Carrier – Cigna

Jason Powers: I’m Jason Powers and I’m joined today by Alex Adams, the new business manager at Cigna. Welcome to our carrier product update. This is a special edition, it’s our Q4 kickoff summit and we’re all ready for January one renewals so we can get onto spring. Alex, you’re no stranger to our carrier product update. We were just talking before the show that the last time you were on I think was two years ago during COVID, so we were virtual. So it’s great to have you here in our studio.

Alexandra Adams: Yeah. Thanks, Jason. I’m super happy to be here. Being in person is always so nice to get the face to face in our action, so happy to come meet with you.

Jason Powers: Yeah. We’re excited to have you here. Cigna’s a really important partner of ours. Obviously Cigna is a different space than many of the carriers we might have here today and there may be brokers out there that are wondering, where does Cigna fit in their portfolio? So I’m glad to have you here to help kind of break that down for those brokers out in the market. So we’ll get right into it. What is going on with Cigna in Q4? We talked pre-show about some of the exciting things, but I’m really interested to hear some of the risk mitigation stuff that you’ve got going later in the slides. So what’s new with Cigna? What’s going on?

Alexandra Adams: Yeah. So just diving head first into fourth quarter right now and I think one of the biggest things, I think, to keep in mind or to think about whenever you’re looking for a quote from Cigna is truly the flexibility that we have in terms of plan design, broker incentives. So spot bonuses, customized bonus programs, and I would also say our customer service experience. So we treat a 25 life client just the same as we do a 500 life client, and I think that’s really valuable and important and kind of differentiates us in the marketplace.

As I know, there’s some other carriers who do have maybe cutout plan designs that are there for the under 50 clients or those smaller size, and we have the flexibility to customize plan designs and benefits, and even just in terms of incentives on what we can offer. You can look at admin fee credits, wellness funds, tech credits, second year rate caps, to give some of that comfort for that first year renewal. So many different things. I won’t go on too long of a spiel, but just I think hitting on the fact that Cigna wants to make a customized solution for each client that we get in the door.

Jason Powers: That’s great. It’s a carrier model, but it really is a custom model, and that comes through, I think, in everything that you do from plan design down to, like you mentioned with the incentives. Are there things that we want to cover here for fourth quarter, getting brokers kind of geared up to go out and they’ve got a Cigna proposal, what are the things that they should be looking for?

Alexandra Adams: Yeah, definitely. So I handle 25 enrolled employees up to 500 eligible. And so-

Jason Powers: That’s a big space.

Alexandra Adams: It is. The volume’s getting up there, but hey, it’s a good thing. And anything under 50, we will always quote level funding, level funding or even graded funding, which is a more traditional self-funded product. But level funding, I think a lot of the producers out there are pretty familiar with it, but I do want to just kind of reiterate. With Cigna’s level funding, as you know Jason, our reporting and transparency is super robust, very detailed, provide a lot more detail, I would say, than what I’ve seen on some other reports. So I think that’s something really important to keep in mind for those smaller clients, but also for those larger. So we write level funding on 4, 5, 600 life clients as well.

Jason Powers: Wow. That’s a different space. You typically would see those in maybe a graded funded or even fully insured product, but that’s a different space to see going in the direction of level funded. But I guess if they’re coming off of fully insured, that might be a good transition if they’ve not really had an opportunity to take advantage of a program like yours.

Alexandra Adams: Yeah, absolutely. And I think that’s something else to hit on, is just our variety of funding arrangements. But kind of going back to the customizable and flexibility that we have to offer is, we even have a dividend eligible fully insured product now that we can quote down to 50 lives. And a key differentiator there is, we provide paid monthly reporting, which I know we’ve all been waiting for a fully insured product that will provide reporting. And so that’s another, I would say, key differentiator.

And one of the other things I’m going to hit on throughout these slides later on is wellness. I know that’s becoming more and more of a priority of groups, I would say, just within the last couple years it seems like. With attracting talent and providing their employees with, not only incentive programs to stay engaged with their health, get their preventative visits done and so forth, but also to get their population healthier and try to help those claims trend in a better direction than maybe they have in the past.

Jason Powers: That’s good. That’s good. So what, specifically on the group medical side, what are we seeing for… I think you’ve got some incentive programs for the agent, and then there’s also incentives on the group side. Brokers love bonuses.

Alexandra Adams: Yes. Let’s talk money.

Jason Powers: And I’ll say, as a GA contractor with Cigna, we don’t have any impact on… Those are fully paid to the producers that are out there writing these cases. So there definitely is an incentive model built to work their Cigna business and really receive all of that incentive model. So what is the broker bonus for Cigna’s medical product? What does that look like?

Alexandra Adams: Yeah, absolutely. So our national incentive program is called Cigna’s Platinum Producer Incentive Program. And to qualify for that is, you need three new sales with us, three new groups, and 250 net new enrolled employees. So let’s say you move a hundred life group to us and then 275 life groups with us, then you’re qualified. And it kind of goes over the metrics on the slides on what you can earn on a per employee basis, but the neat thing is, and going back to the flexibility aspect is, we can offer, what we call, local incentive programs on top of this.

So we really have a lot of creativity, I guess, in terms of what we can offer our producers in regard to incentives, bonus programs, and so forth. So [00:08:00] again, this one is our national producer incentive program, and we have a lot of producers who end up kind of double dipping. So they’ll get this national bonus program, but then they’ll also get a kind of customized local program that we may have created specifically for them. So they kind of get hit from two different angles and just doubles the earnings there, and so I think that’s something to really hit on and just, of course, individual spot bonuses for cases as well.

Jason Powers: Sure. And we’ve really, over the years, enjoy being able to build programs like that with Cigna, specifically if we’re talking to an agent that is looking to transition a block of business from a carrier, incentivizing that broker to get that business moved over to Cigna. But it’s not all about new business, you’ve got retention bonuses as well, right?

Alexandra Adams: Yes.

Jason Powers: Part of it.

Alexandra Adams: Yes. So there’s the retention side as well, which, as I know you know Jason, is very important too in the relationship between carriers and producers and broker agencies. And so we do also offer that retention bonus as well, and as you can see on the slide, that lists out the different metrics that you have to hit. So 84% is what we require to be qualified for the under 500 segment. But if you keep building that retention and keep doing that three cases, 250 employees every year, I mean, you’ll just continue qualifying for it year after year.

Jason Powers: Yeah. That’s great. Now talk to me about networks. I think one of the things that we’ve seen in the quotes that we’ve received, not only are we seeing Cigna OAP, but you’ve got more of an EPO product, if you will, with Cigna LocalPlus.

Alexandra Adams: Yeah, you’re exactly right. And LocalPlus, I would say, has really grown, or I’ve seen a lot more interest over the last several months. We rolled it out first 4/1 of last year, and it’s kind of an evolved version of what we called our Sure Fit Network. And so there’s LocalPlus markets all over the country, specific to Kansas City, LocalPlus includes North Kansas City Hospital, HCA, and then Children’s Mercy. So for example, maybe a group has employees in Kansas City, California, and in Texas. Well as long as those employees fall within a LocalPlus zip code, they’re able to enroll in that plan. And so it’s really a great solution for groups who even have employees scattered all over the United States or just concentrated here locally in Kansas City.

Jason Powers: And you hit on it, it’s in any market. So I know we’ve got brokers in the St Louis market, down in Texas, Colorado, down into Florida. They’re able to tap into that Cigna LocalPlus in each one of those markets. So if they’ve got groups or they’ve got maybe a group located in Kansas City, but they also have a location in St. Louis, we can offer that side by side with those St. Louis employees.

Alexandra Adams: Absolutely. Yeah and we would always pair this alongside our open access network, which is our broadest nationwide network, just because there will be some employees, usually always, who maybe their provider currently doesn’t fall within LocalPlus. But some of the really great benefits of LocalPlus is, once again, hitting on flexible, but some of the key features is no PCP referral or specialist referral is required, although we encourage. Away from home care coverage. This is really neat because if you think about those people who may have a son or daughter away in college in another area, maybe you have a daughter who goes to school in Michigan, where we don’t have LocalPlus, well, they’ll have access to our broad network while they’re there. So for anyone temporarily traveling, or maybe you travel for business, and you need to seek care while you’re in an area without LocalPlus, you will still be covered in network with our broad OAP network. So it’s kind of that safety net, if you will.

Jason Powers: It really is. And you mentioned all the different funding options. So I know we primarily work in the level funded space is, I  would say most of the agents that we talk to are most comfortable in that level funded space. But if agents haven’t ever seen your graded funded product, it certainly fits in some of the larger, I’d say 60, maybe 70 enrolled plus is where we see that most competitive, but it’s a great option in that space. And then you also, obviously the fully insured. What are you seeing… I often get asked that, well, can you quote it all three ways? Are you seeing that on your side?

Alexandra Adams: Yeah, we are seeing that quite a bit, where we’ll be asked for a hybrid or level funded quote and a fully insured. And I think we’re getting more flexible or comfortable with providing two different options together. We ideally like to kind of stick with the strategy, but we know it’s just becoming the new norm. And so we kind of have a rule of thumb, fully insured, it’ll be a couple points, typically less than level funding, but we also try to keep that pretty in line because we see the benefits of level funding and we really want to push our clients that way. But again, kind of going back to what you were saying, Jason, we do have many options, really even outside of just this, if you want to get into minimum premium and all of that jazz, but really there’s a solution that’s going to fit any and every single client.

Jason Powers: Yeah. Definitely not a one size fits all approach with Cigna. It really depends on the type of client you’re talking about, where they’re located, what their demographics are, what kind of employees. Are they all localized? Are they remote? There’s a lot of opportunity, I think, to customize a solution using Cigna as the platform across the board. You mentioned wellness incentives, and I know when we’ve built out maybe a level funded or a graded funded strategy, we can put wellness on the table. So talk us through what, and again, I know it’s custom so it’s hard to say, “Well, this is the box that you fit in,” but what are you seeing from a wellness engagement perspective in the group market with Cigna?

Alexandra Adams: Yeah, absolutely. So we have an assigned health engagement consultant for every client of ours, whether they are 500 or 50. So I think that’s something key because they’re able to work with both you, or the agent and the group, on finding a solution that fits them. Some things that we’re able to do, and what we actually, I would say, offer pretty frequently, is wellness funds. And we provide examples on what that can be used for, or maybe what we’ve seen some of our current clients use that for, but it’s certainly not limited to just what’s on this flyer. How it would work is, the client would submit a request to us and we would approve, and then we would reimburse them pulling from that wellness fund. And from dollar amounts, I mean, I’ve seen anywhere from $2,000 to $25,000. So I mean, we can get pretty creative with it.

Jason Powers: And that’s why it’s hard to explain that to agents. I think the key for producers, you don’t have to come up with the wellness program because the health engagement coordinator at Cigna is going to have some ideas and really give you food for thought on how to build that out for the client, because let’s face it… Well, maybe there are some brokers out there with some creativity, but I think for the most part we talk about health insurance plans, we talk about the deductibles, we talk about risk strategy, but we don’t, the wellness side of it. If it’s canned, well, that’s what it is. But with a custom design, I think it opens people’s aperture to being able to bring in massage chairs once a month during maybe a busier season for an employer. There’s a lot of different ways to use those funds to target the actual wellness incentives that the employer’s going after. So I like that about your group program.

Alexandra Adams: And the other thing I would hit on is that with our wellness, we have an automated incentive program that we can offer, but we could also work with the employer to just create one that fits in their agenda or in their schedule. So where we can provide even monthly reports, but it’s not necessarily on our automated incentive platform. And we even have a program we rolled out called Healthy Rate to really tie that participation to potential savings off of that second year renewal. So now we’re trying to really put our money where our mouth is and show that we really do believe that more engagement and wellness leads to better claims down the road.

Jason Powers: And so it’s not always just about lifting weights or going in to get your steps in, there’s also the emotional and the mental wellness. We just came off of the summer at our mental wellness expo, and you’ve got Prevail and Happify. Talk us through what those two programs look like.

Alexandra Adams: Absolutely. So for every client under 500, this emotional wellbeing program will come built in. And so that’s something, I would say, that kind of differentiates Cigna because this does come with some different programs like Prevail and Happify, where it’s self-directed programs to help reduce stress, kind of get your mind off of the day to day stress or stressors that you may be dealing with, but it’s just available right there on your My Cigna app. So it’s really just convenient to pick up your phone and maybe try to steer towards one of these programs versus social media, taking a little break.

And then, I would say the even bigger aspect of our emotional wellbeing program is the three face to face visits that come included with an EAP provider. Live chat, unlimited telephone counseling, and then even just access [00:20:00] to legal, financial, even identity theft, resources. I met with a broker, this was a couple months ago, and they had mentioned that their client in previous years was talking about looking at a standalone EAP policy and they moved them to Cigna and realized, they got the feedback, we don’t even need a standalone EAP because this feels just like it. And our employees are getting great utilization from it. So I’d say that’s some pretty good feedback.

Jason Powers: I have to applaud Cigna and really the industry in and of itself, I think, for stepping up and bridging that gap for a lot of people out there, because it’s like wandering around in a forest if you don’t know where you’re going, and to have those kind of support tools available inside a health plan is really, I think it’s a good first step. I think, like I said, applaud Cigna for it. So moving on to, I think, really just talking about overall with the health plan, what does it look like to move to Cigna, right?

Alexandra Adams: Yeah, absolutely. So I know that’s, usually, I would say I guess nine times out of 10, an employer doesn’t want to move their coverage with the fear of disruption, just the extra leg work, the extra just intensity and [00:21:30] even stress that you may hear back from employees too, and in fear of, oh my gosh, is my drug not going to be covered or is my doctor not going to be in network? And just adding more to HR’s plate. I know HR is already busy enough these days. And so we try to really provide as much resources and support as possible to make it super seamless and smooth for that transition. Part of how we do that is we provide an implementation manager to lead that process.

And what we’ll do is, we’ll host a welcome call and it kind of gives the team over at the client to meet our team, meet their client manager, meet me, our implementation manager, billing analyst, really everyone assigned to them, and walk through timelines, what banking is going to look like, just the overall picture. And these calls are scheduled for an hour and usually they end up being like an hour and a half just because we get great questions. We really see a lot of value from it. So I think that just gives a lot of comfort, knowing that right off the bat, you have this whole army, this whole Cigna army to support you. And one of the other big things I want to point out is our 24/7 pre-enrollment line that we provide. And I think Cigna’s the only carrier that provides that today.

Jason Powers: I can echo that. I don’t think there’s any other pre-enrollment guidance out there.

Alexandra Adams: And that again, just kind of takes some weight off of HR’s shoulders because they’re not having to have every single employee come screaming again about providers being in network or I’m trying to decide what plan to choose. They can actually call into Cigna and they can get one, kind of some guidance on maybe what plan would be best fit for them. It could be more generic, about providers or if a drug is covered on the formulary we’re quoting. So really a variety of questions we can help with, but I think that’s something that I would really drive home and we’ve gotten a lot of good feedback on it.

Jason Powers: It helps the brokers too, right? There’s only so much that they can take on their plate during this busy time of year. So that’s a great support tool for sure. You mentioned identity theft as part of, is that kind of tied to what you’re doing there with the EAP? Is this an add on? Is this included, whether it’s fully insured, graded, funded or level funded? What’s that look like?

Alexandra Adams: Yeah. So identity force is what we rolled out, I believe it was 1/1/22, so this past January, and it is baked in to every single client under 500 from then and going forward. And we’ve really seen this as another kind of differentiator, something different that we’re pushing out to the market and for producers, for agents to show their clients, hey, you may be seeking to find an identity theft solution from a third party vendor or even identity force on its own, which I think has a market value of around $19 PEPM. So again, another baked in solution that we’re trying to offer employees and just add another branch to support kind of an issue that we’re running into. It’s always been around, identity theft, but of course I think over the last few years it’s increasingly got a little bit worse and I think having this as another solution that you can tell your client, “Hey, this comes with your health plan. You don’t have to worry about seeking this outside of that,” is just really imperative.

Jason Powers: Well, and in particular, if there are employers out there who have already purchased a separate identity theft plan for their employees, to be able to just package that in with the group medical, for sure, that eliminates an added cost.

Alexandra Adams: Right. Yeah. And I mean, a $19 PEPM value is pretty substantial as you kind of move into some of those larger groups. So it’s a nice little built in value add.

Jason Powers: Yeah. You mentioned something pre-show that we’ll pull up here that I thought was really intriguing. This is sort of targeted risk management, and there’s so much more we could talk about with Cigna. I think we almost have to have a two part series to cover all the things that we can do inside Cigna’s program, but this one was really intriguing to me. Talk to us about the promise of gene therapy. What are we talking about here?

Alexandra Adams: Yeah, absolutely. And this is something else too, I think, that may be different on how Cigna’s driving to find some different solutions in the market that really stands out and makes you think, oh gosh, not many other carriers or providers offer this. This is really specific to Cigna as of right now. But gene therapy in itself is becoming more and more common and we’re seeing more gene therapy drugs come off the market too and continuing to see more get approved by the FDA as well.

So currently we have two FDA approved drugs, Luxturna and Zolgensma. Luxturna is for childhood blindness and Zolgensma is for a spinal muscular atrophy. But as you can see, I mean, these are huge dollar amounts that, you think about a 50 life group, that would just totally tank them. I mean, that would be, one, not covered by many carriers, but two, their claims experience would be out the roof. And so what Embark does, we came out with a program that really shields the group from these gene therapy costs. Again, these two drugs are what we have approved so far, but I know we’re working to have one have final approval here really soon. And so again, it’s covered. We have a 99 cents charge per member per month that we bake in on the back end or the internally, and that way, which we have run into one of these gene therapy drugs, one, it’s covered, but two, it doesn’t affect their claims experience.

Jason Powers: So that’s proactive risk targeting, where you’re going and saying, “We want to…” I kind of liken this to, I feel like it’s probably been more than 10 years ago, but what we saw come out of the self-funded space, and that’s where Cigna lives primarily in that level funded, graded funded, in the self-funded space is transplant coverage. So there was a different transplant network. This is targeted risk management for specific indicators that are, they would absolutely destroy a group’s claims experience with just one diagnosis.

So it’s innovative on the risk management side. And again, we could go, I think we had 10 or 15 more slides, there’s so much going on with Cigna. I think that the highlights here though are that there’s flexibility in the plan design, there’s flexibility in the funding arrangements, and certainly flexibility in the network. Couple that with a company that’s managing the risk a little bit differently and providing reporting packages that are robust, makes Cigna head and shoulders on that field, being a primary player in the market. So any last parting words for agents as they head into the busy Q4 that we’re all just anxious to get into, if we haven’t already started?

Alexandra Adams: Yeah, absolutely. No. I was really happy to be here and talk about Cigna. And as Jason mentioned, there’s so many more things I could talk about. And I think some of the key things to just keep in mind is just all of the value that’s built in that you can share with your clients and prospects that we’re not nickling and diming you for. It’s a baked in solution and we’re continuing to evolve and innovate and continuing to come up with more creative solutions.

Jason Powers: Well, Alex, it’s always a pleasure to have you come and join us for our carrier product update series. And brokers, if you’ve got additional questions for Alex, she’s going to be over in our virtual carrier booth here at the end so please stick around for that. Until then, have a great Q4. We’ll see you next time.