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.
Download The New Group Enrollment Kit for 2017
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
Download UCCI PA Rates and Benefits 2017
Download UCCI Group Application 2017
Download UCCI PA Employee Enrollment Form
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.
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