Id Card Brochure - DL2021

QUICK GUIDE TO
CIGNA ID CARDS
2016
We pack a lot of important Table of contents
information on our ID cards. Managed care plans��3
This brochure can help define and clarify
Network Open Access��3
information that appears on Cigna’s most
common customer ID cards. It can also help you Open Access Plus��3
understand the requirements associated with our
various plans, allowing you to quickly and HMO Open Access and POS Open Access ��3
efficiently serve your patients.
LocalPlus®��5
We may occasionally update this brochure during
the year. Download the most current version at HMO, POS, and HMO POS ��5
Cigna.com > Health Care Professionals >
Resources > Doing Business with Cigna. Network and Network POS��5
PPO or EPO��7
Important information about
this guide Individual & Family Plans��7
Please note: Some Cigna ID cards include Connect Network��7
“GWH-Cigna” or a “G” in the upper-right
corner, and may have different service LocalPlus Network��9
channels, including customer service phone
numbers and claim appeal addresses. Focus Network��9
Sample standard Cigna ID card images are shown Open Access Plus Network��9
in this guide. However, the actual content may
vary to conform to an individual state’s legislative Global Health Benefits plans��11
and regulatory requirements. Networks in U.S.: PPO and OAP�� 11
Always be sure to check the back of your patient’s
ID card for the correct contact information. Networks Outside U.S.: Vary by location�� 11
You can also refer to the Important contact
Cigna Choice Fund® plans�� 13
information page in the back of this guide, or
refer to the Cigna Reference Guide for physicians, Cigna Choice Fund or
hospitals, ancillaries, and other health care Cigna Choice Fund Open Access �� 13
professionals by logging in to the Cigna for Health
Care Professionals website (CignaforHCP.com). Shared Administration Repricing plans�� 13
Shared Administration PPO�� 13
Shared Administration Open Access Plus�� 13
Strategic Alliance plans�� 15
Open Access Plus�� 15
Indemnity plans�� 15
Indemnity�� 15
The myCigna Mobile App�� 18
Important contact information�� 20
2
MANAGED CARE PLANS
Network: Network Open Access
18
CSN logo WWW.CIGNA.COM
TPV logo 11 Client
logo You may be asked to present this card when you receive care. The card does not guarantee coverage. You must comply with all
Cigna
Care Network 6 terms and conditions of the plan. Willful misuse of this card is considered fraud.
Legal entity name 5 5 12 INPATIENT ADMISSION:

Your provider must call the toll-free number listed below to pre-certify the above services. Refer to your plan documents for your
Coverage effective date: MM/DD/CCYY Network Open Access
Group: 1234567
7 No referral required
pre-certification requirements. Failure to do so may affect benefits. In an emergency, seek care immediately, then call your primary
care doctor as soon as possible for further assistance and directions on follow-up care within ### hours.
Issuer (80840) PCP Visit $10/$25
For information about mental health services and coverage, call MHSA Stmt Tel
ID: U23456789 01 1
Specialist $10/$25
Name: John Public Hospital ER 4 $50 Med Group: Sunset Med Group
PCP: James Smith 8
Urgent Care $25 Send claims to: 123 Main Street, Suite 999, Anytown, USA 12345-6789 13
Vision Yes For Pharmacy, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
PCP Name Ln2
Rx $10/20%/40%/100% For Vision, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
PCP Phone: XXX.XXX.XXXX Rx Indiv Deduct $50 Cigna Claims: PO Box XXXX, Anytown, USA 12345-6789
ID card acct name 10
Coinsurance applies
3 TPV Name, PO Box XXXX, Anytown, USA 12345-6789
RxBIN XXXXXX RxPCN XXXXXXXX CSN Name, PO Box XXXX, Anytown, USA 12345-6789
DOI 9 SAR Customer Service: 1.800.XXX.XXXX 14 MH/SA: 1.800.XXX.XXXX
PCP required Referral required Away from home care Out-of-network benefits
Encouraged No No No
For more information, see the next page.
Network: Open Access Plus
CSN logo 18 WWW.CIGNA.COM

TPV logo 11 Client You may be asked to present this card when you receive care. The card does not guarantee coverage.
Cigna
6 logo You must comply with all terms and conditions of the plan. Willful misuse of this card is considered fraud.
Care Network
Legal entity name 5

12 INPATIENT ADMISSION AND OUTPATIENT PROCEDURES:
Your network provider must call the toll-free number listed below to pre-certify the above services. Refer to your plan documents
Coverage effective date: MM/DD/CCYY 7 Open Access Plus for your pre-certification requirements. Failure to do so may affect benefits. In an emergency, seek care immediately, then call your
Group: 1234567 No referral required primary care doctor as soon as possible for further assistance and directions on follow-up care within ### hours.
Issuer (80840) PCP visit $10/$25
Specialist $10/$25 For pharmacy, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
ID: U23456789 01 1 Hospital ER $50 4 For vision, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
Name: John Public Urgent care $25
PCP: James Smith 8 Vision Yes Send claims to:
PCP Name Ln2 Rx $10/20/30 CAD name, PO Box XXXX, Anytown, USA 12345-6789
Network Coinsurance: TPV name, PO Box XXXX, Anytown, USA 12345-6789
13
PCP phone: XXX.XXX.XXXX In 90%/10%
ID card acct name 10 Out 3 70%/30% All others: PO Box XXXX, Anytown, USA 12345-6789
RxBIN XXXXXX RxPCN XXXXXXXX Med/Rx deductible applies Customer service: 1.800.XXX.XXXX 14 MH/SA: 1.800.XXX.XXXX
DOI 9 Cat# We encourage you to use a PCP as a valuable resource and personal health advocate. 15 AWAY FROM HOME CARE
Encouraged No Yes Yes
Networks: HMO Open Access and POS Open Access
CSN logo
WWW.CIGNA.COM
TPV logo Client
You may be asked to present this card when you receive care. The card does not guarantee coverage.
Cigna 2 logo You must comply with all terms and conditions of the plan. Willful misuse of this card is considered fraud.
Care Network
Legal entity name

5 12 INPATIENT ADMISSION:
Coverage effective date: MM/DD/CCYY 7 POS (or HMO) Open Access
No referral required
for your pre-certification requirements. Failure to do so may affect benefits. In an emergency, seek care immediately, then call your
Group: 1234567 primary care doctor as soon as possible for further assistance and directions on follow-up care within ### hours.
Specialist 4 $15/$25 For information about mental health services and coverage, call MHSA Stmt Tel
ID: U23456789 01 1
Name: John Public Hospital ER $50 Med Group: Sunset Med Group 13
Urgent Care $25 Send claims to:
PCP: James Smith 8 Vision Yes
PCP Name Ln2 For pharmacy, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
Rx $10/20%/40%/100% For vision, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
PCP Phone: XXX.XXX.XXXX Rx Indiv Deduct $50 Cigna claims: PO Box XXXX, Anytown, USA 12345-6789
ID card acct name 10 TPV name, PO Box XXXX, Anytown, USA 12345-6789
RxBIN XXXXXX RxPCN XXXXXXXX Coinsurance applies 3 CSN name, PO Box XXXX, Anytown, USA 12345-6789
DOI 9 SAR Customer service: 1.800.XXX.XXXX 14 MH/SA: 1.800.XXX.XXXX

HMO Encouraged No No No
Encouraged
POS No No Yes
3
Key
Network Open Access
Refer to this key for explanations of the
Plans that use this network offer customers access to health information found on the sample Cigna ID cards
care professionals who participate in the network, with no featured in this brochure.
referrals required.
1 Use this ID number for all claims and inquiries.
› Flexible plan designs allow for an array of 2 Indicates a seamless network where a patient
cost-sharing options, including copayments,
can receive in-network care on a regional or
coinsurance, and deductibles.
statewide basis.
› Customers can select a PCP to help coordinate care; 3 For patients with coinsurance, submit claims
it’s recommended, but not required. to Cigna or its designee, and receive an
› Referrals are not required to see specialists in the explanation of payment (EOP), which will show
Cigna network. any remaining amount due from the patient.
› Precertification may still be required for certain services 4 Collect any copayment at the time of service.
and procedures. 5 May read as: “Cigna Health and Life Insurance
Company” or “Connecticut General Life
› Out-of-network coverage for emergencies only.* Insurance Co.” or “Cigna HealthCare of
For a directory of health care professionals who participate in XXXX, Inc.”
this network, visit Cigna.com/HCPDirectory. 6 ID cards with the Cigna Care Network® logo
Open Access Plus indicate the patient’s liability varies based
on the health care professional’s Cigna Care
Plans that use this network offer customers direct access to a designation status. Refer to the online health
broad, national network of health care professionals. care professional directory at Cigna.com>
They include health advocacy programs to help customers Find a Doctor to determine a physician’s
engage in wellness initiatives and manage chronic conditions. Cigna Care designation status.
› Customers can select a PCP to help coordinate care; 7 Effective date of coverage.
it’s recommended, but not required. 8 Name of patient‘s primary care
physician (PCP).
› Referrals are not required to see participating or
non-participating specialists. 9 Network Savings Program (NSP) logo indicates
that out-of-network discounts may be available
› Precertification may still be required for certain services to the customer.
and procedures.
Employer name.
10
For a directory of health care professionals who participate 11 If a third party administers services in
in this network, visit Cigna.com/HCPDirectory. conjunction with Cigna, the ID card may
include multiple logos, and show a different
claim address or telephone number on the
Health Maintenance Organization (HMO) Open Access
back of the card.
and Point of Service (POS) Open Access
Precertification requirements may be shown as
12
Plans that use these networks offer customers access to
either “Inpatient Admission” or “Inpatient
local health care professionals and a variety of different
Admission and Outpatient Procedures.’’
benefit options.
13
Submit claims to the claim submission address
They include negotiated network-specific discounts and fee shown on the card.
schedules, along with robust medical management, to help
14
Call the customer service number(s) indicated
reduce use of non-essential procedures. on the card. Some plans have dedicated
› Customers can select a PCP to help coordinate care; numbers for accessing information. Always
it’s recommended, but not required. check the card for the correct number or refer
› Referrals are not required to see specialists. to the Important contact information page in
this guide.
› Precertification may still be required for certain services 15 “Away From Home Care” indicates the patient
15
and procedures. has access to the Cigna national Open Access
› Out-of-network coverage for emergencies only.* Plus network.
For a directory of health care professionals who participate 16
Indicates shared administration repricing.
in these networks, visit Cigna.com/HCPDirectory. 17
Union identifier.
*Emergency services as defined in their plan. 18
Client-specific network (CSN) logo.
4
4
MANAGED CARE PLANS (CONTINUED)
Network: LocalPlus®
CSN logo WWW.CIGNA.COM

TPV logo 11 18 Client You may be asked to present this card when you receive care. The card does not guarantee coverage.
logo You must comply with all terms and conditions of the plan. Willful misuse of this card is considered fraud.
INPATIENT ADMISSION AND OUTPATIENT PRECEDURES: 12
Legal entity name
Coverage effective date: MM/DD/CCYY
LocalPlus pre-certification requirements. Failure to do so may affect benefits. In an emergency, seek care immediately, then call your primary
Group: 1234567 No referral required care doctor as soon as possible for further assistance and directions on follow-up care within EF hours.
Issuer (80840) PCP Visit $10 Coinsurance/deductible is paid directly to the doctor/facility by Cigna using individual’s available health funds.
ID: U23456789 01 1 Specialist $15 4
Carve out 1 Prt Line
Carve out 2 Prt Line 13
Name: John Public Hospital ER $50
Urgent Care $25
PCP: James Smith Vision Yes Send claims to:
Jane Smith Rx $10/20/30 CAD Name, PO Box XXXX, Anytown, USA 12345-6789
PCP Phone: 860.123.4567 Network coinsurance: TPV Name, PO Box XXXX, Anytown, USA 12345-6789
ABC12 & Sons Company In 90%/10%
Out 70%/30% All Other: PO Box XXXX, Anytown, USA 12345-6789
RxBIN XXXXXX RxPCN XXXXXXXX Med/Rx deductible applies Customer Service: 1.800.XXX.XXXX 14 MH/SA: 1.800.XXX.XXXX Open Access Plus 15
DOI 9 Cat # We encourage you to use a PCP as a valuable resource and personal health advocate. AWAY FROM HOME CARE
Encouraged No Yes No
Networks: HMO, POS, and HMO POS
WWW.CIGNA.COM
2 Client
logo You may be asked to present this card when you receive care. The card does not guarantee coverage.
You must comply with all terms and conditions of the plan. Willful misuse of this card is considered fraud.
Legal entity name 5 12 INPATIENT ADMISSION:
Coverage effective date: MM/DD/CCYY 7 HMO (or POS)
for your pre-certification requirements. Failure to do so may affect benefits. In an emergency, seek care immediately, then call your
Group: 1234567 PCP visit $15
primary care doctor as soon as possible for further assistance and directions on follow-up care within ### hours.
Issuer (80840) Specialist $15
Hospital ER 4 $50 Med group: Sunset Med Group
ID: U23456789 01 1 Send claims to: 123 Main Street, Suite 999, Anytown, USA 12345-678 13
Urgent care $25
Name: John Public Vision Yes For pharmacy: Call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
PCP: John Smith 8 Rx 41/$20/$40 For vision: Call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
PCP phone: XXX-XXX-XXXX Rx indiv deduct $50
ID card acct name 10 Cigna: PO Box XXXXX, Anytown, USA 12345-6789
Coinsurance applies 3
RxBIN Rx Bin RxPCN Rx Contr
DOI
9 Cat#
Member services: 1.800.XXX.XXXX MH/SA: 1.800.XXX.XXXX C

HMO Yes Yes No No
Yes
POS Yes No Yes
Networks: Network and Network POS
18 WWW.CIGNA.COM
TPV logo
bl
11 CSN logo
2 Client You may be asked to present this card when you receive care. The card does not guarantee coverage. You must comply with all
Cigna
Care Network
6 logo terms and conditions of the plan. Willful misuse of this card is considered fraud.
Legal entity name 5

12INPATIENT ADMISSION:
Coverage effective date: MM/DD/CCYY 7 Network
pre-certification requirements. Failure to do so may affect benefits. In an emergency, seek care immediately, then call your primary
Group: 1234567 care doctor as soon as possible for further assistance and directions on follow-up care within ### hours.
Specialist 4 $15/$20 For information about mental health services and coverage, call MHSA Stmt Tel
ID: U23456789 01 1 Med Group: Sunset Med Group
Name: John Public Hospital ER $50
Urgent Care $25 Send claims to: 123 Main Street, Suite 999, Anytown, USA 12345-6789 13
PCP: James Smith 8 Vision Yes For Pharmacy, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
PCP Name Ln2
Rx $10/20%/40%/100% For Vision, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
PCP Phone: XXX.XXX.XXXX Rx Indiv Deduct $50 Cigna Claims: PO Box XXXX, Anytown, USA 12345-6789
ID card acct name 10 TPV Name, PO Box XXXX, Anytown, USA 12345-6789
RxBIN XXXXXX RxPCN XXXXXXXX Coinsurance applies 3 CSN Name, PO Box XXXX, Anytown, USA 12345-6789
DOI 9 OAP# Customer Service: 1.800.XXX.XXXX 14 bo MH/SA: 1.800.XXX.XXXX

Network Yes Yes No No
Network
Yes Yes No Yes
POS
5
Key
LocalPlus®
Plans that use this network offer customers access to care information found on the sample Cigna ID cards
through a network that is limited to local doctors, physicians, featured in this brochure.
and hospitals in their home area, plus a suite of wellness
services and programs to help customers get on the right
path to health. 2 Indicates a seamless network where a patient
› Customers must go to health care professionals who statewide basis.
participate in the LocalPlus network in their home area,
3 For patients with coinsurance, submit claims
or in any area in the country where one exists,
to Cigna or its designee, and receive an
for coverage at the in-network cost.
explanation of payment (EOP), which will show
› In areas where the LocalPlus network is not available, any remaining amount due from the patient.
they can access care through our Away From Home Care 4 Collect any copayment at the time of service.
(OAP) feature for coverage at the in-network cost.
5 May read as: “Cigna Health and Life Insurance
› If customers choose to go to health care professionals Company” or “Connecticut General Life
outside the LocalPlus network (or outside the Away From Insurance Co.” or “Cigna HealthCare of
Home Care feature when the LocalPlus network isn’t XXXX, Inc.”
available) they will likely pay more. (With the LocalPlus IN
6 ID cards with the Cigna Care Network® logo
plan, they will pay the full cost of their care.)
indicate the patient’s liability varies based
› Precertification may still be required for certain services on the health care professional’s Cigna Care
and procedures. designation status. Refer to the online health
For a directory of health care professionals who participate in care professional directory at Cigna.com>
this network, visit Cigna.com/HCPDirectory. Find a Doctor to determine a physician’s
Cigna Care designation status.
7 Effective date of coverage.
8 Name of patient‘s primary care
HMO, POS, and HMO POS
physician (PCP).
Plans that use these networks offer customers cost savings,
9 Network Savings Program (NSP) logo indicates
and access to a local network of health care professionals.
› Customers must select a PCP who participates in to the customer.
the network to coordinate care for coverage at the Employer name.
10
in-network cost.
11 If a third party administers services in
› Referrals are required to see specialists except OB/GYNs. conjunction with Cigna, the ID card may
› HMO POS plans include benefits and features similar to include multiple logos, and show a different
HMO plans, plus out-of-network coverage at reduced claim address or telephone number on the
benefit levels. back of the card.
12
For a directory of health care professionals who participate
in these networks, visit Cigna.com/HCPDirectory.
13
shown on the card.
Network and Network POS
14
Plans that use these networks offer customers cost savings, on the card. Some plans have dedicated
local convenience, and choice. numbers for accessing information. Always
› Customers must select a PCP from a local network to check the card for the correct number or refer
coordinate care for coverage at the in-network cost. to the Important contact information page in
this guide.
› Referrals are required to see specialists except OB/GYNs. 15 “Away From Home Care” indicates the patient
15
› Network POS plans include benefits and features similar to has access to the Cigna national Open Access
Network plans, plus out-of-network coverage at reduced Plus network.
benefit levels.
16
For a directory of health care professionals who participate in 17
Union identifier.
these networks, visit Cigna.com/HCPDirectory.
18
6
MANAGED CARE PLANS (CONTINUED)
Networks: PPO or EPO

Cigna
Care Network 6 logo You must comply with all terms and conditions of the plan. Willful misuse of this card is considered fraud.
Legal entity name 5 12 INPATIENT ADMISSION AND OUTPATIENT PROCEDURES:

Coverage effective date: MM/DD/CCYY 7 PPO for your pre-certification requirements. Failure to do so may affect benefits. In an emergency, seek care immediately, then call your
Group: 1234567 Dr. visit $10/$25 primary care doctor as soon as possible for further assistance and directions on follow-up care within ### hours.
Issuer (80840) Specialist $10/$25
Hospital ER $50
ID: U23456789 01 1
Urgent care
4 $25 For pharmacy, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
Name: John Public Vision Yes For vision, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
Rx $10/20/30 Send claims to:
ID card acct name 10 Network coinsurance: CAD name, PO Box XXXX, Anytown, USA 12345-6789 13
In
RxBIN XXXXXX RxPCN XXXXXXXX Out
3 90%/10%
70%/30%
TPV name, PO Box XXXX, Anytown, USA 12345-6789
All others: PO Box XXXX, Anytown, USA 12345-6789
DOI Med/Rx deductible applies
9 Cat#
Customer service: 1.800.XXX.XXXX 14MH/SA: 1.800.XXX.XXXX 15 AWAY FROM HOME CARE

PPO Encouraged No Yes Yes
EPO
Encouraged No Yes No
INDIVIDUAL & FAMILY PLANS
Network: Connect
1
3 13
8
4
14
Yes* Yes* No No
*PCP selection and referrals are encouraged in Missouri.
7
Key
PPO or EPO information found on the sample Cigna ID cards
Plans that use these networks offer customers access to featured in this brochure.
participating health care professionals across the country. 1 Use this ID number for all claims and inquiries.
PPO: 2 Indicates a seamless network where a patient
› Both in- and out-of-network benefits are available. can receive in-network care on a regional or
statewide basis.
› Customers can access services from health care 3 For patients with coinsurance, submit claims
professionals who do not participate in the network,
but will assume additional costs and be reimbursed at
a lower coinsurance level.
any remaining amount due from the patient.
EPO: 4 Collect any copayment at the time of service.
› Out-of-network coverage for emergencies only* 5 May read as: “Cigna Health and Life Insurance
› Referrals are not required to see specialists in the Company” or “Connecticut General Life
Cigna network. Insurance Co.” or “Cigna HealthCare of
XXXX, Inc.”
in these networks, visit Cigna.com/HCPDirectory.
designation status. Refer to the online health
Individual & Family Plans care professional directory at Cigna.com>
Find a Doctor to determine a physician’s
Cigna offers Individual & Family Plans with medical,
pharmacy, and (when applicable) pediatric dental benefits
in Arizona, California, Colorado, Connecticut, Florida, 7 Effective date of coverage.
Georgia, Maryland, Missouri, North Carolina, South Carolina, 8 Name of patient‘s primary care
Tennessee, and Texas. Depending on the plan, customers physician (PCP).
will have access to health care professionals who participate 9 Network Savings Program (NSP) logo indicates
in one of four networks: Connect Network, Focus Network, that out-of-network discounts may be available
LocalPlus Network, or Open Access Plus Network. The to the customer.
network name will appear on the top right of the ID card.
Employer name.
10
Connect Network 11 If a third party administers services in
Plans that use this network offer customers access to health conjunction with Cigna, the ID card may
care professionals in their local area. include multiple logos, and show a different
› Customers must select a PCP** who participates in the back of the card.
network to coordinate their care.
12
› Referrals are required to see specialists.** either “Inpatient Admission” or “Inpatient
› Out-of-network coverage, except in emergencies,* and Admission and Outpatient Procedures.’’
Away From Home Care are not included. 13
For a directory of health care professionals who participate shown on the card.
in this network, visit Cigna.com/IFP-Providers. 14
* Emergency services as defined in their plan.
on the card. Some plans have dedicated
** PCP selection and referrals are encouraged in Missouri. numbers for accessing information. Always
check the card for the correct number or refer
to the Important contact information page in
this guide.
15 “Away From Home Care” indicates the patient
15
has access to the Cigna national Open Access
Plus network.
16
17
Union identifier.
18
8
INDIVIDUAL & FAMILY PLANS (CONTINUED)
Network: LocalPlus
5
7
1 13
3
4
8
14
15
LocalPlus No No Yes Yes*
No
LocalPlus IN No Yes No**

*Cigna Health plans in California, Florida, Georgia, Tennessee, and Texas, as well as Cigna California plans.
**Cigna Vantage® plans in Colorado, Florida, and Texas.
Network: Focus
7
1
8 4 13
14
No No No No
13
8 3
4
14
15
No No Yes Yes
9
LocalPlus Network Key
Plans that use this network offer customers access to Refer to this key for explanations of the
health care professionals who participate in the national information found on the sample Cigna ID cards
LocalPlus network. featured in this brochure.
In areas where the LocalPlus Network is not available, 1 Use this ID number for all claims and inquiries.
if the customer has a: 2 Indicates a seamless network where a patient
› Cigna Vantage® plan can receive in-network care on a regional or
statewide basis.
In Florida or Texas, out-of network visits are not
–
covered, except in emergencies.*
– In Colorado, they can access Away from Home Care explanation of payment (EOP), which will show
using the Open Access Plus network for coverage at any remaining amount due from the patient.
the in-network cost.
4 Collect any copayment at the time of service.
› Cigna Health plan 5 May read as: “Cigna Health and Life Insurance
– In California, Florida, Georgia, or Tennessee, Company” or “Connecticut General Life
they can access Away from Home Care using the Insurance Co.” or “Cigna HealthCare of
Open Access Plus network for coverage at the XXXX, Inc.”
in-network cost. 6 ID cards with the Cigna Care Network® logo
› Visits to non-participating health care professionals indicate the patient’s liability varies based
when in a LocalPlus area will not be covered except on the health care professional’s Cigna Care
for emergencies.* designation status. Refer to the online health
care professional directory at Cigna.com>
› Referrals are not required to see specialists. Find a Doctor to determine a physician’s
For a directory of health care professionals who participate Cigna Care designation status.
in this network, visit Cigna.com/IFP-Providers. 7 Effective date of coverage.
*Emergency services as defined in their plan. 8 Name of patient‘s primary care
physician (PCP).
Focus Network
Plans that use this network offer customers access to that out-of-network discounts may be available
health care professionals in their local area. to the customer.
› Customers can select a PCP to help coordinate care; Employer name.
10
it’s recommended, but not required. 11 If a third party administers services in
› Referrals are not required to see specialists. conjunction with Cigna, the ID card may
› Customer visits to providers not in the network are include multiple logos, and show a different
considered out-of-network, except in the case of
back of the card.
emergency services as defined by their plan.
12
in this network, visit Cigna.com/IFP-Providers.
13
Open Access Plus Network shown on the card.
Plans that use this network offer customers access to 14
health care professionals who participate in the national on the card. Some plans have dedicated
Open Access Plus network. numbers for accessing information. Always
› Customers can select a PCP to help coordinate care; check the card for the correct number or refer
it’s recommended, but not required. to the Important contact information page in
this guide.
› Referrals are not required to see specialists in- or 15 “Away From Home Care” indicates the patient
15
out-of-network.
› Precertification may still be required for certain services Plus network.
and procedures. 16
For a directory of health care professionals who participate 17
Union identifier.
in this network, visit Cigna.com/IFP-Providers.
18
10
Policy No:
Employer:
GLOBAL HEALTH BENEFITS PLANS
To verify benefits, please see the contact information on the back of this card.
Networks in U.S.: PPO and OAP www.CignaEnvoy.com
A customer with this card lives in the U.S. and makes frequent visits outside the U.S.
Preferred care network in the U.S.: Cigna HealthCare PPO
All benefits are subject to verification of eligibility, definitions, exclusions,

Medical Benefits Abroad and contract limitation. Card possession does not certify eligibility
for benefits. For U.S.-inpatient services pre-authorization required.
Members and Providers

Policy No: US Provider: Payor ID# Cigna – 62308
Fax Claims: 1.800.243.6998 (toll-free) or 001.302.797.3150 (direct fax)
Employer: Contact: 1.800.243.1348 (toll-free) or 001.302.797.3535 (outside the U.S.)

302.797.3535 (inside the U.S.)
Mail Claims: Cigna PO Box 15111, Wilmington, DE 19850-5111
To verify benefits, please see the contact information on the back of this card. Courier: Cigna 300 Bellevue Parkway, Wilmington DE 19809-3718
Website: www.CignaEnvoy.com
www.CignaEnvoy.com
Network Savings Program AWAY FROM HOME CARE
Preferred care network in the U.S.: Cigna HealthCare PPO

Networks outside U.S.: Vary by location
All benefits are subject to verification of eligibility, definitions, exclusions,
and contract limitation. Card possession does not certify eligibility
A customer with this
for benefits. For U.S.-inpatient card
services lives outside
pre-authorization required. the U.S. and makes frequent visits to the U.S.
Members and Providers
US Provider: Payor ID# Cigna – 62308
Fax Claims: 1.800.243.6998 (toll-free) or 001.302.797.3150 (direct fax)
Contact: 1.800.243.1348 (toll-free) or 001.302.797.3535 (outside the U.S.)
302.797.3535 (inside the U.S.)
Mail Claims: Cigna PO Box 15111, Wilmington, DE 19850-5111
Courier: Cigna 300 Bellevue Parkway, Wilmington DE 19809-3718 12
Website: www.CignaEnvoy.com
1
AWAY FROM HOME CARE
Network Savings Program
10
14
13
9 15
PCP Required Referral Required Away from home care Out-of-network benefits
For more information, see the next page
112094 11/15
11
Key
Global Health Benefits plans Refer to this key for explanations of the
We offer Cigna Global Health Benefits® plans for globally information found on the sample Cigna ID cards
mobile employees, including U.S. expatriates and inpatriates featured in this brochure.
to the U.S. There are multiple coverage options 1 Use this ID number for all claims and inquiries.
encompassing medical, business travel medical, dental, life,
2 Indicates a seamless network where a patient
accidental death and dismemberment, and a range of
ancillary coverage. The network name will appear on the
statewide basis.
ID card.
For more information and to access the directory of
participating health care professionals, visit CignaEnvoy.com.
any remaining amount due from the patient.
4 Collect any copayment at the time of service.
Company” or “Connecticut General Life
Insurance Co.” or “Cigna HealthCare of
XXXX, Inc.”
physician (PCP).
to the customer.
Employer name.
10

conjunction with Cigna, the ID card may
back of the card.
12
13
shown on the card.
14
numbers for accessing information. Always
this guide.
15
Plus network.
16
17
Union identifier.
18
12
CIGNA CHOICE FUND® PLANS
Networks: Cigna Choice Fund or Cigna Choice Fund Open Access Plus

Cigna
Care Network 6 logo You must comply with all terms and conditions of the plan. Willful misuse of this card is considered fraud.
Legal entity name 5

12 INPATIENT ADMISSION:
Coverage effective date: MM/DD/CCYY 7 Choice Fund OA Plus pre-certification requirements. Failure to do so may affect benefits. In an emergency, seek care immediately, then call your primary
Group: 1234567 No referral required care doctor as soon as possible for further assistance and directions on follow-up care within ### hours.
PCP Visit 15%/20%
Specialist 3 15%/20%
Issuer (80840) Coinsurance/deductible is paid directly to the doctor/facility by Cigna using individual’s available health funds.
ID: U23456789 01 1 Hospital ER 20% For Pharmacy, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
Name: John Public Vision Yes For Vision, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
Rx 30%/40%/50%
PCP: John Smith
PCP Name Ln2 8 Network Coinsurance: 13 Send claims to:
In 90%/10% CAD Name, PO Box XXXX, Anytown, USA 12345-6789
PCP Phone: XXX.XXX.XXXX Out 70%/30% TPV Name, PO Box XXXX, Anytown, USA 12345-6789
ID card acct name 10 9 Med/Rx deductible applies All Others: PO Box XXXX, Anytown, USA 12345-6789
RxBIN XXXXXX RxPCN XXXXXXXX Customer Service: 1.800.XXX.XXXX 14 MH/SA: 1.800.XXX.XXXX
16
DOI Cat# We encourage you to use a PCP as a valuable resource and personal health advocate. AWAY FROM HOME CARE
No No Yes Varies by network
SHARED ADMINISTRATION REPRICING PLANS
Network: Shared Administration PPO
TPV logo 11 Client You must comply with all terms and conditions of the plan. Willful misuse of this card is considered fraud.
logo 12 INPATIENT ADMISSION:
Your provider must call the toll-free number listed below to pre-certify your medical services or benefits may be affected. Refer to your
Legal entity name 5 plan documents for your plan’s precertification requirements. In an emergency, seek care immediately, then notify Cigna within 48 hours.
Coverage effective date: MM/DD/CCYY 7 Provider network: Mail all non-medical claims and correspondence to: ID card name back
Group: 1234567 Cigna HealthCare PPO SAR fund name
Issuer (80840) Doctor visit $10 4 13 Submit/mail claims to: Cigna Payor 62308, PO Box 188004, Chattanooga, TN 37422-8004
All other:
ID: U23456789 01 1 Specialist $20
Coinsurance 3 TPV N&A print line
Name: John Public
In-network 90% / 10% Pre-certification: Member Srvc Nu Pharmacy Questions: 1.800.244.6224
S 16
This plan is self-funded by:
Out-of-network 70% / 30% Eligibility, Benefit and Claim questions please call: SAR TPA phone 14
Rx 30% / 40% / 50%
ID card account name To access the online provider directory go to www.CignaSharedAdministration.com
Fund #: SAR F To access member pharmacy tools go to www.myCigna.com
RxBIN Rx Bin RxPCN XXXXXXXX Deductible applies
DOI
Cat#
15 AWAY FROM HOME CARE Benefits are not insured by Cigna HealthCare 17
Network: Shared Administration Open Access Plus
TPV logo 11 Client You must comply with all terms and conditions of the plan. Willful misuse of this card is considered fraud.
5 logo 12 INPATIENT ADMISSION:
Legal entity name Your network provider must call the toll-free number listed below to pre-certify the above services. Refer to your plan documents
Coverage effective date: MM/DD/CCYY
7 for your pre-certification requirements. Failure to do so may affect benefits. In an emergency, seek care immediately, then call your
Group: 1234567 Open Access Plus primary care doctor as soon as possible for further assistance and directions on follow-up care within ### hours.
Issuer (80840) No referral required Mail all non-medical claims and correspondence to:
ID: U23456789 01
1 PCP visit $15 4 Fund name
Specialist $20 Fund address
Send claims to: Claims address 13
Name: John Public
S 16 Rx 30% / 40% / 50%
PCP: James Smith Network coinsurance: All others: PO Box XXXX, Anytown, USA 12345-6789
PCP name Ln2 In 90% / 10% 3 Pre-certification: Member Srvc Nu Pharmacy Questions: Pharm Num
PCP phone: 860-555-1212 Out 70% / 30% Eligibility, Benefit and Claim Questions: Please call Payor Num 14
Fund Name Deductible applies To access the online provider directory go to www.cignasharedadministration.com
Fund #: Fund number To access member pharmacy tools go to www.mycigna.com
RxBIN XXXXXX RxPCN XXXXXXXX We encourage you to use a PCP as a valuable resource and personal health advocate.
DOI Cat# AWAY FROM HOME CARE 15 17
13
Key
Cigna Choice Fund® plans Refer to this key for explanations of the
These plans combine an employer-funded health information found on the sample Cigna ID cards
reimbursement account (HRA) or employer/employee-funded featured in this brochure.
tax-advantaged health savings account (HSA) with certain 1 Use this ID number for all claims and inquiries.
medical plans.
2 Indicates a seamless network where a patient
Depending on the plan, customers will have access to health can receive in-network care on a regional or
care professionals who participate in one of five networks statewide basis.
(PPO, EPO, Open Access Plus, LocalPlus, or indemnity).
Cigna Choice Fund or Cigna Choice Fund Open Access Plus to Cigna or its designee, and receive an
Plans that use these networks offer customers access to a explanation of payment (EOP), which will show
suite of health care professionals, and allow them to be in any remaining amount due from the patient.
charge of how and when they spend their health fund dollars. 4 Collect any copayment at the time of service.
› Customers can select a PCP to coordinate care; 5 May read as: “Cigna Health and Life Insurance
it’s recommended but not required. Company” or “Connecticut General Life
› Referrals are not required to see specialists. XXXX, Inc.”
› No copayments are required. 6 ID cards with the Cigna Care Network® logo
› Health care professionals should bill Cigna directly. indicate the patient’s liability varies based
› Precertification may still be required for certain services designation status. Refer to the online health
and procedures.
For a directory of health care professionals who participate in Find a Doctor to determine a physician’s
these networks, visit Cigna.com/HCPDirectory.com. Cigna Care designation status.
physician (PCP).
Shared Administration Repricing plans
The Shared Administration Repricing plan is offered by
the Cigna Taft-Hartley and Federal Business Segment.
to the customer.
It’s designed for Taft-Hartley and federal plan employers
Employer name.
10
that want to continue processing and paying their claims,
retain customer and provider service, or use a third-party 11 If a third party administers services in
administrator to perform these functions. conjunction with Cigna, the ID card may
Shared Administration PPO and Open Access Plus claim address or telephone number on the
Plans that use these networks offer customers access to a back of the card.
national network of health care professionals. Precertification requirements may be shown as
12
› Customers can select a PCP to help coordinate care; either “Inpatient Admission” or “Inpatient
it’s recommended, but not required. Admission and Outpatient Procedures.’’
› Referrals are not required to see specialists. 13

shown on the card.
› Both in- and out-of-network benefits are available. 14
Customers can access health care professionals that
participate in a national network that includes Away
From Home Care.
For a directory of health care professionals who participate in to the Important contact information page in
these networks, visit Cigna.com/HCPDirectory.com. this guide.
15
Plus network.
16
17
Union identifier.
18
14
STRATEGIC ALLIANCE PLANS
WWW.CIGNA.COM
TPV / Alliance CareLink Client
logo 11 logo logo
You must comply with all terms and conditions of the plan. Willful misuse of this card is considered fraud.
Legal entity name 5

Coverage effective date: MM/DD/CCYY Open Access Plus for your pre-certification requirements. Failure to do so may affect benefits. In an emergency, seek care immediately, then call your
Group: 1234567 No referral required
primary care doctor as soon as possible for further assistance and directions on follow-up care within 48 hours.
Issuer (80840)
7 PCP visit $15
ID: U23456789 01 1 Specialist 4 $30 Coinsurance/deductible is paid directly to the doctor/facility by Cigna using individual’s available health funds.
Name: John Public Hospital ER $50 13 For pharmacy: Call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
Urgent care $25 For vision: Call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
PCP: John Smith
Vision Yes Send claims to: CSN name, PO Box XXXXX, Anytown, USA 12345-6789
PCP name Ln2
Rx $10/$20/$40/90%
PCP phone: 860.555.1212 All other: PO Box XXXXX, Anytown, USA 12345-6789
Rx indiv deduct $50
ID card acct name 10 Network coinsurance: 3 Customer service: 1.800.XXX.XXXX 14MH/SA: 1.800.XXX.XXXX
RxBIN XXXXXX RxPCN XXXXXXXX In 90%/10%
DOI 9 Cat# We encourage you to use a PCP as a valuable resource and personal health advocate. 15 AWAY FROM HOME CARE
INDEMNITY PLANS
Network: Not Applicable
WWW.CIGNA.COM
Client You may be asked to present this card when you receive care. The card does not guarantee coverage. You must comply with all
logo terms and conditions of the plan. Willful misuse of this card is considered fraud.
Legal entity name 5 Your provider must call the toll-free number listed below to pre-certify the above services. Refer to your plan documents for your
5
Coverage effective date: MM/DD/CCYY 7 Indemnity pre-certification requirements. Failure to do so may affect benefits. In an emergency, seek care immediately, then call your primary
Group: 1234567 Rx $10/20%/40%/100% care doctor as soon as possible for further assistance and directions on follow-up care within ### hours.
Issuer (80840) Rx indiv deduct $50
Indiv deduct $300 Coinsurance/deductible is paid directly to the doctor/facility by Cigna using individual’s available health funds.
ID: U23456789 01 1 Family deduct $500
3
Note: You can reduce your out-of-pocket expenses if you use a Network Savings Program provider. Use of a Network Savings
Name: John Public 1 Hospital deduct $200 Program provider does not affect your benefit coverage. For help finding a participating provider, please visit our website, or call
ER deduct $50 the toll-free number listed on this card.
Coinsurance:
ID card acct name 10 Medical 80%/20% 13 For Pharmacy, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
For Vision, call ABC Company 1.800.XXX.XXXX (Not a Cigna Company)
bk
RxBIN XXXXXX RxPCN XXXXXXXX
Med/Rx deductible applies Send Claims to: PO Box XXXX, Anytown, USA 12345-6789
DOI
9 Cat# Customer Service: 1.800.XXX.XXXX 14MH/SA: 1.800.XXX.XXXX
Encouraged No N/A Yes
15
Key
Strategic Alliance plans information found on the sample Cigna ID cards
featured in this brochure.
Cigna has entered into strategic alliances with several
nationally recognized health care companies. These plans give
our customers access to an alliance’s network of health care 2 Indicates a seamless network where a patient
professionals and discounts in specific geographic areas. They can receive in-network care on a regional or
also provide the alliance’s customers with access to Cigna’s statewide basis.
national health care professional network and discounts 3 For patients with coinsurance, submit claims
outside their specific geographic area. to Cigna or its designee, and receive an
› Customers can select a PCP to help coordinate care; it’s explanation of payment (EOP), which will show
recommended, but not required. any remaining amount due from the patient.
› Referrals are not required to see specialists. 4 Collect any copayment at the time of service.
› Precertification may still be required for certain services Company” or “Connecticut General Life
and procedures.
XXXX, Inc.”
Indemnity plans Cigna Care designation status.
These plans give customers the freedom to choose any health 7 Effective date of coverage.
care professional. 8 Name of patient‘s primary care
› No network requirements. physician (PCP).
› Referrals are not required to see specialists. 9 Network Savings Program (NSP) logo indicates
to the customer.
Employer name.
10

conjunction with Cigna, the ID card may
back of the card.
12
13
shown on the card.
14
this guide.
15
Plus network.
16
17
Union identifier.
18
16
The myCigna Mobile App
The myCigna Mobile App gives Cigna customers a simple way to personalize, organize, and access their important
myCigna - ID Cards - Print or Request Page 1 of 1
health and coverage information – on the go. Your patients may present their Cigna ID card claims information and
myCigna -eligibility
coverage ID Cardsto - Print
you or
viaRequest
the app on their smartphone or tablet. Page 1 of 1
Sample ID card information you might see on your patients’ myCigna Mobile App:
ID Cards - Print or Request

ID Cards - Print or Request
Click the "Print" button below to print your card.

Click the "Print" button below to print your card.
Please note: Please note:

Temporary Temporary
cards are not ancards
exact are
copynot an exact
of your copy of
permanent IDyour
card permanent ID cardalland
and do not contain the do notinformation
same contain allasthe same information as
your
your permanent ID permanent ID card. Your
card. Your temporary temporary
card will expire incard will expire
ten days in ten
or on your days or
coverage ondate,
end yourwhichever
coverageisendfirst.date, whichever is first. To request
To request
a permanent
a permanent ID IDCards--Print
card, go to ID card, go to or
IDRequest.
Cards--Print or Request.
Issue Date: 07/21/2015

Issue Date: 07/21/2015 You may be asked to You maythis
present becard
askedwhento you
present this card when you access
access
For coverage info: care. This card doesn't
For coverage info: care. This card
guarantee doesn't
coverage. Youguarantee
must coverage. You must
comply with all items and conditions
with allofitems
the plan.
andWillful
Review your coverage
Reviewon the on theof this card is comply
your coveragemisuse considered fraud.
conditions of the plan. Willful
myCigna website myCigna
or mobile app,
misuse of this card is considered fraud.
website or mobile app,
Hospital Admission:Hospital
Prior to any non-emergency
or or Admission: Priorhospital
to any non-emergency hospital
admission, you or your doctor must call the toll-free
Nov Eleven
Nov Elevencall 1.866.494.2111. admission, you or your doctor must call the toll-free
ID:100654369 call 1.866.494.2111. Customers and HealthCustomers
Care Professionals number shown
and Health Care Professionals number shown
PREFERRED ID:100654369 below to request "precertification." In the case of an
PROVIDER PREFERRED emergency, you, your family,toorrequest
below your doctor"precertification."
must call withinIn the case of an
PROVIDER emergency,
48 hours of hospital admission. you,toyour
Failure family,
contact or will
Cigna your doctor must call within
ORGANIZATION
Group Number:ORGANIZATION affect your coverage. 48 hours of hospital admission. Failure to contact Cigna will
Group Number: affect
In an Emergency: Seek your
care coverage.Go directly to the
immediately.
00617573
00617573
Coverage Effective Date: In anorEmergency:
nearest emergency facility call 911. Seek care immediately. Go directly to the
01/01/2014 Coverage Effective Date: nearest Visit
Health Care Professionals:. emergency facility or call 911.
www.CignaforHCP.com or
Issuer: 80840 01/01/2014 call 800-882-4462. Health Care Professionals:. Visit www.CignaforHCP.com or
Issuer: 80840 Customers and Health call 800-882-4462.
Send Medical Claims To:
Care Professionals: Cigna
Customers and Health Send Medical Claims To:
ID card features 1.866.494.2111
Care
1000 Great-West Drive
Professionals: Cigna
(24 hours a day, 365 days Kennett, MO 63857
› Quickly view ID card information (front and back)
a year) 1.866.494.2111
(24 hours a day, 365 days
1000 Great-West Drive
Kennett, MO 63857
for the entire family a year)
› Easily print, email, or scan right from a smartphone Payer ID: #62308
or tablet Payer ID: #62308
Additional
PRINT app features:
CANCEL
The myCigna
PRINT Mobile App includes features that help your patients – and you – have an
CANCEL
easier health care experience.
Health care professional directory Trackers
› Locate doctors and health care facilities › View in-network and out-of-network medical
› ©Access
2015 Cigna. All rights reserved.
maps for instant driving directions and dental year-to-date deductibles, as well as
out-of-pocket
Selecting these links will take you away from myCigna.com. Cigna does not control the linked sites' content orand annual
maximums
links. Details
Health wallet
› Store and ©organize
2015 Cigna. All rights reserved.
all contact information for
Coverage
Selectingand
doctors, hospitals, links will take you away from myCigna.com. CignaSee
thesepharmacies does plan ›
coverage
not control the linkedand
sites'benefit
content orinformation
links. Details for
› Add health care professionals to contact list right

medical, dental, pharmacy, behavioral health,
substance abuse, and disability
from a claim or directory search
Claims ›
Access and view health fund balances
› View and search recent and past medical, dental, and ›

Review plan deductibles and coinsurance
pharmacy claims
› Bookmark and group claims for easy reference
17 http://a-mycigna-0024.cigna.com/web/secure/my/profile/id-cards/!ut/p/a1/hc9ND4IwDAb... 7/21/2015
Additional app features (cont.)
Customers can download the free
Drug search
myCigna Mobile App**
› View medication costs based on their plan and
see lower-cost alternatives*
› Find closest pharmacy location using GPS
› Research medicine and dosages
› Speed dial Cigna Home Delivery Pharmacy SM
The Apple logo is a trademark of Apple Inc., registered in the U.S. and other countries. App
*Prices are not guaranteed, nor is the display of a price a guarantee of coverage. Store is a service mark of Apple Inc. Android and Google Play are trademarks of Google Inc.
Medication costs and coverage may vary at the time prescriptions are filled at the Amazon, Kindle, Fire and all related logos are trademarks of Amazon.com, Inc. or its affiliates.
pharmacy, and pricing at individual pharmacies may vary. Coverage and pricing Blackberry and Blackberry World are trademarks or registered trademarks of BlackBerry Limited,
terms are subject to change. the exclusive rights to which are expressly reserved. Cigna is not affiliated with, endorsed,
**The myCigna Mobile App is available to Cigna health plan customers. Actual sponsored, or otherwise authorized by BlackBerry Limited. The downloading and use of the
features may vary depending on their plan. myCigna Mobile App is subject to the terms and conditions of the app, and the online store
from which it is downloaded. Standard mobile phone carrier and data usage charges apply.
More ways to access patient information when you need it
Use our electronic tools Learn more

› Log in to the Cigna for Health Care Professionals To access our educational resources, log in to
website (CignaforHCP.com) CignaforHCP.com > Resources > eCourses. Select
› Connect to us through electronic data interchange courses about EDI, eligibility and benefits, estimating
patient out-of-pocket costs, precertification, electronic
(EDI): Visit Cigna.com/EDIVendors to learn more
claim submission, claim status inquiry, enrolling in and
› Call our automated phone system: 1.800.88Cigna managing EFT, online remittance reports, and more.
(882.4462)
Conduct administrative
transactions electronically
Cigna’s convenient eServices tools help you manage
the administrative details of health care.
› Access patient eligibility and benefits
› Estimate patient out-of-pocket costs
› View and submit precertification requests
› Check claim status
› Enroll online for electronic funds transfer (EFT),
then view, print, and share online remittance reports
the same day you receive electronic payments
› Receive electronic remittance advices and
automatically load them to your accounts
receivable system
› Submit questions about fee schedules and
specific patient benefits
18
Important contact information
Find the contacts you need to get in touch with us for information about your patients with Cigna coverage.*
Please note that call, claim, and service channels may differ based on the patient’s ID card.
If you want to: Use the following:
Update your contact or demographic information Email: Intake_PDM@Cigna.com

Fax: 1.877.358.4301
Mail: Cigna Provider Data Management
Two College Park Dr., Hooksett, NH 03106
Perform online transactions:** Cigna for Health Care Professionals website:

• Verify patient eligibility CignaforHCP.com
• Inquire about patient coverage and
covered services
• Predict the total cost of service and patient liability
for specific medical procedures
• Request precertification for services
• Inquire about precertification for services
• View claim-coding policies and payment guidelines
• Review medical or pharmacy coverage positions
• View the prescription drug list
• View sample ID cards
• Obtain a Reference Guide
• Request a copy of your contract
• Request fee schedule information
Perform transactions using a multipayer website or Refer to Cigna.com/EDIvendors for a list of directly connected Cigna vendors.
vendor via Electronic Data Interchange (EDI):**
• Verify patient eligibility and coverage
• Inquire about patient coverage and
covered services
• Check the status of a claim
• Request precertification for services
• Submit claims electronically
• Receive electronic remittance advices
• View list of EDI vendors
Enroll to receive electronic funds transfer (EFT) • Enroll in EFT and manage EFT accounts with multiple payers, including Cigna, using
the Council for Affordable Quality Healthcare® (CAQH) website: https://solutions.
CAQH.org
• Enroll in EFT directly with Cigna by logging in to CignaforHCP.com > Working with
Cigna > Enroll in Electronic Funds Transfer (EFT) Options
* Excluding customers with third-party administrator plans.

** Not all transactions are available for all Cigna plans.
19
If you want to: Use the following:
Perform telephone transactions:** 1.800.88Cigna (882.4462)

• Learn about electronic services For patients with GWH-Cigna or “G” ID cards:
• Verify patient eligibility and coverage
1.866.494.2111
• Check the status of a claim
• Request precertification for services Customer service numbers are also included on the patient’s ID card.
• Request an exception to the prescription drug list
Submit a paper claim Refer to patient’s ID card
Submit or inquire about an appeal or dispute 1.800.88Cigna (882.4462)

Cigna National Appeals
PO Box 188011
Chattanooga, TN 37422
Fax: 1.877.815.4827
For patients with GWH-Cigna or “G” ID cards:
Cigna National Appeals
PO Box 188062
Chattanooga, TN 37422-8062
Fax: 1.877.804.1679
Submit or inquire about health care professional credentialing 1.800.88Cigna (882.4462)
Obtain information about the organ and tissue transplant network Cigna LifeSOURCE Transplant Network®
CignaLifeSOURCE.com
1.800.668.9682
Obtain other telephone numbers and addresses Refer to the patient’s ID card
Other important contacts: Use the following:
Cigna Behavioral Health CignaforHCP.com

1.800.926.2273
Cigna Dental Cigna.com

1.800.Cigna24 (244.6224)
1.866.494.2111
Cigna Home Delivery Pharmacy 1.800.285.4812
Cigna Specialty Pharmacy Services 1.800.351.3606

(specialty medications administered by injection or infusion,
and certain oral medications)
Medical management (including precertification) CignaforHCP.com

1.800.88Cigna (882.4462)
1.866.494.2111
Customer Service numbers are also included on the patient’s ID card.
** Not all transactions are available for all Cigna plans.
20
Other important contacts (continued): Use the following:
eviCore healthcare (formally CareCore | MedSolutions, Inc.) eviCore healthcare

Use for high-technology radiology, diagnostic cardiology, and pain For precertification requests:
management precertification (effective January 1, 2016) myportal.medsolutions.com
For customers in AK, HI, and MT: Before 1/1/16 use information below.
Exceptions:
Strategic alliance customers in MA and RI, all customers in other
alliance service areas:
CignaforHCP.com
1.800.88Cigna (882.4462)
Pharmacy prior authorizations 1.800.244.6224

(small molecule and specialty drug)
TheraCare® 1.800.633.6521
(specialty therapy management program)
21
18
All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company, Connecticut General Life
Insurance Company, Cigna Behavioral Health, Inc., Cigna Health Management, Inc., Tel-Drug, Inc., Tel-Drug of Pennsylvania, L.L.C., and HMO or service company subsidiaries of Cigna Health
Corporation and Cigna Dental Health, Inc. “Cigna Specialty Pharmacy Services” refers to the specialty drug division of Tel-Drug, Inc. and Tel-Drug of Pennsylvania, L.L.C., doing business as Cigna
Home Delivery Pharmacy. The Cigna name, logo, and other Cigna marks are owned by Cigna Intellectual Property, Inc.
591795 t 06/16 THN-2016-289 © 2016 Cigna. Some content provided under license.

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Shared Administration PPO������������������������������������������������������ 13

Shared Administration Open Access Plus�������������������������� 13

Strategic Alliance plans���������������������������������������������������������� 15

Open Access Plus�������������������������������������������������������������������������� 15

The myCigna Mobile App������������������������������������������������������� 18

Important contact information��������������������������������������������� 20

Network: Network Open Access

Legal entity name 5 5 12 INPATIENT ADMISSION:

Network: Open Access Plus

CSN logo 18 WWW.CIGNA.COM

Legal entity name 5

Networks: HMO Open Access and POS Open Access

Legal entity name

For more information, see the next page.

CSN logo WWW.CIGNA.COM

Networks: HMO, POS, and HMO POS

For more information, see the next page.

Networks: Network and Network POS

Legal entity name 5

Networks: PPO or EPO

CSN logo 18 WWW.CIGNA.COM

Legal entity name 5 12 INPATIENT ADMISSION AND OUTPATIENT PROCEDURES:

For more information, see the next page.

INDIVIDUAL & FAMILY PLANS

*PCP selection and referrals are encouraged in Missouri.

For more information, see the next page.

Network: Open Access Plus

Networks in U.S.: PPO and OAP www.CignaEnvoy.com

Preferred care network in the U.S.: Cigna HealthCare PPO

All benefits are subject to verification of eligibility, definitions, exclusions,

Members and Providers

Employer: Contact: 1.800.243.1348 (toll-free) or 001.302.797.3535 (outside the U.S.)

Network Savings Program AWAY FROM HOME CARE

Preferred care network in the U.S.: Cigna HealthCare PPO

11 If a third party administers services in

CSN logo 18 WWW.CIGNA.COM

Legal entity name 5

For more information, see the next page.

SHARED ADMINISTRATION REPRICING PLANS

Network: Shared Administration PPO

Network: Shared Administration Open Access Plus

› Referrals are not required to see specialists. 13

Network: Open Access Plus

Legal entity name 5

Network: Not Applicable

11 If a third party administers services in

ID Cards - Print or Request

Click the "Print" button below to print your card.

Please note: Please note:

Issue Date: 07/21/2015

› Add health care professionals to contact list right

› View and search recent and past medical, dental, and ›

Use our electronic tools Learn more

If you want to: Use the following:

Update your contact or demographic information Email: Intake_PDM@Cigna.com

Perform online transactions:** Cigna for Health Care Professionals website:

* Excluding customers with third-party administrator plans.

Perform telephone transactions:** 1.800.88Cigna (882.4462)

Submit a paper claim Refer to patient’s ID card

Submit or inquire about an appeal or dispute 1.800.88Cigna (882.4462)

Submit or inquire about health care professional credentialing 1.800.88Cigna (882.4462)

Other important contacts: Use the following:

Shared Administration PPO�� 13

Shared Administration Open Access Plus�� 13

Strategic Alliance plans�� 15

Open Access Plus�� 15

The myCigna Mobile App�� 18

Important contact information�� 20