Jason Jordan
318 lines
13 KiB
XML
318 lines
13 KiB
XML
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<font size="6" isUnderline="false"/>
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<text><![CDATA[Eligibility]]></text>
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<font size="6" isUnderline="false" isPdfEmbedded="false"/>
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<font size="6" isBold="false" isItalic="false"/>
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<text><![CDATA[To confirm eligibility, verify benefits,
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or check claim:
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]]></text>
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<font size="6" isBold="false" isItalic="false"/>
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<text><![CDATA[Call (8am – 5pm):
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1.800.676.1182]]></text>
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<font size="6" isBold="true"/>
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<text><![CDATA[Group #/ID:]]></text>
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</textElement>
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<text><![CDATA[Name:]]></text>
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<textElement>
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<font size="6" isBold="true"/>
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</textElement>
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<text><![CDATA[Member #:]]></text>
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<textElement>
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<font size="6" isBold="true"/>
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</textElement>
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<text><![CDATA[Effective Date:]]></text>
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<textElement>
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<font size="6"/>
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<textFieldExpression><![CDATA[$F{group_number}]]></textFieldExpression>
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<textElement>
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<font size="6"/>
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<textFieldExpression><![CDATA[$F{full_name}]]></textFieldExpression>
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<text><![CDATA[Covered Dependents:]]></text>
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<font size="6" isBold="true"/>
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<text><![CDATA[Benefits are not insured by Cigna or affiliates]]></text>
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<font size="6" isBold="false" isItalic="false"/>
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<text><![CDATA[This card does not
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guarantee eligibility or payment.]]></text>
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<font size="6" isBold="false" isItalic="false"/>
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<text><![CDATA[(24/7) Online
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www.bbstpa.com]]></text>
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<band splitType="Stretch"/>
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