By guiding covered employees to use local, quality doctors and hospitals, LocalPlus can help improve the effectiveness of your health plan and save money. Smaller businesses (51 to 499 employees) may especially see more value with this type of plan.
About the Network
The LocalPlus limited provider network is designed around a focused set of quality, cost-effective doctors and hospitals in our 26 service areas. Employees can access the LocalPlus network in any of these areas. When traveling outside a LocalPlus area, employees may use the larger Away from Home Care feature at the in-network cost.
Typical Plan Structure
Your plan will vary based on what you discuss with your local Cigna representative, but here is a basic summary of how the LocalPlus plan typically works:
- Primary care physician (PCP) selection is encouraged, but not required.
- Referrals are not required to see a specialist.
- Out-of-network coverage is included at a higher out-of-pocket cost, or excluded with a lock-in option on this plan.
- Premiums for LocalPlus plans are often lower than Cigna PPO and OAP plans, thanks to the limited network.
- Deductibles can be lower to limit the cost burden on employees, while still encouraging smart health spending. Cost-sharing options are available through customized deductibles, copays, coinsurance, and out-of-pocket maximums.
LocalPlus Gets Results
When compared to clients in similarly designed Cigna Open Access Plus plans, LocalPlus clients could save 5% to 15% in medical costs.1
Benefits of Cigna Medical Plans
- 24/7/365 live customer service, when and where employees need it
- Award-winning digital tools for employees, including the myCigna® mobile app
- Worldwide in-network coverage for emergencies2
- Most plans offer access to Cigna's large national network of labs, x-ray and radiology offices, and dialysis centers
- Option for employers to offer consumer driven health plan (CDHP) accounts, including health reimbursement accounts (HRAs,) health savings accounts (HSAs), and flexible spending accounts (FSAs) (available with most plan types)
- Option for employers to bundle pharmacy, behavioral health, dental, and more.
- Optional health and wellness incentive programs to encourage and reward employees3
- Self-funded and fully insured funding options for employers, if applicable
- Dedicated client service team
1Percentage of savings is estimated based on an internal national Cigna study conducted in 2015 comparing Cigna’s LocalPlus and LocalPlus IN plans to Cigna’s Open Access Plus (OAP) and Open Access Plus IN (OAPIN) plans with the same benefit structure, deductibles, copay and out-of-pocket maximum limits. Savings are not guaranteed and will vary depending on plan design, geographic distribution and utilization patterns. Medical cost savings do not directly translate to rate or premium rates.
2For Emergency Services as defined by the applicable plan documents.
3Incentive programs are funded by the employer and may not be available with all product types
This plan provides access to a network that is smaller than Cigna’s national Open Access Plus (OAP) network. In this plan customers have access to in-network benefits only from the health care professionals and facilities in the LocalPlus network when in a LocalPlus Network service area. Please consult the limited network directory or visit the online directory at Cigna.com to determine which health care professionals and facilities are included in the LocalPlus network. For a paper copy, contact your Cigna representative.
LocalPlus plans are insured and/or administered by Cigna Health and Life Insurance Company. Product availability may vary by location and plan type and is subject to change. All group health insurance policies and health benefit plans contain exclusions and limitations. For costs and complete details of coverage, contact your Cigna representative. TN policy form: TN - HP-POL43/HC-CER1V1 et al.