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Cagney Health and Life Insurance Company may change the premiums of this Policy after 30 days written notice to the Insured Person. However, We will not change the premium schedule for this Policy
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It is a form used for reporting information related to a specific Cigna health insurance plan.
Employers or individuals who have a Cigna health insurance plan are required to file this form.
The form can be filled out online or by mail with the required information about the Cigna health insurance plan.
The purpose of the form is to provide detailed information about a Cigna health insurance plan for reporting and compliance purposes.
Information such as plan details, premiums, coverage dates, and participant information must be reported on the form.
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