Get Cigna Dental Enrollment Form - Teigit

Completing the CIGNA Dental Enrollment Form - TEIGIT online is a straightforward process that ensures users can easily enroll in dental coverage. This guide provides step-by-step instructions to help users fill out each section of the form accurately.

Follow the steps to complete your enrollment efficiently.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Enter the effective date of your coverage by specifying the month, day, and year in the designated field.
3. Indicate whether this is a new enrollment, change, reinstatement, or cancellation by marking the appropriate checkbox. If canceling, provide a reason for cancellation in the space provided.
4. Fill in your personal information, including your name (last, first, middle initial), address, email address, and telephone number. Ensure all information is displayed clearly.
5. Provide your date of birth and social security number in the specified fields.
6. Indicate your primary language. This step is optional but can assist in ensuring better communication.
7. Input your date of employment and employer information, including the employee identification number if applicable.
8. Select your dental plan by marking whether you are choosing CIGNA Dental Care, Dental PPO, or Traditional. Input the corresponding group numbers if applicable.
9. For each person to be covered, fill in the relationship, name, social security number, address, sex, and date of birth for them, ensuring clarity and accuracy.
10. If selecting CIGNA Dental Care, provide your dental office selections by indicating your first and second choice.
11. Indicate the start date of continuous dental coverage for those opting for CIGNA Dental PPO.
12. Read and agree to the authorization and acceptance conditions by signing and dating the form.
13. Once all information is completed and reviewed, you can save the changes, download, print, or share the form as desired.

Start filling out your CIGNA Dental Enrollment Form - TEIGIT online today!