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Go Anywhere, See Any Doctor
Choosing the CIGNA indemnity plan offers the flexibility of your health care choices. Members can visit any doctor; choose the hospitals and health care facilities and don't need a referral to visit a specialist.
Next (How It Works) >
Flexibility, Freedom and Choice
With the indemnity plan, you pay for the cost of the visit at the time you receive health care services. To be reimbursed, typically, you are responsible for filing a claim form. Then, after you meet a predetermined deductible and pay a certain percentage of the expense – called coinsurance – you're reimbursed. This applies to planned, routine services as well as emergency and urgent care situations.
| Cost Example |
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| PCP office visit/exam fee |
$85 |
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| You Pay |
$85 |
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| |
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| Lab fees |
$115 |
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| You Pay |
$115 |
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| |
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| Specialist visits/fee for three visits |
$300 |
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| You Pay |
$300 |
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| You meet your $500 deductible |
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| Follow-up visit with specialist |
$100 |
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| You pay 20% coinsurance |
$20; |
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Next (Special Programs) >
Health and wellness programs
Members of CIGNA HealthCare plans may also have access to valuable Health and Wellness Programs:
- Well Informed — a personalized health improvement program designed to let CIGNA HealthCare members and their doctors know about opportunities to maintain or improve the member's health.
- 24-hour health information — call the CIGNA HealthCare 24-Hour Health Information LineSM any time to speak with a registered nurse or listen to our audio library for health-related information.
- Support for chronic conditions — manage your asthma, diabetes, heart condition, low back pain, or chronic obstructive pulmonary disease with help from CIGNA Well Aware for Better Health®.
- Member discounts — save up to 60% on products and services-from acupuncture to weight management-with our Healthy Rewards® discount program. Note: not all programs are available in all states.
- Quality transplant care — access care from nationally recognized facilities in the CIGNA LIFESOURCE Transplant Network®.
- CIGNA HealthCare Healthy Babies® — give your child a healthy beginning with information and support from the CIGNA HealthCare Healthy Babies® program.
- CIGNA Healthy Pregnancies, Healthy BabiesSM — the CIGNA Healthy Pregnancies, Healthy Babies® program offers a full scope of educational and care management services to members who are pregnant or considering pregnancy.
- Cancer prevention and education — the Comprehensive Oncology Program® addresses cancer prevention and education, as well as active management of members diagnosed with cancer.
- High Touch Personal Assistance — with CIGNA Health AdvisorSM, CIGNA Health Advisors proactively identify and reach out to members who are at risk for significant health issues but are not appropriate candidates for chronic or acute disease or case management programs.
- Lose weight and improve your health — when you enroll in the CIGNA Healthy Steps to Weight LossSM, you won't be starting a diet. Instead, this program helps you change your behaviors permanently. You'll learn healthier eating habits and how to incorporate exercise into your schedule – helping you to feel better, look better and improve your overall health.
Check your plan materials or log in to myCIGNA for more information about your Indemnity plan, including your eligibility for specific programs and services. Or ask your employer or benefits manager for more information about enrolling in a CIGNA HealthCare plan.
Next (Employer Advantages) >
Employer Advantages
Benefits
The CIGNA HealthCare EPO provides your employees with referral-free access to participating physicians. Your employees also have the option to choose out-of-network coverage; however, there are no out-of-network benefits except in emergency or urgent care situations.
The flexible plan designs also include:
- no primary care physician (PCP) selection requirement;
- customized cost-sharing choices-deductibles, coinsurance and plan maximums;
- multiple funding options;
- our Network SavingsSM Program—provides discounts for services provided by certain out-of-network physicians, hospitals and other facilities;
- consolidated billing, accounting, reporting and banking; and
- standard health and wellness features, with optional features available at an additional cost.
Support
We've designed a flexible communication program to help your employees understand their plan and make better health care purchase decisions.
Pre-enrollment
- optimum communications time line and approach
- implementation plan
- introductory letter from your CEO/President or benefits administrator
- customized Intranet articles
- newsletter articles
- e-mail notices
- presentation scripts
- posters
- payroll stuffers
- "train the trainers" presentation
Open enrollment
- enrollment kits
- toll-free help line
- benefit fair
- kiosk (at an additional cost)
- on-site enrollers, workshops and seminars
Post-enrollment
- handbook
- monthly e-mail copy
- customized Intranet services with online forms and detailed information about your company's plan
- customized, secure employee portal, myCIGNA, with extensive, reliable health information from Web MD®, physician and hospital ratings, side-by-side drug comparisons and health records and trackers
Your implementation manager will help you every step of the way with communication strategies and materials that best suit you and your employees.
Options
Funding Options
Choose from multiple funding options:
Fully Insured
- Full premium paid monthly
- Predetermined and guaranteed rates
- Predictable, easy-to-budget expenses
- Protection from high claim costs
Fully Insured - Participating
- Full premium paid monthly
- Predetermined and guaranteed rates
- Predictable, easy-to-budget expenses
- Protection from high claim costs
- Year-end settlement
- Can earn cash back at year end if claims are low
Minimum Premium
- Lower premium paid monthly
- Claims funded through bank account with a monthly claim cap
- Protection from high claim costs
- Year-end settlement
- Improved cash flow
- Lower expenses and premium taxes
Administrative Services Only
- No monthly premium or premium taxes paid, just an administrative fee
- Exempt from most state regulations and mandates on coverage levels
- Stop Loss coverage available
- Maximizes cash flow
- Freedom to design your health benefits
- Financial protection against unanticipated, catastrophic claims
Health and Wellness Programs
Members of CIGNA HealthCare plans may also have access to valuable Health and Wellness programs and support.
- 24-hour health information — call the CIGNA HealthCare 24-Hour Health Information LineSM any time to speak with a registered nurse or listen to our audio library for health-related information.
- Support for chronic conditions — manage your asthma, diabetes, heart condition, low back pain, or chronic obstructive pulmonary disease with help from CIGNA Well Aware for Better Health®.
- Member discounts — save up to 60% on products and services-from acupuncture to weight management-with our Healthy Rewards® discount program. Note: not all programs are available in all states.
- Quality transplant care — access care from nationally recognized facilities in the CIGNA LIFESOURCE Transplant Network®.
- CIGNA HealthCare Healthy Babies® — give your child a healthy beginning with information and support from our Healthy Babies program.
- CIGNA Healthy Pregnancies, Healthy BabiesSM — the CIGNA Healthy Pregnancies, Healthy BabiesSM program offers a full scope of educational and care management services to members who are pregnant or considering pregnancy.
- Cancer prevention and education — the Comprehensive Oncology Program addresses cancer prevention and education, as well as active management of members diagnosed with cancer.
- High Touch Personal Assistance — with CIGNA Health AdvisorSM, CIGNA Health Advisors proactively identify and reach out to members who are at risk for significant health issues but are not appropriate candidates for chronic or acute disease or case management programs.
- Award Prgrams To Fit Your Needs — through the Healthy Awards Account® you can offer your employees health and well-being programs that are specific to your culture and needs.
- Lose weight and improve your health — when you enroll in the CIGNA Healthy Steps to Weight LossSM, you won't be starting a diet. Instead, this program helps you change your behaviors permanently. You'll learn healthier eating habits and how to incorporate exercise into your schedule – helping you to feel better, look better and improve your overall health.
Next (FAQ) >
FAQ
Do I have to choose a PCP?
You are not required to choose a primary care physician. You can choose to see any physician you want.
Do I need a referral to see a specialist?
Though you may want your personal doctor's advice and assistance in arranging care with a participating specialist, you do not need a referral to see a participating specialist.
Do I have to choose between in-network and out-of-network coverage now?
No. The Indemnity plan does not have a network, so each time you seek medical care, you can choose your doctor.
How do I pay for my health services?
With the indemnity plan, you will pay for the cost of the visit at the time you receive health care services. Then, after you meet a predetermined deductible and pay a certain percentage of the expense – called coinsurance – you will be reimbursed. This applies to planned, routine services as well as emergency and urgent care situations.
Who is responsible for filing a claim for reimbursement?
To be reimbursed, typically, you are responsible for filing a claim form. Then, if you have met your plan's predetermined deductible, you will pay a certain percentage of the expense – called coinsurance – and be reimbursed the rest.
Am I covered for emergency care?
Whenever there is an emergency, seek medical help immediately. You will be required to pay at the time you receive care. Then, if you have met your plan's predetermined deductible, you will pay a certain percentage of the expense – called coinsurance – and be reimbursed the rest.
Next (Features & Benefits) >
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