Embarc Benefit Protection
Embarc helps employers manage the cost of select high-cost gene therapies while supporting access for your employees.
Offered by Cigna Health and Life Insurance Company
Making Gene Therapy Treatments More Accessible
Embarc Benefit Protection® was created to help shield plans and members from the cost of breakthrough gene therapy treatments.
Gene therapies can cost hundreds of thousands to several million dollars per treatment.1 We understand the burden these therapies can place on you and your employees.
Embarc brings together the health services, medical management, and specialty pharmacy expertise of Cigna Healthcare®, EviCore®, Accredo®, and Express Scripts® to provide protection from the effects of costly gene therapy claims.
1 in 10 Americans live with a rare disease, half of whom are children.2
Why Employers Choose Embarc
Embarc is designed to improve access and create cost predictability. Our solution connects eligible employees with best-in-class care while prioritizing affordability.
Together with participating plans, Embarc helps:
Control high-cost financial risk
by protecting your plan from the impact of gene therapy claims.
Create predictable costs
where plans pay a set per member per month (PMPM).
Improve access to gene therapies
for eligible employees, reducing financial barriers to quality care.
Support long-term value
through year-end surplus-sharing, when applicable.
How Embarc Works
Embarc Benefit Protection is a network-based solution that offers value beyond stop-loss coverage by managing the cost of select gene therapy drugs.
1. Employers pay a fixed monthly fee.
Plans pay a predictable PMPM cost for the provision of gene therapy drugs through EviCore’s network.
2. Gene therapies are arranged through a specialized network.
Providers identify when gene therapy may be needed and request prior authorization through Cigna Healthcare.
3. Zero out-of-pocket costs for members.
There are no out-of-pocket charges or additional expense to the plan when covered under the plan and medically necessary.
Note: Members with a Health Savings Account (HSA) must meet the applicable minimum deductible required for high-deductible health plans
4. Drug cost is removed from the plan’s claims experience.
The cost of the gene therapy is managed within the program instead of through traditional claims. This helps reduce financial volatility as well as the impact on stop-loss renewals and laser recommendations.
5. Surplus sharing helps balance program costs.
Surplus settlement is paid to clients on a pro-rata basis if utilization across the Embarc book of business is lower than anticipated.
Included Gene Therapies
Embarc continues to evaluate new gene therapies as they achieve FDA approval. These durable, single-dose drugs may be high-cost but have potentially life-changing impact. Here are the gene therapy drugs included in Embarc:
- WaskyraTM 3
- Encelto TM 3
- Itvisma® 3
- Elevidys® 3
- KebilidiTM 3
- LenmeldyTM 3
- Casgevy® 3
- Lyfgenia TM 3
- Hemgenix® 3
- SkysonaTM 3
- ZyntegloTM 3
- Zolgensma® 3
- Luxturna® 3
Ready to learn more about Embarc Benefit Protection?
Connect with your Cigna Healthcare representative or broker to review availability, eligibility, and plan details.
Embarc FAQs (Frequently Asked Questions)
Who is Embarc for?
Embarc is designed for employers seeking protection from high-cost gene therapy claims.
What is the difference between Embarc and stop-loss coverage?
Stop-loss insurance reimburses employers for high-cost claims after they happen.
Embarc provides first dollar coverage and removes drug claims from the experience, eliminating impact on future renewals.
Does Embarc cover every gene therapy treatment?
Embarc is committed to developing the most robust network solutions possible. This means that we are evaluating all upcoming gene therapies for inclusion in the solution. Decisions about the addition of gene therapies to Embarc Benefit Protection will be primarily determined by our core guiding principles:
- High Cost
- Potentially Life-altering
- Durable
- Single Administration
How does Embarc help control costs?
Embarc can reduce financial risk by providing protection for eligible gene therapies that can cost up to several million dollars per treatment.1
View Cigna Healthcare Company Names
1 The estimated annual financial impact of gene therapy in the United States, Nature, November 8, 2023, https://www.nature.com/articles/s41434-023-00419-9
2 Rare Disease Facts & Statistics, National Organization for Rare Disorders, accessed June 15, 2026, https://rarediseases.org/understanding-rare-disease/rare-disease-facts-and-statistics/
3 Financial protection applies when medical necessity review requests are received after the Embarc Inclusion Date for employers actively enrolled in Embarc Benefit Protection.
LUXTURNA is the registered trademark of Spark Therapeutics, Inc. and ZOLGENSMA is the registered trademark of AveXis, Inc. ZYNTEGLO and SKYSONA are both registered trademarks of bluebird bio, Inc. HEMGENIX is the registered trademark of CSL Behring, L.L.C. CASGEVY is a registered trademark of Vertex Pharmaceuticals Inc. LYFGENIA is a registered trademark of bluebird bio, Inc. LENMELDY is a registered trademark of Orchard Therapeutics group. KEBILIDI is a registered trademark of PTC Therapeutics, Inc. in the U.S. and other countries. ELEVIDYS is a registered trademark of Sarepta Therapeutics, Inc. ENCELTO is a registered trademark of Neurotech Pharmaceuticals, Inc. ITVISMA is a registered trademark of Novartis AG. WASKYRA is a registered trademark of FONDAZIONE TELETHON ETS.
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 details of coverage, contact a Cigna Healthcare representative.
Cigna Healthcare products and services are provided exclusively by or through operating subsidiaries of The Cigna Group, including Cigna Health and Life Insurance Company (Bloomfield, CT.) (CHLIC), Express Scripts, Inc., or their affiliates. In Utah, all products and services are provided by Cigna Health and Life Insurance Company (Bloomfield, CT). Policy forms: OK – HP-APP-1 et al., OR – HP-POL38 02-13, TN – HP-POL43/HC-CER1V1 et al. (CHLIC); GSA-COVER, et al. (CHC-TN).
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