Dental Plan Option for
Lafayette College Students

UNITED CONCORDIA FLEX PPO DENTAL PLAN
2024-2025 Policy Year
Spring Enrollment Form

The enrollment deadline for coverage effective January 1, 2025 through August 31, 2025 is December 15, 2024. Enrollment will be processed after the deadline. Once processed, coverage will be effective January 1, 2025 though August 31, 2025.

TO CONTINUE THE ENROLLMENT PROCESS, PLEASE FILL OUT THE REQUIRED FIELDS BELOW: