Cost Management

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

Complex Claim Review
Complex Claim Review is a coding and billing review program done on a pre-pay basis. It helps ensure doctors and other health care professionals submit reasonable, accurate and appropriate charges for the services and supplies they provide.

Out-of-Network Cost Containment Programs (Network Savings Program (NSP) and Bill Negotiation Services (BNS))
Our out-of-network cost containment programs give employees and their families access to a supplemental network of out-of-network hospitals, health care facilities and doctors who offer services at discounted rates. These discounts lower out-of-pocket and claim costs without requiring benefit plan or administration changes. These programs are used in combination with the employer's maximum reimbursable charge.

Our Out-of-Network Containment Programs offer:

  • Access to a supplemental network of health care professionals who are not part of the Cigna network but who provide out-of-network care at discounted rates
  • Lower out-of-pocket expenses for people when they receive covered services from these out-of-network health care professionals
  • Lower out-of-network claim costs for employers when their employees use out-of-network health care professionals
  • Fully integrated and automated benefit administration

Post Pay Audit Recovery Programs
Cigna's post payment programs review medical bills to determine the reasonableness, appropriateness and accuracy of charges. These programs can help employers and employees save on their health care costs.

Maximum Reimbursable Charge (Out-of-Network Benefits)
The maximum reimbursable charge (MRC) benefit helps employers manage out-of-network medical costs. MRC represents the maximum amount under the medical plan that Cigna will pay an out-of-network health care professional for a covered service. For employers, MRC:

  • Helps keep health benefits more affordable by lowering unit costs
  • Includes all charges (health care professional and health care facility) at a greater discount
  • Reduces exposure to unnecessary billing by out-of-network health care professionals
  • Improves in-network use by providing a strong financial incentive for employees to use participating health care professionals and hospitals
  • Drives greater incentives for health care professionals and hospitals to join the Cigna network

Contact your Cigna representative for more information.

Customer Experience

24/7 Live Customer Service
Our customers can talk with a representative whenever it's convenient for them.

Explanation of Benefits (EOB)
We provide customers with a quick summary of recent claim activity. It's easy to see what's been paid and what's owed. The Cigna Explanation of Benefits ranked third amount national health plans, with an excellent designation for clarity, content and design in an evaluation by DALBAR, Inc.1

MyCigna.com
With myCigna.com, registered users can quickly view coverage, monitor claims, find doctors, research health issues and enjoy wellness programs.

Clear Communication
We've developed customer interaction guidelines, including the use of easy-to-understand words, to help make sure our customer communication is as clear as possible.

Contact your Cigna representative for more information.

1Dalbar, Inc., [2013] Explanation of Benefits Statements Rankings.

Dental Coverage

Dental Health Maintenance Organization (DHMO)1
The Cigna Dental Care® DHMO is one of the largest Dental HMO network in the nation2 and offers 75% savings off average area charges3 with 40% lower premiums4, on average, than a Cigna Dental PPO. There’s a DHMO plan option to help meet any client's needs, with features like surgical implant coverage5, coinsurance customer out-of-pocket payment, discounts and more. Most preventive procedures are covered at no charge5, which supports our focus on prevention. And with teeth whitening coverage (take-home bleaching with gel trays), the ability to offer up to four cleanings a year, coverage for crowns/bridges over implants5, coverage for athletic mouth guards5, ID theft resolution services6, a Dental Information Line, and other value-added features, Cigna's DHMO plans are designed to offer a great customer experience.

Contact your Cigna representative for more information.

Dental Preferred Provider Organization (DPPO)
Cigna's Dental PPO lets customers choose any dentist, in- or out-of-network. Coverage includes most preventive procedures at low or no cost, and individuals don’t need a referral  to see specialists.7 Cigna's Dental PPO is designed with network flexibility to help meet any employer’s benefit strategy:

  • Largest Dental PPO in the nation8, with customizable in- and out-of-network discount configurations
  • Dental Network Savings Program (DNSP) gives customers access to a supplemental listing of dentists who aren’t part of the Cigna networks, but who provide out-of-network care at a discounted rate9
  • A projected 4% higher net effective discount than the industry by 201410
  • Customizable plan designs with numerous cost-saving features
  • Multiple funding options :
  • Cigna's network is expected to grow by 85% from 2009 to 2014.11 Cigna is currently contracted with 68%12 of active dentists and plans to be contracted with 80% of active dentists in 2014 with a goal of 90% by 201611

Contact your Cigna representative for more information.

Dental Exclusive Provider Organization (DEPO)
The Cigna Dental EPO provides the flexibility of broad network access with in-network only coverage. Customers will be reimbursed for all or part of their costs for covered procedures, up to the annual dollar maximum, and after meeting a deductible and/or satisfying any waiting periods. Coverage includes most preventive procedures at low or no cost, and individuals don’t need a referral to see specialists.7

For employers, the benefits of choosing DEPO include:

  • Two network options, including Cigna Dental Radius Network®, which is ideal for employers where network size is the primary driver. The second network is Cigna Dental Core Network, which is ideal for employers looking for a strong balance between network access and dentist discounts
  • Dental Network Savings Program (DNSP) gives customers access to a supplemental network of dentists who are not part of the Cigna networks but who provide out-of-network care at a discounted rate9
  • Customizable plan designs with numerous cost-saving features13
  • Multiple funding options:

Contact your Cigna representative for more information.

Dental Indemnity
Cigna Traditional is our dental indemnity-style plan. Since there are no networks associated with Cigna Traditional, customers can visit any dentist or specialist they choose, without a referral. Coverage includes most preventive and diagnostic services.7 For all covered services individuals pay a set coinsurance amount, and since there are no negotiated network discounts, they may pay the difference between coinsurance and the dentists' usual charges. Benefits of choosing this plan include:

  • Customizable plan designs with numerous cost-saving features13
  • A Dental Network Savings Program that gives customers access to dentists who are not a part of the Cigna network, but who provide care at a discounted rate9
  • Multiple funding options:

Contact your Cigna representative for more information.

CignaFlex Advantage®
CignaFlex Advantage lets customers switch monthly between our Cigna Dental Care (DHMO) plan and either the Cigna Dental PPO or the Cigna Traditional indemnity plans—with no additional administrative work options for clients. There are three options available to meet clients' needs, including Cigna Managed Switch, Client Managed Switch and Client/Cigna Managed Switch.

Contact your Cigna representative for more information.

CignaPlus Savings®14
CignaPlus Savings is a discount dental program—not an insurance product. This program is designed to meet the needs of employers looking to offer dental care to anyone who's ineligible for traditional insurance coverage, such as part-time employees, seasonal employees or retirees. It's a cost-effective option that gives customers access to dental care services at discounted rates.

Contact your Cigna representative for more information.

Cigna Dental Oral Health Integration Program®
The Cigna Dental Oral Health Integration Program is available to all dental customers because better oral health may contribute to better overall health. Cigna dental customers who have any of the medical conditions below qualify for 100 percent reimbursement of out-of-pocket costs for certain related dental procedures15. There's no additional charge for the program-those who qualify get reimbursed.16

  • Diabetes
  • Maternity
  • Heart Disease
  • Stroke
  • Head and neck cancer radiation
  • Organ transplants
  • Chronic kidney disease

The Cigna Dental Oral Health Integration Program goes beyond typical dental coverage and offers:

  • More savings. Program participants get discounts on certain prescription dental products through Cigna Home Delivery PharmacySM-regardless of their pharmacy carrier
  • More wellness. Participants can choose to get information on how behavioral issues are linked to oral health. These articles are designed to help program participants overcome these behaviors so they can improve their oral and overall health

Contact your Cigna representative for more information.

Some plans and plan features may not be available in all states. Actual plan coverages will vary based on plan design, location and funding type. All plans and insurance policies contain exclusions and limitations which are more fully set forth in the applicable plan documents. Cigna dental insurance plans and administrative services are offered by Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, or their affiliates.

1The term “DHMO” is used to refer to product designs that may differ by state of residence of enrollee, including but not limited to, prepaid plans (Oklahoma, et al), managed care plans, and plans with open access features (OK and MN, et al). 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. For the DHMO company name and other information for your particular state, see Cigna Companies by State. Terms and conditions of coverage are set forth in DHMO policy forms GM6000 DEN201V1* (CGLIC) and HP-POL115* (CHLIC), and DPPO policy forms GM6000 ELI288* et al (CGLIC) and HP-POL99* (CHLIC) (*actual number may vary by state).

2Source: NetMinder. DHMO data as of September 2015 and is subject to change. The Ignition Group makes no warranty regarding the performance of the data and the results that will be obtained by using. Data is subject to change.

3The national average charges used in the calculation are based on a combination of Cigna and FAIR Health claim data projected to 7/1/2013 using a 3% annual cost trend. Calculation assumes customer out-of-pocket savings with Cigna DHMO plan versus no dental insurance coverage.

42012 Cigna Dental book of business; clients who offer both DHMO and DPPO have on average 40% lower DHMO premiums than their DPPO premiums.

5Individuals must receive services through their network general dentist for coverage to apply, except in emergencies. Prior authorization may be required for certain specialty care treatments. Only those procedures that are medically necessary and listed on the plan’s Patient Charge Schedule (PCS) are covered. Services related to the surgical placement of a dental implant are limited to one per year with replacement of a surgical implant frequency limitation of one every 10 years. The frequency limitations of certain other covered services are set forth in the PCS. The following are excluded from coverage unless otherwise listed on the PCS or required by law: (a) Experimental and cosmetic dentistry; (b) Treatments or surgery if associated with a poor or hopeless diagnosis; (c) Recementation of crowns, inlays and onlays, post and cores, and veneers within 180 days of initial placement; (d) Crowns, bridges and implant supported prosthesis used solely for splinting; and (e) Work already in progress for crowns, bridges, dentures, root canal treatment, or implant supported prosthesis. A complete list of your plan’s terms, including exclusions and limitations, is set forth in the applicable plan documents.

6Cigna's Identity Theft services are provided under contract with Europ Assistance USA. Full terms are contained in Cigna's Identity Theft Program service agreement.

7Routine exams and X-rays are limited to 2 per calendar year. Waiting periods may apply to basic restorative, major restorative, and orthodontic services and are more fully set-forth in the group insurance certificate or group service agreement.

8NetMinder. DPPO data as of March 2013, including combined reported Cigna Dental Radius Network® and Dental Network Savings Program counts of unique dentists. Data is subject to change. The Ignition Group makes no warranty regarding the performance of data and the results that will be obtained by using.

9Dental Network Savings Program (DNSP) is a discount savings program and is not insurance. DNSP is included as a standard feature but availability may vary and is subject to change. This program enables plan participants to receive discounts for out-of-network services received from a dentist participating in the DNSP. Not all providers that participate in DNSP are part of our DPPO network or credentialed by Cigna. Dentists who participate in the Cigna Network or DNSP are independent contractors solely responsible for treatment provided. DNSP is not available in the following states: AK, CA, ID, IA, MT, NM (not available for indemnity clients), ND, RI, SD and WY.

102014 industry projection based on actual 2011 Ruark Discount Study industry results projected to 2014. Industry projections for 2014 reflect a 2% effective discount growth, based on historical industry trends.

112013-2016 Cigna projections are based on previous recruitment and competitive positioning in the industry. Competitive positioning is measured using NetMinder data as of March 2013 program counts of unique dentists. Data is subject to change. The Ignition Group makes no warranty regarding the performance of the data and the results that will be obtained by using it.

12As of June 2013.

13Options include: varying deductibles, coinsurance levels, maximums, stricter exclusion & limitation language, procedural class-shifting, benefit waiting periods, WellnessPlus plans, etc.

14CignaPlus 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. This program is not available in all states. A discount program is NOT insurance, and the member must pay the entire discounted charge.

15 The Cigna Dental Oral Health Integration Program offers 100% reimbursement for out-of-pocket costs for certain related dental procedures, subject to the following limitations: coverage for periodontal maintenance is limited to 4 per year during active therapy; customers undergoing treatment for chronic kidney disease, organ transplants, or head/neck cancer radiation receive coverage for topical fluoride application and varnish, and dental sealants (age limits removed, other plan limitations may apply); maternity patients receive coverage for one additional oral evaluation and cleaning during their pregnancy term. All other plan exclusions and limitations apply.

16Deductible does not apply. Reimbursement counts toward maximum for DPPO/indemnity plans. Program exclusions and limitations apply.Deductible does not apply. Reimbursement counts toward maximum for DPPO/indemnity plans. Program exclusions and limitations apply.

Group and Voluntary Coverage
Find cost-effective plan designs and solutions to meet your needs and help your employees actively engage in programs to help them be healthy, productive and more financially protected – even if they never file a claim.

Enrollment Technology

Choicelinx
Choicelinx® delivers web-based enrollment tools. Employers can streamline their administrative process, reduce cost and offer a personalized enrollment experience. The benefits of choosing Choicelinx include:

  • A continual review and enhancement of our enrollment solutions to meet market trends, and most importantly, the needs of our customers
  • A secure and innovative solution

To learn more, visit choicelinx.com.

Funding Arrangements for Health Care

Fully Insured
Under Cigna's fully insured plans, you have full protection for covered claims. Fixed, monthly premiums allow for predictable expenses that are easy to budget.

Contact your Cigna representative for more information.

Self Funded
Under self-funding (also known as administrative services only), you fund the claims, and Cigna provides the plan administration. If claims are lower than expected, you realize immediate savings. We also offer stop loss insurance coverage options to provide you with protection for high claims.

Contact your Cigna representative for more information.

Participating Funding

Shared Returns®, Cigna's insured participating funding options, provide full protection for covered claims, cash flow advantages and the ability to participate in your claim experience. Plus, you'll receive complete reporting with a year-end settlement of premium and claim costs.

There are two types of Shared Returns:

Shared Returns Fully Insured
With Shared Returns Fully Insured, you have complete protection from high claim costs and predictable expenses that are easy to budget. Low claims can earn you a credit at the end of the year.

Shared Returns Minimum Premium
With Shared Returns Minimum Premium, you have lower monthly payments and premium tax savings. You fund claims as they occur and enjoy increased cash flow.

Contact your Cigna representative for more information.

Health and Wellness

Health Foundations
Cigna can help build a foundational health coverage plan that will meet the health needs of your workforce.

Health Assessment
Cigna's health assessment includes the University of Michigan Health Management Resource Center health assessment and exclusive access to its proprietary Trend Management System(SM). This gives Cigna the unique ability to analyze how current health risks impact future health status, costs, productivity and disability. Using information from our health assessment, we are able to help our clients address, reduce and reverse health risks with the support of our health coaching interventions, including online coaching and clinical programs.

Our health assessment service helps employers:

  • Predict two to three years out, with 83 percent accuracy, which individuals will become the next high users of health care services based on their unique risk combinations1
  • Identify the most appropriate health strategies to support the population
  • Monitor and evaluate an employee population's health, health changes and engagement of health management programs over time
  • Analyze current health risks and their impact on future health status, costs, productivity and disability

Personal Health Solutions
Cigna's personal health solutions can improve health and productivity, and lower costs for populations with acute health care needs, such as hospitalization and/or significant outpatient treatment. The Utilization Review Accreditation Commission (URAC) and/or the National Committee for Quality Assurance (NCQA) have accredited our programs. In addition, the programs are guided by evidence-based guidelines.

Well Informed-Gaps In Care
The Cigna Well Informed program uses medical, pharmacy and laboratory data to proactively identify and address customers' gaps in care. Gaps in care occur when people don't receive, or adhere to, medical care that is consistent with medically-proven guidelines for prevention and treatment. This can result in more serious illnesses and additional costs for customers and employers.
Well Informed helps employers:

  • Identify and communicate gaps to members and providers
  • Create greater health awareness among employees and effective interactions with doctors
  • Improve health, productivity and quality of life for employees
  • Reduce costs


Health Screenings
Health screenings give participants a convenient way to assess their current health status. They also help clients identify health risks in their employee population. Cigna offers a variety of health screenings at the worksite, including blood pressure, glucose testing, body mass index and cholesterol testing. Post-screening health coaching services are also available.

24-Hour Health Information Line
The health information line is a 24/7 resource that provides live support from a nurse about general health conditions and their symptoms. Nurses also help determine the appropriate level of care. Depending on the service purchased, employees may also listen to hundreds of podcasts on almost any health topic.

Employee Assistance Program (EAP)
Cigna's Employee Assistance Program helps deliver the support employees and employers need to better manage work and life issues so they can manage their health, stay focused and productive. The service is designed to meet the personal assistance needs of employees and managers, and the organizational needs of businesses. Depending on the services purchased, support is available via:

  • Telephone
  • Online
  • Face-to-face at the worksite or via a referral to a mental health professional

Mental Health and Substance Use
Almost every employee can benefit from integrated behavioral health services. By increasing the use of behavioral services across your organization, you can help decrease overall medical and behavioral expenses.

On-site Health Centers
Time, transportation and cost are real barriers to people getting the care they need to help improve their health. By bringing health support to the worksite, employers can eliminate these obstacles and dramatically impact employee participation in health improvement. They can also reduce absenteeism and boost productivity. Cigna has built a large suite of on-site capabilities, ranging from education and health screening, to lifestyle management programs to on-site coaching and health centers. Our health professionals will guide you to a solution set that meets the needs of your organization.

Contact your Cigna representative for more information.

Health Focus
We can provide the products and services that can help healthy people avoid risks, at-risk people reduce risks, people with chronic conditions control risks, and people with acute conditions resolve risks.

Health Focus: Time-Sensitive Needs
For those with time-sensitive needs, our service focuses first on those who need to or have spent time in the hospital-helping them get the support they need and make the most of their coverage.

  • Health Advisor-Personal Health Team
    Cigna offers health coaching for healthy and at-risk populations to help customers reduce risks related to cholesterol, blood pressure, nutrition, physical activity and pre-diabetes. Health coaches also provide valuable information to help customers make treatment decisions and close gaps in their care. The team helps to improve productivity, and reduce wage and benefit costs by improving employee health, and preventing future illnesses and their expenses
  • Cigna Healthy Pregnancies, Healthy Babies®
    While most women have healthy, uncomplicated pregnancies, others may need specialized support to deliver healthy babies. Cigna Healthy Pregnancies, Healthy Babies can give women the support they need to have healthier pregnancies and deliveries

Contact your Cigna representative for more information.

Health Focus: Ongoing Care
For those requiring ongoing care, we offer services to help them live better with their condition. Cigna offers:

Your Health FirstSM
Health coaching focuses on the entire health needs of people with chronic conditions such as diabetes, asthma, depression, back pain and cardiac conditions. Health coaching can help to reduce the risks related to tobacco, weight, stress, cholesterol, and blood pressure. Depending on the services purchased, we deliver health coaching through:

  • Telephone
  • Online
  • Face-to-face at the worksite

Integrated Personal Health Team
Cigna's 360-degree health coaching team provides a dedicated health coach for each customer, to support their health needs.

Cigna Cancer Support Program
The Cigna Cancer Support program supports employees by providing individuals and families information and assistance from diagnosis to treatment to remission.

Cigna Total Behavioral HealthSM
This is our integrated approach to improving health, productivity and a company's bottom line by focusing on the person. Cigna's behavioral health coverage can increase the cost-effectiveness of medical and pharmacy plans, which can result in decreased costs and more peace of mind.


Contact your Cigna representative for more information.

Health Focus: Preserving Health and Well-Being
For those people who want to maintain, preserve, or improve their health and well-being, we find opportunities to reduce risks through:

Cigna Health Advisor®
Health coaching can help customers reduce risks related to cholesterol, blood pressure, nutrition, physical activity and pre-diabetes. Health coaching also can help customers by providing information about treatment options and helping to close gaps in care. Depending on the services purchased, health coaching for these topics is provided via:

  • Telephone
  • Online
  • Face-to-face at the worksite

Lifestyle Management Programs
Health coaching can provide the support employees need to make lasting behavior changes to reduce risks related to tobacco, weight and stress. These changes can result in decreased medical costs and improved productivity. Depending on the services purchased, health coaching for these topics is provided via:

  • Telephone
  • Online
  • Face-to-face at the worksite

Flu Clinics
One of the best ways to help prevent the flu is with annual flu vaccinations. To help people fight the flu and avoid its consequences, Cigna partners with clients to offer flu immunizations at worksites. The benefits of our flu clinics include:

  • Coordination by Cigna of the planning and delivery of the on-site flu clinics
  • Promotional and educational materials that deliver coordinated and cohesive messages to encourage participation
  • Potential reduced costs from the flu
  • A safe, convenient way to provide health needs to employees

Contact your Cigna representative for more information.

Health Pays
You can provide incentives to increase participation in Health Foundations (e.g., for health assessment completion) and Health Focus (e.g., for condition management goal achievement) programs.

Healthy Awards
Through our Healthy Awards Account® (tied to the Cigna Choice Fund®; product), healthy activities offer an incentive for employees to live healthier and allow them to earn money to be deposited in their health spending accounts.

Cigna Incentive Points Program
Our Incentive Points program allows employers to reward employees for taking action to improve their health and wellness. The program is flexible with the types of activities included and rewards.

Key initiatives include:

Well-Being Solutions
Cigna can deliver relevant, engaging and cost-effective well-being solutions for your organization, which can result in healthier, happier, more productive employees and a better bottom line for your organization. Success is grounded in Cigna's commitment to delivering personalized well-being solutions, based on our knowledge of your company.

Through a needs-based, consultative approach, we assess the top health risks or your employee population, along with your values, goals and budget for supporting well-being in the work place. Then we recommend a well-being solution set, designed to meet the needs of your organization.

Our programs are organized by specific goals and can be mixed and matched to design the perfect fit for your workforce. Our programs include:

  • Health Awareness. Hands-on services to help people know their numbers and better understand their health status and potential risks
  • Education. Easy-to-understand resources to help individuals learn how to be well for life
  • Prevention. Helpful programs aimed at preventing illness and disease
  • Lifestyle. Highly engaging, behavior-change programs that help encourage your employees to practice healthy habits for a lifetime
  • Activity. Motivational programs and challenges to help inspire people to actively participate in their health
  • Coaching. Expert guidance and consultation to support organizations and individuals throughout the process

It's our tailored, highly personalized approach that sets Cigna apart and allows us to help deliver meaningful behavior change-all potentially leading to better health and a better bottom line.

1"University of Michigan Health Risk Assessment (HRA) and Trend Management System (TMS)," Cigna White Paper, 2008

Incentives

Healthy Awards
Through a Healthy Awards Account® (tied to the Cigna Choice Fund® product), healthy activities offer an incentive for employees to live healthier and allow them to earn money to be deposited in their health spending accounts.

Incentive Points
Our Incentive Points program allows employers to reward employees for taking action to improve their health and wellness. The program is flexible in both the types of activities included and rewards.

Contact your Cigna representative for more information.

Medical

Cigna Choice Fund Consumer-Driven Health Plans
Cigna Choice Fund® delivers a true consumer-focused solution-one that puts the individual's needs and goals first. We focus on shifting behaviors, not costs, to create active participants who are encouraged and rewarded for choosing quality care.

Health Reimbursement Account (HRA)
The Cigna Choice Fund® Health Reimbursement Account (HRA) is a consumer-driven health plan that combines a medical plan with an account funded by the employer. The Cigna Choice Fund HRA is designed to help lower overall medical costs through a focus on the engagement of participants. It offers the added security of rolling over unused funds to the next plan year to save for future expenses. The benefits of choosing a Cigna HRA include:

  • Choice in the underlying medical plan
  • Choice in your own limits on remaining HRA dollars that roll over to future plan years
  • Choice in incentive programs to reward employees for healthy behaviors
  • Choice in offering a Flexible Spending Account in addition to the HRA
  • Automatic claim forwarding option to pay health care professionals directly from the HRA

Health Savings Account (HSA)
The Cigna Choice Fund® Health Savings Account (HSA) is a consumer-driven health plan that lets individuals make a personal investment in improving their health and quality of life. Accompanied by an IRS-qualified, high deductible health plan, the HSA gives individuals ownership of a tax-advantaged savings account they can use to put aside money to help pay for current or future medical, prescription drug, dental and other IRS-approved health care expenses.

Benefits of choosing a Cigna HSA include:

  • Implementation support for installation of the health plan and Health Savings Account
  • A centralized point-of-contact for the health plan, interest-bearing savings account and investment options
  • A single website, myCigna.com, for customers to access information about medical and pharmacy plan and claim activity
  • Enhanced and integrated online decision support tools
  • Automatic claim forwarding option to help pay health care professionals directly from the health savings account
  • Incentive programs to help drive desired behavior changes
  • The option to waive the deductible for a select set of preventive prescription drugs

Flexible Spending Account (FSA)
With a Flexible Spending Account (FSA), participants can set aside pre-determined, pre-tax dollars to pay for eligible medical, dental and pharmacy expenses. FSAs are a cost-effective way for participants to manage eligible out-of-pocket expenses not covered by medical plans. The participant pays no taxes on the contributions or the withdrawals.

All you need to do is make the payroll deductions and report the funds. Cigna takes care of the rest, including accounting, eligibility verification, claim verification, customer service and reimbursement. The benefits of choosing a Cigna FSA include:

  • A valued resource for employees
  • Potential of reduced costs for employers
  • Automatic claim forwarding option to pay providers directly from the FSA
  • An integrated medical plan

Contact your Cigna representative for more information.


Health Maintenance Organization (HMO)
Our HMO is a doctor-directed, participating health care professional-only plan for employers concerned about controlling costs. The benefits of choosing a Cigna HMO include:

  • Primary care physician (PCP) involvement that can result in early intervention and cost-effective outcomes
  • Referral requirement to see specialists
  • Wellness features and disease management programs

Contact your Cigna representative for more information.


Medical Indemnity

The traditional indemnity plan can help employees take charge of their health care choices, and have the freedom to choose any health care professional, hospital or clinic without a referral or network boundaries. Cigna's exclusive network savings program uses preferred rates to help lower claim costs and out-of-pocket costs for businesses and their employees. The benefits of choosing a Cigna indemnity plan include:

  • Cost control options through flexible plan designs and utilization management
  • Cigna's exclusive Network Savings Program that can lower claim costs and out-of-pocket costs
  • Wellness features and disease management programs

Contact your Cigna representative for more information.


Open Access Plus (OAP)
Cigna's Open Access Plus plan is a solution for employers who want choice, convenience and cost control. We offer access to a national network of health care professionals, hospitals and clinics, and consistent plan designs. The benefits of choosing a Cigna OAP include:

  • Competitive network discounts
  • Flexible plan designs and funding options
  • Cost control through customizable plan designs which can encourage the use of participating health care professionals
  • Encouragement of seeing primary care physicians (PCPs)
  • No referral requirement to see specialists
  • Simplified administration and hassle-free service

Contact your Cigna representative for more information.


Open Access Plus In-Network (OAP-IN)
Cigna's OAP-IN can help control costs by requiring employees to see participating health care professionals to receive coverage under their plan, with the exception of for emergency services. With the plan, you'll get flexible plan designs, funding options and competitive network discounts. The benefits of choosing a Cigna OAP-IN include:

  • Competitive network discounts
  • Flexible plan designs and funding options
  • Cost control by requiring employees to see participating health care professionals, with the exception of for emergency services
  • Encouragement of employees to see primary care physicians (PCPs)
  • No referral requirement to see specialists
  • Simplified administration and hassle-free service

Contact your Cigna representative for more information.


LocalPlus
Cigna's LocalPlus plan is a solution for employers who want to control cost without sacrificing quality or scope services. We offer access to a network of health care professionals, hospitals and facilities in select LocalPlus geographies. The benefits of choosing a Cigna LocalPlus include:

  • Highly competitive discounts in a more concentrated network
  • Flexible plan designs and funding options
  • Cost control through customizable plan designs, which encourage the use of in-network health care professionals
  • Primary care physician (PCP) use encouraged
  • No referral requirement
  • Simplified administration and hassle-free service

Contact your Cigna representative for more information.


LocalPlus In-Network
Cigna's LocalPlus IN can help further control costs by requiring employees to see participating health care professionals to receive coverage under their plan, with the exception of emergency services. We offer access to a network of health care professionals, hospitals and facilities in select LocalPlus geographies. The benefits of choosing a Cigna LocalPlus IN plan include:

  • Highly competitive discounts in a more concentrated network
  • Flexible plan designs and funding options
  • Cost control by requiring employees to see participating health care professionals, with the exception of for emergency services
  • Encouragement of employees to see primary care physicians (PCPs)
  • No referral requirement to see specialists
  • Simplified administration and hassle-free service

Contact your Cigna representative for more information.


Preferred Provider Organization (PPO)
Cigna's PPO option offers choice and convenience, with no referrals required. Customers can choose from a national network with a broad range of health care professionals, hospitals and clinics. The benefits of choosing a Cigna PPO include:

  • Quality and convenience
  • Customizable plan designs and funding options
  • No primary care physician (PCP) requirement and no referral requirement
  • Wellness features and disease management programs
  • Simplified administration and hassle-free service

Contact your Cigna representative for more information.


Network Open Access
Network Open Access provides the benefits of an in-network only plan for cost conscious employers who are looking for choice, convenience and flexibility. This product combines the quality of care from participating health care professionals with referral-free access to see specialists. The benefits of choosing Network Open Access include:

  • No referral requirement
  • Encouragement of employees to see primary care physicians (PCPs)
  • Wellness features and disease management programs
  • Flexible plan design and funding options

Contact your Cigna representative for more information.


Network Open Access Point of Service
Network Open Access POS offers all the benefits of a standard network plan and adds out-of network coverage for cost-conscious employers who are looking for choice, convenience and flexibility. The benefits of choosing Network Open Access Point of Service include:

  • No referral requirement
  • Encouragement of employees to see primary care physicians (PCPs)
  • Out-of network coverage at reduced benefit levels
  • Wellness features and disease management programs
  • Flexible plan design and funding options

Contact your Cigna representative for more information.


Network Point of Service
Network Point of Service offers out-of network coverage at reduced benefit levels. It's designed for cost- conscious employers looking to provide greater access to care. The benefits of choosing Network Point of Service include:

  • Referral requirement to see a specialist
  • Primary care physician (PCP) involvement that can result in early interventions and cost-effective outcomes
  • Wellness features and disease management programs
  • Flexible plan design and funding options

Contact your Cigna representative for more information.

Access (Cost and Quality)

Cigna Care Designation
This Cigna program can help encourage employees to seek care from doctors in 19 specialties in 68 markets who meet additional standards for performance. Specialists must meet objective, evidence-based criteria that includes more than just claims data, using instead a wide range of external and internal evidence.

The benefits of the Cigna Care Network® include:

  • An innovative benefit design that can encourage employees to use specialty care doctors who achieve performance measures
  • Multiple levels of in-network benefits that can provide incentives to use Cigna Care-designated doctors. Employees pay a regular co-pay or coinsurance when they visit a Cigna-contracted specialist, but get lower co-pays or coinsurance levels to access care from a Cigna Care-designated doctor
  • Relevant information for employees on quality and performance
  • An estimated first-year claim cost savings of one to three percent1

Contact your Cigna representative for more information.

Cigna Centers of Excellence
We review how successful a participating hospital or clinic is in treating 29 common conditions and procedures. Hospitals and clinics that deliver better health outcomes at affordable prices earn our top three-star rating. They are identified as Centers of Excellence in search results for hospitals. It's just another way we help employees make informed choices about health care.

Contact your Cigna representative for more information.

Collaborative Accountable Care
Our Collaborative Accountable Care program can help improve the way health systems and health plans work together for our clients and customers, building on the foundation of a patient-centered medical home model and outcomes of an accountable care organization. We do this through frequent communication with doctors, by sharing patient-specific information and establishing a care coordinator to help people manage their health. By working together more closely, we're helping to improve quality, affordability and patient satisfaction.

Contact your Cigna representative for more information.

1The actual savings will depend on many factors including the difference in benefits between the Cigna Care designation tier and the in-network tier, market location and current claim patterns.

Pharmacy

Benefit Design Choices for Clients
Our suite of pharmacy program choices offers the flexibility to select from options such as multiple drug lists (with three and four tiers). We offer preventive medication benefit choices, including waiving deductibles for preventive drugs and promoting use of preventive generic drugs with little or no customer cost share. Our integrated pharmacy clinical programs can help improve health outcomes and lower cost.

Cigna Home Delivery PharmacySM
Get prescriptions delivered directly to your door. Cigna Home Delivery PharmacySM offers refill reminder notices and one-click refills, a customer resolution team dedicated to resolving customer issues, and licensed pharmacists available 24/7 to answer questions.

Exclusive or Incentivized Cigna Home Delivery Pharmacy benefit**
Clients can require (or strongly encourage) customers who take maintenance medications to refill them through Cigna Home Delivery Pharmacy (after a certain number of refills).

**Available for all clients with self-funded (ASO) ERISA plans. Not available in all states for insured plans.

Clinical Programs to Help Improve Health Outcomes 

CoachRx
CoachRx can help customers adhere to their drug therapy. It assists them in overcoming barriers through condition education, refill reminders, incentives and coaching with pharmacists.

Complex Psychiatric Case Management Program
This program can help customers using multiple psychotropic drugs, as well as customers who are seeing primary care doctors, rather than psychiatrists. It involves integration with a behavioral intensive care management program and support from a Cigna behavioral psychiatrist.

Gaps in Care
Gaps in Care focuses on adherence issues and other gaps in care for customers with specific chronic conditions. It includes outreach by health coaches, including case managers and disease management nurses.

Medication Safety Management Program
This program addresses the potential inappropriate use of narcotics and other controlled substances. We offer physicians resources, including integration with behavioral health, disease management and low back pain programs, and investigation support.

Contact your Cigna representative for more information.


Clinical Programs to Help Lower Pharmacy Costs

Clinical Edits

We offer flexibility for clients to choose their level of clinical management edits. This might include:

  • Benefit exclusion-enforces the limits of prescription drug benefits
  • Unit cost and utilization management-manages prescription cost and promotes cost-effective medication alternatives
  • Clinical appropriateness of use-promotes appropriate use of medications

Prospective and Concurrent Drug Utilization Review Edits
This is a series of point-of-service screenings for which claim protocols are consistently applied to prevent risk and costly stock piling. This includes drug-disease interactions, drug-drug interactions, over and under use, therapeutic duplications, refill too soon, duplicate prescriptions, gender, age and pregnancy edits.

Rx Savings Messenger
Rx Savings Messenger educates customers about generic and lower cost preferred brands, as well as the benefits of filling prescription drugs through Cigna Home Delivery Pharmacy. It shows real-time pricing based on customer pharmacy plans and can provide cost-saving solutions to cut down on the amount of mail sent to customers.

Step Therapy
Step Therapy can promote the use of cost-effective prescription drugs and provides the flexibility to use brand-name drugs when medically necessary. Our robust communication program for customers and doctors can foster conversion with little or no disruption in therapy.

Contact your Cigna representative for more information.

Specialty Pharmacy Management
Covered individuals with Cigna Medical and Pharmacy coverage benefit from a holistic and seamless approach to managing their health condition. Employers benefit from our integrated reporting and aggressive unit cost discounts on all specialty drugs through Cigna Home Delivery Pharmacy, regardless of where they are administered. Our unique approach to treating chronic conditions can lower total health costs and improve health and productivity for these individuals.

TheraCare®
This is a targeted condition drug therapy program for customers using specialty prescription drugs for a number of chronic conditions. TheraCare® can help customers better understand their condition, medication side effects and the importance of adherence. This program coordinates with other Cigna health coaching programs.


Contact your Cigna representative for more information.

Seniors and Retiree Services

Seniors and Retirees
Cigna offers many retiree solutions, including Medicare Advantage plans with pharmacy coverage, Medicare Part D plans, retiree drug subsidy support services and Medicare Supplement plans. Our account teams can make it easier to transition active employees to Medicare.

Contact your Cigna representative for more information.

Vision

Vision Preferred Provider Organization (PPO)
Cigna Vision can add value to any Cigna medical or dental plan. It provides both in- and out-of-network coverage through a large national routine vision network. It offers access to quality eye care professionals, claims processing, eligibility and customer service, and no-hassle administration. Cigna Vision is a great addition to any Cigna medical or dental plan. The benefits of choosing Cigna Vision include:

  • A wide range of benefit plans with options for funding (administrative services only and fully insured)
  • Voluntary offerings
  • A national, fully-credentialed network of eye care professionals, including national and regional retail opticals and private practice optometrist and ophthalmologist offices
  • Hassle-free administration, with one monthly statement, one eligibility file and one account manager for all your Cigna Healthcare products


Contact your Cigna representative for more information.

Global

Core Product Offering

  • Cigna Global Health Benefits® Group Medical Plans (Short and Long-term Assignments)
    Cigna offers a range of medical programs for globally mobile group customers. We offer flexible benefit designs, global networks of health care professionals, real-time guarantees of payment and more
  • Individual Medical Plans
    Our Cigna Global Health Options® Individual Medical Plans can work well for globally mobile individuals and their families. Customers can build a plan that’s tailored to their personal situations. They can also select from optional benefits
  • International Business Travel
    We offer group plans designed for international business travelers. These plans provide medical benefits for unexpected illnesses or injuries that may occur while a customer is on a company-authorized business trip outside their home country or country of permanent assignment

Value-added products and services

  • Pharmacy
    Cigna Global Health Benefits offers Cigna Pharmacy Management services, allowing for several options when getting prescription drugs in the United States. We also offer pharmacy benefits and services outside the United States.
  • Dental
    Cigna's dental products can provide employees with discounted access to preventive care and a broad range of other dental services and coverage options. 
  • Vision
    We offer optional vision programs, which can include access to routine eye exams and allowances for frames and lenses.
  • Long-Term Disability (LTD)
    Our long-term disability products pay a portion of an employee’s income to help provide financial protection for globally mobile customers during a covered disability. We actively monitor each case and promote the employee's return to work.
  • Life / Accidental Death and Dismemberment*
    We offer employers Group Term Life plans, along with accidental death and dismemberment (AD&D) coverage. This coverage is available to groups with as few as two employees. We offer several product options
  • Emergency Evacuation and Repatriation / Emergency Assistance
    We offer optional emergency assistance services to help employees have peace of mind when on assignment overseas. Employees can receive access to emergency evacuation and  medical assistance services to help them in an emergency situation and return to his or her home country.
  • Global Wellness Products and Services
    We offer health and well-being assessments, targeted risk assessments and online health improvement programs as part of our global wellness solutions. In addition, we offer Employee Assistance Program products and services.

 

Insurance Products and Services for Globally Mobile Employees
View the Cigna Global Health Benefits website for more information.