Cigna 2010 Annual Report Download - page 24

CIGNA CORPORATION  2010 Form 10K
4
PARTI
ITEM 1 Business
Stop Loss Coverage
CIGNA HealthCare off ers stop loss insurance coverage for self-insured
plans.  is stop loss coverage reimburses the plan for claims in excess
of a predetermined amount, either for individuals (“specifi c”) or the
entire group (“aggregate”), or both. CIGNA HealthCare also includes
stop loss features in its experience-rated policies (discussed below).
Shared Administration Services
CIGNA HealthCare provides Taft-Hartley trusts and other self-
insured groups access to its national provider network and provides
claim re-pricing and other services (e.g., utilization management).
Medicare
Private Fee For Service
CIGNA’s Medicare Advantage private fee-for-service plan, CIGNA
Medicare Access Plan, which was off ered by CIGNA through
December 31, 2010, was approved by the Centers for Medicare and
Medicaid Services (CMS) to be a replacement for Original Medicare.
 e CIGNA Medicare Access Plan off ered the same benefi ts as
Original Medicare Parts A & B, as well as supplemental benefi ts,
including annual physicals, emergency worldwide coverage and health
and wellness programs. Beginning on January 1, 2011, CIGNA no
longer off ers an individual Medicare Private Fee for Service Plan.
To meet the needs of Medicare eligible groups desiring this coverage,
CIGNA has contracted with Humana Inc. to provide group Medicare
Advantage Plans underwritten and issued by Humana and reinsured
by CIGNA under a 50% coinsurance agreement.
Medicare Part D
CIGNA’s Medicare Part D prescription drug program, CIGNA
Medicare Rx®, provides a number of plan options as well as service and
information support to Medicare and Medicaid eligible customers.
CIGNA Medicare Rx is available in all 50 states and the District of
Columbia.
Specialty
Medical Specialty
Health Advocacy
CIGNA HealthCare off ers medical management, disease
management, and other health advocacy services to employers and
other plan sponsors.  ese services are off ered to customers covered
under CIGNA HealthCare administered plans, as well as, individuals
covered under plans insured and/or administered by competing
insurers/third party administrators. CIGNA off ers a seamless
integration of services to address the clinical and administrative
challenges that are inherent in coordinating multiple vendors.
 rough its health advocacy programs, CIGNA HealthCare works
to help: (1) healthy people stay healthy; (2) people change behaviors
that are putting their health at risk; (3) people with existing health
care issues access quality care and practice healthy self-care; and
(4) people with a disabling illness or injury return to productive work
quickly and safely.
CIGNA HealthCare off ers a wide array of health advocacy programs
and services to help individuals improve their health, well-being and
sense of security, including:
•early intervention by CIGNA’s network of clinical professionals;
•CIGNA’s online health assessment, powered by analytics from the
University of Michigan Health Management Research Center,
which helps customers identify potential health risks and learn what
they can do to live a healthier life;
•the CIGNA Well Aware for Better Health® program, which helps
patients with chronic conditions such as asthma, diabetes, depression
and weight complications better manage their conditions;
•CIGNA Health Advisor®, which provides customers with access to
a personal health coach to help them reach their health and wellness
goals;
•CIGNA’s Well Informed program, which uses clinical rules-based
software to identify potential gaps and omissions in customers’
health care through analysis of the Company’s integrated medical,
behavioral, pharmacy and lab data allowing CIGNA HealthCare to
communicate the gaps to the customer and their doctor; and
•CIGNA’s online coaching capabilities.
CIGNA Onsite Health
CIGNA Onsite Health was formed in 2007. CIGNA operates nine
onsite health centers and expects to continue to open additional
onsite health clinics. In addition, the Company has expanded onsite
services to include onsite pharmacies, dedicated health advocates at
employer sites across the country, hourly coaching services and onsite
biometric screenings through the acquisition of Kronos Optimal
Health. Services and operations are projected to continue to expand
throughout 2011 and beyond.
Cost Containment Service
CIGNA administers cost containment programs with respect to
health care services/supplies that are covered under benefi t plans.
 ese programs, which may involve contracted vendors, are intended
to control health costs through the reduction of out-of-network
utilization, the auditing of provider bills and recovery of overpayments
from other insurance carriers or health care professionals. CIGNA
earns fees for providing or arranging these services.
Behavioral Specialty
Behavioral Health
CIGNA arranges for behavioral health care services for individuals
through its network of participating behavioral health care
professionals and off ers behavioral health care management
services, employee assistance programs, and work/life programs to
employer and other groups sponsoring health benefi t plans, HMOs,
governmental entities and disability insurers. CIGNA Behavioral
Health focuses on integrating its programs and services to facilitate
customized, holistic care.
As of December 31, 2010, CIGNA’s behavioral national network
had approximately 88,000 access points to independent psychiatrists,
psychologists and clinical social workers and approximately
8,500 facilities and clinics that are reimbursed on a contracted fee-
for-service basis.