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Paper Craft

ENROLL or WAIVE Coverage

Enter Enrollment Information on our Secure Site
*Required fields



UHC Dental Plan Options
Dental - Coverage Level

(choose only one dental plan OR waive dental coverage)

UHC Vision
Vision - Coverage Level

Add Dependent Information

UHC Life/AD&D Insurance Beneficiary Information

Employer paid flat $15,000 Life/AD&D benefit. 

Supplemental Life/AD&D

TOTAL = 100%

If you wish to cover additional dependents or add more beneficiaries, please contact Amanda Garcia at 210-283-5571.

Organization you work for:
What type of employee are you?
Thanks for enrolling!
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