Controlling Costs and Improving Quality

Achieving better health outcomes and sustaining lower health care costs can be an attainable goal that we can help you achieve. Cigna offers a large, national network of health care providers as well as focused, more cost effective networks to suit the unique needs of your organization.

Our supporting programs and services are designed to help improve the health of your employees and save you money.

Cost Containment Programs

Cigna's medical cost containment programs are designed to provide more savings to our clients and customers. To help lower costs, we offer:

• Payment Integrity programs like Complex Claim Review, our coding and billing review program, to help ensure doctors and other health care providers submit reasonable, accurate, and appropriate charges for complex claims. We also offer Audit Recovery programs which review certain medical bills to determine the reasonableness, appropriateness, and accuracy of charges.
• Network Savings Program (NSP) and Bill Negotiation Services (BNS) to help reduce overall out-of-network costs for health care providers who may agree to accept discounted reimbursements off of their billed charges, thus avoiding the risk of customer balance billing. We achieve savings through direct negotiations, supplemental networks, and repricing offers made through Cigna’s third party partners. These programs are used in combination with the employer's maximum reimbursable charge election.
• Maximum Reimbursable Charge (MRC) to help employers manage out-of-network medical costs. MRC represents the maximum amount that Cigna will pay an out-of-network health care provider for a covered service under the medical plan absent resolution through the NSP or BNS.

Cigna Choice Fund^®

Cigna Choice Fund^® is a true consumer-focused solution - one that puts the individual's needs and goals first by focusing on their health improvement efforts. This focus can create engaged customers who take appropriate action to improve their health and reduce medical costs.

With Cigna Choice Fund^®, you can offer employees an option between health savings account, (HSA), health reimbursement account (HRA) and flexible spending account (FSA)-compatible plans, providing additional opportunities for savings.

Many individuals today may not be engaged with their health care purchases and as a result, they may not understand how their plan works or how health care quality and costs can vary between different doctors and facilities. Cigna is out to help change all that. We focus on improving health and spending habits to create an empowered health care consumer. We focus on shifting behaviors, not costs, by employing strategies and tactics designed to create active participants who are encouraged and rewarded for choosing and using quality care.

Funding Arrangements for Health Care

Cigna is dedicated to giving your company a sustainable, competitive edge, with health services designed to keep health benefit costs under control and keep your employees healthier in the process. Your account support team will help you and your employees get the maximum value out of your health plan. Funding arrangements include:

• Self-Funded Plans. You fund covered claims and Cigna provides the plan administration
• Participating Funding. Cigna provides full protection for covered claims, cash flow advantages and the ability to participate in your claim experience
• Shared Returns^® Fully Insured. You have complete protection from high claim costs and predictable expenses that are easy to budget
• Shared Returns Minimum Premium. A fully insured arrangement where you get lower monthly payments and premium tax savings when claims are lower than expected.

View Cigna Company Names

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 representative. Group health plans are insured or administered by Cigna Health and Life Insurance Company or its affiliates. Policy forms: OK - HP-APP-1 et al; OR - HP-POL38 02-13; TN - HP-POL43/HC-CER1V1 et al.