Transcript Slide 1

CIGNA Consumer-Driven Health Care
HSA-qualified HDHP Program Overview
For employers with 50 or fewer employees
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Today’s Discussion

Growth of Consumer-Driven Health Plans

The CIGNA Approach To Consumer-Driven Health Care

HSA Overview

Engagement and Advocacy

Service Experience and Employee Education
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Consumer-Driven Health Momentum
Has Reached All Segments
All employers (>1,000)
Large employers
Mid-size employers
Small employers
Currently Offer*
Offer by 2007
16%
38%
20 - 25%
50%
5 – 8%
33%
Under 3%
33%
Optional Slide
* end of 2004
Forrester Research. Employers Sound Off on CDHPs, May 2005.
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Approach To
Consumer-Driven Health Care
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What We Stand For
Optional Slide
Improve health.
It’s our single focus.
It means we stand for care that is effective
and personal choices that matter.
It means we connect the health of your employees
to the health of your business.
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Our Approach
Improve Health – Control Costs
Consumerism: personal choices that matter

Enabling informed healthcare decisions
Health Advocacy: care that’s effective

Delivering integrated care for superior clinical outcomes
Actionable Information: connecting employee health to the health of
your business

Providing consumers with the tools they need to make informed
decisions about their health
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HSA Overview
Definitions
Health Savings Account

A tax-exempt trust or custodial account created exclusively to pay for the
qualified medical expenses of the account holder and his or her spouse or
dependents.

Covers all medical expenses listed in IRC section 213(d)

Can be used only in conjunction with a qualified high-deductible health plan

Funded with actual dollars

Remains the property of the account holder; no “use it or lose it” rules
High-Deductible Health Plan

A medical plan that meets certain criteria set by the federal government
Minimum Deductible*
$1,100 single / $2,200 family
Out-of-Pocket Maximum*
$5,500 single / $11,000 family
* These are 2007 limits. Limits for future years will be set by the IRS.
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Working Together
The Health Plan
A high deductible health plan (HDHP) is
required for an HSA
Minimum Deductible*:


Maximum Out of Pocket*:

100%
Coverage
$1,100 Single / $2,200 Family
$5,500 Single / $11,000 Family

Deductible and covered expenses
apply to out-of-pocket maximum

100% Preventive coverage recommended

One deductible amount for Medical and
Pharmacy
100% Preventive Care

HighDeductible
Health Plan
(coinsurance)
$
Health Savings
Account
Deductible
*2007 Federal Limits
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HSA Overview
Funding
Employer and/or Employee
Maximum: Lesser of in-network deductible
or annual limit set by IRS (For 2007, $2,850 for
individuals/$5,650 for families)
Tax Advantages
Account balances & Investment earnings grow tax-free
Withdrawals for qualified expenses are tax-free
Account Ownership
Employee
Flexibility
Employee chooses to use or save $
Portability
Yes. Employee owns the fund
Annual Rollover
Yes
Qualifying Expenses
213(d) medical expenses not covered by HDHP, longterm care, COBRA
CIGNA Advantages
•HSA banking option powered by JPMorgan Chase
•Industry-leading consumer decision support tools, including WebMD® suite of tools
•Leading clinical resources
…Helping create more engaged consumers and lower medical costs.
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CIGNA Plan Design Options
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Tax Advantages of an HSA*


Tax-Free Contributions

Employee contributions: income tax-free

Employer contributions (optional): Deductible for employer;
not taxable for employee
Tax-Free Interest and Investment Gains


Interest and gains accrue tax free while they remain in the
HSA
Tax-Free Withdrawals

Withdrawals for a qualified medical expense are not taxed

Other withdrawals incur income taxes plus 10% penalty (<65)
*In Alabama, California, New Jersey, and Wisconsin, contributions are prior to federal
taxes but after state income taxes. Employer contributions, earned interest and investment
income are taxable as gross income for state income tax purposes.
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Engagement and Advocacy
CIGNA Resources Address the
Continuum of Consumer Health Needs
Health Promotion
Lifestyle Management
Disease Management
Care Management
Number of members impacted
Goal:
Keep everyone well
Healthy
Help  Assess  Target
Cost of medical care per member
7% of cost; 43% of members
Goal:
Prevent from migrating to more chronic/acute condition
At Risk
10% of cost; 22% of members
Goal:
Minimize impact of illness
Chronic
35% of cost; 18% of members
Goal:
Resolve acute illness impact as quickly and effectively as possible
Acute
48% of cost; 17% of members
CIGNA
Programs

Health Risk Assessment

Physician report card and
member reminder mailings

Prenatal/Maternal Care

Work/Life Balance

Preventative Care Programs

Discounts on Health &
Wellness services

Tobacco Cessation

Cardiac

Asthma
 Cancer
 Musculoskeletal

Weight Loss

Depression

 Inpatient
Stress Management

Diabetes
Low Back
Pain
 High


COPD
 Neonatal
 Intensive

10 Secondary
“targeted
conditions”

Substance Abuse

Obesity
Risk
Maternity
Intensive
Care
Management
Behavioral
 Transplant
 Extended
care
Health advocacy services to engage, navigate and facilitate
services across the continuum of care
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Consumers, Armed With
Right Information, Can Take Action
Criteria
The
Diagnostic Lab
Drug
Outpatient
Surgery
Opportunity to
plan
MRI
Prozac
Arthroscopic
Joint surgery
Price variation
Hospital vs.
Stand-alone
imaging centers
Brand vs. Generic
Retail vs. Mail
Hospital vs.
Stand-alone
surgery center
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The Key: myCIGNA.com

Review benefit
coverage levels

Track account
balance, claims
and payments

Support
important health
decisions

Cost and quality
information

Read
personalized
messages
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Health Risk Assessment
 15-minute questionnaire
helps determine
accurate personal
health status
 Employs 5,000+
calculations that screen
for over 21 clinical risk
factors
 Results are integrated
with CIGNA’s Disease
Management Programs
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Procedure Pricing Tool
Saint Hospital
Community Hospital
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Prescription Pricing Tool
• Members select
pharmacy and drug
• Receive actual price
they’ll pay
LOCAL PHARMACY
123 MAIN STREET
HOMETOWN, ST 00000
(555) 123-4567
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Hospital Quality Information
Saint Hospital
123 Main Street
Hometown, ST 00000
(123) 555-1234
Community Central
Hospital
123 Center Street
Hometown, ST 00000
(123) 555-5678
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Hospital Quality Information

Hospital information tool
allows members to
compare hospitals based
on data for 164 surgical
and medical procedures

Personalized with In/Out
of Network indicators to
help members
understand financial
implications of decisions

Physician Surgical
Volume results will be
included in limited areas
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Service Experience and Employee
Education
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CIGNA HSA-qualified HDHP
when powered by JPMorgan Chase
We have capitalized on the strengths of both organizations
to deliver an empowered HSA
CIGNA
JPMorgan Chase
■ HDHP claim adjudication
■ Debit card/checkbook processing
■ JD Power certified customer service
■ Financial service specialists
■ Large National Network
■ Interest crediting
■ Medical management
■ Scheduled and unscheduled
■ Decision support tools
deposits
■ Investment options
■ Enrollment and communication support
CIGNA Advantages
Employer
 An affordable alternative to health care
 Provides employees with savings
opportunity
 Potential for reduced claim costs
Consumer
 One toll-free member services
number
 Combined web experience via
myCIGNA.com and link to JPMC
 Online bank application and
signature
 100% Preventive Care coverage
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Two Ways to Access HSA Dollars
if account is established through JPMorgan Chase…


HSA Debit Card
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Visa® branded, issued by Chase

Can be used at ATM as well
Checkbook
Two Ways to Track Utilization
if account is established through JPMorgan Chase…
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
myCIGNA.com

Access to claim transactions and history

Link to JPMC member website
JPMorgan Chase Member Website

Access to Health Savings Account transaction and balance information

General Information (including investment options) available
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Improve Health – The CIGNA Advantage
A more aware health care consumer
Member Education
Open Enrollment
Personalized Media
Provider Outreach
Member activities
24-Hour
Nurse Line
Clinical guidance
and care
support
Behavior Change
Lifestyle
Management
myCIGNA.com,
WebMD,
800.CIGNA24
Education
Clinical Programs:
Outreach triggers:
• Health promotion
• Disease
Management
• Care Management
• Health risk assessment
• Predictive model
• Integrated data
• Referrals
CIGNA Health Advocacy & Clinical Resources
CIGNA
activities
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Simplifying Your Communication Needs

Access to
communication
materials

Newsletters

Business
activities
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Using Communications
To Build Active, Engaged Members
ENROLLMENT
POST-ENROLLMENT
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Awards And Recognition Demonstrate
CIGNA’s Commitment To The Consumer
Optional Slide
“CIGNA has catapulted itself into the top ranks”
- Consumer Driven Market Report, September 2004
#1 in Health Sector IT
- 2006 InformationWeek 500
2005 Health Plan/
Managed Care Organization
Disease Management
Leadership Award
Best Technology &
Communications Introduced by
a Health Plan Organization for
Employee/Consumer Choice
– Disease Management
Association of America
– 2005 Consumer Directed Health
Care Conference & Expo
America’s
Best Health
Plans
NCQA
– 2005 CIGNA Plans
Recognized
NCQA
Highest Effectiveness of Care
Measures
5 years in a row
(2001 – 2005)
Top 100 IT Innovators 2005
for technology
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