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Cagney Healthcare of Arizona, Inc. (referred to herein as Cagney) may change the Premiums of this EOC after 60 days written notice to the Subscriber. However, We will not change the Premium schedule
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This is a specific form related to Cigna health insurance.
Employers offering Cigna health insurance to their employees may be required to file this form.
The form should be filled out with detailed information about the health insurance coverage provided.
The purpose of this form is to report information about the health insurance coverage provided to employees.
Information such as employee details, coverage offered, and premiums paid must be reported on this form.
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