Cigna 20-51

Cigna is a leading health services provider with an international presence. That being said, we are fully committed to serving the needs and finding solutions to the challenges that small business owners and their employees face every day in regards to their benefits package. Cigna is a ‘top 5’ medical, dental and Life/disability carrier in the mountain states with a proven track record of success in the market. Our level funding product provides our clients with the ability to enter the partially self-funded world without the back side risk of traditional self-funded plans. Full comprehensive claims reporting, a robust built in wellness strategy and the ability to save additional dollars when claims run favorably are a few of the reasons why Cigna has been so successful in the UT market.

New Business Submission Forms/ Quote Request Forms:

Employer Forms-

RFP Information Required- Cigna

Utah Application Cover Letter

Utah Application for Stop Loss

Prior Carrier most recent Bill

Prior Carrier Renewal

Prior Carrier Benefit Summary

Employee Forms-

Sample enrollment form-health statement 20-50

  • This must be completed by every full time employee. If they do not want to do this we can do a phone interview. This usually takes 5 minutes per an employee. They will discuss any ongoing or past medical conditions. What we will need is a list of the employees with phone numbers to call please also list any good times to call if possible.

For any quote information for Cigna please contact our staff


Servicing Forms:

Employee Changes-

Change of address, change of name, dependent add or removal, and employee terminations.

Sample enrollment form-health statement 20-50

New Hire-

Sample enrollment form-health statement 20-50


Provider Search:

Please click the below link for an up-to-date provider search.


Marketing/Sales Material:

Cigna UT team

Healthier Company Flier

Level Funding 1 in 10

Level Funding data sheet

PPACA slide.ppt

Sample CAP Report

Dental Flyer

Life, Accident, and Disability

We would recommend that you review this information to learn more about Cigna’s level funded product and how this may help your employer groups.

The forms posted on this page are for 2017. If you are interested in any forms for previous years or any pre-ACA plan forms please contact our staff.

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