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WHY CIGNA?
100% coverage for in-network preventive care*
Access to quality doctors and hospitals in your local area
Online tools to compare cost and quality across doctors and facilities and more than 400 procedures
* Plans may vary. Includes eligible in-network preventive care services. Some preventive care services may not be covered, including most immunizations for travel. Reference plan documents for a list of covered and non-covered preventive care services.
COVERAGE INFORMATION
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10/1/2018
11/1/2018
12/1/2018
Type
Home
Work
Cell
Please fill out the fields above with information for the Parent or Guardian of the child covered:
First Name
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Last Name
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Phone
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Email
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Yes
No
Yes
No
Yes
No
Primary
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Female
Male
Medical
Dental
Spouse
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Female
Male
Medical
Dental
Child 1
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Female
Male
Yes
No
Medical
Dental
Child 2
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Female
Male
Yes
No
Medical
Dental
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To meet the Affordable Care Act requirements, Cigna Individual and Family medical plans that are not sold through the Federal Marketplace have pediatric dental benefits included for children 18 years of age or younger. Depending on your child(ren)'s dental coverage needs, you may not need to purchase a separate dental plan for them.
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