Transcript Cigna PowerPoint presentation - St. Charles Community College

St. Charles Community College 2014
Open Enrollment
Cigna Medical, Pharmacy, and Dental Options
Plan Year Beginning– July 1, 2014
Open Enrollment Meetings:
April 23rd - 3:00pm, 5:00pm
April 24th - 10:00am, 1:00pm, 3:00pm
April 29th - 8:30am, 10:00am
Presented by: Amy M. Twitchell, CWPC – Cigna Client Engagement Manager
®
You are one of a kind.
And we want to help you live that way.
That’s why we offer coverage
tools
resources that work for you as an individual –
and ultimately help keep you healthier
2
What’s Changing for 2014?
Medical & Pharmacy Coverage:
 Cigna will be the new carrier for your medical and pharmacy benefits
beginning July 1, 2014.
 You will use the Cigna Open Access Plus (OAP) network of medical
providers and pharmacies.
 You can look up your providers on www.Cigna.com at any time to verify that
your providers are in the Cigna OAP network.
 You can also call 1.800.Cigna.24 for assistance with locating Cigna OAP
providers as well as ask benefit questions 24/7/265.
Dental Coverage:
 No Changes to Dental – Cigna will remaining the carrier for your dental plan
with no changes to the benefits.
 You will continue to use the Cigna DPPO CORE Dental PPO network of
dental providers.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna
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What you need to know…..
Current Year Medical Plan Deductible and Out-of pocket Credit:
Cigna will be honoring any Medical plan Deductibles and Out of Pocket Maximums met from
January 1, 2014 through June 30, 2014 under your prior carrier. We will be receiving this
information and loading into our system to provide the appropriate credit. Medical Claims will be on
hold until this information is loaded, however this will not impact your ability to received
Medical or Pharmacy Services beginning July 1, 2014 with Cigna.
Medical Transition of Care for current treatment by a non-Cigna Provider:
Cigna offers a Transition of Care (TOC) benefit to those who are currently undergoing a major
course of treatment such as chemotherapy or maternity from a provider that is not part of the Cigna
OAP network when your Cigna benefits become effective. It is rare that your current provider will
not be in the Cigna network. The TOC benefit allows you to submit for approval to continue
treatment up to 90 days with your current out of network provider at the in-network level of benefit.
This allows time for you to complete treatment or transition to an in-network provider. Should you
decide to continue to see the out of network provider once the approved TOC period has ended,
those services would fall under the out of network benefit ongoing. TOC forms must be submitted
within 30 days of your effective date.
TOC requests are reviewed by our Clinical staff on a case-by-case basis and we cannot guarantee
all TOC requests will be approved.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna
4
your
options
overview of plans
5
YOUR
MEDICAL PLAN
OPTIONS
Plan year: 2014
862431
Offered by: Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, or their affiliates.
PLANNING FOR MEDICAL EXPENSES
Open Access Plus Plan
OAP1 – Option 1
Single
Deductible
Out-of-pocket
maximum
includes medical copays
and deductible
Plan co-insurance
Single
Family
$500 In-network
$1,000 Out-of-network*
$1000 In-network
$2,000 Out-of-network*
$500 In-network
$1,000 Out-of-network*
$1,000 In-network
$2,000 Out-of-network*
$1,500 In-network
$3,000 Out-of-network*
$3,000 In-network
$6,000 Out-of-network*
$1,500 In-network
$3,000 Out-of-network*
$3,000 In-network
$6,000 Out-of-network*
90% in-network / 70% out-of-network
80% in-network / 60% out-of-network
Unlimited
Unlimited
Lifetime maximum
Doctor Visits
Family
Open Access Plus Plan
OAP2 – Option 2
PCP - $20 copay
Specialist - $30 copay
Plan pays 70% after the
plan deductible is met.
PCP - $20 copay
Specialist - $30 copay
Plan pays 60% after the
plan deductible is met.
Plan pays 100%.
Plan pays 70% after the
plan deductible is met.
Plan pays 100%.
Plan pays 60% after the
plan deductible is met.
Preventive Care
Unlimited. Well baby, well
child, well woman, adult
preventive care. Preventive
labs/screenings.
Immunizations
*If you choose to receive care outside of your plan’s network, only covered expenses will be applied to your
deductible – subject to your plan’s Maximum Reimbursable Charge provisions.
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PLANNING FOR PRESCRIPTION EXPENSES
Open Access Plus Plan(s)
OAP1 – Option 1 & OAP2 – Option 2
Retail
(30-day supply)
Home delivery*
(90-day supply)
Generic (1st Tier)
You pay $10
You pay $20
Cigna-preferred brand (2nd Tier)
You pay $35
You pay $70
Non-preferred brand (3rd Tier)
You pay $60
You pay $120
25% per prescription
25% per prescription
In-network
Self-injectable medications (4th Tier)
4th Tier Self-injectable Out-of-pocket Maximum
*applies to in and out of network retail and home delivery
for 4th Tier Self-injectable medications ONLY. Once the 4th
Tier out-of-pocket max is met, 4th Tier medications are
covered at 100% for the remainder of the year.
Out-of-network
Individual - $2,500
Family - $5,000
Retail
(30-day supply)
Home delivery
(90-day supply)
You’ll pay 50% for all out-of-network prescription medications
regardless of your plan
*You can receive a cost savings by using Cigna Home Delivery for maintenance medications. You will receive
a 90-day supply for the cost of 60-days. That’s a savings of 1 retail copay every 90 days.
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THE BENEFITS OF CIGNA HOME DELIVERY PHARMACY
QUALITY
CONVENIENCE
SAVINGS
• Talk with a licensed
pharmacist on call 24/7/365
• Quick on-time delivery –
overnight if necessary
• Every order quality inspected,
FDA-approved
• Tamper-resistant, confidential
packaging
•
•
•
•
• Possible lower out-of- pocket
cost*
• Shop and compare prices on
myCigna.com or Mobile App
• Free shipping
• We will offer generic versions
of your medication to save
you money
• No charge for supplies
(syringes, needles, etc.)
• Save gas – no trips
to store
Order by phone 24/7/365
Get up to a 90-day supply
Delivery to any location
Refill reminders by phone,
email or text
*Costs and savings opportunity is dependent on your pharmacy plan design.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
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MAKE THE SWITCH. IT'S EASY.
BY PHONE
• Have your medication,
doctor’s name and
your payment
information ready.
• Call 1.800.285.4812.
ELECTRONICALLY
• Ask your doctor to write you
a prescription for a 90-day
supply with refills and send
it electronically to Cigna
Home Delivery Pharmacy.
• This is the easiest way to
fill with us.
• We’ll request a
prescription from your
doctor for a 90-day
supply with refills.
@
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
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EASY ORDERING. QUICK DELIVERY.
@
Submit order
Order filled
Order arrives
Phone or electronically
from your doctor
Check order
status online
anytime
Order is received,
logged and
screened for
exceptions
Checked for
interactions
with other home
delivery orders
Filled by a
registered
pharmacist
Order shipped
Orders ship in 5 days for new, 2 days for refill
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
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how it
works
the claims process
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YOUR CLAIMS PROCESS
Visit in-network
doctor/hospital/
facility.
Show Cigna ID card.
Pay copay or
coinsurance as
required.
You get an Explanation
of Benefits, or “EOB”
(your receipt)
from Cigna.
These examples are used for illustrative purposes only.
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TRACKING YOUR CLAIMS
Explanation of Benefits (EOB)
• Clearly shows how and when claims were paid
• Available in print or online at myCigna.com
• You choose if you would like EOBs mailed to
your home or go paperless and receive email
alerts after each claim is processed and
posted to myCigna.com
Doctor’s fee
Cigna discount
Amount billed
Amount paid to doctor
What you saved
What you owe
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Deductible & Out-of-Pocket Maximum Claim Scenarios**
Example 1A – Option 1 OAP Plan - Family Coverage: Employee
Employee has an outpatient surgery after July 1, 2014. The customer has had 1 Specialist office visit prior to the surgery with a $30
copay under the prior carrier.
– Surgical Date of Service 07/9/2014 - Total Billed $2,000
Cigna receives the claim, applies the contracted discount, and processes the balance per the plan benefit for in-network outpatient
surgery. (Plan pays 90% after deductible)
– Contracted Discount $1,000
– Total Covered Charge $1,000
Cigna checks the Customer’s deductible met to date and shows that $0 has been met, the claim processes as follows:
$1,000 covered amount after discount
- $ 500 applied to In-network Plan Deductible (customer pays to provider)
$ 500 balance after deductible
- $ 450 amount paid by plan (Plan pays 90% after deductible)
$ 50 balance after deductible and plan payment (customer pays to provider)
- Total paid by plan = $450 (90% co-insurance after deductible was satisfied)
- Total paid by Customer $550 ($500 deductible + $50 co-insurance)
- Customer has met $500 in-network plan deductible
- $500 of the Family deductible has been met. $500 of the $1,000 Family deductible remains.
- Customer has met $580 of the Individual out-of-pocket max ($500 deductible + $50 co-insurance + $30 specialist ov copay.)
$920 of the $1,500 Individual out-pocket max remains.
- $580 of the Family out-out-of-pocket has been met. $2,240 of the $3,000 Family out-of-pocket remains.
**scenarios are for illustration purposes only and based on in-network care.
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Deductible & Out-of-Pocket Maximum Claim Scenarios**
Example 1B – Option 1 OAP Plan - Family Coverage: Child #1
SEE EXAMPLE 1A for Employee’s claims example
Child #1 has an outpatient surgery after July 1, 2014. The Child has not had any other services this year.
– Surgical Date of Service 8/04/2014 - Total Billed $3,500
Cigna receives the claim, applies the contracted discount, and processes the balance per the plan benefit for in-network outpatient
surgery. (Plan pays 90% after deductible)
– Contracted Discount $1,500
– Total Covered Charge $2,000
Cigna checks the Family deductible met to date and shows that $500 of the $1000 has been met, the claim processes as follows:
$2,000 covered amount after discount
- $ 500 applied to In-network Plan Deductible – the Family deductible has now been met (customer pays to provider)
$1,500 balance after deductible
- $ 1,350 amount paid by plan (Plan pays 90% after deductible)
$ 150 balance after deductible and plan payment (customer pays to provider)
- Total paid by plan = $1350 (90% co-insurance after deductible was satisfied)
- Total paid by customer $650 ($500 deductible + $150 co-insurance)
- Customer has met $500 in-network plan deductible
- The $1,000 Family Deductible has been met.
- Customer has met $580 towards their $1500 in-network out of pocket max ($500 deductible + $50 co-insurance +
$30 specialist ov copay.)
- $1,230 of the Family out-of-pocket maximum has been met. $1,770 of the $3,000 Family out-of-pocket maximum remains.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
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Deductible & Out-of-Pocket Maximum Claim Scenarios**
Example 1C – Option 1 OAP Plan - Family Coverage: Spouse
•
•
SEE EXAMPLE 1A for Employee’s claims example
SEE EXAMPLE 1B for 1st Child’s claims example
Spouse has an inpatient surgery and 2 PCP Visits and 2 Specialist Visits ($100 in copays) after July 1 2014. The Family Deductible of
$1,00 in-network has been met.
2 PCP Visits – 8/16/2014 & 8/27/2014 - $20 x 2 = $40
2 Specialist Visits – 9/5/2014 & 9/19/2014 - $30 x 2 = $60
Surgical Date of Service 10/3/2014 - Total Billed $50,000
Cigna receives the claim, applies the contracted discount, and processes the balance per the plan benefit for in-network outpatient
surgery. (Plan pays 90% after deductible)
– Contracted Discount $10,000
– Total Covered Charge $40,000
Cigna checks the Family deductible met to date and shows that $500 of the $1000 has been met, the claim processes as follows:
$40,000 covered amount after discount
- $36,000 amount paid by plan (Plan pays 90% after deductible – Family deductible has been met)
$4,000 balance after plan payment
- $ 1,400 customer 10% co-insurance which satisfies the Individual out-of-pocket maximum (customer pays to provider)
$ 270 balance paid at 100% by plan due to the Individual out-of-pocket maximum being met
- Total paid by plan = $36,270 (90% co-insurance + balance at 100% after out-of-pocket max was met)
- Total paid by customer $1,500 ($100 copays + $1,400 co-insurance to satisfy the Individual out-of-pocket maximum)
- Customer has met $1,500 Individual out-of-pocket max
- $2,730 of the Family out-of-pocket maximum has been met. $270 of the $3,000 Family out-of-pocket maximum remains.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
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Deductible & Out-of-Pocket Maximum Claim Scenarios**
Example 1D – Option 1 OAP Plan - Family Coverage: Child #2
•
•
•
SEE EXAMPLE 1A for Employee’s claims example
SEE EXAMPLE 1B for Child #1’s claims example
SEE EXAMPLE 1C for Spouse’s claims example
Child #2 needs a piece of Durable Medical Equipment and 2 PCP Visits and 1 Specialist Visits ($70 in copays) after July 1 2014. The
Family Deductible of $1,00 in-network has been met.
2 PCP Visits – 10/15/2014 & 10/22/2014 - $20 x 2 = $40
1 Specialist Visit – 10/30/2014= $30
DME Date of Service 11/11/2014 - Total Billed $3,500
Cigna receives the claim, applies the contracted discount, and processes the balance per the plan benefit for in-network outpatient
surgery. (Plan pays 90% after deductible)
– Contracted Discount $200
– Total Covered Charge $3,300
Cigna checks the Family deductible met to date and shows that $500 of the $1000 has been met, the claim processes as follows:
$3,300 covered amount after discount
- $2,970 amount paid by plan (Plan pays 90% after deductible – Family deductible has been met)
$ 330 balance after plan payment
- $ 200 customer 10% co-insurance which satisfies the Family out-of-pocket maximum (customer pays to provider)
$ 130 balance paid at 100% by plan due to the Family out-of-pocket maximum being met
- Total paid by plan = $3,130 (90% co-insurance + balance at 100% after out-of-pocket max was met)
- Total paid by customer $270 ($70 copays + $200 co-insurance to satisfy the Family out of-pocket maximum)
- Customer has met $3,000 Family out-of-pocket max
All covered in-network medical services will now be paid at 100% for the entire family for the remainder of the year.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
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Deductible & Out-of-Pocket Maximum Claim Scenarios**
Example 2 – Option 1 OAP Plan - Single Coverage: Employee
•
Employee has an inpatient surgery after July 1, 2014. The Customer had a PCP ov copay of $20 and a Specialist copay
of $30 in January 2014 and met $200 of the in-network plan deductible in February 2014 under the prior carrier.
– Date of Service 09/01/2014
– Total Billed $20,000
Cigna receives the claim, applies the contracted discount, and processes the balance per the plan benefit for in-network
outpatient surgery. (Plan pays 90% after deductible)
– Contracted Discount $4,000
– Total Covered Charge $16,000
Cigna checks the customer’s deductible met to date and shows that $200 has been met, the claim processes as follows:
$16,000
- $ 300
$15,700
- $14,130
$ 1,570
- $ 950
$
620
covered amount after discount
applied to remaining In-network Plan Deductible (customer pays to provider)
balance after deductible
amount paid by plan (Plan pays 90% after deductible)
balance after deductible and plan payment
customer 10% co-insurance which satisfies the out-of-pocket maximum (customer pays to provider)
balance paid at 100% by plan due to the out-of-pocket maximum being met
- Total paid by plan = $14,750 (90% co-insurance + balance at 100% after out-of-pocket max was met)
- Total paid by customer $1,250 ($300 to satisfy the deductible + 10% co-insurance to satisfy the out-of-pocket max)
- Customer has met $500 in-network plan deductible
- Customer has met the $1,500 in-network out of pocket max ($500 deductible + $50 ov copays + $950 co-insurance.)
**scenarios are for illustration purposes only and based on in-network care.
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YOUR
DENTAL PLAN
OPTIONS
Plan year: 2014
862420 Offered by: Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, Cigna HealthCare of Connecticut, Inc., or Cigna Dental Health, Inc. and its subsidiaries.
DPPO
In- and outof-network
coverage
Choice and savings.
Find the right balance for you.
Cigna
Dental PPO - Core
The Cigna Dental PPO is underwritten and/or administered by Connecticut General Life Insurance Company (CGLIC) or Cigna Health and Life Insurance
Company with network management services provided by Cigna Dental Health, Inc. In Arizona and Louisiana, the insured dental PPO plan offered by CGLIC is
known as the CG Dental PPO. In Texas, this insured dental product is referred to as the Cigna Dental Choice Plan.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
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DPPO
CHOICE AND SAVINGS
In- and outof-network
coverage
SAVINGS
• Biggest savings – dentists in the
Cigna Dental Core Network
CHOICE
• The freedom to visit
any licensed dentist
or specialist
CHOICE
SAVINGS
• You can also save money out-ofnetwork – with dentists or
specialists in the Dental Network
Savings Program1
• Save on out-of-pocket costs for
many services not covered under
your plan1
A healthy balance
• Receive Healthy Rewards®2
discounts
1. Dental Network Savings Program (DNSP) is a discount savings program and is not insurance. Availability may vary and is subject to change. Customers receive discounts for out-ofnetwork services received from a dentist participating in the DNSP. Not all providers that participate in DNSP are part of the Cigna network or credentialed by Cigna.
2. Healthy Rewards is a discount program and is separate from your dental benefits. If your plan includes coverage for any of the services offered through Healthy Rewards, this
program is in addition to, not instead of, your plan benefits. Some Healthy Rewards programs are not available in all states and may be discontinued at any time. A discount
program is NOT insurance, and you must pay the entire discounted charge.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
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DPPO
USING YOUR PLAN
• Choose a licensed dentist. NOTE: If you select a
Cigna Dental Core dentist from our Provider
Directory, you will typically spend less
• No ID card needed
• No referral needed to visit a specialist
In- and outof-network
coverage
DPPO − Core
In-network
dentists:
Greater savings
on covered
procedures
• Most Cigna Dental Core Network dentists will
submit claims for you. Your plan will then pay the
dentist or you (based on the claim form)
• The amount your plan pays depends on the
coinsurance level for the service you received, if
you’ve paid your deductible and/or reached your
maximum
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
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DPPO
YOUR COVERAGE
In- and outof-network
coverage
PERCENTAGE YOUR PLAN PAYS
Cigna Dental Core Network
Out-of-network*
Class I – Preventive care
100% no deductible
80% no deductible
Class II – Basic restorative
80% after deductible
50% after deductible
Class III – Major restorative
50% after deductible
50% after deductible
Class IV – Orthodontia
50% up to a lifetime maximum of $1,500
^for dependent children to age 19
Class V - TMJ
50% after deductible, up to a lifetime maximum of $1,500
Individual
Family
Annual deductible
$25
$75
Calendar-year maximum
^applies to Class I, II, and III expenses
$1,500 – per person
*The amount your plan will pay for covered out-of-network services will be subject to your plan’s Maximum Reimbursable Charge provisions.
When going out-of-network, you may be balance-billed by the dentist for any charges that are not covered by your plan.
All plans have exclusions and limitations. Please refer to your Benefit Summary for details about your specific plan.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
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A HEALTHY SMILE AND A HEALTHY BODY
Research shows an association between oral health and medical conditions such
as diabetes, stroke, heart disease, preterm birth and more.
Covered medical condition
Did you know…
Maternity
Pregnant women with untreated chronic gum disease during the second trimester
were up to eight times more likely to give birth prematurely.1
Stroke and heart disease
Those with gum disease may be twice as likely to suffer from heart disease and
stroke.2
Diabetes
Some studies show that gum disease may make it more difficult for people with
diabetes to control their blood sugar.3
Head and neck cancer radiation
Head and neck radiation can harm normal cells, including cells in the mouth.4
Organ transplants
Due to compromised immune systems, organ transplant patients may need
specialized dental care to avoid infections.5
Chronic kidney disease
Researchers found that subjects with gum disease and those with missing teeth
were nearly twice as likely to have chronic kidney disease (60% and 85%,
respectively) compared to those without these risk factors.6
1.
2.
3.
4.
Journal of the American Dental Association, July 2001 “Oral Health During Pregnancy: An Analysis of Information.”
American Academy of Periodontology. (2012, April 18). Gum disease links to heart disease and stroke. Retrieved from www.perio.org/consumer/mbc.heart.htm.
American Academy of Periodontology. (2012, April 18). Gum disease and diabetes. Retrieved from www.perio.org/consumer/mbc.diabetes.htm.
“Head and Neck Radiation Treatment and Your Mouth,” U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Dental and
Craniofacial Research, July 2008.
5. Dental Management of the Organ Transplant Patient. National Institutes of Health. National Institute of Dental and Craniofacial Research. NIH Publication No. 10-6270.
Reprinted October 2009.
6. Colgate World of Care. Reviewed by the Columbia University College of Dental Medicine. Retrieved 12/31/09. www.colgate.com.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
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CIGNA DENTAL ORAL HEALTH INTEGRATION PROGRAM®
Pays 100% for enhanced preventive and periodontal services to help keep you at 100%
More programs
More discounts
More wellness
Available to ALL Cigna
Dental customers with
qualifying condition(s)
Articles on behavioral
issues linked to oral health
Up to 50% off average retail
prices on certain prescription
dental products1
Maternity
Chronic
Kidney
Disease
Organ
Transplants
Head and
neck
cancer
radiation
u
u
u
u
Fluoride – topical application
and varnish5
u
u
u
Sealants5
u
u
u
Covered dental
procedures and
medical conditions
Heart
Disease
Stroke
Diabetes
Periodontal treatment
and maintenance2
u
u
u
Periodontal evaluation
u
Oral evaluation3
u
Cleaning4
u
Emergency palliative treatment
u
The Cigna Dental Oral Health Integration Program is one of the most
comprehensive programs available*. The benefit is all yours.
*Based on an internal market survey conducted from 2008–2012 including over ten leading dental carriers which indicates Cigna
reimburses for more procedures and qualifying conditions than any other carrier reviewed.
1 . December 2010, Cigna Home Delivery Pharmacy Average Retail Price Surveys 2. Four times per year.
3. One additional evaluation. 4. One additional cleaning. 5. Age limits removed; all other plan limitations apply.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
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YOUR DENTAL TREATMENT COST ESTIMATOR
• Convenient, online access to estimate dental care costs
• Helps you to plan and budget
• Specific to your plan information, adjusted for your geographic location
DPPO screen shot
These examples are provided for illustrative purposes only. The Treatment Cost Estimator is for informational purposes and provides rough calculations only, based on the
treatment or procedure you choose. It does NOT guarantee the exact amount of your out-of-pocket costs and it does NOT guarantee coverage for any treatment or
procedure or any dental benefit plan payment. Your actual out-of-pocket cost for dental care will depend on the specific terms of your dental benefit plan.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
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help with
your health
28
RESOURCES FOR MANAGING EVERY STEP OF YOUR HEALTH
•
Use Cigna Healthy Rewards® to save money on health and wellness products and services like fitness clubs,
eyewear, massage therapy and more*
•
Easy-to-use, confidential health assessment gives you an overall health “score” and a personalized report
•
Online coaching programs help you maintain a healthy lifestyle
•
Coverage for preventive care, including immunizations and preventive screenings**
•
A personal health advocate can help you prepare for office visits, improve your lifestyle, reduce your health risks,
explore/choose treatment options and answer questions about health and coverage
•
Programs to help you better manage stress, quit tobacco or lose weight
•
Work with a dedicated health advocate to help you manage your chronic health condition, treatment options and selfcare
•
Easily refill drug orders, track shipments and get in touch with a pharmacist at any time on our Cigna Home Delivery
Pharmacy page on myCigna.com
•
Compare real-time drug prices specific to your plan with our Prescription Drug Price Quote Tool to see if there is a
lower cost option – helpful for 4th Tier self-administered injectable medications.
•
TheraCare coaches trained as nurses can help guide you if you’re dealing with complex conditions that require a
specialty pharmacy.
*Healthy Rewards is a discount program and is separate from your medical benefits. If your plan includes coverage for any of the services offered through Healthy Rewards, this program is
in addition to, not instead of, your plan benefits. Some Healthy Rewards programs are not available in all states and may be discontinued at any time. A discount program is NOT
insurance, and you must pay the entire discounted charge.
**Subject to the terms of your plan. All plans have exclusions and limitations. See your Benefit Summary and enrollment materials for details about the services covered under your plan.
29
YOUR FAMILY HEALTH
• Healthy Babies, Healthy Pregnancies Incentive education program helps every mom and baby
get a healthy start
• Fit and Fun Family Toolkit created by the Healthy Kids Challenge® offers tips and activities to
keep your family healthy and active
• Reminders to help you stay up-to-date on childhood immunizations
• Alerts can be sent to you and your doctor when we see a missed preventive screening, like a
mammogram or colonoscopy
• Cigna and Everyday Health ValuesSM provides coupons to help make it easy to save on many of
the everyday health and wellness products you buy at the supermarket.* Visit us at
www.Cigna.com to start saving!
*The Everyday Healthy Values trademark is owned by CoOptions, Inc. and this website is
provided by Coupons.com.
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how we
can help
tools and resources
31
MAKING SURE YOU’RE GETTING QUALITY CARE
!
Quality and cost
ratings let you
compare doctors
and hospitals
Online resources let
you check for
dangerous drug
interactions
Alerts are sent to
you and your
doctor if we see or
anticipate possible
gaps in care; for
example, if you
don’t refill a
prescription needed
to treat a chronic
condition
Our case managers
work with you and
your doctors to help
them develop a
complete care plan
if you are
hospitalized with a
serious illness or
injury
32
SAVING YOU TIME
• Find a dentist, doctor, hospital, pharmacy or other health facility whenever you need one –
online, by phone or on the go with any web-enabled device*
• Easy-to-use decision support information and tools on myCigna.com and
myCigna mobile app
– Compare treatment and procedure costs
– Find cost and quality ratings for doctors and hospitals
– Find lower cost prescription drugs and pharmacies
•
Keep track of your health history and records with a secure online personal health record
• Switch a prescription to Cigna Home Delivery Pharmacy with one easy phone call and get
90-days of your medications delivered to your door so you don’t miss a dose
• Speak with a Registered Nurse 24/7 – 24-Hour Health Information Line
Talk with a coach,
trained as a nurse
when you can’t
reach your doctor
No claim
forms
needed
in-network
*Your carrier’s standard mobile phone and data usage charges apply.
33
WE’RE HERE FOR YOU
By phone – 1.800.Cigna.24 (1.800.244.6224)
• Call us anytime day or night – live, 24/7 customer service, 365 days a year – including holidays.
• Speak to us in your preferred language – interpreter service is available in over 150 languages
Prefer to go online?
• Visit your personalized Cigna site www.myCigna.com**






Award-winning* directory of doctors, hospitals, facilities with cost and quality ratings
Coverage details (copays, deductibles, out-of-pocket maximums, etc.)
Claim activity and history
Temporary ID cards or info on how to order new ones (myCigna.com only)
A wealth of health information and resources (myCigna.com only)
Savings on prescription medications when ordered through Cigna Home Delivery Pharmacy® (myCigna.com only)
On the go? We have an App for that!
• myCigna.com Mobile App – available for Apple & Android devices
 Gives you access to almost all of the myCigna tools and resources…on the go!
 Carry your Cigna ID Cards right on your device
**myCigna is available to current Dental participants, Medical/Rx information available as of July 1, 2014
34
how to
enroll
get ready to smile
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
35
YOUR ENROLLMENT
!! IMPORTANT DATES !!
• 2014 OPEN ENROLLMENT PERIOD:
 April 28, 2014 to May 9, 2014
• ALL ENROLLMENT FORMS MUST BE TURNED IN BY:
 May 9, 2014
Don’t Forget…
Cigna Pre-enrollment Information Line: Available to answer questions about the Cigna Medical,
Pharmacy, and Dental plans 24/7 starting now by calling 1.800.Cigna.24 (1.800.244.6224) and
identifying yourself as an employee or employee’s dependent of St. Charles Community College.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
36
Q&A
what you want to know
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
37
Health care professionals who participate in Cigna’s network are independent contractors solely responsible for the treatment provided and are not agents of Cigna. The
information in this presentation summarizes the highlights of your plan. For a complete list of both covered and not covered services, including benefits required by your state,
see your employer’s group insurance certificate, summary plan description or group service agreement – the official plan documents. If there are any differences between the
information in this presentation and the plan documents, the information in the plan documents takes precedence.
“Cigna,” the “Tree of Life” logo, “GO YOU,” “TheraCare” and “Healthy Rewards” are registered service marks, and “Cigna Home Delivery Pharmacy” is a service mark, of
Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided by or through such operating
subsidiaries and not by Cigna Corporation. Such operating subsidiaries include Connecticut General Life Insurance Company (CGLIC), Cigna Health and Life Insurance
Company (CHLIC), Tel-Drug, Inc., Tel-Drug of Pennsylvania, L.L.C., Cigna Onsite Health, LLC, Cigna Behavioral Health, Inc., Cigna Health Management, Inc., and HMO or
service company subsidiaries of Cigna Health Corporation, including Cigna HealthCare of Arizona, Inc., Cigna HealthCare of California, Inc., Cigna HealthCare of Colorado,
Inc., Cigna HealthCare of Connecticut, Inc., Cigna HealthCare of Florida, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of Illinois, Inc. (IL & IN), Cigna HealthCare
of Indiana, Inc., Cigna HealthCare of St. Louis, Inc. (MO, KS & IL), Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of New Jersey, Inc., Cigna HealthCare of South
Carolina, Inc., Cigna HealthCare of Tennessee, Inc. (TN & MS), and Cigna HealthCare of Texas, Inc. “Cigna Home Delivery Pharmacy” refers to Tel-Drug, Inc. and Tel-Drug
of Pennsylvania, L.L.C. In Texas, Open Access Plus and LocalPlus plans are considered Preferred Provider plans with certain managed care features and Open Access Plus
IN and LocalPlus IN plans are considered Exclusive Provider plans with certain managed care features. All models are used for illustrative purposes only.
862431 07/13
© 2013 Cigna. Some content provided under license.