What is wrong with Cigna


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A big name in health insurance, Cigna traces its roots back to two venerable insurance companies that came together in the 1980s. Cigna offers individual and group health insurance plans as well as a range of supplemental products including Medicare, dental, and lump sum terminal illness plans.

About Cigna

Cigna has an impressive history; it was created in 1982 by the merger of two very old insurance companies. The first, Connecticut General Life Insurance Company, was founded in 1865. The second, INA Corporation, is the parent company of Insurance Company of North America, formed in 1792 and the nation’s first stock company. That takes Cigna’s history can more than 200 years.

Initially a big player in the property & casualty market, Cigna sold off a lot of worldwide assets in the 1990s including its life insurance business and focused on healthcare. The 2011 acquisition of HealthSpring, Inc. gave Cigna a big step into the Medicare market.

In 2015, Anthem, Inc. made a deal to acquire Cigna, but the merger was shot down in early 2017 after a protracted antitrust suit. The merger would have created a true health insurance giant.

For 2017, Cigna was ranked at number 70 on the Fortune 500 list. The company employs about 40,000 people and serves 15.2 million medical customers around the world. They provide Medicare Advantage plans in 17 states and Supplemental plans in all 50; our review of Cigna’s Medicare plans can be found here.

Cigna’s head office is located in Bloomfield, Connecticut. They have branch offices located in multiple locations across the country.

Cigna Products

Cigna offers a variety of individual and group health insurance plans that differ from state to state. The website lists nine states in which individual plans are offered but provides employer-sponsored group plans across a larger region. Currently, Cigna offers individual plans in Arizona, Colorado, Florida, Illinois, Missouri, New Jersey, North Carolina, Tennessee, and Virginia

Beyond major medical, they also have an array of supplemental health plans available.

Individual Health Plans

For the purpose of this review, we chose to examine the plans offered in Illinois as a sample; again, these plans may differ from state to state. Plans are available at the Bronze, Silver, and Gold levels, with cost-sharing reduction options for those who qualify through the marketplace. These plans all utilize the Connect network and none of them offer out of network coverage. Cigna does offer PPO plans elsewhere.

Bronze Plans

There are two Bronze tier plans offered by Cigna, each with a cost-sharing plan option for those who meet income requirements.

The Cigna Connect 6650 has a $6,650 individual deductible that is doubled for a family. The plan has a $25 copay for primary care office visits, and a 50% coinsurance for specialist visits, which kicks in after the deductible is met. Copays for prescription drugs start at $10 with this plan.

The Cigna Connect 7150 plan has a higher $7,150 individual deductible, doubled for a family. Most services are subject to the deductible, including primary care visits for illness or injury. After the deductible is met, these are covered at 50%.

Silver Plans

There are two Silver plans available, each of which has multiple levels of cost-sharing options as well as American Indian specific plans. Applicants must qualify for these options through the marketplace.

The Cigna Connect 4000 has deductibles of $4,000 individual and $8,000 family. Primary care office visits are covered with a $25 copay before the deductible is met, but specialist visits are not; they are covered with a 30% coinsurance only once the deductible has been met. Prescription drugs are not subject to the deductible and start at $8 for Tier 1.

With a slightly lower deductible, the Cigna Connect 3400 plan covers primary care visits with a $15 copay before the $3,400 individual/$6,800 family deductible is met. Specialists, however, are subject to the deductible and covered with 30% coinsurance thereafter. Like the Connect 4000 Silver plan, prescriptions start at an $8 copay and are not subject to the deductible.

Gold Plan

There is only one plan at the Gold level, and it also has a few cost-sharing reduction options. This plan is the Cigna Connect 1400, which has a $1,400 individual deductible and a $2,800 family deductible.

While both primary care visits and specialist visits are covered before the deductible is met – at $15 and $50 copays respectively – many other services are still subject to the deductible and covered with a 20% coinsurance thereafter. The deductible on this plan is relatively low, but a Gold plan typically as better coverage than what we see here. Prescriptions on the Gold plan have the same copay amounts as the Silver plans, again surprising.

Supplemental Plans

Cigna offers a range of different supplemental plans to fill the gaps left by major medical plans.

Dental plans are available at several levels, from basic plans to cover preventative services, to more comprehensive options including orthodontic coverage.

Other supplemental health plans include:

  • Accident Expense
  • Lump Sum Cancer
  • Lump Sum Heart Attack and Stroke
  • Cancer Treatment

Life Insurance

Although Cigna has mainly divested itself of the life insurance market, they do still offer a whole life insurance product.

This permanent coverage is available with the option of a level benefit or a modified benefit amount. It is intended as a final expense plan, with issue ages between 50-85. Death benefit amounts range from $2,000 to $25,000.

The whole life program is available in most states.

Rates

This review was written outside of open enrollment, and as a result, Cigna was not offering rate quotes on their website. The site instead directs visitors to the marketplace website to compare quotes; here those who qualify for special enrollment can compare rates from multiple companies and not just Cigna.

That website required a series of qualification steps, and as a result, we were unable to obtain quotes.

It is unusual for a company as big as Cigna to make it difficult for visitors to get a quote, even outside of open enrollment. Since any number of reasons may qualify a person for special enrollment, quoting should be readily available at all times. This is the first major health insurer we have encountered where quoting was not available all year.

Claims

Cigna does not make any claims information readily available on their website, a practice that is common for health insurance companies. Most claims are handled internally.

Customers can view claims status when logged into the “myCigna” area of the website.

Ratings and Consumer Reviews

Cigna has an A+ rating with the Better Business Bureau (BBB), with 426 total complaints on file in the past three years. 165 of those were closed in the past 12 months. For such a huge company, that’s not a particularly high complaint volume.

Since Cigna serves a number of states under a variety of company names, there is more than one report on this company from the National Committee for Quality Assurance. An overview of most of the states they serve, however, shows an average rating of 2.5-3.5, with a 3.0 in most states. Only in Maryland did the company earn a 4.0 rating.

Consumer Affairs has 644 reviews of Cigna, most of which are negative. Most of the complaints cite denied claims and poor customer service. Again, the complaint volume is not high for a huge company, and although the comments are similar in nature, they are generally the same complaints we see with most health insurance companies.

Cigna has been at the center of a few controversies; most notably a 2007 case where they denied a liver transplant to a patient who died while the case was being appealed.

The Bottom Line

Cigna’s appeal is most likely to depend on where the customer lives and what plans are available; it appears that a large portion of their business comes via employer group benefits rather than marketplace purchases. This means many customers are with Cigna because it’s what their employer offers, and may not have selected that company on the open market. Cigna’s complaint volume and ratings seem to put them in the middle of the pack for health insurers – average. Without rates for comparison, we are unable form a solid conclusion on Cigna.