Cigna Pathwell Specialty - New Infusion Network Effective 7/1/2022

7/19/2022

This communication from Cigna is for brokers with self-funded clients with under 500 employees regarding the availability of a new infusion network.

On average, specialty drugs contribute to 50% of a client’s total pharmacy spend and 22% of their total health care spend.2 These types of large-scale challenges are what ignite innovative breakthroughs at Cigna. They are leading the way with our groundbreaking specialty solutions that work together across benefits to impact total health care costs. 

Cigna Pathwell SpecialtySM is being implemented in phases starting with some of your Level and Graded self-funded clients’ benefit plans with 7/1/2022 renewal or effective dates. Other phases of Cigna Pathwell Specialty implementation will be communicated in the fall. 

As of July 1, 2022, Cigna’s new and renewing self-funded clients with fewer than 500 employees1 will have Cigna Pathwell Specialty as a standard within their plan design. 

About Cigna Pathwell Specialty
Cigna Pathwell Specialty is a new network benefit that manages injected and infused specialty medication costs by guiding customers to the most cost-effective and clinically appropriate in-network providers,3 including specialty pharmacies and other treatment settings. It will be supported by their new, high-touch Cigna Pathwell Specialty Care Management Team, which will proactively guide customers using out-of-network providers to in-network benefits while also providing them with education and referrals to other Cigna health programs, including those focused on wellness and behavioral health as needed. 

Additionally, both customers and providers will have access to new, easy-to-use provider look-up tools with geolocation features that identify in-network providers. Cigna committed to providing support for our customers who use out-of-network providers and are most in need of clinical coordination and benefit support as they continue their health journey.

What’s Next

Following renewal, all customers will receive new ID cards with the Cigna Pathwell Specialty indicator. Cigna estimates that less than 2% of customers are not currently using an in-network provider.4 Customers who are using an out-of-network provider will receive a letter notifying them of this benefit change and next steps. In addition to the Cigna Pathwell Specialty Care Management Team, these customers will have access to online resources to learn more about the benefit, such as how it works, where to look up providers and a list of frequently asked questions. If, at any time, customers have questions, they will be able to call the Care Manager Team. 

Attached is a copy of the client communication

You can also view the following resources:
Cigna Client Broker Deck
Cigna Pharmacy Health Living Guarantee Client Broker Flyer



For more information, please contact your Cigna representative.



1. Cigna Pathwell Specialty availability will vary by funding type, client size and funding platform. Initial rollout will be inclusive of new and renewing self-funded clients on our Facets platform with fewer than 500 employees. Additional availability based on funding type and platform will be announced in the coming months.

2. Cigna national book of business analysis, 2019. Average impact is 50%. Results vary by client.

 

3. “Provider” means an in-network specialty pharmacy the doctor orders medication from or the place (location) where patients are having their treatment done.

4. Cigna internal analysis, 2022. Results may vary. 

All Cigna products and services are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company. 

 

Source: Cigna