UNWAVERING.

Just like our firm quote.

A lot can change in a matter of months. Your client's firm stop loss quote doesn't have to.

Don't let not-so-firm quotes leave your clients vulnerable to tacked-on lasers and exclusions. Count on Cigna to lock in rates, terms and conditions up to 6 months in advance. Watching out for your client's financial protection through even troubled waters.


Is this stop loss quote really firm?

When it comes to bidding your stop loss, there are contingent quotes, "firm" quotes and Cigna firm quotes. They're all a little different, and sometimes language isn't clear about which kind you're dealing with. We're here to shed a little light.

Contingent quotes

This type of quote doesn't lock in rates and terms until about one month before the policy's start date, which can make it difficult to set a budget or financial plan in place. Cigna only provides contingent quotes upon request or if we're awaiting information.

The downside of contingent quoting:

Example: One company received a firm quote from Cigna for $100k and a contingent quote from another carrier for $80k. They elected to go with the contingent quote. Thirty days prior to the effective date, they were required to disclose that an individual on their plan was awaiting a transplant. Just after this disclosure, their final quote came in at $380k.*

 

Is my quote contingent? Look for language like "subject to revision based upon updated large claims information," "special risk questionnaire" or "disclosure reporting is required."

"Firm" quotes

This type of quote is promoted as having a firm rate—however, a signed disclosure may be required as part of its terms and conditions. Disclosure is meant to document all known or emerging risk. As part of this process, lasers and exclusions may be applied—even after rates are already locked in. These add-ons create holes in the policy, leaving overall liability on shaky ground. Cigna does not require disclosure.

The downside of "firm" quoting:

Example: One company received a firm quote from Cigna for $150k and a "firm" quote from another carrier for $100k. They elected to go with the "firm" quote. Thirty days prior to the effective date, they were required to submit updated large claims reporting. An individual had just been diagnosed with kidney failure, so a last-minute laser of $200k was applied.*

Is my quote "firm"? Look for language like "subject to revision based upon updated large claims information" and "special risk questionnaire" or "disclosure reporting is required."

The Cigna firm quote: a firm quote you can count on

Who doesn't like a sure thing? Especially when it comes to rate. Cigna locks in rates, terms and conditions up to 6 months in advance. Plus, disclosure reporting is never required for new business or renewals, and lasers are only applied upon request. That's our policy.

The bright side of Cigna firm quoting:

Example: One company received a firm quote from Cigna for $200k and a contingent quote from another carrier for $90k. They elected to go with the Cigna firm quote option. Thirty days prior to their effective date, an individual on their plan delivered a set of premature twins with major health complications. The company was relieved to know that both the rates and terms Cigna issued as part of their firm quote remained locked-in; thus, no new loads, lasers or exclusions would apply.*

Is my quote Cigna firm? Look for language like "disclosure reporting is not required," and "lasers will not be applied."

*Note: Examples and amounts are for illustrative purposes only. Actual client results will vary.

 

WHY SELF-FUND?
  • Plan design flexibility: Self-funded plans are generally exempt from most state mandates.
  • Improved cash flow: Claims are funded as they occur. When total claims are lower than expected, employers benefit immediately.
  • Potential savings: Employers keep health care dollars that aren’t needed to cover claims. Plus, they may save more with a reduced premium tax.

 

WHY STOP LOSS?

Just one severe illness or injury can have a significant impact on claims liability. Thankfully, stop loss can help mitigate these costs.

$120,000

Cigna’s average cost of the initial hospital stay for a mother and her baby born prematurely.1

9.6% per year

Percent of American babies born prematurelythat’s more than half a million2

$500,000

Potential cost of a single organ transplant procedure in the U.S., depending on complexity.3

79 per day

Average number of Americans who receive organ transplants4

$80,000 per admission

Cigna’s estimated cost of treatment for a trauma victim—with many requiring several admissions for post-trauma care.1

41,000,000 per year

Number of American emergency room visits caused by trauma5

$300,000 per year

Average annual cost of treating hemophilia in the U.S. Some patients exceed $1,000,000 per year.1,3,6

400 per year

Number of American babies born with hemophilia—a lifelong condition7

$50,000+ per month

Cigna’s estimated cost of new forms of cancer treatment and medications for immune disorders. Most treatment plans run for several months.1

14,500,000

Number of Americans who have had cancer in their lifetime8

  1. Cigna analysis based on claims data from 01/01/2013–12/31/2013. December 2014.
  2. 2015 Premature Birth Report Card: United States. March of Dimes Foundation, 2015.
  3. Bentley, T. Scott, FSA, comp. 2014 U.S. Organ and Tissue Transplant Cost Estimates and Discussion. Milliman Research Report, Dec. 2014.
  4. "The Need Is Real: Data." Organdonor.gov. U.S. Department of Health & Human Services, 2014.
  5. "Trauma Statistics." National Trauma Institute, Feb. 2014.
  6. National Hemophilia Foundation. Co - Sponsor The Patients’ Access to Treatments Act to Ensure Access to Life - Saving Therapies. Hemophiia.org., 15 Oct. 2015.
  7. "Data & Statistics in the United States." Centers for Disease Control and Prevention. U.S. Department of Health & Human Services, 08 July 2015.
  8. Cancer Facts & Figures 2015. Fact Sheet. American Cancer Society, 2015.

 

WHY CIGNA?

As a broker, you can count on your experience when evaluating the risks associated with a self-funding strategy. Too bad you can’t always count on the options being clear when it comes to comparing stop loss coverage for your clients. Especially when a firm understanding of the contract provisions can be the difference between a happy, confident client, and one that could be caught unaware. While a “low-cost” plan may seem cost-effective, unexpected charges and shortfalls in coverage could end up costing your clients more money down the road.

Don’t let your clients take on more risk than they need to. Count on Cigna to help keep your clients protected with honest, simple stop loss coverage.

 

BRIDGE THE GAPS

  • Consistent coverage. Coverage under the medical plan aligns with the stop loss policy—identical coverage determinations for terms like “experimental and investigational treatment” or “medical necessity.”
  • No gaps between carriers. Clients who transfer to Cigna can elect to cover claims incurred before the contract start date.
  • Sick employees, included. Cigna does not include “actively at work” or “non-confinement” provisions. We reimburse employers for covered stop loss claims, even when the employee or dependent is already in the hospital when the contract starts.
  • Simple claim management. Covered claims are reimbursed automatically. No hoops to jump through and no claim filing necessary.
  • Transplants, covered. No separate limitations or exclusions for costly transplants contained within the stop loss policy.

 

KEEP FIRM QUOTES FIRM

  • No disclosures. Cigna’s firm quotes are always firm, no invasive questions required.
  • No last-minute lasers. We don’t recommend “lasers” that limit coverage on sick individuals, and shift risk back onto the client. We especially do not require them at the eleventh hour before coverage kicks in.

 

PEACE OF MIND

  • Honest, clear contract terms. Our stop loss contract is straightforward and easy to read and understand with no hidden fees or surprises.
  • Fast & simple reimbursement. Claims are reimbursed automatically. Over 93% of stop loss claim dollars are reimbursed within 2 days and 99% are reimbursed within 5 days.9 Reimbursements above $250,000 are made immediately, before or at the same time that the health care professional payment is withdrawn.
  • A dedicated team your clients trust. With Cigna, your clients have a single point of contact—one dedicated, experienced stop loss team. We retain 100% of the risk with no outside reinsurers.
  • A comprehensive carrier. Our extensive product portfolio and experience can help consolidate and simplify your client’s business model.
  • 9. Cigna analysis based on claims data from 1/1/13 - 12/31/13. December 2014.

 

Count on it. Count on us.

STUDY UP

Cigna offers two stop loss training courses for continuing education credit. We can even tailor an interactive session to meet your needs.

EMAIL US

KNOW

What are some of the essential building blocks of a solid stop loss plan? Here’s our perspective.

DOWNLOAD

GET IN TOUCH

Questions about stop loss? Our knowledgeable sales team can answer even your most complex questions.

LEARN MORE