Cigna Expands Individual Health Insurance Market Participation

Cigna is expanding its presence in the individual health insurance market, the payer announced ahead of the 2022 open enrollment season.

“Cigna's offerings are designed to support whole-person health and create superior outcomes throughout our customers' health care journeys,” said Lisa Lough, president of Cigna's individual and family plans business. 

“There is a societal need for affordable, predictable and simple health care, especially among individuals and families without access to employer coverage or government programs. Our IFP growth in 2022 will enable Cigna to help more individuals and families access the care they need.”

The payer is venturing into three entirely new states as well as many new counties in states where the company already has a foothold. The new states are Georgia, Mississippi, and Pennsylvania. In 2022, Cigna plans will be available in a total of 13 states nationwide.

The payer is also adding new counties in Virginia, Arizona, and Florida. With these new counties, Cigna will serve 1.5 million more consumers across 93 new counties. In total, the payer will offer plans in 313 counties.

“Cigna remains intently focused on providing access to high-quality, cost-effective and stable health care coverage individuals and families need and deserve,” said Matt Manders, president of Cigna’s government and solutions segment. 

“We are meeting customers where they are and closing critical coverage gaps. We look forward to introducing new solutions and services on the individual exchanges in 2022 and beyond.”

The plans that Cigna offers in these markets will feature the trademarks of Cigna’s Affordable Care Act marketplace plans. This includes the free MDLIVE telehealth benefit for wellness screenings. Through their patient portal, members can access a provider virtually.

In addition to MDLIVE, the payer will leverage its myCigna patient portal in its app as well as the Cigna One Guide.

For members with chronic disease management needs, Cigna offers personalized guidance with no cost-sharing. These relationships with members who have chronic disease management demands will be vital as chronic disease management claims potentially increase. Payers have been raising their rates in anticipation of this trend.

The payer also covers prescription drug costs with a $0 to $3 copay. It also caps the prices of drugs like insulin. Among health plans on the individual health insurance marketplace and employer-sponsored health plans, prescription drug costs tend to consume the largest share of the member’s premium dollar, so improvements on those prices can go a long way. 

The Cigna marketplace plans also offer miscellaneous benefits, such as acupuncture.

The open enrollment period for Affordable Care Act marketplace plans that go into effect January 1, 2022 will start on November 1, 2020 and ends December 15, 2021.

Earlier in the year, Cigna announced that it would be extending the Oscar Health virtual primary care program to its Cigna + Oscar health plans for plan year 2022. Oscar Health originally launched this virtual primary care plan in July 2020. 

Since the Oscar Health virtual primary care product has been in effect for such a short period of time, it is fairly early to discern the product’s impact. However, the payer has seen enough success with its efforts to expand the plan and offer access to more consumers.

The Affordable Care Act marketplaces saw gains in payer participation in plan year 2020 and in plan year 2021. In 2021, payer participation increased 11 percent over payer participation in 2020 and 20 percent over payer participation in 2019.

Consumers are also showing more interest in the Affordable Care Act marketplace, particularly due to the American Rescue Plan’s subsidies. Enrollment in 2021 has been historic due to the special enrollment period, surpassing 1.2 million new enrollees for a total of 31 million Americans enrolled in the Affordable Care Act marketplace.

As payers and consumers alike gain more confidence in the Affordable Care Act marketplaces, Cigna may not be the last payer to announce plans to increase penetration into this market.