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St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings: April 23 rd - 3:00pm, 5:00pm April 24 th - 10:00am, 1:00pm, 3:00pm April 29 th - 8:30am, 10:00am Presented by: Amy M. Twitchell, CWPC – Cigna Client Engagement Manager

St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

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Page 1: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

St. Charles Community College 2014 Open Enrollment

Cigna Medical, Pharmacy, and Dental OptionsPlan Year Beginning– July 1, 2014

Open Enrollment Meetings:April 23rd - 3:00pm, 5:00pm

April 24th - 10:00am, 1:00pm, 3:00pm

April 29th - 8:30am, 10:00am

Presented by: Amy M. Twitchell, CWPC – Cigna Client Engagement Manager

Page 2: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

2

You are one of a kind.

That’s why we offer coverage tools resources that work for you as an individual –

®

and ultimately help keep you healthier

And we want to help you live that way.

Page 3: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

What’s Changing for 2014?

Medical & Pharmacy Coverage: Cigna will be the new carrier for your medical and pharmacy benefits beginning July 1, 2014. You will use the Cigna Open Access Plus (OAP) network of medical providers and pharmacies. You can look up your providers on www.Cigna.com at any time to verify that your providers are in the Cigna OAP network. You can also call 1.800.Cigna.24 for assistance with locating Cigna OAP providers as well as ask benefit questions 24/7/265.

Dental Coverage: No Changes to Dental – Cigna will remaining the carrier for your dental plan with no changes to the benefits. You will continue to use the Cigna DPPO CORE Dental PPO network of dental providers.

3Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna

Page 4: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

What you need to know….. Current Year Medical Plan Deductible and Out-of pocket Credit:

Cigna will be honoring any Medical plan Deductibles and Out of Pocket Maximums met from January 1, 2014 through June 30, 2014 under your prior carrier. We will be receiving this information and loading into our system to provide the appropriate credit. Medical Claims will be on hold until this information is loaded, however this will not impact your ability to received Medical or Pharmacy Services beginning July 1, 2014 with Cigna.

Medical Transition of Care for current treatment by a non-Cigna Provider:

Cigna offers a Transition of Care (TOC) benefit to those who are currently undergoing a major course of treatment such as chemotherapy or maternity from a provider that is not part of the Cigna OAP network when your Cigna benefits become effective. It is rare that your current provider will not be in the Cigna network. The TOC benefit allows you to submit for approval to continue treatment up to 90 days with your current out of network provider at the in-network level of benefit. This allows time for you to complete treatment or transition to an in-network provider. Should you decide to continue to see the out of network provider once the approved TOC period has ended, those services would fall under the out of network benefit ongoing. TOC forms must be submitted within 30 days of your effective date.

TOC requests are reviewed by our Clinical staff on a case-by-case basis and we cannot guarantee all TOC requests will be approved.

4Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna

Page 5: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

your options

5

overview of plans

Page 6: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

YOUR MEDICAL PLANOPTIONSPlan year: 2014

862431 Offered by: Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, or their affiliates.

Page 7: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

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Open Access Plus PlanOAP1 – Option 1

Open Access Plus PlanOAP2 – Option 2

Single Family Single Family

Deductible$500 In-network

$1,000 Out-of-network*

$1000 In-network

$2,000 Out-of-network*

$500 In-network

$1,000 Out-of-network*

$1,000 In-network

$2,000 Out-of-network*

Out-of-pocket maximumincludes medical copays and deductible

$1,500 In-network$3,000 Out-of-network*

$3,000 In-network$6,000 Out-of-network*

$1,500 In-network$3,000 Out-of-network*

$3,000 In-network$6,000 Out-of-network*

Plan co-insurance 90% in-network / 70% out-of-network 80% in-network / 60% out-of-network

Lifetime maximum Unlimited Unlimited

Doctor Visits PCP - $20 copaySpecialist - $30 copay

Plan pays 70% after the plan deductible is met.

PCP - $20 copaySpecialist - $30 copay

Plan pays 60% after the plan deductible is met.

Preventive Care Unlimited. Well baby, well child, well woman, adult preventive care. Preventive labs/screenings. Immunizations

Plan pays 100%. Plan pays 70% after the plan deductible is met.

Plan pays 100%. Plan pays 60% after the plan deductible is met.

PLANNING FOR MEDICAL EXPENSES

*If you choose to receive care outside of your plan’s network, only covered expenses will be applied to your deductible – subject to your plan’s Maximum Reimbursable Charge provisions.

Page 8: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

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Open Access Plus Plan(s)

OAP1 – Option 1 & OAP2 – Option 2

In-networkRetail

(30-day supply)Home delivery* (90-day supply)

Generic (1st Tier) You pay $10 You pay $20

Cigna-preferred brand (2nd Tier) You pay $35 You pay $70

Non-preferred brand (3rd Tier) You pay $60 You pay $120

Self-injectable medications (4th Tier) 25% per prescription 25% per prescription

4th Tier Self-injectable Out-of-pocket Maximum*applies to in and out of network retail and home delivery for 4th Tier Self-injectable medications ONLY. Once the 4 th Tier out-of-pocket max is met, 4th Tier medications are covered at 100% for the remainder of the year.

Individual - $2,500Family - $5,000

Out-of-networkRetail

(30-day supply)Home delivery (90-day supply)

You’ll pay 50% for all out-of-network prescription medications regardless of your plan

PLANNING FOR PRESCRIPTION EXPENSES

*You can receive a cost savings by using Cigna Home Delivery for maintenance medications. You will receive a 90-day supply for the cost of 60-days. That’s a savings of 1 retail copay every 90 days.

Page 9: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

THE BENEFITS OF CIGNA HOME DELIVERY PHARMACY

• Talk with a licensed pharmacist on call 24/7/365

• Quick on-time delivery – overnight if necessary

• Every order quality inspected, FDA-approved

• Tamper-resistant, confidential packaging

9Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna

• Order by phone 24/7/365• Get up to a 90-day supply• Delivery to any location• Refill reminders by phone,

email or text

• Possible lower out-of- pocket cost*

• Shop and compare prices on myCigna.com or Mobile App

• Free shipping• We will offer generic versions

of your medication to save you money

• No charge for supplies (syringes, needles, etc.)

• Save gas – no trips to store

*Costs and savings opportunity is dependent on your pharmacy plan design.

QUALITY CONVENIENCE SAVINGS

Page 10: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

BY PHONE ELECTRONICALLY

MAKE THE SWITCH. IT'S EASY.

• Ask your doctor to write you a prescription for a 90-day supply with refills and send it electronically to Cigna Home Delivery Pharmacy.

• This is the easiest way to fill with us.

10Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna

• Have your medication, doctor’s name and your payment information ready.

• Call 1.800.285.4812.

• We’ll request a prescription from your doctor for a 90-day supply with refills.

@

Page 11: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

EASY ORDERING. QUICK DELIVERY.

11Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna

Submit order

Phone or electronically from your doctor

Order is received, logged and screened for exceptions

Filled by a registered pharmacist

Order shipped

Order arrivesCheck order status online anytime

Checked for interactions with other home delivery orders

Orders ship in 5 days for new, 2 days for refill

Order filled

@

Page 12: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

how it works

12

the claims process

Page 13: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

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You get an Explanation of Benefits, or “EOB” (your receipt) from Cigna.

Show Cigna ID card. Pay copay or coinsurance as required.

Visit in-network doctor/hospital/facility.

YOUR CLAIMS PROCESS

These examples are used for illustrative purposes only.

Page 14: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

TRACKING YOUR CLAIMS

Explanation of Benefits (EOB)• Clearly shows how and when claims were

paid

• Available in print or online at myCigna.com• You choose if you would like EOBs mailed to

your home or go paperless and receive email alerts after each claim is processed and posted to myCigna.com

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Doctor’s fee

Cigna discount

Amount billed

Amount paid to doctor

What you saved

What you owe

Page 15: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

Deductible & Out-of-Pocket Maximum Claim Scenarios**

Example 1A – Option 1 OAP Plan - Family Coverage: Employee

Employee has an outpatient surgery after July 1, 2014. The customer has had 1 Specialist office visit prior to the surgery with a $30 copay under the prior carrier.

– Surgical Date of Service 07/9/2014 - Total Billed $2,000

Cigna receives the claim, applies the contracted discount, and processes the balance per the plan benefit for in-network outpatient surgery. (Plan pays 90% after deductible)

– Contracted Discount $1,000 – Total Covered Charge $1,000

Cigna checks the Customer’s deductible met to date and shows that $0 has been met, the claim processes as follows:

$1,000 covered amount after discount

- $ 500 applied to In-network Plan Deductible (customer pays to provider)

$ 500 balance after deductible

- $ 450 amount paid by plan (Plan pays 90% after deductible)

$ 50 balance after deductible and plan payment (customer pays to provider)

- Total paid by plan = $450 (90% co-insurance after deductible was satisfied)

- Total paid by Customer $550 ($500 deductible + $50 co-insurance) - Customer has met $500 in-network plan deductible

- $500 of the Family deductible has been met. $500 of the $1,000 Family deductible remains.

- Customer has met $580 of the Individual out-of-pocket max ($500 deductible + $50 co-insurance + $30 specialist ov copay.)

$920 of the $1,500 Individual out-pocket max remains.

- $580 of the Family out-out-of-pocket has been met. $2,240 of the $3,000 Family out-of-pocket remains.

15**scenarios are for illustration purposes only and based on in-network care.

Page 16: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

16Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna

Deductible & Out-of-Pocket Maximum Claim Scenarios**

Example 1B – Option 1 OAP Plan - Family Coverage: Child #1

SEE EXAMPLE 1A for Employee’s claims example

Child #1 has an outpatient surgery after July 1, 2014. The Child has not had any other services this year. – Surgical Date of Service 8/04/2014 - Total Billed $3,500

Cigna receives the claim, applies the contracted discount, and processes the balance per the plan benefit for in-network outpatient surgery. (Plan pays 90% after deductible)

– Contracted Discount $1,500 – Total Covered Charge $2,000

Cigna checks the Family deductible met to date and shows that $500 of the $1000 has been met, the claim processes as follows:

$2,000 covered amount after discount

- $ 500 applied to In-network Plan Deductible – the Family deductible has now been met (customer pays to provider)

$1,500 balance after deductible

- $ 1,350 amount paid by plan (Plan pays 90% after deductible)

$ 150 balance after deductible and plan payment (customer pays to provider)

- Total paid by plan = $1350 (90% co-insurance after deductible was satisfied)

- Total paid by customer $650 ($500 deductible + $150 co-insurance)

- Customer has met $500 in-network plan deductible

- The $1,000 Family Deductible has been met.

- Customer has met $580 towards their $1500 in-network out of pocket max ($500 deductible + $50 co-insurance +

$30 specialist ov copay.)- $1,230 of the Family out-of-pocket maximum has been met. $1,770 of the $3,000 Family out-of-pocket maximum remains.

Page 17: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

17Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna

Deductible & Out-of-Pocket Maximum Claim Scenarios**

Example 1C – Option 1 OAP Plan - Family Coverage: Spouse

•SEE EXAMPLE 1A for Employee’s claims example

•SEE EXAMPLE 1B for 1st Child’s claims example

Spouse has an inpatient surgery and 2 PCP Visits and 2 Specialist Visits ($100 in copays) after July 1 2014. The Family Deductible of $1,00 in-network has been met.

2 PCP Visits – 8/16/2014 & 8/27/2014 - $20 x 2 = $40

2 Specialist Visits – 9/5/2014 & 9/19/2014 - $30 x 2 = $60 Surgical Date of Service 10/3/2014 - Total Billed $50,000

Cigna receives the claim, applies the contracted discount, and processes the balance per the plan benefit for in-network outpatient surgery. (Plan pays 90% after deductible)–Contracted Discount $10,000 –Total Covered Charge $40,000

Cigna checks the Family deductible met to date and shows that $500 of the $1000 has been met, the claim processes as follows:

$40,000 covered amount after discount

- $36,000 amount paid by plan (Plan pays 90% after deductible – Family deductible has been met)

$4,000 balance after plan payment

- $ 1,400 customer 10% co-insurance which satisfies the Individual out-of-pocket maximum (customer pays to provider)

$ 270 balance paid at 100% by plan due to the Individual out-of-pocket maximum being met

- Total paid by plan = $36,270 (90% co-insurance + balance at 100% after out-of-pocket max was met)

- Total paid by customer $1,500 ($100 copays + $1,400 co-insurance to satisfy the Individual out-of-pocket maximum)

- Customer has met $1,500 Individual out-of-pocket max

- $2,730 of the Family out-of-pocket maximum has been met. $270 of the $3,000 Family out-of-pocket maximum remains.

Page 18: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

18Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna

Deductible & Out-of-Pocket Maximum Claim Scenarios**

Example 1D – Option 1 OAP Plan - Family Coverage: Child #2

•SEE EXAMPLE 1A for Employee’s claims example

•SEE EXAMPLE 1B for Child #1’s claims example

•SEE EXAMPLE 1C for Spouse’s claims example

Child #2 needs a piece of Durable Medical Equipment and 2 PCP Visits and 1 Specialist Visits ($70 in copays) after July 1 2014. The Family Deductible of $1,00 in-network has been met.

2 PCP Visits – 10/15/2014 & 10/22/2014 - $20 x 2 = $40

1 Specialist Visit – 10/30/2014= $30 DME Date of Service 11/11/2014 - Total Billed $3,500

Cigna receives the claim, applies the contracted discount, and processes the balance per the plan benefit for in-network outpatient surgery. (Plan pays 90% after deductible)–Contracted Discount $200 –Total Covered Charge $3,300

Cigna checks the Family deductible met to date and shows that $500 of the $1000 has been met, the claim processes as follows:

$3,300 covered amount after discount

- $2,970 amount paid by plan (Plan pays 90% after deductible – Family deductible has been met)

$ 330 balance after plan payment

- $ 200 customer 10% co-insurance which satisfies the Family out-of-pocket maximum (customer pays to provider)

$ 130 balance paid at 100% by plan due to the Family out-of-pocket maximum being met

- Total paid by plan = $3,130 (90% co-insurance + balance at 100% after out-of-pocket max was met)

- Total paid by customer $270 ($70 copays + $200 co-insurance to satisfy the Family out of-pocket maximum)

- Customer has met $3,000 Family out-of-pocket max

All covered in-network medical services will now be paid at 100% for the entire family for the remainder of the year.

Page 19: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

Deductible & Out-of-Pocket Maximum Claim Scenarios**

Example 2 – Option 1 OAP Plan - Single Coverage: Employee

•Employee has an inpatient surgery after July 1, 2014. The Customer had a PCP ov copay of $20 and a Specialist copay of $30 in January 2014 and met $200 of the in-network plan deductible in February 2014 under the prior carrier.

– Date of Service 09/01/2014– Total Billed $20,000

Cigna receives the claim, applies the contracted discount, and processes the balance per the plan benefit for in-network outpatient surgery. (Plan pays 90% after deductible)

– Contracted Discount $4,000 – Total Covered Charge $16,000

Cigna checks the customer’s deductible met to date and shows that $200 has been met, the claim processes as follows:

$16,000 covered amount after discount

- $ 300 applied to remaining In-network Plan Deductible (customer pays to provider)

$15,700 balance after deductible

- $14,130 amount paid by plan (Plan pays 90% after deductible)

$ 1,570 balance after deductible and plan payment

- $ 950 customer 10% co-insurance which satisfies the out-of-pocket maximum (customer pays to provider)

$ 620 balance paid at 100% by plan due to the out-of-pocket maximum being met

- Total paid by plan = $14,750 (90% co-insurance + balance at 100% after out-of-pocket max was met)

- Total paid by customer $1,250 ($300 to satisfy the deductible + 10% co-insurance to satisfy the out-of-pocket max)

- Customer has met $500 in-network plan deductible

- Customer has met the $1,500 in-network out of pocket max ($500 deductible + $50 ov copays + $950 co-insurance.)

19**scenarios are for illustration purposes only and based on in-network care.

Page 20: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

YOUR DENTAL PLANOPTIONSPlan year: 2014

862420 Offered by: Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, Cigna HealthCare of Connecticut, Inc., or Cigna Dental Health, Inc. and its subsidiaries.

Page 21: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

21

The Cigna Dental PPO is underwritten and/or administered by Connecticut General Life Insurance Company (CGLIC) or Cigna Health and Life Insurance Company with network management services provided by Cigna Dental Health, Inc. In Arizona and Louisiana, the insured dental PPO plan offered by CGLIC is known as the CG Dental PPO. In Texas, this insured dental product is referred to as the Cigna Dental Choice Plan.

CignaDental PPO - Core

Choice and savings.Find the right balance for you.

DPPOIn- and out-of-network coverage

Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna

Page 22: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

CHOICE AND SAVINGS

CHOICE

• The freedom to visit any licensed dentist or specialist

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1. Dental Network Savings Program (DNSP) is a discount savings program and is not insurance. Availability may vary and is subject to change. Customers receive discounts for out-of-network services received from a dentist participating in the DNSP. Not all providers that participate in DNSP are part of the Cigna network or credentialed by Cigna.

2. Healthy Rewards is a discount program and is separate from your dental benefits. If your plan includes coverage for any of the services offered through Healthy Rewards, this program is in addition to, not instead of, your plan benefits. Some Healthy Rewards programs are not available in all states and may be discontinued at any time. A discount program is NOT insurance, and you must pay the entire discounted charge.

A healthy balance

CHOICE SAVINGS

SAVINGS• Biggest savings – dentists in the

Cigna Dental Core Network

• You can also save money out-of-network – with dentists or specialists in the Dental Network Savings Program1

• Save on out-of-pocket costs for many services not covered under your plan1

• Receive Healthy Rewards®2

discounts

DPPOIn- and out-of-network coverage

Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna

Page 23: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

USING YOUR PLAN

• Choose a licensed dentist. NOTE: If you select a Cigna Dental Core dentist from our Provider Directory, you will typically spend less

• No ID card needed

• No referral needed to visit a specialist

• Most Cigna Dental Core Network dentists will submit claims for you. Your plan will then pay the dentist or you (based on the claim form)

• The amount your plan pays depends on the coinsurance level for the service you received, if you’ve paid your deductible and/or reached your maximum

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DPPO − CoreIn-network dentists: Greater savings on covered procedures

DPPOIn- and out-of-network coverage

Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna

Page 24: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

YOUR COVERAGE

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PERCENTAGE YOUR PLAN PAYS

Cigna Dental Core Network Out-of-network*

Class I – Preventive care 100% no deductible 80% no deductible

Class II – Basic restorative 80% after deductible 50% after deductible

Class III – Major restorative 50% after deductible 50% after deductible

Class IV – Orthodontia^for dependent children to age 19

50% up to a lifetime maximum of $1,500

Class V - TMJ 50% after deductible, up to a lifetime maximum of $1,500

Individual Family

Annual deductible $25 $75

Calendar-year maximum ^applies to Class I, II, and III expenses

$1,500 – per person

All plans have exclusions and limitations. Please refer to your Benefit Summary for details about your specific plan.

*The amount your plan will pay for covered out-of-network services will be subject to your plan’s Maximum Reimbursable Charge provisions. When going out-of-network, you may be balance-billed by the dentist for any charges that are not covered by your plan.

DPPOIn- and out-of-network coverage

Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna

Page 25: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

A HEALTHY SMILE AND A HEALTHY BODY

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Research shows an association between oral health and medical conditions such as diabetes, stroke, heart disease, preterm birth and more.

Covered medical condition Did you know…

Maternity Pregnant women with untreated chronic gum disease during the second trimester were up to eight times more likely to give birth prematurely.1

Stroke and heart disease Those with gum disease may be twice as likely to suffer from heart disease and stroke.2

Diabetes Some studies show that gum disease may make it more difficult for people with diabetes to control their blood sugar.3

Head and neck cancer radiation Head and neck radiation can harm normal cells, including cells in the mouth.4

Organ transplants Due to compromised immune systems, organ transplant patients may need specialized dental care to avoid infections.5

Chronic kidney disease Researchers found that subjects with gum disease and those with missing teeth were nearly twice as likely to have chronic kidney disease (60% and 85%, respectively) compared to those without these risk factors.6

1. Journal of the American Dental Association, July 2001 “Oral Health During Pregnancy: An Analysis of Information.” 2. American Academy of Periodontology. (2012, April 18). Gum disease links to heart disease and stroke. Retrieved from www.perio.org/consumer/mbc.heart.htm.3. American Academy of Periodontology. (2012, April 18). Gum disease and diabetes. Retrieved from www.perio.org/consumer/mbc.diabetes.htm.4. “Head and Neck Radiation Treatment and Your Mouth,” U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Dental and

Craniofacial Research, July 2008.5. Dental Management of the Organ Transplant Patient. National Institutes of Health. National Institute of Dental and Craniofacial Research. NIH Publication No. 10-6270.

Reprinted October 2009.6. Colgate World of Care. Reviewed by the Columbia University College of Dental Medicine. Retrieved 12/31/09. www.colgate.com.

Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna

Page 26: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

CIGNA DENTAL ORAL HEALTH INTEGRATION PROGRAM®

Covered dentalprocedures and medical conditions

Heart Disease

Stroke Diabetes MaternityChronic Kidney Disease

Organ Transplants

Head and neck

cancer radiation

Periodontal treatmentand maintenance2

Periodontal evaluation

Oral evaluation3

Cleaning4

Emergency palliative treatment

Fluoride – topical application and varnish5

Sealants5

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Available to ALL CignaDental customers with qualifying condition(s)

Articles on behavioral issues linked to oral health

Up to 50% off average retail prices on certain prescription dental products1

The Cigna Dental Oral Health Integration Program is one of the most comprehensive programs available*. The benefit is all yours.

Pays 100% for enhanced preventive and periodontal services to help keep you at 100%

More programs More wellness More discounts

*Based on an internal market survey conducted from 2008–2012 including over ten leading dental carriers which indicates Cigna reimburses for more procedures and qualifying conditions than any other carrier reviewed.1 . December 2010, Cigna Home Delivery Pharmacy Average Retail Price Surveys 2. Four times per year. 3. One additional evaluation. 4. One additional cleaning. 5. Age limits removed; all other plan limitations apply. Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna

Page 27: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

YOUR DENTAL TREATMENT COST ESTIMATOR

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• Convenient, online access to estimate dental care costs• Helps you to plan and budget• Specific to your plan information, adjusted for your geographic location

DPPO screen shot

These examples are provided for illustrative purposes only. The Treatment Cost Estimator is for informational purposes and provides rough calculations only, based on the treatment or procedure you choose. It does NOT guarantee the exact amount of your out-of-pocket costs and it does NOT guarantee coverage for any treatment or procedure or any dental benefit plan payment. Your actual out-of-pocket cost for dental care will depend on the specific terms of your dental benefit plan.

Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna

Page 28: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

help with your health

28

Page 29: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

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RESOURCES FOR MANAGING EVERY STEP OF YOUR HEALTH

• Use Cigna Healthy Rewards® to save money on health and wellness products and services like fitness clubs, eyewear, massage therapy and more*

• Easy-to-use, confidential health assessment gives you an overall health “score” and a personalized report

• Online coaching programs help you maintain a healthy lifestyle

• Coverage for preventive care, including immunizations and preventive screenings**

• A personal health advocate can help you prepare for office visits, improve your lifestyle, reduce your health risks, explore/choose treatment options and answer questions about health and coverage

• Programs to help you better manage stress, quit tobacco or lose weight

• Work with a dedicated health advocate to help you manage your chronic health condition, treatment options and self-care

• Easily refill drug orders, track shipments and get in touch with a pharmacist at any time on our Cigna Home Delivery Pharmacy page on myCigna.com

• Compare real-time drug prices specific to your plan with our Prescription Drug Price Quote Tool to see if there is a lower cost option – helpful for 4th Tier self-administered injectable medications.

• TheraCare coaches trained as nurses can help guide you if you’re dealing with complex conditions that require a specialty pharmacy.

*Healthy Rewards is a discount program and is separate from your medical benefits. If your plan includes coverage for any of the services offered through Healthy Rewards, this program is in addition to, not instead of, your plan benefits. Some Healthy Rewards programs are not available in all states and may be discontinued at any time. A discount program is NOT insurance, and you must pay the entire discounted charge.

**Subject to the terms of your plan. All plans have exclusions and limitations. See your Benefit Summary and enrollment materials for details about the services covered under your plan.

Page 30: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

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YOUR FAMILY HEALTH

• Healthy Babies, Healthy Pregnancies Incentive education program helps every mom and baby get a healthy start

• Fit and Fun Family Toolkit created by the Healthy Kids Challenge® offers tips and activities to keep your family healthy and active

• Reminders to help you stay up-to-date on childhood immunizations

• Alerts can be sent to you and your doctor when we see a missed preventive screening, like a mammogram or colonoscopy

• Cigna and Everyday Health ValuesSM provides coupons to help make it easy to save on many of the everyday health and wellness products you buy at the supermarket.* Visit us at www.Cigna.com to start saving!

*The Everyday Healthy Values trademark is owned by CoOptions, Inc. and this website is provided by Coupons.com.

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how we can help

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tools and resources

Page 32: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

MAKING SURE YOU’RE GETTING QUALITY CARE

Quality and cost ratings let you compare doctors and hospitals

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Online resources let you check for dangerous drug interactions

Alerts are sent to you and your doctor if we see or anticipate possible gaps in care; for example, if you don’t refill a prescription needed to treat a chronic condition

Our case managers work with you and your doctors to help them develop a complete care plan if you are hospitalized with a serious illness or injury

!

Page 33: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

SAVING YOU TIME• Find a dentist, doctor, hospital, pharmacy or other health facility whenever you need one

– online, by phone or on the go with any web-enabled device*

• Easy-to-use decision support information and tools on myCigna.com and myCigna mobile app

– Compare treatment and procedure costs

– Find cost and quality ratings for doctors and hospitals

– Find lower cost prescription drugs and pharmacies

• Keep track of your health history and records with a secure online personal health record

• Switch a prescription to Cigna Home Delivery Pharmacy with one easy phone call and get 90-days of your medications delivered to your door so you don’t miss a dose

• Speak with a Registered Nurse 24/7 – 24-Hour Health Information Line

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Talk with a coach,trained as a nurse when you can’t reach your doctor

No claimformsneeded

in-network

*Your carrier’s standard mobile phone and data usage charges apply.

Page 34: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

WE’RE HERE FOR YOU

By phone – 1.800.Cigna.24 (1.800.244.6224)• Call us anytime day or night – live, 24/7 customer service, 365 days a year – including holidays.

• Speak to us in your preferred language – interpreter service is available in over 150 languages

Prefer to go online?• Visit your personalized Cigna site www.myCigna.com**

Award-winning* directory of doctors, hospitals, facilities with cost and quality ratings Coverage details (copays, deductibles, out-of-pocket maximums, etc.) Claim activity and history Temporary ID cards or info on how to order new ones (myCigna.com only) A wealth of health information and resources (myCigna.com only) Savings on prescription medications when ordered through Cigna Home Delivery Pharmacy® (myCigna.com only)

On the go? We have an App for that!• myCigna.com Mobile App – available for Apple & Android devices

Gives you access to almost all of the myCigna tools and resources…on the go! Carry your Cigna ID Cards right on your device

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**myCigna is available to current Dental participants, Medical/Rx information available as of July 1, 2014

Page 35: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

how to

enroll

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get ready to smile

Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna

Page 36: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

YOUR ENROLLMENT

!! IMPORTANT DATES !!

•2014 OPEN ENROLLMENT PERIOD: April 28, 2014 to May 9, 2014

•ALL ENROLLMENT FORMS MUST BE TURNED IN BY: May 9, 2014

36Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna

Don’t Forget…Cigna Pre-enrollment Information Line: Available to answer questions about the Cigna Medical, Pharmacy, and Dental plans 24/7 starting now by calling 1.800.Cigna.24 (1.800.244.6224) and identifying yourself as an employee or employee’s dependent of St. Charles Community College.

Page 37: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

Q&A

37

what you want to know

Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2013 Cigna

Page 38: St. Charles Community College 2014 Open Enrollment Cigna Medical, Pharmacy, and Dental Options Plan Year Beginning– July 1, 2014 Open Enrollment Meetings:

Health care professionals who participate in Cigna’s network are independent contractors solely responsible for the treatment provided and are not agents of Cigna. The information in this presentation summarizes the highlights of your plan. For a complete list of both covered and not covered services, including benefits required by your state, see your employer’s group insurance certificate, summary plan description or group service agreement – the official plan documents. If there are any differences between the information in this presentation and the plan documents, the information in the plan documents takes precedence.

“Cigna,” the “Tree of Life” logo, “GO YOU,” “TheraCare” and “Healthy Rewards” are registered service marks, and “Cigna Home Delivery Pharmacy” is a service mark, of Cigna Intellectual Property, Inc., licensed for use by Cigna Corporation and its operating subsidiaries. All products and services are provided by or through such operating subsidiaries and not by Cigna Corporation. Such operating subsidiaries include Connecticut General Life Insurance Company (CGLIC), Cigna Health and Life Insurance Company (CHLIC), Tel-Drug, Inc., Tel-Drug of Pennsylvania, L.L.C., Cigna Onsite Health, LLC, Cigna Behavioral Health, Inc., Cigna Health Management, Inc., and HMO or service company subsidiaries of Cigna Health Corporation, including Cigna HealthCare of Arizona, Inc., Cigna HealthCare of California, Inc., Cigna HealthCare of Colorado, Inc., Cigna HealthCare of Connecticut, Inc., Cigna HealthCare of Florida, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of Illinois, Inc. (IL & IN), Cigna HealthCare of Indiana, Inc., Cigna HealthCare of St. Louis, Inc. (MO, KS & IL), Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of New Jersey, Inc., Cigna HealthCare of South Carolina, Inc., Cigna HealthCare of Tennessee, Inc. (TN & MS), and Cigna HealthCare of Texas, Inc. “Cigna Home Delivery Pharmacy” refers to Tel-Drug, Inc. and Tel-Drug of Pennsylvania, L.L.C. In Texas, Open Access Plus and LocalPlus plans are considered Preferred Provider plans with certain managed care features and Open Access Plus IN and LocalPlus IN plans are considered Exclusive Provider plans with certain managed care features. All models are used for illustrative purposes only.

862431 07/13 © 2013 Cigna. Some content provided under license.