Cigna 2008 Annual Report Download - page 22

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that were historically sold in connection with certain experience-rated medical products. These products and services are provided and
administered by subsidiaries of CIGNA Corporation.
CIGNA HealthCare is focused on helping to improve the health, well-being and security of the individuals which it serves.
CIGNA HealthCare believes the most sustainable approach to enhancing quality and managing health care costs is to fully engage
customers in their own health care. Therefore, CIGNA HealthCare seeks to engage its members by providing actionable information
about health and advocacy programs, including information about the cost and quality of care that members can use to make informed
choices about health care for themselves and their families.
Underlying CIGNA HealthCare’s operations is a foundation of clinical expertise and an ability to provide quality service.
CIGNA HealthCare’s strengths include: (1) its ability to integrate medical and specialty product offerings to achieve a more holistic
and integrated approach to members’ health that promotes consistent case management; and (2) its ability to provide predictive
modeling and other analytical tools (for example, through the Company’s exclusive access to analytical tools and algorithms
developed by the University of Michigan), to assist in providing targeted outreach and health advocacy by CIGNA’s clinical
professionals to CIGNA HealthCare members.
Principal Products and Services and Funding Arrangements
With the exception of HMO and Medicare Part D products, each of CIGNA HealthCare’s products (as described below) is offered
with multiple funding options (also described below). CIGNA may sell multiple products under the same funding arrangement to the
same employer. Accordingly, the revenue table included in the Health Care section of the Management’s Discussion and Analysis
(“MD&A”) beginning on page 54 reflects both the product type and funding arrangement as well as the impact from the acquisition in
April of 2008 of Great-West Healthcare, the health care division of Great-West Life & Annuity Insurance Company. CIGNA
HealthCare companies offer products and services in all 50 states, the District of Columbia, Puerto Rico and the US Virgin Islands.
Medical
CIGNA HealthCare provides a wide array of products and services to meet the needs of employers and other sponsors of health
benefit plans and the employees and dependents participating in these plans, including:
• Network and Open Access Plus Plans. CIGNA HealthCare offers a product line of indemnity managed care benefit plans. All
indemnity benefit plans in the managed care product line use meaningful coinsurance differences for “in-network” versus “out-of-
network” care, give members the option of selecting a primary care physician, and use a national provider network, which is
somewhat smaller than the national network used with the preferred provider (“PPO”) plan product line. The Network, Network
Open Access, and Open Access Plus In-Network (“OAPIN”) products cover only those services provided by CIGNA HealthCare
participating (“in-network”) providers and emergency services provided by non-participating (“out-of-network”) providers. The
Network POS, Network POS Open Access and Open Access Plus plans cover health care services provided by participating (“in-
network”), and non-participating (“out-of-network”) health care providers.
• Preferred Provider (“PPO”) Plans. CIGNA HealthCare also offers a PPO product line that features a broader national network
with generally less favorable provider discounts than the managed care products described above, no requirement to select a
primary care physician, and in-network and out-of-network coverage, but with lesser benefit incentives to encourage the use of
participating providers.
• Health Maintenance Organizations (“HMOs”). HMOs are required by law to provide coverage for all basic health services.
They use various tools to facilitate the appropriate use of health care services through employed and/or contracted health care
providers. HMOs control unit costs by negotiating rates of reimbursement with providers and by requiring that certain treatments
be authorized for coverage in advance. CIGNA HealthCare offers HMO plans that require members to obtain all non-emergency
services from participating providers as well as point of service (“POS”) HMO plans that also provide a lesser level of insurance
coverage for out-of-network care from non-participating providers.
• Voluntary Plans. CIGNA HealthCare’s voluntary medical products are offered to employers with 51 or more eligible employees
and are designed to meet the needs of the working uninsured (such as hourly or part-time employees) by offering more limited
and more affordable coverage than traditional major medical plans.