RESOURCE CENTER

Client Service Forms
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03.31.2014
Dental Enrollment Form
Form to be used for employee eligibility; new business or otherwise. For employer groups.
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08.18.2011
Claim Form
Form to be used should member incur a claim that must be manually submitted to the carrier. Include copy of paid receipt.
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03.16.2011
Online Access Agreement
Agreement to be completed by client if they or broker wish to obtain online access to the group's UCCI account
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