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Funding Solutions

Designed to meet your needs and provide opportunities for cost savings

About Funding Solutions

Funding is the method in which an employer pays for employee benefits. Employers can purchase insurance that covers claims and other expenses, known as fully insured funding, or they can self-fund their benefit plan, which means the employer pays an administrator to administer the plan, but the employer funds the claims expenses from their own bank account.

Think about the fully insured and self-funded concepts in the construct of bills that most consumers pay.

Fully Insured is like your cable bill – no matter how many times you turn it on, or how many hours you watch, you pay the same amount each month and you know what you owe. It’s predictable and easy to budget.

Self-Funding is more like your electric bill – you pay as you go, or pay for what you use. You can use more efficient bulbs, turn off unnecessary lighting and take other measures that keep the money in your account.

Cigna recognizes that different employers have different needs. We offer a market-differentiating suite of funding solutions designed to meet these unique needs and offer advantages, such as:

  • Help manage risk and cash flow to fit your budget
  • Offer payment options to help achieve immediate and sustainable cost savings
  • Drive additional savings when health and wellness programs are successful
  • Drive informed plan design choices to improve affordability
  • Help maximize savings when paired with integrated products

Insured Funding Solutions

Cigna offers four insured funding solutions based on an insurance policy. Please check with your broker or Cigna representative for availability based on employer size and state.

Fully Insured (also called Guaranteed Cost or GC)
  • The employer pays a fixed monthly premium which includes all plan costs (administration, claims, and taxes/fees, etc.)
  • Cigna pays covered claims
Insured 50% Dividend Eligible
  • The employer pays a fixed monthly premium which includes all plan costs (administration, claims, and taxes/fees, etc.)
  • Cigna pays covered claims
  • Renewing employers share in 50% of savings if claims are lower than expected; Cigna covers the excess claims if they are higher than expected
Shared Returns® Fully Insured
  • The employer pays a fixed monthly premium which includes all plan costs (administration, claims, and taxes/fees, etc.)
  • Cigna pays covered claims
  • The employer shares in up to 100% of savings when claims are lower than expected. Cigna covers excess claims if they are higher than expected (losses carry-forward and may reduce savings opportunity in future years).
Shared Returns® Minimum Premium
  • Reduced monthly premium includes administration, cost of insurance coverage and taxes/fees
  • The employer pays claims as they occur.
  • If claims are less than estimated, the employer saves money in real time. If claims are higher than estimated, Cigna reimburses the excess claim cost (losses carry-forward and may reduce savings opportunity in future years).

Self-Funding Solutions

Cigna offers three funding solutions based on self-funded (ASO) agreements. Please check with your broker or Cigna representative for availability based on employer size and state.

Cigna Level FundingSM
  • The employer pays a pre-set monthly payment, which includes administration, stop loss insurance premium and claims funding
  • Upon renewal, the employer has the opportunity receive a surplus credit at the end of the plan year if claims are lower than expected
  • The employer owes nothing more if claims are higher than expected, or if they decide to terminate the plan
  • Cigna processes claims and secures discounted services from contracted health care providers
Cigna Graded FundingSM
  • Pay as you go – the employer pays for actual claims each month and keeps any savings.
  • Lower payments in the first two months, and insight into terminal costs at time of sale.
  • Individual Stop Loss and Aggregate Stop Loss are included to help protect the employer from unexpected claim costs.
  • Detailed, paid claim reporting helps employers make informed health and wellness decisions.
  • Cigna processes claims and secures discounted services from contracted health care providers.
Self-funding/Administrative Services (ASO)
  • The employer pays an administrative fee for Cigna to administer the plan.
  • The employer funds claims as they occur, keeping any unspent money or paying more than expected as claims fluctuate.
  • Individual and Aggregate Stop Loss is available to help protect the employer from unexpected costs.
  • Cigna processes claims and secures discounted services from contracted health care providers.

Get long-term cost savings with the right mix of solutions for your business.

Contact your broker or connect with a Cigna representative to discuss your organization’s unique needs.

Product availability may vary by location, group size and plan type and is subject to change. All group health insurance policies, stop-loss insurance policies and health benefit plans contain exclusions and limitations. For costs and details of coverage, contact a Cigna representative. Group health plans and stop loss insurance policies are insured or administered by Cigna Health and Life Insurance Company or its affiliates. Medical Policy forms: OK - HP-APP-1 et al; OR - HP-POL38 02-13, TN - HP-POL43/HC-CER1V1 et al.