CIGNA HealthCare of Southern California. Let Us Improve Your Health Healthier Employees, for a Healthier Business / a 09/07

Transcription

1 CIGNA HealthCare of Southern California Let Us Improve Your Health Healthier Employees, for a Healthier Business / a 09/07

2 Our Customer Commitments Improve health At CIGNA HealthCare of Southern California, it s our single focus It means that we stand for care that s effective and personal choices that matter It also means that we connect the health of employees to the health of a business Imagine what would happen to employees health not to mention the related health care costs if we could: Get smokers to kick the habit for good? Prevent overweight employees from getting Type II diabetes? Reduce the incidence of heart attacks and strokes? Minimize the effects of stress on health? Lower the number of premature births? As health care costs rise, employers, producers, consumers, providers and the government all face challenging and difficult decisions To help their customers overcome these challenges, the health care industry must evolve and find new solutions to meet our customers needs CIGNA HealthCare of Southern California is committed to delivering superior value to our customers and the people we serve Our commitment is centered on engaging individuals, understanding our customers needs and providing the right products and solutions Because when our members improve their health, our customers improve their business As one of the largest investorowned health and related benefit companies, CIGNA is built on a proud history as an innovator in health, pharmacy, behavioral health, dental, disability, life and accident benefits domestically and in select international markets And we see a promising future by combining these capabilities with our critical role as a health advocate for consumers and the companies that employ them 2

3 Our Products & Programs Taking advantage of its national vision and local perspective, CIGNA HealthCare of Southern California offers a wide range of integrated medical, behavioral, pharmacy, dental and vision plans, and a broad portfolio of group medical and specialty health care programs and services Our Products Medical We offer a broad selection of physician-directed and self-directed medical plans that provide consistent, quality coverage, throughout California and the entire United States Our medical plans include: Consumer-directed Health Plans (Health Reimbursement Arrangements, Health Savings Accounts and Flexible Spending Accounts), Health Maintenance Organizations, Preferred Provider Organizations, and Point of Service, Open Access and Indemnity plans Behavioral CIGNA Behavioral Care offers a broad array of behavioral health and substance abuse treatment programs that provide important mental health coverage and services, including Managed Behavioral Health Care, Employee Assistance Programs, Work/Life Services and Psychiatric Disability Management Pharmacy Our pharmacy capabilities offer a balanced approach to controlling benefit costs and improving employee health Our pharmacy products CALIFORNIA Our Market include tiered benefit designs with a range of formulary plans, mail-order and online pharmacy options, and a Medicare Part D prescription drug plan Dental CIGNA Dental plans offer nationwide coverage, with no charge for routine cleaning and preventive care exams Included are: Dental Health Maintenance Organization, Dental Preferred Provider Organization and Indemnity plans Vision Our nationwide Managed and Indemnity vision plans provide coverage for routine exams, as well as significant discounts on eyewear and contact lenses Our Programs PACIFIC OCEAN When it comes to the health and wellness of our members and customers, CIGNA HealthCare of Southern California has the programs and services to help improve member health, while maximizing a customer s health care investments CIGNA Well Aware for Better Health is our award-winning disease management program, Santa Clarita Los Angeles Long Beach Ontario San Clemente Riverside Escondido San Diego Palm Springs Yucca Valley MEXICO providing personal support, health information and ongoing clinical outreach to people with chronic health conditions such as asthma, depression, diabetes, low back pain, weight complications, and heart and pulmonary disease Our customers have seen as much as 3 percent in medical cost savings for introducing these programs Health Advocacy programs provide a more productive work force and an improved bottom line These programs include Case Management, Utilization Management, Disease Management, Health Advisor SM and Health Risk Assessments To date, our combined Health Advocacy programs have brought our customers an additional savings of 8 to 11 percent 3

4 Our Services mycignacom, our member-specific Web site filled with consumer-directed tools, can actively engage your members, helping them make decisions regarding their health and the care they choose to receive and promoting cost-effective quality CIGNA HealthCare 24-Hour Health Information Line SM gives our members 24-hour access to a registered nurse when they need immediate health information or assistance Members also can choose from hundreds of helpful health and fitness topics in our audio library 4 Our Clinical Expertise CIGNA s clinical superiority is two-fold We have experts in the field of medical management who not only understand how to identify and address our members immediate medical needs We are also able to translate our medical management information into action As we identify and address medical gaps in member care, this enhanced learning helps us more effectively improve our medical programs, and more successfully improve our members health Our programs not only improve members health, but also increase savings for employers as well as members Our specialty case management programs help members with significant, complex medical conditions become active and informed participants in their own care Through the CIGNA Well Informed program, we combine our clinical expertise with state-of the-art software to identify gaps, omissions and errors in member care Then we use what we ve learned to inform and educate our members and their providers Predictive Modeling tools help us identify more members health issues earlier On a monthly basis, we identify all members who incur more than $10,000 in claims the lowest threshold in the industry and then we work to engage them in programs that will help them change their behaviors and improve their health To date, 30 percent of all our members are engaged in some sort of health improvement program, and 10 percent are actively managed Our Provider Network Access CIGNA HealthCare has broad national networks of doctors and other health care providers, and the competitive rates available from these providers help our members make the most of their health care spending Our Service Center CIGNA HealthCare of Southern California is serviced by the Visalia Service Center, located in the Central Valley, halfway between San Francisco and Los Angeles The center was opened in 1984 Today it handles numerous CIGNA HealthCare products, and more then 4,500 accounts, representing over 1 million participating members Some 300 employees work in the Visalia Service Center, receiving approximately 11,000 calls, and processing approximately 25,000 claims every day An employees average length of service is approximately 57 years, and many Visalia employees enjoy a highly successful work-at-home program in order to maintain a healthy work-life balance The Visalia Service Center handles a number of key Fortune 500 companies In the summer of 2006, JD Power and Associates certified CIGNA HealthCare and the Visalia Service Center as one of a select group of Call Centers in the nation that can successfully and consistently provide a satisfying customer experience

5 Our Leadership in Quality CIGNA s Commitment to Quality In California, CIGNA ranked fourth in HEDIS Quality Measures, beating all commercial competitors According to the Member Connections national accreditation survey (an NCQA report), phone and online communications received a score of 8696 out of a possible 90 CIGNA is at the forefront of the following initiatives aimed at improving health care quality: Benefit designs that offer incentives to members to use high-performing specialists Pay-for-performance contracts and programs that directly reward providers for quality Public reporting of CIGNA s quality efforts and results through the National Committee for Quality Assurance We provide consumers and employers with meaningful, easy-to-use quality information to assist them in making health care and benefits choices: CIGNA HealthCare developed a free online Centers of Excellence hospital rating system to help consumers compare hospitals The health care patient outcome and cost efficiency ratings are based on data for hospital-based treatments of 29 medical conditions We launched the CIGNA Health Improvement Score (Hi Score ) system, which delivers helpful information to employers by measuring and benchmarking the relationship between behavior, education and incentives in achieving desired outcomes And we created the CIGNA Care Network, a designation given to specialty providers who meet or exceed our quality and efficiency standards Consumers may obtain reduced copayments for choosing a specialist designated as a CIGNA Care Network provider Additionally: CIGNA International offers online second opinions through the renowned ecleveland Clinic for expatriate executives based around the world CIGNA Group Insurance uses disability summary and trend reports based on Employer Measures of Productivity and Quality metrics that enable employers to analyze and make improvements in their disability plans Intracorp customer Waste Management won the 2005 Quality Leadership Award from the Certification of Disability Management Specialists Commission for its Transition to Recovery program that Intracorp implemented in 2004 Waste Management reduced lost-time claims by 45 percent and lost workdays by 40 percent 5

6 Our Emerging Solutions Looking to improve health through innovation HealthePass CIGNA HealthCare is teaming up with industry leaders like American Express and others to develop HealthePass, a comprehensive solution designed to simplify and improve the patient payment process and address the issue of patient bad debt Using HealthePass, both patient and provider will know the patient s estimated costs up front and be able to ensure payment funding so the provider does not have to separately bill the patient HealthePass benefits include: Enhancing the value of an employer s benefit offering by preparing its employees for the financial transactions that come with visits to physicians or hospitals Eliminating confusion about how much members owe and reduces time wasted on an outdated payment process Assuring that providers get paid by enabling the member to understand their obligation and reserve funds while in the provider s office In addition, HealthePass reduces the time and cost associated with existing patient collection processes Custom Benefit Builder CIGNA Custom Benefit Builder enables employees to build their own benefit plan based upon their unique needs Employees can choose their benefits similar to the way they would purchase a car, would make investments, or would build and buy a computer online personalized to their individual needs The employer establishes the benefit parameters for choice Convenient online tools provide employees with information and support throughout the benefit selection process Employees can review and compare the relative cost of the benefit choices and select the option that best meets their needs CIGNA Custom Benefit Builder is an integrated tool, allowing employees to compare, choose and enroll in their benefits seamlessly in one online application For customers who have an existing relationship with an online enrollment vendor, Custom Benefit Builder can be attached or bolted to that vendor s online enrollment application This allows the customer to offer customizable benefits to its employees while maintaining its business relationship with the existing online enrollment vendor Voluntary Benefits CIGNA HealthCare Voluntary Benefit plans can improve the health of your employees and the health of your business Our plans offer low-cost benefit options to employers wanting to attract, retain and satisfy employees who are paid hourly wages or are not eligible for your company s core medical package These plans also give employees access to quality emergency, urgent and preventive health care services, helping them improve their health and prevent more costly medical expenses National studies tell us most employers offering voluntary benefits believe these benefits: Help recruitment; being able to say benefits are available improves recruitment results Help retention; studies show that employees who have enrolled in these benefits have a four times greater retention level compared with employees who do not enroll in benefits Reduce absenteeism and increase productivity; employees with medical benefits are more likely to see a doctor, get a prescription and be back on the job more quickly 6

7 Our Funding Solutions Helping you manage cash flow and risk At CIGNA HealthCare we know that a one-size-fits-all approach to health care benefits just doesn t work And we understand that when it comes to managing cash flow and risk, your company has unique needs Which is why we are leaders in developing the most extensive selection of funding solutions in the industry Solutions that let you decide how you want to manage your cash flow and risk Which funding solution is right for you? Funding Option Features Benefits to You FULLY INSURED Full premium paid monthly Rates are predetermined and guaranteed Predictable expenses that are easy to budget Complete protection from high claim costs FULLY INSURED PARTICIPATING Full premium paid monthly Rates are predetermined and guaranteed Year-end settlement Predictable expenses that are easy to budget Complete protection from high claim costs Low claims can earn you cash back at year end MINIMUM PREMIUM Lower premium paid monthly You fund claims through a bank account as they are paid Monthly claim cap Option to hold reserves Lower expenses and premium taxes Improved cash flow Protection against high monthly claim expenses Greater cash management control ADMINISTRATIVE SERVICES ONLY No monthly premium or premium taxes paid just an administrative fee Exempt from most state regulations and mandates on coverage levels Stop Loss coverage available Maximizes your cash flow Freedom to design your health benefits the way you want Financial protection against unanticipated, catastrophic claims 7

8 CIGNA of Southern California Leadership Team Christopher De Rosa President & General Manager CIGNA of Southern California CHRISTOPHER DE ROSA President & General Manager LINCOLN ACHOLONU Regional Marketing Officer CHRIS BLANTON VP of Sales & Account Management BARRY CARVALHO VP of Small Group Sales MICHELLE DEMONTEVERDE Director of Provider Contracting GWYN DILDAY Director of Public Relations LAURA HOSMER Director of Sales Operations WILLIAM JAMESON, Esq General Council RANDY MATHEWS Director of Network Operations RYAN MCGROARTY Regional Financial Officer DOUG STEWART Director of Service Operations JAMES WANG, MD Regional Medical Officer Visit CIGNA online at wwwcignacom Contact Information: LOS ANGELES CIGNA HealthCare of Southern California 400 N Brand Blvd Glendale, CA Veronica Avila Sales & Account Management Office hours: 8:00 am to 5:00 pm (PST) Monday through Friday Tel: Fax: ORANGE COUNTY CIGNA HealthCare of Southern California 26 Executive Park Irvine, CA Chris Blanton VP of Sales & Account Management Office hours: 8:00 am to 5:00 pm (PST) Monday through Friday Tel: Fax: CIGNA and CIGNA HealthCare refer to various operating subsidiaries of CIGNA Corporation Products and services are provided by these operating subsidiaries and not by CIGNA Corporation These operating subsidiaries include Connecticut General Life Insurance Company, Tel-Drug, Inc and its affiliates, CIGNA Behavioral Health, Inc, Intracorp, and HMO or service company subsidiaries of CIGNA Health Corporation and CIGNA Dental Health, Inc In Arizona, HMO plans are offered by CIGNA HealthCare of Arizona, Inc In California, HMO plans are offered by CIGNA HealthCare of California, Inc In Connecticut, HMO plans are offered by CIGNA HealthCare of Connecticut, Inc In Virginia, HMO plans are offered by CIGNA HealthCare Mid-Atlantic, Inc In North Carolina, HMO plans are offered by CIGNA HealthCare of North Carolina, Inc All other medical plans in these states are insured or administered by Connecticut General Life Insurance Company a 09/ CIGNA