review the cigna presentation -
TRANSCRIPT
2 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 2
Medical
3 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
Medical Plan Highlights For 2014
• Orange County Government has chosen to partner with
Cigna for both our medical and prescription plans.
• Each family member will receive an ID card with their own
name listed. This will be a combined medical and
prescription card. (4 ID cards per envelope)
• Orange County Government is pleased to announce
there are no plans changes or increases in premium.
• We will continue to offer two medical plans allowing our
employees to choose the best plan for you and your
family.
4 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
How To Find A Provider
Before January 1, 2014
• Visit www.Cigna.com
• Select “Find A Doctor” in orange on the top of the screen
• Search by person or place by entering the provider name
or specialty
• Enter your desired address
• Select “Search”
• Once the providers appear, narrow the search by Plan
• Click on “Select a Plan” in orange
• Select the “Open Access Plus, OA plus, Choice Fund OA Plus” radio
button
5 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 5
Cigna Medical Plans Choice Fund OAP HSA
In-Network Out-of-Network
OAP Low Plan
In-Network Out-of-Network
Employer HSA Contribution $750 EE
$1,250 Family None None
Plan Year Deductible $1,250 EE
$2,500 Family
$3,000 EE
$6,000 Family
$500 EE
$1,000 Family
$1,000 EE
$2,000 Family
Out-of-Pocket Maximum (includes deductibles & copays)
$2,400 EE
$4,800 Family
$6,000 EE
$12,000 Family
$1,500 EE
$3,000 Family
$6,000 EE
$12,000 Family
Preventive Care $0 40% after ded $0 40% after ded
Primary Care 20% after ded 40% after ded $20 40% after ded
Specialist 20% after ded 40% after ded $35 40% after ded
Diagnostic Lab & X-ray 20% after ded 40% after ded
$20 / $35 Copay
(physician’s office) or 20%
after ded (outpatient)
40% after ded
Advanced Radiology
Imaging (MRI, CAT, PET) 20% after ded 40% after ded
Covered 100%
(physician’s office), 20%
after ded (outpatient)
40% after ded
Inpatient 20% after ded 40% after ded 20% after ded 40% after ded
Outpatient 20% after ded 40% after ded 20% after ded 40% after ded
Convenience Care Clinic 20% after ded 40% after ded $20 40% after ded
Urgent Care 20% after ded 40% after ded $40 40% after ded
Emergency Room 20% after ded 20% after ded
6 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
Know Before You Go
7 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
Transition of Care (TOC)
• Allows you to continue to receive services for specified medical
and behavioral conditions for a defined period of time with
health care professionals who do not participate in the Cigna
network
• You must apply for TOC at enrollment or no later than 30 days
after January 1, 2014
• Examples:
• Pregnancy in the 2nd or 3rd trimester on 1/1/14
• Newly diagnosed or relapsed cancer in the midst of chemotherapy,
radiation therapy or reconstruction
• Trauma
• Transplant candidates, unstable recipients or recipients in need of ongoing
care due to complications associated with a transplant
• See the Transition of Care brochure for a full listing of
conditions that may apply
8 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 8
Cigna Pharmacy Plans
Choice Fund OAP HSA
In-Network Out-of-Network
OAP Low Plan
In-Network Out-of-Network
Preventive Drugs
Before and after your deductible is met, you pay
according to the 3-tier schedule below
Note: Does not count towards your deductible, but does
count towards your out-of-pocket max
You pay according to the 3-tier schedule below
Note: Prescription copays do not count towards your
deductible, but do count or out-of-pocket max on this
plan Treatment Drugs
You pay full price until your deductible is met.
AFTER your deductible is met, you pay
according to the 3-tier schedule below.
Retail (30 day supply)
Generic Smoking
Cessation $0 $0
PPACA No Cost
Preventive
Medications
$0 $0
Preventive Drug List Deductible Waived, then you pay according to
the 3-tier schedule below
Does not apply as there is not a deductible for
pharmacy
Generic $10
40% after ded
$10
40% after ded Preferred Brand
You pay 10% plus a $30
copay. (Coinsurance will apply
before the copay)
You pay 10% plus a $30
copay. (Coinsurance will apply
before the copay)
Non-Preferred
Brand
You pay 10% plus a $50
copay. (Coinsurance will apply
before the copay)
You pay 10% plus a $50
copay. (Coinsurance will apply
before the copay)
9 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 9
Cigna Pharmacy Plans
Choice Fund OAP HSA
In-Network Out-of-Network
OAP Low Plan
In-Network Out-of-Network
Preventive Drugs
Before and after your deductible is met, you pay
according to the 3-tier schedule below
Note: Does not count towards your deductible, but does
count towards your out-of-pocket max
You pay according to the 3-tier schedule below
Note: Prescription copays do not count towards your
deductible, but do count or out-of-pocket max on this
plan Treatment Drugs
You pay full price until your deductible is met.
AFTER your deductible is met, you pay
according to the 3-tier schedule below.
Home Delivery (90 day supply)
Generic Smoking
Cessation $0 $0
PPACA No Cost
Preventive
Medications
$0 $0
Preventive Drug List Deductible Waived, then you pay according to
the 3-tier schedule below
Does not apply as there is not a deductible for
pharmacy
Generic $25
40% after ded
$25
40% after ded Preferred Brand
You pay 10% plus a $75
copay. (Coinsurance will apply
before the copay)
You pay 10% plus a $75 copay. (Coinsurance will apply before the
copay)
Non-Preferred
Brand
You pay 10% plus a $125
copay. (Coinsurance will apply
before the copay)
You pay 10% plus a $125
copay. (Coinsurance will apply
before the copay)
10 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
Global Step Therapy
Cigna Pharmacy Management offers step therapy for
several common ongoing medical conditions:
• ADD / ADHD - NEW
• Allergy
• Asthma - NEW
• Bladder Problems - NEW
• Cholesterol Lowering
• Depression – NEW
• Heartburn / Ulcer
• High Blood Pressure
• Mental health - NEW
• Narcotic pain relievers – NEW
• Non-Narcotic pain relievers (NSAID) – NEW
• Osteoporosis
• Skin conditions
• Sleep disorders - NEW
11 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
What happens if I already went through step
therapy or I am going through it on 1/1/14?
• Cigna will allow a 60-day introduction period to educate you
about the program and no drugs will be denied for step
therapy during this time frame (1/1/14 – 2/28/14).
• If a step therapy drug is filled between 1/1/14 and 2/28/14,
Cigna will mail a personalized letter to the member to notify
them they are taking a step therapy drug and what to do
next.
• After March 1st we will still allow one more claim to pay and
we will then notify both the member and the physician.
• If the member has already met the pre-requisite, the
physician can coordinate with Cigna Pharmacy via phone
or fax.
12 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
Specialty Prescriptions
• A specialty drug is defined as being derived from
biotechnology processes or a small molecule. These drugs
treat the underlying disease which is considered to be rare
and chronic. Specialty drugs require special handling and
close supervision when being administered.
• During the transition from Express Scripts, Cigna Specialty
Pharmacy Coaches will reach out to specialty members to
assist with their transition.
• The Specialty Coaches will introduce the member to Cigna
Specialty Pharmacy, order new prescriptions for the
member and coordinate prior authorizations with the
physician.
13 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
How will Prior Authorization work during the
transition?
• Cigna will honor Express Scripts (ESI) authorizations
and it will be managed through a file transfer process
prior to the effective date.
• ESI will send a file of the active authorizations. Cigna
will load the authorizations with a start date of 1/1/14
and use the end date indicated on the file from ESI.
• After the authorization expires, the member will need
to obtain authorization again, just as they would have
with ESI.
14 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
Will there be any formulary changes when our
prescriptions move from Express Scripts to Cigna?
• Yes – there are a few differences from Express Script’s
preventive list and Cigna’s list • Preventive Immunizations will now be covered under the
medical, not pharmacy as it was under Express Scripts.
They are still no cost to you.
• Cigna will send letters to notify the customers of the
drug tier change for the patients negatively affected by
the change.
• Those negatively affected will be moved from preferred
brand (2nd tier) to non-preferred brand (3rd tier).
• A current list of Cigna’s prescription drugs can be found
on Orange County’s HR intranet.
15 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
Home Delivery (Optional)
Mail:
1.Request that your doctor write you a prescription for a 90-day
supply with refills.
2.Download an order form from www.myCigna.com
3.Mail the completed order form, prescription and payment to us.
Phone – Cigna’s Quick Switch Program:
1.Have your medication, doctor’s name and credit card information.
2.Call 1.800.285.4812
We’ll request a prescription from your doctor for a 90-day supply
with refills.
16 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
Home Delivery – Cigna Free Diabetes Meter Program
• On your pharmacy plan, there are two diabetic test strip products that are
lower-cost, preferred brands.
• The preferred diabetic test strip products include ACCU-CHEK® from Roche
Diagnostics and One Touch® from LifeScan, a Johnson & Johnson
Company.
• If the diabetic test strips you are currently using are not a preferred brand,
you may be paying a higher amount or you may not have coverage for your
current diabetic test strips.
• Each of the four glucose systems listed below uses one of the preferred
brand diabetic test strips:
AccuChek Aviva Plus System OneTouch Ultra 2 System
AccuChek Nano SmartView System OneTouch UltraMini System
OneTouch Verio IQ System
17 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 17
Health Savings Account
18 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
Health Savings Account
• United HealthCare partnered with Optum Bank as their
banking partner
• Cigna has partnered with JP Morgan/Chase as their
banking partner
• Effective January 1, 2014 Orange County Government is
transferring the HSA administration from Optum Bank to
Chase (Cigna’s banking partner).
• You will need to open your HSA with Chase during Open
Enrollment on www.myCignaplans.com
19 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
High Deductible Health Plan with HSA
IRS Requirements
2014 2013
Single Family Single Family
Orange County Contribution $750 $1,250 $750 $1,250
Maximum Employee Contribution $2,550 $5,300 $2,500 $5,200
Maximum HSA Contribution $3,300 $6,550 $3,250 $6,450
Catch up Contribution
(Age 55-65) $1,000 $1,000
HSA – Are You Eligible?
In order to open and make and/or receive contributions to an
HSA, an individual:
• Must be covered by a federally qualified high deductible health
plan (HDHP)
• Cannot have any other medical coverage, including a spouse’s
FSA, unless the other medical coverage also qualifies as a
federal HDHP and the individual is covered as a dependent by
the secondary plan
• Must not be enrolled in Medicare or TRICARE
– When an individual is enrolled in Medicare, they have a medical coverage in
addition to the HDHP plan which renders them ineligible to make or receive
HSA contributions.
• Cannot be claimed as a dependent on someone else’s tax
return.
20 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
HSA Online Tools
21 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
Take advantage of the convenience of www.myCigna.com
and its many easy-to-use resources, such as:
• Online access to your current account balance, past transactions and
claim status
• Online bill pay and fund transfer features
• Text and email alerts that best meet your needs
• Cost and Quality comparisons for specific medical procedures and
treatments
• Lists of medical expenses that qualify for coverage by your plan
• Tools to help you assess, track and manage your personal health
• Frequently asked questions – about health care in general and Cigna
Choice Fund specifically
• Health statements which show claim activity, payments made from
your account, and your current account balance
22 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 22
Wellness Programs
23 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
Cigna 24/7 Customer Assistance
• One toll-free number – on the back of the Medical ID card
• Specially-trained Customer Service Representatives
answer questions
• Find a Doctor
• Check Your Coverage
• Ask About a Claim
• Talk to a Trained Nurse about Health Conditions
• Listen to more than 1,000 topics recorded in our Health
Information Library (HIL)
• Access Health Coaching Programs
• Don't wait for "normal business hours”
(800) Cigna24
24 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 24
• Maternity education program
• No additional purchase required
• Participants opt-in
• Participant receives:
• $400 incentive for calling during the 1st trimester
• $200 incentive for calling during the 2nd trimester
• Guidelines for a healthy pregnancy and baby
• Information on important pregnancy health issues
• Information on prenatal care from the March of Dimes
• A list of informative online and telephone resources
• 24 hour toll-free access to registered nurses
Healthy Pregnancies, Healthy Babies
25 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 25
Personal Health Assessment • Taking a health assessment is a quick and easy way to determine the current
state of your overall health and to figure out what steps you need to take now
to improve your health in the future.
• Effective January 1st, 2014 you may select to take your health assessment on
www.myCigna.com.
• After completing the health assessment, you’ll receive a wellness score based
on how you compared to people in your gender and age group. You’ll be
surprised how just a few simple changes can improve your wellness score
significantly.
• You will also get recommended next steps to help you get started on a path to
better health. And based on your responses, you may also receive a web
invitation to join one of our Online Health Coaching Programs for the support
you need to get healthy and stay healthy.
26 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 26
Personal Health Coaching
• A health advocate, nurse, health educator or behavioral health specialist may be calling you to get your healthy lifestyle started.
• You may also call Cigna’s Coaches to get started anytime at (855) 246-1873.
• We can help you:
– Manage a chronic condition
– Create a personal care plan
– Understand medications or doctor’s orders
– Identify health risk that could affect your condition
– Make educated decision on your treatment options
– Know what to expect if you need to spend time in the hospital
– Improve your lifestyle by coping with stress, quitting tobacco use, maintaining good eating habits and managing or losing weight.
27 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 27
Online Coaching
• There are a variety of self-service resources to help you better understand your condition and overcome barriers to better health
– Articles and podcasts on hundreds of health topics
– Online Programs with email campaigns to help you with lifestyle issues like weight, stress, tobacco use, depression and anxiety and living with a medical condition
– A tool to help you understand your condition and make more informed decisions with actual cost information down to the procedure in your doctor’s office, hospital or pharmacy
28 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 28
Online Coaching (continued)
29 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 29
• Work directly with your personal health coach to:
– Lose Weight with Healthy Steps to Weight Loss
– Cope Better with Stress with Strength & Resilience
– Quit Smoking with Quit Today Tobacco Cessation Program
• Call (855) 246-1873 to set up an appointment with your coach today
Lifestyle Management Programs
30 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
• Value-added health and wellness member discount program up to 40% discount
• No claim forms or physician referrals; members pay discounted rate for services
• Over 12,000 fitness facilities including Curves, Anytime Fitness, select Gold's Gym, Jazzercise, Snap Fitness and other chain/local centers
• Alternative Medicine featuring over 31,000 chiropractors, acupuncturists, massage therapists, and Registered Dietitians
• Weight Management Programs
• Tobacco Cessation Programs
• Online store featuring: – Vitamins, supplements, herbal products & personal body care
– Dental products
– Homeopathic remedies & natural products
– Diet & sports nutrition
– Yoga & fitness activities
– Books, audio, video & DVDs
Healthy Rewards®
31 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
• Get free coupons now and save on your next grocery bill.
• Cigna and Everyday Healthy ValuesTM makes it easy to save
on many of the health and wellness products you buy at the
supermarket.
• Here’s how:
1. Visit everydayhealthyvalues.com and choose your coupons
2. Print your coupons
3. Save instantly at checkout
4. Share with your family, friends and neighbors (everyone can save)
• Stop paying more for healthy goods. Start saving today.
EveryDay Healthy Values
32 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 32
Cigna’s Cost
Transparency Tool
33 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 33
Cigna’s Exclusive Cost Transparency Tool
34 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 34 34
Cigna’s Exclusive Cost Transparency Tool
35 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 35 35
Cigna’s Exclusive Cost Transparency Tool
36 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 36 36
Show Me the Math
Cigna’s Exclusive Cost Transparency Tool
Outpatient Facility vs. Inpatient Hospital
37 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 37
Cigna’s Mobile App for iPhone and Android
• Access and view health fund balances.
• Review plan deductibles and coinsurance.
• Store and organize all important contact info
for doctors, hospitals, and pharmacies.
• Add health care professionals to your contact
list right from a claim or directory search.
• AND MUCH MORE!!!
38 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 38
Dental
39 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
Dental Plan Highlights For 2014
• Orange County Government has chosen to partner with
Cigna for our dental plans.
• An ID card is not needed for the dental plans. (if dentist
requests your ID number – you can present your medical ID card)
• Orange County Government is pleased to announce
there are no plans changes. There is a slight increase to
the premium but there is also an enhancement to the
annual maximum.
• We will continue to offer three dental plans allowing our
employees to choose the best plan for you and your
family.
40 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
How To Find A Dental Provider
Before January 1, 2014
• Visit www.Cigna.com
• Select “Find A Doctor” in orange on the top of the screen
• Search by person or place by entering the provider name
or specialty
• Enter your desired address
• Select “Search”
• Once the providers appear, narrow the search by Plan
• Click on “Select a Plan” in orange
• Select the Dental Plan “Cigna Dental PPO or EPO” radio button and
select the “Radius” network
• Click on “Select”
41 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 41
Dental PPO
Radius Network
Low Plan Middle Plan High Plan
Calendar Year Maximum $1,000 $1,000 $1,500
Calendar Year
Deductible
$50 – Employee
$150 – Family
$50 – Employee
$150 – Family
$50 – Employee
$150 – Family
Class 1: Preventive &
Diagnostic 100% - no deductible 100% - no deductible 100% - no deductible
Class 2: Basic
Restorative Care
Paid according to
Schedule of Benefits 70% after deductible 80% after deductible
Class 3: Major
Restorative
Paid according to
Schedule of Benefits 40% after deductible 50% after deductible
Class 4: Orthodontia
(Children only: Up to age
19)
Not Covered 40%, no orthodontia
deductible
50%, no orthodontia
deductible
Class 4: Ortho Lifetime
Max N/A $1,000 $1,000
Out-of-Network
Reimbursement
Based on Contracted Fee Schedule (for location of service rendered); dentist may balance bill up to usual fees. Class 1 only.
70th Percentile 80th Percentile
42 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 42
Dental PPO Claim Example –
In-Network vs. Out-of-Network
Sample Claim for a Crown:
Class 3: Major
Restorative
In-Network
(High Plan)
Out-of-Network
(High Plan)
Dentist Bills $1,000 $1,000
Cigna’s Agreed Upon
Fee $550 $850
Usual & Customary
Reimbursement N/A
$680 (80th percentile)
Cigna’s Payment
(Major Covered at 50%)
$275 (50% of $550)
$340 (50% of $680)
Member
Responsibility* $275
$490 ($340 + $150) balance billed
* Assumes the deductible is met. Member’s share is the coinsurance/copayment, any remaining
deductible, any amount over the annual maximum and any services your plan does not cover.
43 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 43
Dental PPO Enhancements
1. Preventive Cleanings Covered 100%
2. Progressive Dental Benefit effective 1-1-14
– If you receive one preventive cleaning and oral exam a year, you will receive an
additional $250 per member to your calendar year maximum
Example of the progressive benefits
Requirement You Will Receive Low
Plan
Middle
Plan
High
Plan
Year 1 1 preventive cleaning
and oral exam $250 $1,000 $1,000 $1,500
Year 2 1 preventive cleaning
and oral exam $250 $1,250 $1,250 $1,750
Year 3 1 preventive cleaning
and oral exam $250 $1,500 $1,500 $2,000
Year 4 1 preventive cleaning
and oral exam
You have reached the
maximum allowed amount $1,750 $1,750 $2,250
44 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
Our capabilities as a health service company allow us to see the whole person – not just a
dental condition.
Total Health Proactive Outreach Program*
Whole Person, Total Health Focus
Multiple opportunities
to identify and engage
members to improve
health and lower cost
1. Identify
2. Engage
3. Change
Stroke
Maternity
Chronic kidney
disease
Heart
disease
Diabetes
Oral
cancer
Organ
transplants
Head/neck
cancer
radiation
Individual
45 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
Cigna Dental Oral Health Integration Program®
Covered Dental Procedures
and Medical Conditions Maternity
Chronic kidney
disease
Organ
transplants
Head & neck
cancer radiation
Periodontal treatment
and maintenance2*
Periodontal evaluation
Oral evaluation3
Cleaning4
Emergency palliative treatment
Fluoride – topical application and
varnish5
Sealants
One of the most comprehensive programs6 reimbursing
individuals for enhanced preventive and periodontal services!
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
More access More wellness More discounts
*Periodontal treatment and maintenance are covered with Heart Disease, Stroke and Diabetes conditions.2
Total Health
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 limitations apply
6. Based on internal market survey conducted from 2008-2012 including over ten leading dental carriers which indicates Cigna cover more conditions and reimburses for more procedures than any other
carrier reviewed. Cigna also offers eligible program participants information on behavioral conditions that can affect oral health and pharmacy discounts on certain dental prescriptions-no other carrier
reviewed offered these additional services.
46 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
Population Savings*
Diabetes $1,292 or 27.6%
Heart Disease $2,183 or 25.4%
Stroke $2,831 or 34.7%
* Not an underwriting decrement
Average annual medical cost savings for
all individuals in study, with or without a
medical condition, and proper
periodontal treatment:
• $1,020 or 27.5% savings
• 67% lower hospital admission rate
• 54% lower ER rate
Beyond Gum Disease Customers receiving proper preventive dental care have, on average:
• 12.5% fewer extractions
• 5.4% fewer root canals
Average annual medical cost savings
for individuals in study who had the
following medical conditions and
proper periodontal treatment:
1“Appropriate Periodontal Therapy Associated with Lower Medical Utilization and Costs” Presented at the International Association for Dental Research Meeting
March 2013, Seattle
Early Oral Care Saves More
2012 national Cigna study1 shows:
• Medical savings when periodontal conditions are treated, and
• Fewer complex dental procedures with proper preventive care
Total Health
47 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 47
Enrollment Deadlines
48 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
Important Dates:
• Open Enrollment is October 7th - October 25th.
• You may replay this presentation at your convenience by
visiting the Orange County’s HR intranet site and internet
site at anytime
• The Open Enrollment Handbook and Benefits Handbook
will also be available on the Orange County’s HR intranet
site and internet site at anytime
49 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 49
Enrollment Support
50 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
Cigna’s Pre-Enrollment Hotline
• If you have medical or dental plan questions, please call
the Cigna Pre-Enrollment Information Line for answers
• The Hotline is open October 7th - October 25th.
• The Hotline is open 24/7 and can be reached at
(800) 401-4041
51 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
Cigna’s Plan Comparison Tool
• You have access to tools to help you estimate your costs for the coming year via
www.myCignaplans.com
• You can compare your Cigna medical plan options, side by side, including your
payroll contributions.
• Set up your HSA bank account for the High Deductible Health Plan.
• A directory of doctors, hospitals and other facilities that participate in the Cigna
HealthCare network
• Benefit summaries that highlight what your plan covers
• Average costs of common procedures and diagnoses
• Frequently asked questions and answers
• A glossary of medical terms
52 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna
myCignaplans.com Log in with the provided user name and password
Username: ocgov
Password: cigna
53 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna
Accept User Agreement Scroll down to review and accept the User Agreement
Review and
click on
“Accept” to
accept the
user
agreement
54 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2012 Cigna
Welcome Page – Review Plan Options
Click on the links to see more
information
55
Welcome Page – Plan Costs
Cigna also provides
you with tools to
compare the cost of
each Cigna medical
plan your employer
offers. Click on
“Compare Medical
Plan Costs” to get
started.
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56
Compare Medical Plan Costs
Click on “Launch Plan Compare” for a
side-by-side comparison of the benefits
for the plans you selected. You can even
email it to yourself.
Click on the boxes for more details.
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57
Welcome Page – Prescription Drug Costs
You can also
compare the cost of
your prescription
drugs under each
Cigna plan that your
employer offers.
Click on “Compare
Drug Costs” to get
started.
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58
Compare Drug Costs – Medication Advisor
You can easily select the
drugs you would like to
see more information
about, including which
drug tier it’s under as well
as retail cost.
You can select your plan
from the drop down box
for a better estimate of
how much it would cost
under your Choice Fund
plan.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
59
Welcome Page - Open Your HSA Bank Account
When you’re ready to open your
HSA bank account, click on either
link, and follow the simple
instructions.
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60
Landing Page
After reviewing the steps to open
your HSA bank account, click on
“Begin.”
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
61 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna 61
Log In
Enter your Social Security
Number, Date of Birth,
Mailing Address Zip Code,
Open Enrollment ID and the
scrambled words and
numbers, then click “Log
In.”
Open Enrollment ID: ocgov
62
Electronic Disclosure And Consent Agreement
Review and
click on
“Accept” to
accept the
Agreement
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63
Bank Application
Enter your name, phone
number and address.
Now is also when you can
make some decisions about
your HSA.
You can choose whether you
would like to order a
checkbook to use to pay for
expenses from your HSA.
*An additional charge may
apply.
You can choose to order
another debit card for a
spouse, dependent or
someone else.
When you’re done, click on
“Next.”
You can choose
to turn
Automatic
Claims
Forwarding
(ACF) on. This
will
automatically
forward any
eligible claims
from your
medical plan to
your HSA
account for
payment. You
can change your
choice at any
time when you
log on to
myCigna.com.
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64
Terms And Conditions
Review and
click on
“Accept” to
accept the
Terms and
Conditions of
the HSA bank
account
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
65
Review Administrative Fees
You can review
the fees
associated with
your account.
Click on
“Accept” after
you review.
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66
Review & Submit Your HSA Bank Application
Review all the
information you
filled in. If you
need to go back
and change
something, click
on “Change this
information.” If
everything is
correct, click on
“Submit
Application.”
Then, print out a
copy of the bank
application for
your records.
Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
67 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna
Welcome Page – Other Resources
Additional resources
are available to help
you, such as the
Health Care
Professional
Directory, a Glossary
of Terms and a list of
Prescription Drugs.