Hello all,

We finally have some answers to your very well anticipated questions on where we are at with our non-Kaiser health insurance. After many, many hours of benefits discussion and meetings with the city, as well as, presentations by insurance providers, we will be switching to Cigna beginning September 1.

Health insurance has been a hot topic between the union and the city since the PacificSource transition and a large part of our contract negotiations. As most of you know, we have in our contract to get back to a better insurance plan with the most robust network possible, i.e. making sure all major medical providers in the metro area are included such as Providence, Legacy, OHSU, etc. The citywide benefits committee, which included members of the E-Board, narrowed down the finalists to Cigna and CIS/Regence Blue Cross Blue Shield.

About a week and a half ago, Cigna and CIS/Regence provided presentations to the benefits committee and answered questions.

Cigna made a very impressive presentation and has a large focus on customer service and ease of access to benefits. The Cigna representatives that work their phone, email, and text based service go through a 19 week training program and focus on customer service skills and not call center skills. They stated they believe it is not their job to give members homework when there is a problem; giving them a big to do list and who to contact. Their customer service staff is trained to take on those tasks and do the legwork on claims, not the member doing the legwork.

Cigna specifically addressed their focus on first responder health and overall wellness programs for all members. Cigna has specifically trained staff for first responders, to include a 24/7/365 crisis and mental health line with mental health professionals that are trained quarterly on how to deal with first responders. They state that if a member contacts them and is in need of hospitalization or follow up medical treatment, they will take care of contacting places, finding them a bed, and getting them transported.

Cigna also addressed their main focus of customer service and making sure that insurance rates do not increase, but should be matching consumer price index. Other significant take aways from their presentation was that they are ranked as the number one payer nationally for claims (aka they pay their bills).

Cigna also has streamlined the preuath and approval process to get approvals done almost instantly with providers.

Cigna uses American Specialty (ASH) to run their alternative care program covering chiropractic, massage, acupuncture, etc. The Cigna plan provides 20 visits in each of those categories no questions asked. After 20, an approval will be needed for medical necessity. With Regence it is 77 total alternative care and medical necessity needing to be established.

Cigna stated they will provide a concierge line to assist members transition and provide a 90-day transition if, by chance, there is an out of network provider post start date. If a provider is not in network, we can provide the provider information to Cigna and they have a local team that will reach out to the provider to try and bring them into Cigna.

Cigna has an app to assist in contacting customer service, live chat, scheduling virtual doctor visits, and mapping pharmacies and prescription prices.

CIS/Regence BlueCross also made a presentation, which for lack of better words, did not go over well at all and was extremely unimpressive. CIS stated that we will have a unique built plan to start, however, when it comes to renew next year, we will be back on the standard plan they offer without options to customize. CIS mentioned several times the increasing cost of health care and increase in premium costs. CIS stated when we go to their standard plan, we will also go to their new prescription copay plan, which we would see our copay rates double to quadruple depending on the prescription category. CIS continues to uses ExpressScripts for their prescription plan, which coincidentally, is actually owned by Cigna.

CIS was questioned about where the money goes in the trust and if us, as the largest agency in the trust, are paying for the benefit of the smaller groups within the trust. CIS refused to say how or where the funds are carried within the trust. When asked about a post start transition period for out of network, we could not get any firm answer on how long they would be willing to have a transition period.

With all of this being said, the city has chosen Cigna as our new insurance provider with a transition date of 9/1/2020.  In our contract, we had a 7/1/2020 transition, but that was delayed. Also, per contact, a non-Regence choice is also part of opening and bargaining Article 9 of the contract. The executive board, the city, and our attorneys are working on those issues and bargaining. Updates on that will come throughout the summer.

Just a reminder that it is the city’s choice of what insurance carriers we choose, however, your executive board have been active participants in the decision making and also believe this is the best option for us.

If you have any questions, please reach out to Devin, Leah, or Denise.

In the next couple weeks we will send out another note about getting a union meeting time, place and date.