Steps Cigna is taking for clients related to Consolidated Appropriations Act, Title II, Section 204

7/21/2022
California Colorado Texas

This communication, sent to all producers, outlines the information that Cigna will provide to all their medical clients related to compliance with Section 204 of the Consolidated Appropriations Act, which has an enforcement date of 12/27/22. 

 What the rule requires
Health plans (which include employers that offer medical benefit plans to their employees) must report information on plan medical costs and prescription drug spending to the Secretaries of the U.S. Department of Health and Human Services (HHS), Department of Labor, and Department of the Treasury for reporting years 2020 and 2021 by 12/27/22. For subsequent reporting years, clients must report the information by 6/1 annually. 

The primary intent of the data collection is to provide valuable information to policy makers about competition and market concentration in the pharmaceutical and health care industries. The collected data will be used in a report published on the HHS website 18 months after initial data submission, and then every two years thereafter; the report will offer information on prescription drug pricing trends and employer contribution to health insurance premiums.

What Cigna is doing 
•    Cigna will produce medical and/or pharmacy spend reporting annually for both fully insured and self-funded (ASO) clients. 

•    These reports will be provided to the U.S. Departments of Health and Human Services, Department of Labor, and Department of the Treasury. 

•    Reports for reporting years 2020 and 2021 will be delivered by 12/27/22. For reporting year 2022 and beyond, reports will be provided by 6/1 of the following year. 

•    These aggregated spend data reports for U.S. Commercial clients will be available to clients via CignaforEmployers.com. 

•    The reports submitted by 12/27/22 will not incorporate any data from clients or other external parties nor any data that is not maintained by Cigna. 

•    Data will not be provided at the client level. 

•    Federal guidance issued on 6/28/22 does not change our submission approach; client action is not required for reports submitted by 12/27/22. Additional communication regarding reports to be submitted annually beginning 6/30/23 will be provided by December 2022. 

What your clients need to do

There is no action for clients to take for the 12/27/22 report submission. Cigna is producing the required reports and providing them on your clients’ behalf.


More information

For more information, visit Cigna Consultant Access to log in or register for the portal. 

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