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Dental Benefits

AmeriHealth NJ Forms Online

The Dental section provides a comprehensive list of AmeriHealth New Jersey dental forms for you to access. Please contact your AmeriHealth New Jersey broker representative for more information regarding United Concordia Dental plans and rates.

PDF icon Forms are in PDF format.

Option Last Updated
Pediatric Dental Attestation Form 2014-05
United Concordia Application for Group Dental Coverage 2014-05
United Concordia Dental Claim Form 2013-05
United Concordia Dental Claim Form Instructions 2013-05
United Concordia Dental Enrollment Form 2005-07
United Concordia Dental Large Group Application 2005-07
United Concordia Dental Rate Card 2013-12
United Concordia Dental Small Group Application 2005-07