Enrollment consolidated form 2026

1. Click ‘Get Form’ to open the enrollment consolidated form in the editor.
2. In Section A, employers should complete their details including the CIGNA account number, effective date of changes, and employer information.
3. Employees need to fill out Sections B-G. Start with Section B by entering your personal information such as name, date of birth, and contact details.
4. In Section C, select your preferred managed care medical options and provide necessary details about your primary care physician if applicable.
5. For Sections D and E, choose any flexible spending accounts or dental options you wish to enroll in.
6. Section F requires you to disclose any other health coverage you or your dependents may have. Fill this out accurately.
7. Finally, sign and date the form in the designated areas at the end of the document to confirm that all information is correct.

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