Cigna Voluntary Term Life Insurance Enrollment Form 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the Employer section, including details such as your employer's name, class, location/paycode number, date of hire, and annual salary. Ensure all information is accurate for processing.
3. In the Employee section, select your title (Mr., Mrs., Ms.) and provide your full name, Social Security number, birthdate, address, and contact numbers. This information is crucial for identification purposes.
4. Complete the coverage selection by indicating the requested amount and whether you are accepting or declining coverage. If applicable, specify any beneficiaries along with their percentage distribution.
5. Fill out the medical questions thoroughly. If you answer 'Yes' to any question regarding health conditions or treatments in Sections A and B, provide additional details as required.
6. Sign and date the form in the designated areas to validate your application. Remember to review all sections before submission.

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