Forms

Forms & Member Materials

2024 Coke Northeast Non-Union Benefits Guide

Cigna 2024 Gold Plan SBC

Cigna 2024 Silver Plan SBC

Cigna 2024 Dental Plan SBC

Cigna 2024 Vision Plan SBC

2024 PPACA No Cost-Share Preventative Medications

2024 Non-Covered Drugs

2024 Formulary Changes

2024 Cigna Supplemental Health Flyer

myCigna Registration Instructions

myCigna App Flyer

Cigna Customer Resource Guide

Dental Oral Health Integration Program Customer Flyer

Cigna Total Dental PPO Guide

Cigna Vision Serviced with EyeMed FAQ

Cigna Vision Serviced with EyeMed Flyer

Express Scripts Pharmacy Flyer

SaveOnSP Flyer

Pharmacy 2022 Generic Only Preventative Drug List 

Cigna Total Behavioral Network with EAP Flyer 

Cigna Virtual Care All Services Flyer

Cigna Virtual Care Flyer with Behavioral Health

Cigna Virtual Care Know Before You Go Flyer

myCigna Enhancements Flyer

myCigna Supplemental Health ecard

Cigna Total Behavioral Health Flyer

myCigna Price a Medication Flyer

Cigna SaveOn Drug List

Fitness Reimbursement Form

Cigna Diabetes Prevention Program Omada Claims Study Results 2020

Make The Most of Your Cigna Plan

Omada FAQ

Omada Flyer

Basic Life and AD&D Benefit Summary

Optional Life Benefit Summary

Life Conversion Instructions and Form

Portable Optional Life Instructions

Portable Optional Life Application

Short-Term Disability Benefit Summary – Class 1A

Short-Term Disability Benefit Summary – Class 1B

Authorization for the Release of Information Including PHI Form

Reporting Disability and FMLA Instructions

Long Term Disability Benefit Summary – Class 2

Long Term Disability Benefit Summary – Class 3

Evidence of Insurability (EOI)

How to File a Claim for Voluntary Critical Illness, Hospital Indemnity, and Accident Insurance Flyer

Voluntary Critical Illness, Hospital Indemnity and Accident Insurance Flyer

Critical Illness – How to File a Wellness Claim Flyer

Critical Illness – Wellness Benefit Flyer

Voluntary Critical Illness Benefit Summary

Voluntary Hospital Indemnity Benefit Summary

Voluntary Accident Insurance Benefit Summary

2023CokeNortheastNewHireBrainshark