CIGNA Choice Fund^SM

An innovative way to pay for medical expenses

CIGNA Choice Fund packages a consumer health care fund with an underlying PPO or Open Access Plus medical plan that has a deductible, coinsurance and out-of-pocket maximum.

Options and benefits

There are two Choice Fund options: a Health Reimbursement Arrangement (HRA) and a Health Savings Account (HSA). Both include a consumer fund that can help members pay their share of health care expenses, as defined by their underlying medical plan. Some plans allow the consumer fund to be used for expenses that are not covered by the underlying medical plan, such as pharmacy costs and dental and vision expenses.

Unused Choice Fund dollars may also be rolled over to the following year. Careful management enables members to build their Choice Fund to help offset their future health care costs.

Reimbursement

• Choice Fund HRA
  When funds are available to be for eligible services, you'll receive payment directly from CIGNA HealthCare on behalf of the member. After HRA funds have been used, you may balance bill the member as you would with any plan that has a deductible and coinsurance.
  
  
• Choice Fund HSA
  Members may choose to pay providers with a debit card or a check that draws directly from their HSA. Or, they may opt to use non-HSA funds. Beginning in April 2005, members will have a third option: to elect direct payment to the provider from their HSA.

Reimbursement Process

The claim submission process is basically the same as for any plan with deductibles and coinsurance.

• You should not collect deductibles or coinsurance at the time of service. (These plans typically do not have copayments.)
• Submit the claim as usual.
• Member responsibility will be determined by the claim adjudication under the terms of the medical plan.
• You will receive a standard EOP from the medical claim system.
  
  
• If the medical plan EOP has the following remark code, "Final payment determination will follow the review of available funds in a CIGNA Choice Fund Health Reimbursement Arrangement or Flexible Spending Account", the remaining member responsibility has been sent to the Choice Fund for consideration.
  
  
• You will receive a second EOP (and a check if funds are available) from CIGNA Choice Fund along with the final member responsibility. You will receive both EOPs on the same day or a few days apart.
  
  
• You may then bill the member for the final member responsibility shown on the Choice Fund EOP.
  
  
• If the medical plan EOP does not include the above remark code, the remaining member responsibility has not been sent to the Choice Fund system and you may bill the member for the final member responsibility shown on the medical plan EOP.
• Some Choice Fund participants may use special Choice Fund debit cards and/or checks to pay for eligible expenses.

Note: Choice Fund checks are processed daily.