Forms & Compliance Documents

Release of Information

In instances where a specific member's information is being requested, a Release of Information form must be completed.

• General Member Release of Information Form
• Directions for the General Member Release of Information Form
• EAP Management Referral Release of Information (note:This form is only to be used by an Employer Representative who is initiating a Formal EAP Management Referral for one of their employees. It only allows Cigna EAP to report EAP attendance and compliance information to an individual's Employer Representative.)

If your plan has Out of Network Benefits, please download our Out of Network Claim Form.

Please follow the Order Communication Materials instructions to receive additional supplies.

Please complete the Press Release Authorization Form and send it to your Account Manager if you are allowing us to use your company name/logo on our website or in our press releases.

View the Appeals Process here. Please contact your Account Manager with questions.

It's important to stay informed on a variety of legal issues and government regulations that may affect your benefit programs. We'd like to share some basic information on the following: the New York Healthcare Reform Act.