All retirees are eligible to participate in the City of San José’s
Personal
Accident Insurance group policy with Cigna Group Insurance. Personal
Accident Insurance is an optional, supplementary insurance program that
provides retirees with the opportunity to purchase extra insurance to cover
serious injury or death caused by accident. Please click on the links below
to learn more about the City’s Personal Accident Insurance group
policy
with CIGNA.
Please note: You will need Adobe
Acrobat Reader in order to open
PDF documents.
If you don’t see what you’re looking for, please contact the
Retirement
Services
Department at (408) 794-1000.
Personal Accident Insurance Application
Personal Accident Insurance Brochure
& Rates
Personal
Accident Insurance Certificate of Coverage
CIGNA
Privacy Statement |
Contact
Information
PERSONAL ACCIDENT INSURANCE APPLICATION | top
of page |
 - Personal Accident Insurance Application (File Size: 33kb)
Eligible retirees may apply for coverage or change coverage at any time. Please complete this form and forward it to Retirement Services. Coverage will begin on the first day of the month following the month in which we receive your form.
PERSONAL ACCIDENT INSURANCE BROCHURE & RATES | top
of page |
- AD&D Brochure, Rates, and Application (eff 01/01/2010) (File Size: 194kb) - Personal Accident Ins - Identity Theft Program (File Size: 164kb)
PERSONAL ACCIDENT CERTIFICATE
OF COVERAGE | top
of page |
- AD&D Certificare of Coverage (File Size: 122kb) - AD&D Summary Document and Disclaimer (File Size: 137kb)
CIGNA PRIVACY STATEMENT | top
of page |
- CIGNA Privacy Statement (File Size: 299kb)
CONTACT INFORMATION | top
of page |
This policy is administered by the A. Francois Derendinger
Insurance Agency, Inc. Please contact them for additional information
regarding the City of San José’s CIGNA Personal Accident
Insurance Policy.
 A.
Francois Derendinger Insurance Agency, Inc.
1133 Saratoga Avenue
PO Box 9307
San José, CA 95129
Phone: (408) 252-7300
|
