Company type | Public |
---|---|
Industry | Managed healthcare Insurance |
Founded | 1982 |
Headquarters | Bloomfield, Connecticut, U.S. |
Key people | David Cordani (Chairman, President and CEO) Brian Evanko (CFO) |
Products | Healthcare services Health insurance Life insurance PBM |
Revenue | US$180.52 billion (2022) [1] |
US$8.41 billion (2022) [2] | |
US$6.67 billion (2022) [1] | |
Total assets | US$143.93 billion (2022) [1] |
Total equity | US$44.87 billion (2022) [1] |
Number of employees | 102,231 (2022) [1] |
Subsidiaries | Express Scripts |
Website | cigna |
The Cigna Group is a for-profit American multinational managed healthcare and insurance company based in Bloomfield, Connecticut. [3] [4] Its insurance subsidiaries are major providers of medical, dental, disability, life and accident insurance and related products and services, the majority of which are offered through employers and other groups (e.g., governmental and non-governmental organizations, unions and associations). Cigna is incorporated in Delaware. [5]
Cigna offers Medicare [6] and Medicaid products and health, life and accident insurance coverages primarily to individuals in the U.S. and selected international markets. In addition to its ongoing operations described above, Cigna also has certain run-off operations, including a Run-off Reinsurance segment. [7] In the Phoenix metropolitan area, Cigna runs a full-service staff-model health maintenance organization with satellite clinics throughout the region, known as the Evernorth Care Group [8] (formally Cigna Medical Group). [9] Cigna Global Health Benefits also operates under the Cigna corporation.
The company ranked #15 in the 2023 Fortune 500 list of the largest U.S. corporations by total revenue. [1]
Cigna was formed by the 1982 merger of the Connecticut General Life Insurance Company (CG) and INA Corporation (the parent corporation of Insurance Company of North America, the first stock insurance company in America). [10] The company name, Cigna, is a mix of letters from the merging companies, CG and INA. [11] Insurance Company of North America was formed in 1792, while CG was created in 1865 by a special act of the Governor of Connecticut. In October 1871, the great Chicago Fire burned for two days, destroyed 2,000 acres, and left 100,000 people in Illinois homeless. INA paid $650,000, one of only 51 insurance companies (out of a total of 202) to pay claims in full. [12]
Before selling its domestic and international property and casualty business to the Bermuda-based ACE Insurance company in the late 1990s, Cigna was among the companies with a large international network comparable to those of AIG, Allianz, and Zurich. The strategy behind the sale was to concentrate on core business. ACE – at that time a key player at the Bermuda and Lloyd's insurance market – on the other hand, was interested in expanding the international network in the traditional insurance market. [13]
Cigna sold the majority of its life insurance operations to Lincoln National Corporation in 1997. [14] [15]
In 2002, it was alleged in violation of the Securities Exchange Act for earnings manipulation. Its common stock price plummeted significantly as a result. [16] In October 2011, Cigna agreed to buy HealthSpring Inc. for $3.8 billion to jump-start its business selling Medicare plans from 46,000 Medicare Advantage members to almost 400,000 Medicare Advantage members. [17] The payment would come from an issue of new equity to cover about 20 percent of the value, with the rest funded by additional cash and debt. [18] [19] In 2013, Cigna operated in 30 countries, had approximately 35,800 employees and managed around US$53.734 billion in assets. [7]
In June 2015, U.S. health insurer Anthem Inc. announced that it would acquire Cigna for $47 billion in cash and stock. [20] Anthem confirmed it had reached a deal to buy Cigna on July 24, 2015. [21] On July 21, 2016, the US Justice Department filed an antitrust suit to block the proposed merger, [22] and a District Court ruling on February 8, 2017, blocked the merger on anticompetitive grounds. [23] That month, Cigna Corp. called off its $48 billion merger agreement with Anthem Inc., with Anthem stating it would "continue to enforce its rights under the merger agreement and remains committed to closing the transaction." [24] After exhausting federal appeals of the antitrust merger block, the companies turned on each other in Delaware's Court of Chancery. [25] The legal saga came to an end with an August 31, 2020 decision denying both companies claims for compensation from the other for the failed merger. [26]
On March 7, 2018, it was announced that Cigna would acquire Express Scripts in a $67 billion deal [27] [28] and on August 24, 2018, the shareholders of Cigna and Express Scripts approved the deal. [29]
In June 2020, Cigna formed a strategic alliance with Priority Health to make comprehensive health care coverage more affordable and accessible to Michigan employers and customers. [30]
In September 2020, Cigna rebranded its health services portfolio under the name Evernorth, which included Express Scripts, Accredo, and eviCore. [31]
In October 2020, it was announced that Cigna and Envision Healthcare had renewed their agreement to include Envision's clinicians as in-network providers for Cigna's members. [32] In 2021, Molina Healthcare acquired Cigna's Medicaid contracts in Texas for US$60 million. [33]
On February 13, 2023, Cigna renamed its holding company The Cigna Group, its health benefits provider business unit Cigna Healthcare, and its Evernorth business unit Evernorth Health Services. [34]
Company type | Subsidiary |
---|---|
Industry | Employee Benefits |
Founded | 1977 |
Headquarters | Wilmington, Delaware, US |
Key people | Jason Sadler, President, Cigna Global Health Benefits |
Products | Medical, Dental, Disability, Life Insurance |
Revenue | 174,078,000,000 United States dollar (2021) |
Parent | Cigna Corporation |
Website | cignaglobalhealth.com |
Cigna Global Health Benefits is a business unit within Cigna. The company is headquartered in Wilmington, Delaware, close to Philadelphia. Additional Cigna Global Health Benefits operations are located in Visalia, California, and Greenock, Scotland and Shanghai, China and Antwerp, Belgium. Sales offices are located in North America, Europe, Asia and the Middle East.
CGHB global health plans typically include medical, dental, behavioral and disability, as well as business travel and life components. Expatriates are defined as employees of multinational companies working outside their home country on short or long-term international assignments. [35] CGHB maintains its own, in-house international claims platform, and offers a network of physicians and hospitals for its members (including 550,000 in the U.S. and more than 141,000 outside the U.S.).
On February 9, 2005, Cigna elected to adopt in the fourth quarter of 2004 fair value accounting for its stock options in accordance with SFAS No. 123 and to restate prior periods. [36]
The UK newspaper Guardian in their Esc and Ctrl videoblog about control of the Internet by corporations, documented an incident with Nataline Sarkisyan and the former vice president of Cigna talking about astroturfing, the practice of creating fake blogs by interested groups, e.g. health insurance companies, to push claims that are profitable for said company into media, e.g. dismissing universal health care. [37]
Cigna spent more than $4.4 million from 2005 to 2009 on lobbying to attain legislation that the company favors. This includes $720,000 spent in 2009 alone, when it had 20 lobbyists at five firms working on their behalf. [38]
In 2008, the head of Cigna's public relations, Wendell Potter, resigned, becoming a whistleblower who gave testimony in 2009 to the U.S. Senate Committee on Commerce, Science and Transportation in favor of reform of the health care industry. [39]
In December 2007, Cigna was criticized after the company refused to pay for a liver transplant of a California teenage girl, Nataline Sarkisyan, justifying their refusal to pay by claiming that the procedure was experimental, even though there was a liver ready and waiting to be transplanted and doctors estimated she had a 65% chance of surviving at least six months. [40] In response to much protest and public scrutiny, Cigna reversed its decision, though Ms. Sarkisyan died awaiting the transplant. [41] Cigna notes that it had no financial stake in the decision to authorize the transplant because it merely administers the insurance plan of Mr. Sarkisyan's employer and would not bear the cost of any operation. However, Cigna offered to pay for the transplant itself when it made the exception to the policy. [42]
Even though liver transplants have been performed since 1963 and are a well-accepted treatment option for end-stage liver disease and acute liver failure, Cigna defended its actions by claiming that there was insufficient data to show that a transplant for a patient in Sarkisyan's condition would be safe and effective. [42] The California court agreed with Cigna's position that the Sarkisyans’ claims regarding Cigna's decision-making were preempted by federal ERISA law. On April 16, 2009, the United States District Court for the Central District of California dismissed all of the claims against Cigna related to the coverage determination. [43]
Cigna received gold in the 2009 Gartner & 1to1 Customer Experience Excellence Award. The awards are given to the companies that "most clearly demonstrate exemplary customer relationship strategy and an unrivaled level of excellence in delivering the customer experience". [44]
In January 2010, Cigna received the JD Power award for customer service for all of its call centers for the fourth time in a row. [45]
In 2011, the California Nurses Association determined that Cigna denies roughly 39.6% of all claims (compared to competitors such as Aetna who denied about 5.9% of all claims in the same time frame). [46]
On April 16, 2010, Cigna announced an alliance with Humana group to offer a streamlined Medicare Advantage offering through employer clients for retirees. [47] In November 2023, Reuters reported that Cigna and Humana were in talk to merge, in a deal totalling $60 billion. [48] In December 2023, The Wall Street Journal reported that merger talks ended. [49] [50]
In November 2011, Cigna and TTK Group, an Indian business conglomerate focused on healthcare, formed a joint venture called Cigna TTK to develop a health insurance business in India subject to obtaining government approvals. [51]
In 2015, the American Consumer Satisfaction Index named Cigna as one of the most hated companies in the U.S. [52] Cigna's name returned on the ACSI's most hated list in 2018. [53]
In August 2020, the Department of Justice filed a lawsuit against Cigna alleging that the company defrauded Medicare Advantage, Medicare, and Medicaid for $1.4B by submitting diagnostic codes for health conditions that patients did not have. [54]
In November 2020, investors sued Cigna's CEO and board alleging that they had used "black-ops-style" tactics to "blow up" the merger with Anthem in 2017. [55] One pension fund accused Cigna CEO David Cordani of seeking to poison the deal after he had failed to secure the top post in the resulting company. The fund claimed he had utilized lawyers and public relations specialists to set up a "Trojan Horse" campaign. The merger would have produced the largest U.S. health insurer.
In 2023, Cigna was criticized for allowing company doctors to reject claims even if they had not opened the patient file. The company was found to be using a system, "PXDX," that according to Propublica, "saved money in two ways. It allowed Cigna to begin turning down claims that it had once paid. And it made it cheaper to turn down claims, because the company’s doctors never had to open a file or conduct any in-depth review. They simply denied the claims in bulk with an electronic signature." [56]
Aetna Inc. is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, primarily through employer-paid insurance and benefit programs, and through Medicare. Since November 28, 2018, the company has been a subsidiary of CVS Health.
Humana Inc. is a for-profit American health insurance company based in Louisville, Kentucky. In 2023, the company ranked 42 on the Fortune 500 list, which made it the highest ranked company based in Kentucky. It is the fourth largest health insurance provider in the U.S.
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The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care. It has become the predominant system of delivering and receiving American health care since its implementation in the early 1980s, and has been largely unaffected by the Affordable Care Act of 2010.
...intended to reduce unnecessary health care costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; the establishment of cost-sharing incentives for outpatient surgery; selective contracting with health care providers; and the intensive management of high-cost health care cases. The programs may be provided in a variety of settings, such as Health Maintenance Organizations and Preferred Provider Organizations.
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Express Scripts Holding Company is a pharmacy benefit management (PBM) organization. In 2017 it was the 22nd-largest company in the United States by total revenue as well as the largest pharmacy benefit management (PBM) organization in the United States. Express Scripts had 2016 revenues of $100.752 billion. Since December 20, 2018, the company has been a direct subsidiary of Bloomfield, Connecticut-based Cigna.
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Nataline Mary Sarkisyan was an American teenager with recurrent leukemia. Her case became part of the health care reform debate in the United States in 2007 when Cigna HealthCare denied coverage for a liver transplant operation. The company later reversed its decision after a great deal of media attention to her story, but Sarkisyan died hours later.
Wendell Potter is an American advocate for health insurance payment reform, New York Times bestselling author, and former health insurance industry communications director. A critic of HMOs and the tactics used by health insurers, Potter is also a leading national advocate for major reforms of the health insurance industry, including Medicare for All and universal health care.
Catamaran Corporation is the former name of a company that now operates within UnitedHealth Group's OptumRX division. It sells pharmacy benefit management and medical record keeping services to businesses in the United States and to a broad client portfolio, including health plans and employers. Working independently of the government and insurance companies allowed it to operate as a third party verifier; the RxCLAIM online claim processing system allowed for prescription drug claims to be processed online if the customer lived in and filled his/her prescription in the United States. SXC had three separate but interrelated business segments which dealt with prescription drug programs. For 2013, 23% of company revenue came from Cigna Corporation.
Elevance Health, Inc. is an American health insurance provider. Prior to June 2022, Elevance Health was named Anthem, Inc. The company's services include medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans through affiliated companies such as Anthem Blue Cross and Blue Shield, Anthem Blue Cross in California, Wellpoint, and Carelon. It is the largest for-profit managed health care company in the Blue Cross Blue Shield Association. As of 2022, the company had 46.8 million members within its affiliated companies' health plans.
Mark T. Bertolini is an American businessman who is the co-CEO of Bridgewater Associates, one of the world's largest hedge funds. He was previously the CEO of Aetna, a Fortune 50 diversified health care benefits company with over $60 billion in 2015 revenue. Bertolini assumed the role of CEO on November 29, 2010 and of chairman on April 8, 2011, until Aetna was sold to CVS on November 28, 2018.
Oscar Health, Inc. is an American health insurance company, founded in 2012 by Joshua Kushner, Kevin Nazemi and Mario Schlosser, and is headquartered in New York City. The company focuses on the health insurance industry through telemedicine, healthcare focused technological interfaces, and transparent claims pricing systems which would make it easier for patients to navigate.
Bright Health is an American health insurance company based in Minneapolis, Minnesota.
The Patient Protection and Affordable Care Act, often shortened to the Affordable Care Act (ACA) or nicknamed Obamacare, is a United States federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act of 2010 amendment, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the passage of Medicare and Medicaid in 1965. Once the law was signed, provisions began taking effect, in a process that continued for years. Some provisions never took effect, while others were deferred for various periods.
Optum, Inc. is an American healthcare services provider with business interests encompassing technology and related services, pharmacy care services and various direct healthcare services. It has been a subsidiary of UnitedHealth Group since 2011. UHG formed Optum by merging its existing pharmacy and care delivery services into the single Optum brand, comprising three main businesses: OptumHealth, OptumInsight and OptumRx. In 2017, Optum accounted for 44 percent of UnitedHealth Group's profits and as of 2019, Optum's revenues have surpassed $100 billion. Also in early 2019, Optum gained significant media attention regarding a trade secrets lawsuit that the company filed against former executive David William Smith, after Smith left Optum to join Haven, the joint healthcare venture of Amazon, JPMorgan Chase, and Berkshire Hathaway.
Last month, testimony in front of the U.S. Senate Committee on Commerce, Science and Transportation by a former health insurance insider named Wendell Potter made news even before it occurred: CBS News headlined: "Cigna Whistleblower to Testify." After Potter's testimony, the industry scrambled to do damage control: "Insurers defend rescissions, take heat for lack of transparency."
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