California Document Library

California Forms and Important Documents		California Benefit Summaries for HMO plans
Small Group Membership Application (PDF) CIGNA Small Group RAF 4/1/08 - 12/15/08 (rev 5-7-08) (PDF) Small Group Underwriting Guidelines (PDF) Small Biz HMO-POS (PDF) Small Biz OAP (PDF) Small Biz HBS (PDF) CA HMO & POS 4Tier Rates (PDF) CIGNA Dental - Underwriting Guidelines (PDF) CIGNA Dental - Los Angeles Zip Codes (PDF) CIGNA Dental - San Diego Zip Codes (PDF) CIGNA Dental - San Francisco Zip Codes (PDF) Declination of Medical/Dental Coverage Form (PDF) Employer Application (PDF) Group Enrollment/Change Form (PDF) Health Statement (PDF) Medical and Dental Underwriting Checklist (PDF) Sole Proprietor, Partner or Corporate Officer Statement (PDF) The Infertility Benefits for HMO D,E,F - POS I&J - OAP N,O,P (PDF) CA OAP 4 Tier Rates (PDF) Quoting Requirements for Virgin Groups 51+ (PDF) CIGNA Healthy Rewards^® Discount Vision Plan (PDF)		A 2-50 HMO (PDF) B 2-50 HMO (PDF) C 2-50 HMO (PDF) D 2-50 HMO (PDF) E 2-50 HMO (PDF) F 2-50 HMO (PDF)
California Benefit Summaries for POS plans		California Benefit Summaries for Open Access Plus plans
G 2-50 POS (PDF) H 2-50 POS (PDF) I 2-50 POS (PDF) J 2-50 POS (PDF)		K 2-50 OAP (PDF) L 2-50 OAP (PDF) M 2-50 OAP (PDF) N 2-50 OAP (PDF) O 2-50 OAP (PDF) P 2-50 OAP (PDF)
California Benefit Summaries for Dental plans		California Group Service Agreements for HMO plans
Dental HMO F1-06 (PDF) Dental HMO K1-06 (PDF) Dental HMO W1-06 (PDF) Dental PPO - Standard Incentive Plan (PDF) Dental PPO - Combined Choice (PDF) Dental PPO - High Option (PDF) Dental PPO - Platinum (PDF)		HMO GSA Plan A (PDF) HMO GSA Plan B (PDF) HMO GSA Plan C (PDF) HMO GSA Plan D (PDF) HMO GSA Plan E (PDF) HMO GSA Plan F (PDF)
California Group Service Agreements for POS plans		California Booklet Certificates for OAP plans
POS GSA Plan G (PDF) POS GSA Plan H (PDF) POS GSA Plan I (PDF) POS GSA Plan J (PDF)		OAP Cert Plan K (PDF) OAP Cert Plan L (PDF) OAP Cert Plan M (PDF)