RESOURCE CENTER

Installation 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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03.31.2014
Application for Group Dental Insurance
Group application to be completed by employer for new business and renewal submission. In additiona, BOR letter, rate card, and EE applications are needed for complete new business submission.
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08.26.2011
United Concordia BOR letter
Sample of Broker of Record letter to be used for existing UCCI clients. No other version will be acceptable. For use ONLY if group is not in IBC/AHNJ territory or written direct with UCCI; otherwise IBC/AHNJ BOR will takeover linked UCCI cases.
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