Prior to July 1st 2012, Cigna did not offer any maternity insurance plans in California, and their plans were not competitive.  On July 1st they added maternity and autism care to all existing plans and made slight pricing adjustments to position their plans to gain market share in the California marketplace.

Cigna LogoThe Cigna portfolio of health insurance plans is simple to understand, and is composed of only 3 plan families.  The plans are mainly targeting the middle and upper benefit levels, and the pricing is competitive for people age 35 and higher.  Cigna decided not to target the low-cost portion of the market.

One of the major differences between Cigna and other insurance companies is that Cigna still provides a 12 month rate guarantee.  Other companies offer either 6 months or no guarantee at all.

We’ll describe the Cigna portfolio of plans and tell what situations they fit into, along with an analysis of how each of the 3 families of plans compares to the competition.

Open Access Value Plans

These are Cigna’s lowest benefit plans.  The plans provide free preventive care, unlimited office visits for a $40 copay ($60 for specialist), and coverage for generic prescriptions.  The plans do offer brand name prescription coverage, but have a $3500 brand deductible that must be met before any brand prescription coverage begins.  So the Open Access Value plans are primarily generic only coverage.  The plan offers deductibles of 1000, 1500, 2000, 3000, 5000, and 5000/100%.  There is a PPO dental plan that can be added to each of these health plans.

Click here for more details about the Open Access Value plans.

The most popular plan in this family is the 5000/100%.  This plan is virtually identical to the rest of the plans, but the out-of-pocket maximum is equal to the deductible.  The price difference between the 5000 and the 5000/100% is pretty small so the 5000/100% is usually the better value.

The Open Access Value plans are a great fit for families with young children that want the ability to see the doctor more than just a couple times each year.

Cigna Open Access Plans

This is Cigna’s primary full benefit health insurance family.  The Open Access plans offer unlimited office visits for a $30 copay ($40 for specialist), along with both generic and brand name prescription coverage.  The family has deductibles of 1000, 1500, 2000, 3000, 5000, and 5000/100%.  The brand name prescription deductible for this family is $250 for the 1000 and 1500 plans and $500 for all other plans.  There is a PPO dental plan that can be added to each of these health plans.

Click here to get more details about the benefits of each plan.

The Open Access plans are a good fit for individuals and families that need brand prescription coverage or the ability to see a doctor multiple times per year.  Depending upon your age and where you live, these plans are very competitive with the comparable plans from Aetna, Anthem Blue Cross, and Blue Shield of California, and will tend to be lower cost than most of the competition.

Cigna Health Savings Plans

The Health Savings plans are Health Savings Account (HSA) compatible.  These plans offer free preventive care and all other care is covered after you reach the plan deductible.  Office visits, lab tests, prescription coverage, and hospital coverage is subject to meeting the deductible.  The family offers deductibles of 1900, 3400, and 4900.  With the 3400 and 4900 plans when you meet the deductible Cigna then pays 100% of all additional expenses.  The 1900 plan has an additional $600 cost sharing period until you reach the plan’s out-of-pocket maximum (OOPM) of 2500. Once you reach the OOPM, Cigna pays 100% of all additional expenses.

Click here to get more details on the benefits of each plan.

The Health Savings plans are ideal for women that are planning to have a baby, or people that anticipate having medical expenses that are greater than the plan deductibles.  The Cigna Health Savings 1900 plan is the best maternity insurance plan in California as of July 1st. The combination of the out-of-pocket limit and tax savings offered by the HSA can make these plans very cost effective relative to traditional PPO or HMO plans.

Dental PPO Option

The Cigna PPO dental plan can be added to any health insurance plan Cigna offers.  This dental plan is not offered to individuals and families that have health insurance from other companies.

The dental plan has a $50 deductible, a $1000 maximum benefit per year, and provides free preventive care, while covering basic or minor restorative care at 80%, and major restorative care at 50%.  The plan has a 6 month waiting period for minor care and a 12 month waiting period for major care.

Look at the last 2 pages of a plan brochure link above to get more details about the Dental PPO 50 plan benefits.

This dental plan is a great value for a PPO plan and offers an extensive network of dentists in California.  If your dentist is in the Cigna network then add this option to your health insurance.

Summary

Cigna decided to become a larger player in California in July and has made the changes to enable that to happen.  After a few months of results it is clear to us that Cigna’s plans will continue to do well in the maternity insurance market as well as the family and early retiree markets.

With health care reform looming around the corner it’s good to see another nationwide insurance company decide to be a factor in California.  Health care reform will favor the large companies at the expense of the smaller insurance companies that don’t have a large enough customer base to enable them to survive.

See the recent analysis for the other major insurance companies by clicking on these links:
Health Net Analysis
Blue Shield Analysis
Anthem Blue Cross Analysis

If you would like to discuss your specific needs with one of our advisors please call us.  If you want to see what health insurance plans are offered where you live, and what the pricing looks like, “click here” to get a health insurance quote.


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