Product Disclosures

Products and Services Provided by Cigna Corporation Subsidiaries

Cigna Corporation is a holding company and is not an insurance or an operating company. Therefore, all products and services are provided exclusively by or through operating subsidiaries and not by Cigna Corporation. "Cigna" may refer to Cigna Corporation itself or one or more of its subsidiaries, but when used in connection with the provision of a product or service, always refers to a subsidiary. For a listing of the legal entities that offer, insure or administer products and services in your state, please visit www.cigna.com/cignastatedirectory

General Disclaimer

The products and services described on Cigna's websites may not be applicable to you or available to you under your plan. Please refer to your policy or plan documents for information that is applicable to your specific plan.

We recommend reading any disclosure that's applicable to you before purchasing a Cigna insurance policy or enrolling in a Cigna plan so that you can become more familiar with your plan and any state-specific mandates. If you are considering a Cigna plan and have questions about your plan coverage, please contact your licensed insurance agent or Cigna representative.

While reviewing the information on this page, it's important to note:

  • The disclosures provided here are general and your policy or plan documents may contain additional disclosures which are required by your state and/or specific to your plan. The disclosures in your policy or plan documents take precedence.
  • Certain mandates may only apply to certain policies or plan types.
  • State mandates may not apply to employer-funded (or self-insured) group plans. Please contact your plan sponsor if you need to know whether your plan is self-insured and whether any state mandates apply to your plan.
Individual and Family Medical/Dental Insurance Plans

Product details for Cigna Individual and Family Medical and Dental insurance policies may vary by state. Before applying for insurance coverage, be sure to read the plan information and policy disclosures applicable to your specific state and policy. To find information related to your state, visit www.cigna.com/individuals-families.

Exclusions and Limitations

All insurance policies and group benefit plans have exclusions, limitations, reduction of benefits and terms under which the policy may be continued in force or discontinued. Rates may vary and are subject to change. Health coverage is provided subject to any deductibles, co-payment, or coinsurance provisions. For costs and a complete list of both covered and not-covered services under your plan or policy, including benefits required by your state, see your insurance policy, evidence of coverage, or your employer’s insurance certificate or summary plan description.

Product Descriptions - Not Available in all States

The product descriptions, if any, provided on Cigna.com or other Cigna websites are for informational purposes only and are subject to change. Product availability may vary by area and plan type and is subject to change. Product descriptions are not a contract and are not intended to constitute offers to sell or solicitations in connection with any products or services. Anyone interested in a particular product should contact their licensed insurance agent, Cigna sales representative or plan sponsor to determine whether the product is available in their area and to request a copy of the applicable policy or other plan documents for a complete description of the product.

Health Care Provider Network; Patient Satisfaction Scores, Designations, and Ratings

Patient experience, quality designations, cost-efficiency and other ratings found in Cigna's online provider directories reflect a partial assessment of quality and/or cost and should not be the sole basis for decision-making (as such measures have a risk of error). They are not a guarantee of the quality of care that will be provided to individual patients. Individuals are encouraged to consider all relevant factors and consult with their physician when selecting a health care facility. Health care professionals and facilities that participate in the Cigna network are independent contractors solely responsible for the treatment provided to their patients. They are not agents of Cigna. Actual costs will vary depending on the location and type of services received.  Your plan deductible, co-payment and coinsurance requirements apply and may vary based on the type of facility and health care professional providing care. The listing of a health care professional or facility in the network directory does not guarantee that the services rendered by that professional or facility are covered under your specific policy or medical plan. Check your policy or official plan documents for complete details about costs and the services covered under your plan benefits.

Cigna Dental Care (DHMO)

The term "DHMO" is used to refer to group dental product designs that may differ by state of residence of enrollee, including but not limited to, prepaid plans, managed care plans, and plans with open access features. The Cigna DHMO is not available in the following states: AK, HI, ME, MT, NH, NM, ND, PR, RI, SD, VI, VT, WV, and WY.

Discount Program Information

The CignaPlus Savings and Healthy Rewards programs are NOT insurance, and the member must pay the entire discounted charge.

  • CignaPlus Savings® is a dental discount program that provides members access to discounted fees, pursuant to schedules negotiated by Cigna Dental with participating providers, which members are responsible for paying in full, directly to participating providers. Although all participating providers go through a credentialing process to assure that they are appropriately licensed and qualified, Cigna Dental does not otherwise guarantee nor is it responsible for the quality of any services or products purchased by members. Members have the right to cancel within thirty (30) calendar days of enrolling in the program. For more information, please call or write Cigna Dental:

    Cigna Dental
    Attn: Operations
    1571 Sawgrass Corporate Parkway, Suite 140
    Sunrise, FL 33323
    Telephone: 1.877.521.0244


  • Cigna Healthy Rewards® offers discounts on health and wellness programs and services. If your Cigna plan includes coverage for any of these services, this program is in addition to, not instead of, your plan benefits. Healthy Rewards programs are separate from your medical benefits and customers are required to pay the entire discounted charge. Healthy Rewards programs may not be available in all states and may be discontinued at any time.
Health Reimbursement Account (HRA) Plan Option

HRAs can only be chosen together with certain plan types. Your HRA is self-funded by your employer, who is solely responsible for contributing the funds used to pay benefits under your plan using the funds in your HRA. You are not required to make any contribution to the HRA account, either pursuant to a salary deduction election or otherwise under a Section 125 cafeteria plan. You may not enroll under this option if you are considered self-employed (including partners and more-than-2% shareholders in a subchapter S corporation).

Health Savings Account (HSA) Pre-enrollment Statements

You cannot open an HSA if, in addition to coverage under an HSA-qualified High Deductible Health Plan ("HDHP"), you are also covered under a Health Flexible Spending Account (FSA) or an HRA or any other health coverage that is not a HDHP.

If you have elected to enroll in an HSA plan, you expressed your interest in opening a Health Savings Account with an HSA service provider. The HSA service provider you choose will contact you and provide you with an HSA enrollment form, a signature card, a request for information for any Customer Identification Program compliance and other related materials necessary to open an HSA account with the HSA service provider. In order to open an HSA with the HSA service provider, you must:

  1. In a timely manner, complete, sign and submit all the forms required by the HSA service provider; and
  2. Be found to meet all of the requirements prescribed by the HSA service provider.

If you are enrolled in a Cigna Individual and Family Health Savings Plan, you will need to contact the HSA service provider of your choice to set up a Health Savings Account to pair with your Cigna Health Savings Plan.

If you are offered a Cigna-administered HDHP through your employer and your employer has not selected the Cigna-preferred HSA service provider, you may open the HSA with an HSA custodian/trustee that is either arranged by your employer or that you personally select. You must agree to complete necessary forms and meet the requirements set forth by the HSA custodian/trustee pertaining to the establishment and operation of your HSA.

The HSA provider and/or trustee/custodian will be solely responsible for all HSA services, transactions and activities related thereto. Neither your employer nor Cigna is responsible for any aspects of the HSA services, administration and operation.

Prior to enrollment with an HSA provider, you must certify that you have enrolled or plan to enroll under a HDHP and are not covered under any other health coverage that is not a HDHP.

Reimbursement for Out-of-Network Services

Certain Cigna health insurance policies and Cigna-administered health benefit plans cover expenses incurred for services from health care professionals and facilities that do not participate in the Cigna provider network. Those policies and plans include Maximum Reimbursable Charge ("MRC") provisions that may limit the amount of an out-of-network charge that will be considered by Cigna in calculating reimbursement.

For Cigna Individual and Family Medical plans, refer to your policy for details on how MRC is calculated under the terms of your policy.

For group health plans, the plan sponsor (employer or other organization) may choose one of the following MRC provisions that limits the amount that will be considered in calculating benefits under the out-of-network coverage (if any) for non-emergency services:

MRC I
Under this option, a data base compiled by FAIR Health, Inc. (an independent non-profit company) is used to determine the billed charges made by health care professionals or facilities in the same geographic area for the same procedure codes using data. The maximum reimbursable amount is then determined by applying a plan sponsor selected percentile (typically the 70th or 80th percentile) of billed charges, based upon the FAIR Health, Inc. data. For example, if the plan sponsor has selected the 80th percentile, then any portion of a charge that is in excess of the 80th percentile of charges billed by providers in the FAIR Health, Inc. data base for the service in the same relative geographic area (as determined using the FAIR Health, Inc. data) will not be considered in determining reimbursement and the patient will be fully responsible for charges in excess of the MRC.

MRC II
This option uses a schedule of charges established using a methodology similar to that used by Medicare to determine allowable fees for services within a geographic market or at a particular facility. This schedule amount is then multiplied by a percentage (110%, 150% or 200%) selected by the plan sponsor to produce the MRC.

In the limited situations where a Medicare-based amount is not available (e.g., a certain type of health care professional or procedure is not covered by Medicare or charges relate to covered services for which Medicare has not established a reimbursement rate), the MRC is determined based on the lesser of:

  • the health care professional or facility's normal charge for a similar service or supply; or
  • the MRC I methodology based on the 80th percentile of billed charges.

There is no MRC with respect to services for which there is not enough charge data in a geographic area to determine a MRC charge.

Average Contracted Rate ("ACR")
Under this option, the MRC is determined based on the lesser of:

  • the health care professional or facility's normal charge for a similar service or supply; or
  • the Average Contracted Rate - i.e., the average percentage discount applied to all claims in a geographic area paid by Cigna during a recent 6 month period for the same or similar service/supply provided by health care professionals or facilities participating in the Cigna provider network. The ACR is updated by Cigna on a semiannual basis. The geographic area used by Cigna is either a Metropolitan Statistical Areas (MSA) or an area within governmental boundaries (e.g. state, county, zip code).

In some cases, the ACR amount will not be used and the MRC is determined based on the lesser of:

  • the health care professional or facilities' normal charge for a similar service or supply; or
  • the MRC I methodology based on the 80th percentile of billed charges.

Whether the MRC I, MRC II or ACR methodology is used, the patient is responsible for all charges over the MRC amount, as well as any applicable deductible and coinsurance amounts for charges that do not exceed the MRC. The claim is also subject to all other exclusions and limitations in the applicable benefit plan.

If you are enrolled in a plan insured or administered by Cigna, you and your authorized representatives can request the MRC for a particular procedure and geographic location by calling the number on your Cigna ID card.

If you use a health care professional who is not in the Cigna provider network, be sure to check your plan documents to make sure that your plan covers out-of-network services. If you have a Flexible Spending Account, you may be able to use that money for out-of-network services.

Cigna Secure Travel

Cigna Secure Travel® services are provided under a contract with Worldwide Assistance Services, Inc. Full terms, conditions and exclusions are contained in the Cigna Secure Travel service agreement. This program is not insurance and does not include reimbursement of expenses for financial losses.

Cigna Will Preparation Services

Will Preparation Services are independently administered by ARAG®. Cigna does not provide legal services and makes no representations or warranties as to the quality of the information on the ARAG website or the services of ARAG.

Cignassurance

The Cignassurance® Program for beneficiaries is available to beneficiaries receiving coverage checks over $5,000 from Cigna Life and Personal Accident Programs. Phone and face-to-face counseling sessions must be used within one year of the date the claim is approved. Cignassurance accounts are not deposit account programs and are not insured by the Federal Deposit Insurance Corporation or any other federal agency. Account balances are the liability of the insurance company and the insurance company reserves the right to reduce account balances for any payment made in error. Counseling, legal or financial assistance programs are not available under policies insured by Cigna Life Insurance Company of New York.

Cigna Identity Theft Services

Cigna's Identity Theft Services are provided under a contract with Europ Assistance USA. Full terms, conditions and exclusions are contained in Cigna’s Identity Theft Program service agreement.

My Secure Advantage Financial Wellness Program

The My Secure Advantage Financial Wellness Program is independently administered by CLC Incorporated (CLC). Cigna does not provide financial services and makes no representations or warranties as to the quality of the information on the CLC website or the services of CLC.

Disclosure of Financial Arrangements

Compensation is paid to third party brokers and benefits advisors for placing an individual insured's or Client's ("Client" refers to employers or other groups sponsoring a group health plan) insurance coverage and/or self-insured plan administration contract with Cigna. In the case of individual insureds, this compensation is determined by agreement between Cigna and the third party broker. For Clients, this compensation is determined by agreement of the plan sponsor and its broker or benefits advisor. Compensation is typically in the form of a percentage of premiums collected (in the case of insurance policies), or a fixed, per-employee per-month rate in the case of self-insured plans.

Additional compensation may be paid to brokers/benefits advisors based on persistency or other non-case-specific factors. Cigna sends reports to group insurance policyholders annually regarding the commission and other compensation paid to brokers/benefit advisors during the prior calendar year for their use in preparing their Annual Return and Report (Form 5500) where required under federal law (ERISA). Upon request, we will also disclose how the Client may receive more information directly from the broker/benefits advisor regarding compensation arrangements.

The primary compensation received with respect to insurance policies is the policyholder paid insurance premium. The primary source of revenue in connection with administrative services contracts is the service fees paid by the self-insured plan sponsor and/or the plan.

Revenue Sources

In addition to the premium charged to policyholders and the administrative fees charged to sponsors of self-insured plans, Cigna negotiates for compensation from some third-party vendors with which Cigna contracts to perform services in connection with the plans we insure or administer. This compensation is to reimburse Cigna for its costs of implementing and maintaining programs offered by these third-party vendors. This allows Cigna to offer lower premiums and administrative fees.

Cigna may subcontract with a third-party vendor for the performance of a service that Cigna has agreed to provide to a plan sponsor. The amount charged to the Client for the program or services may include both the vendor’s reimbursement as well as a Cigna charge. For example, where Cigna contracts with a third-party for the administration of a disease management program, the plan sponsor may be charged both the reimbursement owed the third-party vendor and an additional amount by Cigna. Cigna may also receive compensation from vendors for placing the business with the vendor. These may be calculated on a per-member per-month (PMPM) basis, flat rate, or on a percentage basis. Cigna may receive performance guarantee payments if a vendor does not meet performance targets. Cigna may receive other compensation from its third-party vendors. These charges are typically reflected in Cigna's agreement with the plan sponsor or in related disclosure documentation.

Cigna may receive payments directly from drug manufacturers or Pharmacy Benefit managers with which it contracts. These payments may be consideration for placement of a manufacturer’s drug on the Cigna drug formulary.

Cigna uses specialized vendors to negotiate discounts for out-of-network claims. The amount charged to self-insured plans reflects the negotiated discount. An administrative fee is paid to the vendor for successfully negotiating a discount under these programs and Cigna charges a percentage of the net savings for administering these programs.

When a third party should have been responsible for the claims incurred by a covered individual (as a result of an automobile accident, for example), after paying the claim, Cigna may try to obtain reimbursement from the third party responsible for the accident, or that party’s liability insurer. Cigna currently pursues reimbursement using a specialized subrogation vendor. For successful efforts, a percentage of the recovery is retained by the vendor and Cigna. Additionally, Cigna reserves a priority right to reimbursement of any prior stop-loss insurance payments it may have made to Clients.

Certain Cigna companies directly provide or arrange for the provision of covered health care services including, but not limited to Cigna Behavioral Health, Inc. and Cigna HealthCare of Arizona, Inc. Their charges for providing or arranging for these services are reimbursed as claims.

Clinical Claims Review Program

In an effort to assure that high dollar claims are correctly billed and paid in accordance with industry and other applicable standards, we have extended our claims review program to include a review of select facility claims for billing and coding errors. This program is now available for all self-insured Clients.

State-Specific Information

+Arizona: Rate Review Notice
Cigna filed for a 38.5% rate increase effective January 1, 2013 for the plans covering any groups enrolled in the healthcare coverage sponsored by the Arizona Small Business Association (ASBA). The ASBA plans are comprehensive major medical plans (including prescription drug coverage) sold to small employer groups through the association. ASBA offers three plans – one HMO plan and two high deductible Open Access plans. Cigna developed the proposed rate increases for 2013 using methods consistent with Cigna's standard large group underwriting practices, and the 38.5% rate increase was applicable to all plans and all age/gender categories.

The Center for Consumer Information and Insurance Oversight (CCIIO) recently found that the 38.5% rate increase was not unreasonable for the Open Access plans but that the increase was unreasonable for the HMO plan. The experience under the HMO plan has been more favorable in recent years, which we believe to be a result of the individuals enrolled in the HMO plan being healthier on average than those enrolled in the Open Access plans. Overall, the recent experience for the entire group has been quite poor. For calendar year 2011 the actual claims exceeded premiums by 36%, and for the first half of 2012 the actual claims exceeded premiums by over 62%.

Cigna's goal with the proposed rate increase was to preserve what we believe are appropriate rate differences between the various plans. We believe those rate differences should be based primarily upon differences in anticipated cost levels related to differences in benefits between the various plans and not differences in the average health of enrollees. If rates for the various plans are set using each plan’s actual experience there is the risk that rate differences will increase to the point where certain plans will become unaffordable and may have to be discontinued altogether. By maintaining a relatively stable rate differential between plans we feel we can offer the widest variety of affordable plan options for all of the association’s member small employer groups.

For the reasons outlined above Cigna believes it is most appropriate to develop and implement a single rate increase that is applicable to all the association’s plans. As a result we have decided not to withdraw the increased rates for the HMO plan offered through Cigna HealthCare of Arizona.

More information can be found here.

California: Disclosure Required of Retail Sellers Under California Civil Code Sec. 1714.43
Cigna Home Delivery PharmacySM does not make efforts to identify or eradicate human trafficking from its direct supply chains for tangible goods that it offers for sale.

California: California Health Plan Information
For information about Cigna Individual and Family Health plans and services in your area, go to http://www.cigna.com/individuals-families/shop-our-health-insurance-plans. For group/employer health plan information, including Cigna companies, accessing group plan services and information about COBRA/conversion privileges, utilization review and grievances/appeals, visit http://www.cigna.com/cignastatedirectory/cigna-in-california.

Colorado: State of Colorado Notice – ACCESS PLAN
If you would like more information on: (1) who participates in our provider network; (2) how we ensure that the network meets the health care needs of our members; (3) how our provider referral process works; (4) how care is continued if providers leave our network; (5) what steps we take to ensure medical quality and customer satisfaction; (6) where you can go for information on other policy services and features. You may request a copy of our Access Plan. The Access Plan is designed to disclose all the policy information required under Colorado law, and is available for your review upon request.

Florida: Provider Performance Outcome and Financial Data Disclosures
Customers are encouraged to view Florida provider performance outcome and financial data that will be posted on the Agency for Health Care Administration’s Health Information website: http://www.floridahealthfinder.gov/index.html. For more information, please call or write us at: Cigna, 2701 North Rocky Point Drive, Suite 800, Tampa, FL 33607. Office hours: 8:00 a.m. to 5:00 p.m. (EST) Monday through Friday. Telephone: 1.813.637.1200 Fax: 1. 813.637.1223. For Customer inquiries, call our Nationwide Customer Services Telephone Number: 1.800.244.6224 (Please note: If you are enrolled in an employer-sponsored plan, this number may be different for your employer group. Please check your Cigna ID card for the correct Customer Services telephone number.)

Illinois: Cigna Dental Care (DHMO) Plans
In Illinois, the Cigna Dental Care plan is considered a prepaid dental plan.

Minnesota Residents: Cigna Dental Care (DHMO) Plans – Out-of-Network Services
If you are considering enrollment or are enrolled in a Cigna Dental Care (DHMO) plan through your employer, you must visit your selected network dentist in order for the charges on the Patient Charge Schedule to apply. You may also visit other dentists that participate in our network or you may visit dentists outside the Cigna Dental Care network. If you do, the fees listed on the Patient Charge Schedule will not apply. You will be responsible for the dentist’s usual fee. We will pay 50% of the value of your network benefit for those services. Of course, you’ll pay less if you visit your selected Cigna Dental Care network dentist. Call Customer Service for more information.

New Mexico: The product or sales information on this site is not intended for residents of New Mexico. If you would like more information about Cigna plans and services in your state, please contact your licensed broker or Cigna sales representative.

Oklahoma: Cigna Dental Care (DHMO) Plans – Out-of-Network Services
DHMO for Oklahoma is an Employer Group Pre-Paid Dental Plan. You may also visit dentists outside the Cigna Dental Care network. If you do, the fees listed on the Patient Charge Schedule will not apply. You will be responsible for the dentist’s usual fee. We pay non-network dentists the same amount we’d pay network dentists for covered services. You’ll pay less if you visit a network dentist in the Cigna Dental Care network. Call Customer Service for more information.

Oklahoma: Oklahoma Policy Numbers
Medical - GM6000 C1 et al (Connecticut General Life Insurance Company, "CGLIC"); HP-APP-1 et al (Cigna Health and Life Insurance Company, "CHLIC"). Dental - Indemnity/PPO: GM6000 ELI288 et al (CGLIC), Cigna Dental Care (DHMO): GM6000 DEN201V1 (CGLIC), Cigna Dental Care Specialty Access: GM6000 DEN200V1 (CGLIC); Indemnity/Dental PPO: HP-POL99 (CHLIC), Cigna Dental Care (DHMO) & Specialty Access: HP-POL115 (CHLIC). Group Universal Life (GUL 2): XX-603404 et al (CGLIC). Disability & Life (other than GUL) - TL-004700 et al, Disability Reserve Buy Out: TL-008610.37. Blanket Accident: BA-01-1000.00 et al, Group Accident: GA-00-1000.00 et al (Life Insurance Company of North America).

Texas: Product Information and Frequently Asked Questions
For information about Cigna Individual and Family Health plans and services available in Texas, visit, http://www.cigna.com/individuals-families/shop-our-health-insurance-plans. For a list of Cigna companies, information about group/employer health plan products, and answers to frequently asked questions, visit http://www.cigna.com/cignastatedirectory/cigna-in-texas.