Cigna form pace 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the employer section. Enter the employer's name, policy number, date of hire, annual salary, and other mandatory data.
3. In the employee section, select your title (Mr., Mrs., Ms.) and provide your full name, Social Security number, birthdate, address, and contact numbers.
4. If electing spouse coverage, complete the spouse information section with their name, Social Security number, birthdate, height, and weight.
5. Indicate any changes to your life insurance coverage by checking the appropriate boxes for increases or decreases in coverage for yourself or dependents.
6. Complete the medical questions if applying for increased coverage. Provide details for any 'Yes' answers in the space provided.
7. Sign and date the form at the bottom to confirm that all information is accurate before submitting it back to your employer.

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