Cigna 2010 Annual Report Download - page 25

CIGNA CORPORATION  2010 Form 10K 5
PARTI
ITEM 1 Business
CIGNA Pharmacy Management
Pharmacy
CIGNA Pharmacy Management off ers prescription drug plans to
its insured and self-funded customers both in conjunction with its
medical products and on a stand-alone basis. With a nationwide
network of over 60,000 contracted pharmacies, CIGNA Pharmacy
Management is a comprehensive pharmacy benefi ts manager (PBM)
off ering clinical integration programs, specialty pharmacy solutions,
and fast, effi cient home delivery pharmacy capabilities.
Programs that facilitate this integration of medical, behavioral
and pharmacy off erings include: Well Informed, which focuses
on the chronic conditions most likely to benefi t from disciplined
prescription therapy, such as asthma, diabetes, back pain and high
cholesterol, as well as Step  erapy, which encourages individuals who
take prescription drugs to treat an ongoing medical condition to use
generic and/or preferred brand drugs before progressing to higher
cost brand-named drugs within the relevant therapeutic drug class.
 is is accomplished through claim management protocols, which
may include communications with the individual and the individual’s
physician.
CIGNA Specialty Pharmacy Management
Clients with CIGNA administered medical and pharmacy coverage
benefi t from better continuity of care, integrated reporting, and
aggressive unit cost discounts on all specialty drugs — regardless of
where they are administered.
 eraCare Program
CIGNA’s specialty pharmacy outcome management program,
 eraCare, takes a unique approach to managing specialty conditions
by lowering cost while improving health and satisfaction for our
customers. CIGNA has a comprehensive list of conditions covered
regardless of the pharmacy used to fi ll the respective prescription, or
under which benefi t the prescription falls.  eraCare is coordinated
with other CIGNA health advocacy programs and all data is captured
for analysis and reporting.
CIGNA Home Delivery Pharmacy
CIGNA also off ers cost-eff ective mail order, telephone and on-
line pharmaceutical fulfi llment services through its home delivery
operation. CIGNA Home Delivery Pharmacy provides an individual-
focused, effi cient home delivery pharmacy with high standards of
quality, accuracy and individual care relating to maintenance and
specialty medications. Orders may be submitted through the mail,
via phone or through the internet at myCIGNA.com.
Dental Specialty
Dental
CIGNA Dental Health off ers a variety of dental care products
including dental health maintenance organization plans (“Dental
HMO”), dental preferred provider organization (“DPPO”) plans,
dental exclusive provider organization plans, traditional dental
indemnity plans and a dental discount program. Employers and other
groups can purchase CIGNA Dental Health products as stand-alone
products or integrated with CIGNA HealthCare’s medical products.
As of December 31, 2010, CIGNA Dental Health customers totaled
approximately 10.3 million, representing employees at approximately
40% of all Fortune 100 companies. Most of these customers are in
self-insured plans, with guaranteed cost and experience-rated insured
plans accounting for the remaining membership. All dental HMO
customers are in guaranteed cost insured plans. Managed dental
care products are off ered in 37 states for Dental HMO and 45 states
and the District of Columbia for Dental PPO through a network
of independent health care professionals that have contracted with
CIGNA Dental Health to provide dental services.
CIGNA Dental Health customers access care from one of the
largest dental HMO and dental PPO networks in the U.S.,
with approximately 194,200 DPPO-contracted access points
(approximately 84,000 unique health care professionals) and
approximately 50,600 dental HMO-contracted access points
(approximately 14,900 unique health care professionals).
CIGNA Dental Health stresses preventive dentistry; it believes that
promoting preventive care contributes to a healthier workforce, an
improved quality of life, increased productivity and fewer treatment
claims and associated costs over time. CIGNA Dental Health off ers
customers a dental treatment cost estimator to educate individuals on
oral health and aid them in their dental health care decision-making.
Vision Specialty
Vision
CIGNA Vision off ers fl exible, cost-eff ective PPO coverage that
includes a range of both in and out-of-network benefi ts for routine
vision services. CIGNA’s national vision care network, which
consists of over 50,100 health care professionals in approximately
22,300 locations, includes private practice ophthalmologist and
optometrist offi ces, as well as retail eye care centers. Routine vision
products are off ered in conjunction with CIGNA HealthCare’s
medical and dental product off erings.
Funding Arrangements, Pricing, Reserves and
Reinsurance
 e segment’s health care products and services are off ered through
the following funding arrangements:
•Insured — Guaranteed Cost;
•Insured — Shared ReturnsSM (Experience-rated, including
minimum premium funding arrangements); and
•Administrative Services Only.
Premiums and fees charged for HMO and most health insurance
products are generally set in advance of the policy period and are
typically guaranteed for one year (unless specifi ed events occur,
such as changes in benefi ts, signifi cant changes in enrollment or
laws aff ecting the coverage or costs). Premium rates for fully insured
products are established either on a guaranteed cost or retrospectively
experience-rated basis.
Beginning on January 1, 2011, the Patient Protection and Aff ordable
Care Act (“Health Care Reform”) requires CIGNA HealthCare’s
comprehensive medical insurance products to meet a minimum
medical loss ratio (“MLR”) of 85% for large groups (generally
defi ned as employers with more than 50 employees) and 80% for