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Cigna plan benefits

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Transition of Care

Cigna Programs


Why did the County make this change? 

  • Broad array of programs that are expected to improve overall health and well-being of members, health coaching programs for 16 chronic conditions
  • Access to more digital, virtual and on-demand care options, for both medical and behavioral health needs
  • Expanded network access from regional to a national panel
  • Projected overall lower costs for members and the County, making the current benefit levels more sustainable
  •  Access to Omada, a no cost, high touch health condition support program for
    • Pre-diabetes
    • Diabetes
    • Hypertension  

What does Cigna offer? 

  • 24/7/365 live customer service
  • Access to a national PPO provider network 
  • Higher touch customer service model with Personal Guides - for everyday needs, work across Cigna departments to resolve issues
  • My Personal Champion - special assistance for members experiencing complex medical situations, billing
  • Access to new digital and virtual behavioral health options
  • Up to three, free EAP-type counseling sessions (separate from the County EAP program)
  • New health management programs for pre-diabetes, diabetes and hypertension through Omada
  • Healthy Pregnancies, Healthy Babies pregnancy support program with incentives for participation
  • Savings for members and plan due to better provider discounts
  • Provider search tool with both cost and quality information, adding fields for finding diverse providers this year

Will Cigna also provide pharmacy benefits?

The pharmacy benefits will continue to be administered by Welldyne.  The information your pharmacy needs to fill your prescription is on the back of your Cigna ID card: Group MULTCO, PCN WDRX, Bin 008878 and your new Cigna member ID number, which is on the front.

Will my dental plan with Delta Dental and my vision plan with Vision Service Plan change? 

No, the dental and vision plans will stay with Delta Dental and Vision Service Plan. You should have received a new Dental only ID member card from Delta Dental.  

Will our medical plans be changing?

Cigna is administering the same plan benefits that we had with Moda but with a different provider network. Take a look at our plan comparison charts for more details about the coverage.


Are my providers In-network with Cigna?

Most providers used by County health plan members are in the Cigna Open Access Plus (OAP) network. Cigna has been actively working to recruit out-of-network providers members have been using, but not all will become Cigna providers. 
You can ask any out-of-network providers you use to consider joining the Cigna network, but you must use Cigna providers to receive the highest level of benefits under your plan for most services. Look below to see if the Transition of Care Benefit applies to you for active treatment. The same local hospitals are in-network:  Legacy, Providence, OHSU & affiliates, Portland Adventist, Tuality, and PeaceHealth.  

How do I look up my providers to see if they are in-network or find new ones in Cigna’s network?

There are two ways:
1. Go to myCigna.com and search as a guest or log in, then go to Find Care and Costs to search in your area. Choose the OAP network if you are searching as a guest.
2. You can call the Cigna Customer service line 24/7/365 for help in finding providers:  800-244-6224 


Cigna representatives can assist you in finding out if your current provider is in-network.  If you are changing providers, you may want to provide your current provider with an authorization to send your medical records to the new provider. 

What if I need to contact a doctor today and my provider is out-of-network?

Cigna has immediate access to telehealth providers through its MDLive service on myCigna as well as nurse triage with its Health Line, call 1-800-244-6224. 


Will I receive new ID cards? When?

Yes, you should have received new member ID cards from Cigna.  You can also access your ID card online when you register with myCigna or download the app. If you have not received your new ID card(s), email employee.benefits@multco.us.

Will Cigna PPO 400 have the chronic condition benefit?

Yes!  Cigna PPO 400 - Chronic condition benefit (21.88 KB)

Does my deductible start over again on 1/1 of each new year? 

In moving from Moda to Cigna, your deductible amounts that were applied in the last quarter of 2021 will carry over to help satisfy the 2022 deductible. This is true each year, not just for the transition from Moda to Cigna. 

What if I need a prior authorization for services in January? Where should the medical information be sent?

Providers that are in-network with Cigna will handle prior authorization. Out-of-network providers may request prior authorization, but it is your responsibility to check with them about this. If they do not file your claim with Cigna, you will need to complete a Cigna claims form.

If I pay a bill, how do I get reimbursed by Cigna?

In-network providers will bill Cigna.  If an out-of-network provider declines to bill Cigna, you should complete and submit a Cigna claim form for reimbursement.

What if I/my dependents have additional health insurance coverage besides Cigna?

Cigna will coordinate benefits with other coverage. When you register on myCigna.com, provide the information about the other coverage.   


Is there a period of time that I can use my out-of-network provider for care I’m already receiving with Moda?

Yes, for qualifying conditions, you may submit a Cigna Transition of Care form (562.89 KB) within 30 days of 1/1/22. If approved, you may continue to see your out-of-network provider for up to 90 days, to allow time to transition to an in-network provider.

IMPORTANT: You do not need to submit the Transition of Care form for mental health or substance use outpatient treatment, please see the next question.

Is there a grace period for me to continue to see my out-of-network (Moda) mental health provider?

Yes, as a new member transitioning from Moda to Cigna, beginning 1/1/22, you have up to 90 days to transition your behavioral health care to an in-network provider without submitting a Transition of Care form. 

How do I submit a Transition of Care form?  

There are a few ways:
1. Call Cigna One Guides at 1-800-244-6224 and ask to submit a Transition of Care request. Your request will be submitted without filling out a form. Be sure to get your confirmation number.
2. Download Cigna Transition of Care form (562.89 KB)using Adobe, fill out and sign electronically, and submit via email to the Employee Benefits Office, who will submit the form to Cigna.
3. Print the form and mail or fax it directly to Cigna.


How does the billing work for the Transition of Care process?
During the initial 90 days of 2022, Cigna will pay out-of-network behavioral health providers as in-network at the in-network Cigna allowable charge. If your out-of-network provider charges more than the allowable amount, they may bill you for the difference and you may owe additional charges. Example: Dr. bills $100, Cigna allows $80, you may owe the remaining balance of $20. (100% of allowable charge on the PPO 400 plan)


When can I expect an answer regarding my Transition of Care (TOC) submission?
Cigna will mail a letter to you with your approval or denial within 10 business days, but average decision time is 5 business days.


Where can I learn more about what Cigna offers?

Welcome to Cigna (1.68 MB)