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INSURANCE APPLICATION Life Insurance Company of North America LINA a CIGNA Company herein called the Insurance Company For info and customer service call 1-800-732-1603. The applicant must sign and date this form. This form cannot be considered unless received within 30 days of the date it is dated. Group Insurance Life Accident Disability Important Please enter all dates in mm/dd/yyyy format.
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How to fill out cigna ar0611 23762 809799 form
How to fill out CIGNA TL-009320 (Birmingham-Southern College)
01
Obtain the CIGNA TL-009320 form from Birmingham-Southern College's health services or the CIGNA website.
02
Fill out the personal information section with your full name, date of birth, and student ID number.
03
Provide your contact information including your email address and phone number.
04
If applicable, fill out the insurance details section, including policy number and group number.
05
Complete the medical history section, answering all questions honestly.
06
If you have any pre-existing conditions, be sure to include those in the appropriate section.
07
Sign and date the form, certifying that the information provided is accurate.
08
Submit the completed form to the designated office at Birmingham-Southern College.
Who needs CIGNA TL-009320 (Birmingham-Southern College)?
01
Students enrolled at Birmingham-Southern College who require health insurance coverage.
02
Individuals seeking medical services through CIGNA as part of the college's healthcare plan.
03
Students who need to document their medical history for health services access.
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What is CIGNA TL-009320 (Birmingham-Southern College)?
CIGNA TL-009320 is a specific form or document related to health insurance coverage provided by CIGNA for students of Birmingham-Southern College.
Who is required to file CIGNA TL-009320 (Birmingham-Southern College)?
Students enrolled at Birmingham-Southern College who are participating in CIGNA's health insurance program are required to file CIGNA TL-009320.
How to fill out CIGNA TL-009320 (Birmingham-Southern College)?
To fill out CIGNA TL-009320, students should gather their personal information, insurance details, and follow the instructions provided on the form for accurate completion.
What is the purpose of CIGNA TL-009320 (Birmingham-Southern College)?
The purpose of CIGNA TL-009320 is to document health insurance enrollment and coverage details for students at Birmingham-Southern College.
What information must be reported on CIGNA TL-009320 (Birmingham-Southern College)?
The form requires information such as student identification, insurance policy number, coverage period, and any pertinent health information.
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