher GerardFranco 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SilviaStarke EricSteinman JamesStephens MichaelStephenson JosephSteve Test Steve TestStevens JamieStevenson RobertStiller TiffanyStingone LisaStoffer Jr. JamesStonehill JoyStoner JohnStoute AlexisStracener MarvinStraubel MercedesStrawbridge JaneStrehl RichardStrelow JodiStrijewski AlexStrong BiragoStruckhoff AdamSullivan ChristineSullivan DavidSumrall ErnieSunderman TimSutherland RobertSwink JamesTapia-Rosa JoseTaylor DavidTaylor RobertTaylor CarolynTemeyer StephenTeran Ruiz JoseTest TestTest TestTest TestThaxton JosephThe Villages Smile DesignThomas LelandThomas SuzanneThomas AlexThomason LarryThompson DedrieThornburg ClydeThornhill ThomasTomecko JosephTornes LuisTorres HugoTownsend DwayaneTownsend MariaTrabal GlendaTrail DawnTrakys VaidotasTurbay MariaTurner BryanUnger MartinUpdyke JeffreyUrban MaryUrena Delvalle OfradisUrquia WalterUrrea WilliamVadovsky KylaVan Iseghem KerryVance HerschelVander Kooi DanielVane NatividadVargas LuisVasquez FrancisVasquez Castro BelkysVega RichardVelieri SusanVentolo GerardVermaak SteveVertich MarkVetere TammyVice SpencerVidair RichardVidal NikkiVidal-Curtis ChariVillamarin SaraVillota AlexandraVimond FrederickVinokur MitchellViti EsterVogel PeterVolosin CharlesWages MelanieWait DelosWalton BrendaWareheim JamesWashington LennyWashington AlvinWatkins FrankWatts KevinWeidner JamesWerner JohnWest NenaWestbury LarryWestbury LarryWestlund RichardWestlund RichardWhaley BeverlyWheeler ScottWhidden RobWhite RosaWhite PerryWhite LatoyaWhittington RobertWichman MatthewWike DeniseWiley YvonneWilkerson KellyWilkinson EugeneWilliams ClaudetteWilliams ChristopherWilliams MaquitaWilliams-Von Zopf JeanWilliamson LindaWillmore RebeccaWinters JeffreyWohlberg MelissaWojan DieterWokasch MelissaWolf PatriciaWolff MichaelWood RandyWoodburn TheodoreWortham CarolWright III AlbertWurstle CarrieWysocki TimothyYancent EgmaYeates EricYeutter CatherineYihdego AsterYoung BradyYoungblood DavidYoussef EliasYoussef EliasZaid DannyZanghi GaryZimmerman HowardZiskie GerardZito GregSource*Select OneRX AdvantageSearch EngineWebsiteE-HealthTBTFacebookeBayDentistOtherDependents: Eligible dependents include your spouse and /or unmarried children from birth to 19 years of age, or 25 years of age if a full-time student or fully dependent on you for support.Freedom Plan Certificate of CoverageIf you wish to enroll in an Argus Dental Plan, please read and agree to the following Terms & Conditions: I have reviewed the Schedule of Benefits or Discounts, Certificate of Coverage or Membership documents on this website and I understand that membership under this program is subject to the terms as described in those documents. I understand that membership under this program will be provided for me and the dependents designated on the enrollment screens. I am responsible for payment of required membership fees and compliance with all of the provisions and conditions of the Argus Dental Plans as described in the Schedule of Benefits or Discounts and Certificate of Coverage or Membership documents. I understand that I am committing to this plan for one full year and as such will not be able to terminate the membership prior to completion of one continuous year of membership under this program. I understand that I will have the opportunity to renew prior to the end of the membership term in order to avoid any interruption of coverage. Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information, is guilty of a felony in the third degree. Argus Dental Plan, Inc. is licensed as prepaid limited health service organization as described in Chapter 636 of the Florida statutes. By checking this box you are acknowledging that you have read and understand the above statements. If you have questions about this Disclosure, please contact our Customer Service Department at 1.877.864.0625. To proceed to the enrollment pages of this website, you must agree to the Disclosure above by placing your initials in the textbox in this section as your online signature.By placing my initials in the textbox, I constitute this as my online signature :*Individual RatesMonthly*Annual (no auto renew)Individual$19.88$238.56Individual + Spouse$39.76$477.12Individual + Child$45.72$548.64Family$65.61$787.32*$35 dollar one-time enrollment fee *For monthly billing, your account will be debited or charged by the 15th of each month for one month’s premium plus a $1 monthly service charge.Coverage Type*IndividualIndividual + SpouseIndividual + ChildFamilyBilling Frequency*MonthlyYearlyWill your spouse be included?*YesNoSpouse Information*First NameMiddle NameLast NameDate of BirthGenderMaleFemaleChildren Information*First NameMiddle NameLast NameDate of BirthGender MaleFemale Child Information*First NameMiddle NameLast NameDate of BirthGenderMaleFemaleFreedom Plan Price: $216.40 Freedom Plan Price: $0.00 Freedom Plan Price: $0.00 Freedom Plan Price: $0.00 Freedom Plan Price: $0.00 Freedom Plan Price: $0.00 Freedom Plan Price: $0.00 Freedom Plan Price: $0.00 Enrollment FeeThis is a one time enrollment fee. Price: $35.00 Promo CodePromo Code Discount Price: $0.00 Promo Code Discount Price: $0.00 Promo Code Discount Price: $0.00 Total Billing Today for Freedom Plan Dental $0.00 Payment Type*CardEcheckCredit Card*American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name Echeck Name on Account Bank Name Routing Number Account Number CheckingSavingsAccount TypeBy clicking the button below, I authorize Argus Dental & Vision, Inc. to charge my credit card or bank account for the initial payment plus enrollment fee, if paying monthly I also authorize a charge on the 15th of each month for the monthly premiums plus a $1 monthly service fee.Enroll in the Freedom Plan Vision RiderYesNoNot Interested / Maybe LaterCopayment Option$0 copay$10 copay$20 copayVision Rider Cost Price: $0.00 Vision Rider Cost Price: $0.00 Vision Rider Cost Price: $0.00 Vision Rider Cost Price: $0.00 Vision Rider Cost Price: $0.00 Vision Rider Cost Price: $0.00 Vision Rider Cost Price: $0.00 Vision Rider Cost Price: $0.00 Vision Rider Cost Price: $0.00 Vision Rider Cost Price: $0.00 Vision Rider Cost Price: $0.00 Vision Rider Cost Price: $0.00 Vision Rider Cost Price: $0.00 Vision Rider Cost Price: $0.00 Vision Rider Cost Price: $0.00 Vision Rider Cost Price: $0.00 Vision Rider Cost Price: $0.00 Vision Rider Cost Price: $0.00 Vision Rider Cost Price: $0.00 Vision Rider Cost Price: $0.00 Vision Rider Cost Price: $0.00 Vision Rider Cost Price: $0.00 Vision Rider Cost Price: $0.00 Vision Rider Cost Price: $0.00 Total for Freedom Plan Dental & Vision Billing Today $0.00 Note: *This copayment option applies to ALL covered individuals. Your selection of monthly/annual billing for the Freedom Plan transfers to the Vision Rider as well, for ALL covered individuals.Vision Rider Certificate of CoverageDisclaimer Language:If you wish to enroll in an Argus Dental Plan, please read and agree to the following Terms & Conditions: I have reviewed the Schedule of Benefits or Discounts, Certificate of Coverage or Membership documents on this website and I understand that membership under this program is subject to the terms as described in those documents. I understand that membership under this program will be provided for me and the dependents designated on the enrollment screens. I am responsible for payment of required membership fees and compliance with all of the provisions and conditions of the Argus Dental Plans as described in the Schedule of Benefits or Discounts and Certificate of Coverage or Membership documents. I understand that I am committing to this plan for one full year and as such will not be able to terminate the membership prior to completion of one continuous year of membership under this program. I understand that I will have the opportunity to renew prior to the end of the membership term in order to avoid any interruption of coverage. Any person who knowingly and with intent to injure, defraud, or deceive any insurer files a statement of claim or an application containing any false, incomplete, or misleading information, is guilty of a felony in the third degree. Argus Dental Plan, Inc. is licensed as prepaid limited health service organization as described in Chapter 636 of the Florida statutes. By checking this box you are acknowledging that you have read and understood the above statements. If you have questions about this Disclosure, please contact our Customer Service Department at 1.877.864.0625. To proceed to the enrollment pages of this website, you must agree to the Disclosure above by placing your initials in the textbox in this section as your online signature.SignatureReview and Submit {all_fields}