Please enter your personal information. This information is completely confidential, and will not be used for any other purpose. If you have multiple corporations/operating names, please use the company name registered with the UCDA.
* Required information.
By choosing to participate in the UCDA Group Health and Dental plan, you have the option of adding some competitively-priced guaranteed-issue group term life insurance, or critical illness coverage. Depending on the size of your company, short and long term disability packages may require medical underwriting for approval.
All eligible employees must participate in the health and dental core insurance benefit, except those that have this coverage through their spouse. The employer must pay at least 50% of the cost of this benefit. For a full list of the health and dental benefits schedule, please visit our Plan Design section.
I understand that participation in the plan is not guaranteed.
I hereby request that The Capital Group Insurance generate a full proposal, and deliver it to the contact person at our company for consideration.
I understand that the rates for this plan are reviewed annually, and new rates are issued effective December 1st each year.
The personal information submitted as part of this request shall be used by The Capital Group Insurance Inc. and its authorized employees, administrative partners, and their respective insurance providers, for the sole purpose of providing an employee benefits quotation with the Used Car Dealer’s Association Group Health and Dental Insurance Plan. This data will not be shared with any other parties, nor used for any other purpose.
