Previous Communications About Cigna

Helpful Information Sent During the Cigna Transition

Cigna and Privia Update; IRS Form 1095C to be Mailed Soon
Email Sent on February 15, 2023

Cigna and Privia Agreement
Great news! Cigna reports that it has reached an agreement with Privia and Privia will continue to remain in the Cigna network. Employees are beginning to receive communications from Privia to this effect. Cigna and Privia have entered into a memorandum of understanding while contract documents are finalized. The Office of Benefit Services will continue to monitor these discussions and will issue additional communications once the contract is executed. 

IRS Form 1095 Arriving in Early March
FCPS employees and retirees who were enrolled in FCPS health plan coverage (or who were eligible for coverage but did not enroll) will receive IRS-Form 1095-C in early March. Much like Form W-2 and Form 1099, which include information about the income you received, Form 1095 provides information regarding your health insurance eligibility and enrollment.

While the information on this form may assist with preparing your tax return, the Internal Revenue Service has stated you will not need to submit these forms with your tax return. You should keep the forms for your records with your other important tax documents.
If you have questions regarding how these forms impact your tax return preparation, please check with your tax professional. For questions, please contact the Office of Benefit Services at 571-423-3200, option 3, to speak with a representative.
 

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Cigna Transition Update
Email Sent on January 29, 2023

We know the transition to Cigna has caused some employees concern about the continuity of their care. Thank you for raising your concerns; we are committed to addressing problems as quickly as we can. The information below may be helpful in helping new Cigna participants navigate this transition into the future.
 

Deductibles and Out-of-Pocket Maximums Reset in January
With most FCPS healthcare providers deductibles and maximum out-of-pocket limits (the amount you pay) operate on a calendar year basis and are reset every year on January 1. Once the deductible is met, claims process at the appropriate copay or coinsurance level. View the Cigna plan design.
 

Health Provider Negotiations
Some participants may have received a letter from Privia regarding their health coverage. All health provider contracts (doctors, labs, hospitals, etc.) go through periodic negotiations, and unfortunately there are times when those negotiations reach a stalemate.  In those cases, the law requires the provider to send a notice to their patients when there is a risk of a contract ending.  This has recently occurred with the Privia Medical Group. 

Recently, other practices in this area have issued termination notices and subsequently negotiated new terms.  For example, Fairfax ENT & Facial Plastic Surgery and the Neurology Center of Fairfax recently came to a contract agreement after issuing a notice of termination. We are hopeful that Cigna and Privia are able to bring their negotiations to a successful conclusion. If the negotiations between Privia and Cigna fail, FCPS employees will have their Privia claims treated as other out-of-network claims for 2023. As new information becomes available, staff will provide updates to employees via web page updates and emails.  If you have questions about how out-of-network claims are filed and paid, please see “Hot Topics” in the Frequently Asked Questions.


Prior Authorizations for Complex Treatment
Unfortunately, we have heard from some participants of unexpected transition issues with prior authorizations. Please know that both Cigna and FCPS staff, along with our former vendors, are working diligently to address and resolve these issues as quickly as possible. 

Prior to plan transition, Cigna received prior authorization information from both CareFirst and Aetna. Upon audit, it was discovered that not all authorizations were transferred. Cigna is working with the carriers to obtain updated data and load the authorizations as quickly as possible. In the interim, many authorizations were extended until February 28, 2023, to allow providers time to submit required medical documentation to Cigna.

If you are a participant who is undergoing complex treatment (such as infusion or radiation therapy), we encourage you to contact your provider as soon as possible to ensure they have an authorization on file with Cigna. If not, your provider can initiate the authorization process with Cigna. You can also verify your authorizations by logging into your MyCigna account (see online account above).
 

Ensure You Provide Your New ID Cards to Your Treating Providers
To help avoid difficulties with your claims, please ensure you provide a copy of your new Cigna identification (ID) cards to each of your treating health care and vision care providers. This helps ensure your claims will be sent to the correct address. If you do not have your hard copy cards, you can contact Cigna to have new cards sent, or access a virtual copy through your MyCigna account. Your Cigna ID card is used for both medical and vision services.

Your card will indicate to providers that you are a member of Cigna Open Access Plus (OAP), which can be confused with Cigna Connect. 
 

Immunization Coverage
Routine immunizations are covered under the Cigna medical plan. However, please keep in mind that if you are receiving your flu or Covid vaccine at a CVS retail pharmacy, you will need to present your CVS/Caremark ID card. 

As a reminder, you may receive routine immunizations from your physician, CVS Minute Clinics and Health Hubs, retail pharmacies (such as Walgreens or Rite Aid) or pharmacies within grocery stores (such as Giant, Safeway, Kroger, Walmart, Publix, etc.). You will present your health plan ID Card at these locations. 
 

Out-of-Network Benefits
If one of your providers is not currently in the Cigna network, please remember that either you or your provider will need to submit claims to Cigna for out-of-network services. See these Cigna Frequently Asked Questions for more information about the claims filing process. If you have not already done so, we encourage you to submit a Provider Nomination Form; Cigna will then reach out to your provider to discuss recruitment in the network. 
 

Mental Health Providers
FCPS is committed to supporting employees’ mental health needs. These supports, along with help navigating access to them, are available through the health plans and our FCPS Employee Assistance Program (EAP). Cigna also offers expanded virtual resources (such as TalkSpace, MDLive, Sondermind and Ginger) for mental health treatment. To see the services available, login or create your MyCigna account. Once logged in, click on "Wellness", then "Mental Health Supports", then click on the condition you would like assistance with. 
 

Have You Set up Your Online Account?
You can view your plan benefits, view or print your virtual ID card and view Explanation of Benefits statements by logging into your MyCigna account. If you have not already done so, we encourage you to set up your online account by going to https://my.cigna.com. This account set-up is not mandatory but is extremely helpful by providing 24/7 online access to your individual health plan supports and specifics.
 

Staying Healthy in 2023
The start of the new year is often a good time to schedule your preventive health care appointments, such as annual exams, screenings, or immunizations. Preventive care is beneficial to your long-term health and wellness, and it could save you money by catching potentially problematic health issues early on. Preventive care immunizations (flu, shingles, whooping cough, etc.) continue to be covered at 100% when received at in-network facilities. 
 

Benefits Contact Information
Cigna 

CVS/Caremark (pharmacy plan for Cigna enrollees)

 Office of Benefit Services

Refer to the Employee Benefits Briefing for information about 2023 benefits and the copay and coinsurance amounts listed on your cards. We appreciate your patience as we work through these transition issues; we will continue to develop regular communications to provide updated plan information.

 

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Open Enrollment Update
Email Sent on October 21, 2022

Dear colleagues,

As we start to feel the effects of fall, including cooler weather, we have a traditional fall event beginning soon – Open Enrollment! This year, Open Enrollment will begin November 1 and will continue until November 18.  Earlier this month, we shared important information regarding upcoming changes to benefit plans for 2023.  Next week, you can expect to see pre-open enrollment confirmation statements in your email. This statement will show your projected health plan participation for next year. We do this so you can see what will happen if you do not make changes in Open Enrollment. If you are an Aetna or CareFirst health plan participant and choose not to make changes during Open Enrollment, we will automatically move you to Cigna Open Access plan, which will provide you similar benefits. No one will lose health insurance because of this change. 

We know this has a very direct impact on many employees, and want to assure you that we undertook this change with the greatest of care. Understandably, you may have questions about how these changes will affect you.  We ask you to review the information below. If you need more information, we invite you to visit the Open Enrollment website.

Cigna and Kaiser Permanente will be our health care vendors for 2023.  If you are currently a member of Aetna or CareFirst, please know:

  • Over 17,000 physician provider records were reviewed and Cigna’s provider network has a 97% match to our current network of primary care and specialist providers. 
  • Even if your doctor isn’t in-network, during this first year, all primary care and specialist providers will be treated as in-network. This means that you do not have to pay more to see an out-of-network doctor.  FCPS will cover out of network claims at the higher in-network rate. To verify if your provider is in the network, click here. If your provider is out-of-network, you can signal that you want them in-network by nominating them to be recruited into the Cigna network. 
  • Cigna is actively recruiting new providers. If your doctors aren’t in-network yet, please check back to see if they have been added.  
  • Preventive care will continue to be paid with no deductible. Services like physical therapy, behavioral health and chiropractic care remain covered with a specialist copay. For specifics, please see the comparison page in the Benefits Briefing. 
  • Current Aetna participants who move to Cigna in 2023 will experience an almost 23% reduction in premiums. Current CareFirst participants will see a slight 3.3% increase, which is less than the national average. Kaiser Permanente premiums will not increase for the 2023 plan year.
  • By moving to Cigna, we have been able to minimize the increase for deductibles and out-of-pocket costs. While the Cigna Open Access plan has small increases to deductibles (+$50 for individual / $100 family), the levels are comparable to most local jurisdictions and well below the average deductible in our region. When two family members meet the deductible, the entire family has met that deductible for the rest of the year.  Also, in- and out-of-network deductibles are combined for 2023, as well as out of pocket maximums. This means you don’t have to meet separate deductibles or out-of-pocket maximums if using an out-of-network provider. If you visit an out-of-network doctor, claims submission may be done by the physician or may be done by submitting your form to the Cigna website. Based on industry experience, most out-of-network providers will file claims directly with the insurance provider. 
  • CVS will continue to provide prescription benefits for Cigna participants.  
  • There are no changes to dental plan offerings. Aetna will continue to administer both plans for 2023. There are also no changes to the Kaiser Permanente plan.

You will have the ability to get additional information about the updates in a variety of ways, including:

More help is coming soon:

  • Open Enrollment Open House events – three in-person and three online events with Benefits staff and vendor representatives in attendance
  • The Cigna website - designed just for FCPS employees with additional resources to help understand the new plan.         
  • Personal one-on-one appointments (in-person and virtual) with a Cigna representative at the Gatehouse Administration Center to get individual assistance with questions and concerns

As we transition to Cigna, please know that we are updating the FCPS open enrollment website with answers to some of your most frequently asked questions. We encourage you to check the site often for new content and don’t forget that Cigna representatives will be available to answer your questions too.  

If you are enrolled in the Flexible Spending Account programs, don’t forget that you must re-enroll during the open enrollment period to continue benefits in 2023.