your medical plan options...plan materials for costs and details of coverage, including other...

YOUR MEDICAL PLAN OPTIONS

Plan year: 2018

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Offered by: Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, or their affiliates.

State of Tennessee

2 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2015 Cigna

Contents

• Network Options – LocalPlus / Statewide OAP

• MyCigna.com

• Cigna Mobile App

• 24 Health Information Line

• Cigna Telehealth ( MDLive /AmWell)

• Healthy Rewards

• Q&A

A health plan that gives you the right mix of health benefits – at the right price.


• You have a network* that is limited to doctors, specialists and hospitals in your local area who understand the needs of your community.

• You don’t need a referral to see a specialist • How you can save:

– In your local area, or when in any LocalPlus Network area, you must receive care from a health care professional or facility in this network to receive in-network coverage.

– If you’re away from home and need care, just look for a participating LocalPlus doctor in the area or if outside the LocalPlus service area, you can use doctors or hospitals in our Away From Home Care feature bu accessing the Open Access Plus Network (OAP).

– If you choose to go outside the LocalPlus Network when one is available (or outside the Away From Home Care feature ( OAP) when LocalPlus isn’t available), you will receive out-of-network coverage.

• You have access to: – Cigna’s national network of labs, x-ray and radiology centers –

plus 75% potential savings through in-network labs** – Nationwide in-network coverage for emergency care

LocalPlus®

MEDICAL PLANS

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*

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A health plan that lets you choose which doctors to see and when


• Larger Network than Local Plus

• You can see a specialist without a referral

• Using doctors and health care facilities in the Cigna network may keep your costs lower

• You can choose doctors or facilities not part of the Cigna network, but your costs may be higher

• You have access to: – Cigna’s national network of labs, x-ray and

radiology centers – plus 75% potential savings through in-network labs**

– Nationwide in-network coverage for emergency care

Statewide options - Open Access Plus (OAP)

MEDICAL PLANS

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As of 6/7/2016

MYCIGNA.COM CUSTOMER WEBSITE

myCigna.com Simplicity and Success

• Offers customers instant access to all their personalized health information in one convenient location.

• Customers can locate a doctor and find quality ratings and personalized out-of-pocket cost estimates before they receive treatment.

• Customers can also access their account balance information, view and pay claims, and much, much more.

myCigna is also available on-the-go. Customers can download the free, personalized myCigna mobile app to access all of their personalized info – whenever it’s most convenient for them.


Easy

Fast

Relevant

SEARCH RESULTS PAGE


Search results are filterable based on: • Cost • Distance • Specialty • Practice • Years in

Practice • Language

SEARCH RESULTS PAGE CONT’D


Results show the estimated cost for each doctor and what the member may owe

Search results are sorted by Cigna Care Designated physicians first; highlighting the best doctors

SHOW ME THE MATH


Click on “Show Me The Math” get the full picture on how all the costs add up

SHOW ME THE MATH AVERAGE COSTS


“Show Me the Math” takes into account: • Deductible • Coinsurance • Estimated

cost

It will also show members how much they saved by staying In-Network, and how much is saved just by being insured

HOW TO USE YOUR PLAN The claim process explained


The claim process


* Your plan may apply a deductible. Copays are paid at the time of service. If a coinsurance applies, it is not paid at the time of service and is billed to you or charged to an HSA/HRA after the claim is processed and the EOB is issued.

CLAIMS PAYING

Your doctor will send Cigna the claim

Show your Cigna ID card

Visit an in-network doctor/hospital/facility

Pay copay or coinsurance* as required

Cigna will send you an explanation of benefits, or “EOB,” as your receipt

WE’RE HERE FOR YOU Tools and resources


By phone – 1.800.997.1617 Call anytime day or night for live customer service • Ask for a Spanish-speaking representative or speak with us in your preferred language –

interpreter service is available in over 200 languages • Talk with a trained nurse 24 /7 when you can’t reach your doctor

We’re here 24/7/365


myCigna – online or through the mobile app • Directory of doctors, hospitals, facilities with cost and quality information • Useful tools to help you:

– Check your coverage and EOBs – Manage and track claims – Track account balances and deductibles, and sign-up for email notifications – Find quality of care information for common procedures and treatments – Get Claims and Balances statements on demand to view claim history and account transactions

TOOLS & RESOURCES

Download the myCigna Mobile App** for easy access on the go!

*Available for Cigna Choice Fund® Health Reimbursement Account (HRA) and Flexible Spending Account (FSA) plans only. **The downloading and use of the myCigna Mobile App is subject to the terms and conditions of the App and the online stores from which it is downloaded. Standard mobile phone carrier and data usage charges apply.

Helping you where and when you need it


• Stay in-network – costs may be lower if you choose to see doctors, hospitals and facilities in Cigna's network

• Access to board-certified doctors by phone or online video through telehealth – MDLive or Amwell.

• Avoid the ER – urgent care and convenience care clinics are covered for minor injuries or illnesses*

• Meet with a case manager – for help discussing a care plan with your doctor

• Utilize our 24 hour health information line and access a registered nurse 24/7.

*Subject to the terms of your plan, including any applicable plan deductibles, copays or coinsurance. See your plan documents for an explanation of Emergency Services, Urgent Care, and related plan requirements.

TOOLS & RESOURCES

Cigna Telehealth Connection overview

16 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2016 Cigna 16

What is it?

Cigna provides access to two telehealth services as part of your medical plan – Amwell and MDLIVE.

Cigna Telehealth Connection lets you get the care you need – including most prescriptions – for a wide range of minor conditions.

Now you can connect with a board-certified doctor via video chat or phone, without leaving your home or office. When, where and how it works best for you!

Availability of MDLIVE and Amwell services is expected for January 1, 2017 but may vary by location and is subject to change. Not all providers have video chat capabilities. Video chat is not available in all areas. Amwell/MDLIVE services are separate from your health plan’s provider network. Telehealth services may not be available to all plan types. A primary care provider referral is not required for Amwell/MDLIVE services. See your plan materials for costs and details of coverage, including other telehealth/telemedicine benefits that may be available under your specific health plan. Amwell and MDLIVE do not guarantee that a prescription will be written. Not all prescription drugs may be covered under your medical plan.

Conditions treated by telehealth doctors


Medical telehealth

General health

Pediatric care

• Acne • Allergies • Asthma • Bronchitis • Colds and flu • Diarrhea • Earaches

• Fevers • Headaches • Infections • Insect bites • Joint aches • Nausea • Pinkeye

• Rashes • Respiratory

infections • Sinus infections • Skin infections • Sore throats • Urinary tract

infections

• Colds and flu • Constipation • Earaches

• Nausea • Pinkeye

In general, to be covered by your plan, services must be medically necessary and used for the diagnosis or treatment of a covered condition. All group health insurance policies and health benefit plans contain exclusions and limitations. See your plan materials for costs and details of coverage, including other telehealth/telemedicine benefits that may be available under your specific health plan.

Cigna Telehealth Connection


for Cigna MDLIVEforCigna.com Toll-free: 888.726.3171

for Cigna AmwellforCigna.com Toll-free: 855.667.9722

How it works


Step 1: Call toll-free Call the toll-free hotline available 24/7/365, including holidays. MDLIVE: 888.726.3171. Amwell: 855.667.9722.

By phone By videoconference

Step 1: Visit website Visit the Amwell or MDLIVE website or download each mobile app* and log in with username and password.

Register online Register online with one or both to use the service when needed

Register with one or both telehealth providers

Step 2: Speak with a coordinator A consultation coordinator locates the next available doctor and prepares you for the consultation.

Step 2: Find a doctor Search for a doctor by a criteria, such as specialty, language, gender, location or simply find the next available doctor.

Step 3: Speak with the doctor Once an available doctor is located, the system automatically calls and connects the doctor to you.

Step 3: See the doctor online Once an available doctor is located, the system automatically connects the doctor to you.

Post-visit

Email communication Decide if the consultation history will be sent to your primary care provider.

Prescription services Amwell and MDLIVE doctors may prescribe medication when appropriate and send the prescription directly to your pharmacy.**

Medical telehealth

Health care services are delivered by Amwell and MDLIVE participating doctors and not by Cigna. Providers are solely responsible for the treatment provided. Availability may vary by location and is subject to change. See vendor sites for details. *The downloading and use of any mobile app is subject to the terms and conditions of the mobile app and the online store from which it is downloaded. Standard mobile phone carrier and data usage charges apply. **Amwell and MDLIVE do not guarantee that a prescription will be written. Not all prescriptions are available.


Helping you stay healthy

• Eye care – exams, frames and lenses, laser vision correction

• Weight management – Jenny Craig®

• Smoking cessation programs

• Hearing care

• Fitness club memberships

• Alternative medicine – acupuncture, chiropractic care, massage therapy

• Mind/body – positive mental visualization and relaxation techniques to help you to lose weight, reduce stress, quit smoking, reduce pain, prepare for surgery or even cope with chronic illness

*Healthy Rewards is a discount program and is separate from your dental benefits. If your plan includes coverage for any of the services offered through Healthy Rewards, this program is in addition to, not instead of, your plan benefits. Some Healthy Rewards programs are not available in all states and may be discontinued at any time. A discount program is NOT insurance, and you must pay the entire discounted charge.

Cigna Healthy Rewards®*

Discounts on a full range of health and wellness programs and services


Contacts

Packets / Materials Celeste Sims 615.595.3134 [email protected]

Middle,TN Cindy Sexton 615.595.3389 [email protected] East, TN Deb Williams 860.902.2815 [email protected]

West, TN Bonnie Hampton 860.902.0639 [email protected]

Enrollment Meetings / Benefit Fairs

Q&A What you want to know


Rates will vary by plan design including the amount of plan deductibles, coinsurance, and out-of-pocket and lifetime maximums.

All health insurance policies and health benefit plans have exclusions and limitations. For costs and details of coverage, see your enrollment materials. The information in this presentation summarizes the highlights of your plan. For a complete list of both covered and not covered services, including benefits required by your state, see your employer’s group insurance certificate, summary plan description or group service agreement – the official plan documents. If there are any differences between the information in this presentation and the plan documents, the information in the plan documents takes precedence.

All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company (CHLIC), Connecticut General Life Insurance Company (CGLIC), Tel-Drug, Inc., Tel-Drug of Pennsylvania, L.L.C., Cigna Onsite Health, LLC, Cigna Behavioral Health, Inc., Cigna Health Management, Inc., and HMO or service company subsidiaries of Cigna Health Corporation, including Cigna HealthCare of Arizona, Inc., Cigna HealthCare of California, Inc., Cigna HealthCare of Colorado, Inc., Cigna HealthCare of Connecticut, Inc., Cigna HealthCare of Florida, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of Indiana, Inc., Cigna HealthCare of St. Louis, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of New Jersey, Inc., Cigna HealthCare of South Carolina, Inc., Cigna HealthCare of Tennessee, Inc. (CHC-TN), and Cigna HealthCare of Texas, Inc. “Cigna Home Delivery Pharmacy” refers to Tel-Drug, Inc. and Tel-Drug of Pennsylvania, L.L.C. In Texas, Open Access Plus and LocalPlus plans are considered Preferred Provider plans with certain managed care features and Open Access Plus IN and LocalPlus IN plans are considered Exclusive Provider plans with certain managed care features. Policy forms: OK - HP-APP-1 et al (CHLIC), GM6000 C1 et al (CGLIC); TN - HP-POL43/HC-CER1V1 et al (CHLIC), GSA-COVER, et al (CHC-TN). The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc. All pictures are used for illustrative purposes only. 862431 b 05/16 © 2016 Cigna. Some content provided under license.

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