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- If any employees reside in or your policy originated in the state of Arkansas, California, Colorado, Connecticut, Delaware, Georgia, Indiana, Kansas, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Mexico, New York, Oregon, Rhode Island, Texas, Utah, Vermont, Virginia, Washington, or West Virginia, please complete the All States Form.
- If any employees reside in or your policy originated in New Hampshire, please complete the New Hampshire Form in addition to the All States Form.
- If any employees reside in Utah, please complete the Utah Form in addition to the All States Form.
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If you have any questions, please contact your Cigna Healthcare representative.
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