How To Enroll
Eligibility for Enrollment
If you are an active IBO and a member of the Independent Business Owners Benefits Association (IBOBA) or spouse and/or dependent child, a U.S. citizen living in the United States and hold a social security number, you may enroll.
Once enrolled in our vision benefits program, you will not be required to satisfy a waiting period before using services; however, should your coverage terminate, for any reason, you (and your eligible spouse and/or dependent children) will have to satisfy a 12-month waiting period to re-enroll.
Listed below are easy to follow step-by-step instructions to complete and submit the IBO CIGNA Vision Enrollment Form.
- Read the details of the CIGNA Vision enrollment coverages, limitations, and exclusions thoroughly located under the “Vision Insurance” tab on this website.
- Please print the enrollment form titled "CIGNA Vision Enrollment Form".
- Complete the enrollment (in ink) by filling in the following information:
- IBO, spouse, and family information
- Your personal information, as applicant
- Personal information for all family members to be covered
- Sign and date
- Mail the completed enrollment and initial premium to:
USI Affinity
14 Cliffwood Ave., Suite 310
Matawan, NJ 07747
Your initial premium is required when applying for vision coverage. Please make your payment payable to "USI Affinity" and attach payment with your completed enrollment form. You may also pay your premium with your Visa, MasterCard, or Discover credit card or debit card. Simply print this credit card payment form, complete the information, and return the signed and completed form with your application.
Please note: An incomplete enrollment without your initial payment will be returned to you. This will delay your enrollment.
Your coverage will be effective on the first day of the month following approval of your enrollment form providing initial down payment has been paid. Do not cancel any other coverage until you have been notified, in writing, of your approval and you have received your certificate of coverage from USI Affinity.
If you have any questions or need assistance in completing your enrollment, please contact one of our professionals at 1-800-254-2327, or email us with your questions.
Download a copy of the CIGNA Vision Enrollment Form