United Concordia small group enrollment forms for 2017
To enroll you on United Concordia they will require the following:
- The rate sheet with the benefit plan circled and the sheet signed at the bottom by the business manager or owner
- The completed employee applications for each employee enrolling. The form needs to be complete with each dependent’s name, date of birth, etc.
- A company check for the first month’s premium payable to United Concordia Companies Inc. or UCCI
- A completed employer application form. Complete what you can and we’ll finish the rest together.
You can fax everything to our secure fax at (888)-287-3186, and then mail the originals to:
Total Benefit Solutions, Inc.
427 E. Street Road
Feasterville, PA 19053
As always please contact your Total Benefit Solutions, Inc account manager at (215)355-2121 if you have any questions or concerns about United Concordia Dental plans and enrollments.