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CIGNA Choice Fund HRA – For You
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More control over your health care decisions
People like to have the freedom to make decisions that best meet their needs. And, given a chance and the right information, most people will make healthy, intelligent decisions that save money. That's the idea behind the CIGNA Choice Fund Health Reimbursement
Arrangement (HRA) – a plan that covers employees through an account funded by employer contributions.
Within the HRA, you also can choose from a broad array of innovative plan design options. For example, unused money can roll over into the next plan year, following limitations you select. And you can choose to include incentives for improving member health and well-being.
Possible benefits
- Control of how benefit dollars are spent.
- Freedom to choose the doctors
- Programs and services yot enhance health and well-being.
- Information to help make smarter decisions about spending benefit dollars and choosing doctors and services.
More of what you're looking for in a health plan.
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Contributions & Requirements
Although plan features vary among employers, here are the basic elements of a CIGNA Choice Fund SM HRA:
Employer contribution
Your employer establishes a health fund that you can use to help pay for any covered health care expenses during the plan year. Amounts paid by the fund for covered services count toward the annual deductible (a fixed amount you pay out-of-pocket).
Your contribution
After you spend all the funds in your HRA, you pay for any additional health care costs up to the amount of your annual deductible.
Your employer and you
After you meet your deductible, your medical plan covers eligible services. Depending on your plan, this means you pay coinsurance for covered services and your plan covers the rest.
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How the HRA can work for you
Single and healthy
You're a single, healthy, active 25-year-old and you usually see your doctor for your physical exam only. You rarely need prescriptions other than allergy medication.
Your company provided you with a Health Reimbursement Arrangement (HRA) that includes a $500 employer-contributed fund, a $1,000 deductible and a medical plan. How might the HRA work for you?
| Year One |
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| Your initial Fund balance contributed by your employer |
$500 |
| You see your doctor for your physical |
-$80 |
| A minor accident sends you to the emergency room. |
-$200 |
| You fill your regular allergy medicine three times. |
-$150 |
| Your fund balance available to roll over to the next year. |
$70 |
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| Year Two |
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| Your initial Fund balance contributed by your employer |
$500 |
| Your initial fund balance from last year |
$70 |
| You see your doctor for a sprained knee |
-$80 |
| You refill your allergy medicine |
-$50 |
| You see your allergist |
-$100 |
| You change your allergy medicine |
-$30 |
| Your fund balance available to roll over to the next year. |
$310 |
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These scenarios are for example only and may not reflect your actual experience.
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Health and wellness programs
Members of CIGNA HealthCare plans may also have access to valuable Health and Wellness Programs:
- Well Informed — a personalized health improvement program designed to let CIGNA HealthCare members and their doctors know about opportunities to maintain or improve the member's health.
- 24-hour health information — call the CIGNA HealthCare 24-Hour Health Information LineSM any time to speak with a registered nurse or listen to our audio library for health-related information.
- Support for chronic conditions — manage your asthma, diabetes, heart condition, low back pain, or chronic obstructive pulmonary disease with help from CIGNA Well Aware for Better Health®.
- Member discounts — save up to 60% on products and services-from acupuncture to weight management-with our Healthy Rewards® discount program. Note: not all programs are available in all states.
- Quality transplant care — access care from nationally recognized facilities in the CIGNA LIFESOURCE Transplant Network®.
- CIGNA HealthCare Healthy Babies® — give your child a healthy beginning with information and support from the CIGNA HealthCare Healthy Babies® program.
- CIGNA Healthy Pregnancies, Healthy BabiesSM — the CIGNA Healthy Pregnancies, Healthy Babies® program offers a full scope of educational and care management services to members who are pregnant or considering pregnancy.
- Cancer prevention and education — the Comprehensive Oncology Program® addresses cancer prevention and education, as well as active management of members diagnosed with cancer.
- High Touch Personal Assistance — with CIGNA Health AdvisorSM, CIGNA Health Advisors proactively identify and reach out to members who are at risk for significant health issues but are not appropriate candidates for chronic or acute disease or case management programs.
- Lose weight and improve your health — when you enroll in the CIGNA Healthy Steps to Weight LossSM, you won't be starting a diet. Instead, this program helps you change your behaviors permanently. You'll learn healthier eating habits and how to incorporate exercise into your schedule – helping you to feel better, look better and improve your overall health.
Next (Employer Advantages - Benefits) >
Employer Advantages
The HRA is all about choice. Your choice of medical plans, plan designs, options and features.
Choose the underlying medical plan-PPO, Open Access Plus, Open Access Plus - In-Network or Indemnity -and the health care plan options that work best for you, including your health fund contributions.
Choose your own limits on remaining HRA dollars that will roll over to future plan years. You can offer a Limited Purpose or Suspended HRA which allows employees to carry forward unused HRA dollars even if they join an HSA. Our Healthy Future AccountSM allows your employees to accumulate dollars over time for future use based on requirements you set, such as years of service.
Choose any or all of the incentive programs to reward members for taking the online health risk assessment, using our other online tools, or participating in one or more of our disease management programs.
Choose to offer a Flexible Spending Account (FSA) in addition to the HRA. Doing so allows employees to cover expenses outside the limits you've established for the HRA with tax-free dollars. Since FSA dollars don't roll over, you can stipulate that FSA funds be used first.
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We've not only designed a consumer-driven health care product, we've also designed a flexible communication program to help your employees understand their plan and make better health care purchase decisions.
Pre-enrollment
- optimum communications time line and approach
- implementation plan
- introductory letter from your CEO/President or benefits administrator
- customized Intranet articles
- newsletter articles
- e-mail notices
- presentation scripts
- posters
- payroll stuffers
- "train the trainers" presentation
Open enrollment
- enrollment support Web site
- enrollment kits
- toll-free help line
- benefit fair
- kiosk (at an additional cost)
- on-site enrollers, workshops and seminars
Post-enrollment
Your implementation manager will help you every step of the way with communication strategies and materials that best suit you and your employees.
Next (Options) >
The CIGNA Choice Fund HRA also offers employers medical management options designed to meet individual needs and improve each member's health care experience.
Personal Health Solutions offers employers the choice of two innovative approaches to medical management.
- Personal Health Solutions (PHS) focuses our clinical resources where they will have the most impact on improving quality outcomes and reducing costs.
- Personal Health Solutions Plus (PHS+) is a more intensive model that includes all the components of the PHS model plus additional focus on high-impact activities that yield the greatest return.
CIGNA Well Aware for Better HealthSM can help you curb the high expense of managing chronic conditions — and help your employees become healthier. We'll help identify eligible employees and family members who could benefit from personalized support and education for asthma, diabetes, heart disease, low back pain, chronic obstructive pulmonary disease, depression, weight complications and certain targeted conditions. Under the care of their physician, members can use the Well Aware program to help monitor, change, and take charge of their health.
CIGNA Health AdvisorSM, available to employers with 10,000 employees or more, offers employees help from a dedicated CIGNA nurse whose role is to:
- partner with a health plan member;
- become the focal point of facilitating consumer-centered health issues;
- coordinate and monitor overall care plan activities;
- help members navigate the health delivery system; and
- identify opportunities for health facilitation.
The CIGNA health care advisor offers employees targeted assistance from a knowledgeable professional with a global perspective of the intricacies of the health care system. That expertise, coupled with a proactive approach to individual needs, can only improve each member's health care experience.
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FAQ
How does the CIGNA Choice FundSM HRA pay claims?
When you see your doctor, you do not have to pay anything at the time of the office visit. Instead, your doctor sends your claim directly to CIGNA HealthCare. CIGNA HealthCare processes the claim and sends you an Explanation of Benefits (EOB) that tells you:
- if your plan covers the services you received; and
- if so, what portion of the covered services your plan pays; and
- if not, how much you owe;
- if you have met/not met your deductible and whether there is a balance due.
If there is money in your HRA, your doctor is paid directly from the fund. You and your doctor receive EOBs explaining that payment has been made from your fund. Your EOB also tells you how much money is left in your fund.
If there is no money in your HRA, or if the expense is not eligible for payment from the fund, you receive an EOB letting you know that the payment cannot be made from the fund and that you are responsible for paying the bill.
If you receive a bill from your doctor, you should always make sure it has been sent to CIGNA HealthCare for processing before you pay it. You can check by:
Do I need to file claim forms?
No, not if you've seen an in-network provider. Most out-of-network providers will submit claims on your behalf, too. But if not, claim forms are always available on myCIGNA.
Can I see any doctor I choose?
Yes. If you choose doctors who participate in the CIGNA network, your costs are lower. If you see providers outside the CIGNA network, your fund dollars will still pay for covered services, but not at the discounted rate.
Which services are covered by the HRA and which will I have to pay for myself?
Because covered services vary from plan to plan, it's important to read your plan materials. Typically, you'll be responsible for paying:
What happens when my HRA dollars are spent?
If you've used all the money in your fund before you've met your annual deductible, then you must pay for medical costs up to and including the amount of your deductible. After that, your medical plan covers services as described in your plan documents.
What if there are funds left over in my account at the end of the year?
One of the advantages of an HRA is that unused dollars are added to your employer's contribution and roll over into following year's fund to be applied to future, qualified medical expenses. Your employer may limit the amount that can be rolled over, so be sure to review your plan materials for details.
How can I track my fund balance?
You can monitor your fund by:
- log in to myCIGNA where you'll find your fund balance, claim status and eligibility information housed in a secure environment;
- read your latest EOB. It includes the fund balance from the time of your most recent transaction;
- call the number on your CIGNA HealthCare ID card; monitoring your quarterly statements for detailed information about your fund balance and claims processed during that quarter.
How can I figure out if a health reimbursement arrangement is right for me?
Use our benefits calculator to estimate your total out-of-pocket expenses. It gives you recent medical cost information (and prescription drug information if CIGNA pharmacy coverage is part of your plan), as well as basic plan information. It's available on myCIGNA.
What if I have questions about my HRA?
You'll find answers to most of your questions on myCIGNA. You can also contact your employee benefits office.
What are the expense guidelines and listings of covered and not covered items?
Go to our Eligible and Ineligible Expenses page for a listing.
Can I obtain an online form to request reimbursement from health care and dependent day care flexible spending accounts?
Yes. We provide both Health Care and Dependent Day Care reimbursement forms
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