united concordia dental

united concordia dental Enrollment Kits

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PLEASE NOTE: This checklist is provided as a guide. The carrier may require additional items and documentation. Please
refer to the carrier’s underwriting guidelines for a complete list of requirements. Please use the latest version of forms.

Our goal is to process your new group enrollment easily and efficiently in order to provide you and your client with a quick approval. The following list outlines the health plan’s case submission requests:
  • Completed United Concordia broker appointment paperwork. 
  • Rate card identifying sold plan and rates. If a United Concordia proposal was generated, a copy of the proposal identifying sold plan and rates.
  • Completed employer master application.
  • Completed employee enrollment forms or enrollment spreadsheet.
  • Employee waiver forms are not required.
  • Employer binder check is not required
After approval, prior carrier termination letter must be submitted by the employer or broker.