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Discount networks
Greater discounts within these networks for prescriptions, vision care, dental care and health and wellness resources, click here.
Starbridge>Important Forms
Claim Identification Form
1. Complete the Claim Identification Form
Note: claim forms may be photocopied
2. Attach original bills (bills must be originals, not photocopies).
3. Attach copy of "Certificate of Creditable Coverage" from your prior
insurer, if applicable.
4. Mail (Facsimile documents can not be accepted) to:
Connecticut General Life Insurance Company
Starbridge
P.O. Box 55270
Phoenix, AZ 85078-5270
Toll Free: (800) 308-5948
Phone: (602) 484-9633
IMPORTANT: Please submit your claim within 90 days of the date of service.
Dental Claim Form
Complete and include this form when submitting a dental claim to Starbridge.
Dependent Verification Form
Complete and include this form when submitting a claim to Starbridge for a dependent.
Authorization From Individuals Form
This form is required under the Health Insurance Portability and Accountability Act of 1996 (HIPAA Privacy Act). The form confirms the authorization from an individual from Starbridge to use or disclose protected health information for a particular purpose. The form can also be used to appoint an individual to personally represent an insured person.
Beneficiary Designation Notification Form
Completing and returning this form will allow Starbridge to pay a chosen beneficiary upon the insured person's death.
CIGNA HealthCare claims department is staffed with Customer Service Representatives able to assist insureds and clients alike at 1-800-308-5948, Monday through Friday 5:00 am - 6:00 pm, MST Time. All claims, concerns and questions can be answered by a live representative in a timely manner. Spanish speaking representatives are available.