These forms are in the .pdf file format. To read and print them you may need to download the latest version of Adobe® Acrobat® Reader (free) from the Adobe site.

All forms must be printed, completed and signed before submission to company. Electronic submission of forms is not permitted at this time.

Retirees have 2 ways to enroll : Web Enrollment or Call Center.

New Retirees:
Enrollment Form (PDF) – Dental / Vision
Retirees will send in 2 months of premium, then will premiums will
be deducted from the retirees Cobb County SunTrust Pension Check

Retirees without a pension through Cobb County
will need to complete the Bank Draft Setup

Dental Claim Form – United Concordia

Vision Claim Form – EyeMed