Dental Plan Option for
Lafayette College Students
UNITED CONCORDIA FLEX PPO DENTAL PLAN
2025-2026 Policy Year
Annual Enrollment Form
The enrollment deadline for coverage effective September 1, 2025 through August 31, 2026 is August 15, 2025. Enrollment will be processed after the deadline. Once processed, coverage will be effective September 1, 2025 though August 31, 2026.
TO CONTINUE THE ENROLLMENT PROCESS, PLEASE FILL OUT THE REQUIRED FIELDS BELOW:
