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Cigna Plus Medical Plan

Tell us who you are looking to cover.

ME
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Smoking Habit
iSmoking HabitDo you currently smoke, or have you smoked in the last 12 months?
Date of Birth
MY SPOUSE
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Smoking Habit
iSmoking HabitDo you currently smoke, or have you smoked in the last 12 months?
Date of Birth
MY CHILD
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Date of Birth
Please select your smoking habit & fill in your date of birth
After completing the application, you will become the Policy Holder.
Last Name*
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Email Address
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By submitting this form, I understand the provision of above information means I agree to Cigna's use and/or transfer of my personal data for direct marketing of its related insurance products and services. I have read and accepted the Personal Information Collection Statement of Cigna.
I am now in Hong Kong and I hold a valid HKID Card to proceed as the policy holder.
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