Get Cigna Evidence Of Insurability Form

Filling out the Cigna Evidence of Insurability Form online is a crucial step in applying for optional long-term disability insurance. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to successfully complete the form online.

1. Press the 'Get Form' button to access the form and open it in the editor.
2. In the first section, provide your employer’s information including the name of the company, policy number, and billing location. Ensure you fill out the worksite details accurately.
3. Complete your personal details in the employee section: provide your name, social security number, date of birth, addresses, contact information, height, weight, and employment details like date of hire and annual salary.
4. In the health history section, answer all questions A to K truthfully regarding your past medical conditions, treatments, and any prescribed medications. Ensure you indicate 'Yes' or 'No' clearly for each question.
5. If you answered 'Yes' to any of the health questions, use the space provided to give detailed information about the conditions, including the date they occurred and any treatments received.
6. On the second page, read through the agreements and authorizations carefully. You must acknowledge the validity of the information you provided before signing.
7. Sign and date the form where indicated to confirm your understanding of the statements made in the application.
8. Review the entire form to ensure all sections are completed fully and accurately. After completion, you can save your changes, download a copy, print it out, or share it as required.

Complete your documents online today to ensure timely processing.