Mar 18, 2022
Cigna is taking steps to help groups meet the Transparency in Coverage requirements.
When does the Transparency in Coverage requirement become effective?
The rule is effective 7/1/22.
What kinds of groups does the rule apply to?
The rule applies to fully insured and ASO clients (Level Funding is ASO).
What is Cigna doing to help groups?
Cigna will generate and host the required client-specific reports on Cigna’s web site. On or before 7/1/22, most clients will need to copy the link below and post it somewhere on their public website to provide access to the MRFs. The link is https://www.cigna.com/legal/compliance/machine-readable-files. Note that prior to 7/1/22, this link will take you to the home page of Cigna.com, but will access the MRFs page after that date.
There will be no individual health information or identifiable information in the reports; claims that do not meet the minimum HIPAA requirements (too few claims) will not be included.
Who is responsible for what?
Cigna provides the report, then the group makes the report publicly available.
What must groups do to be compliant?
Groups with a website: Clients must post a link to the Cigna report on their website. The link must be publicly accessible, rather than an internal/intranet site. It may not be password protected.
If the client has a public website, they must use that rather than the Cigna-hosted site. The intent of the rule is to make the information easily accessible; the obvious place that people will look for the information is on the main company web site. Setting up a separate web site would appear to be covertly providing the information
Groups without a website: If a client does not have a public website, Cigna will build one for them at no cost. If Cigna builds the website, it will be a very simple: an otherwise blank page that includes the link to the Cigna report.
Are there exceptions?
ASO clients (only) can opt out of posting a link to Cigna, and post the reports on their own web site. This is a technical and detailed process, which Cigna does not recommend.
What should groups do next?
Cigna recently reached out to clients. Clients need to respond by March 31 if either of the following apply:
- They need a website built
- They intent to opt out and host their own files
When will the reports be available?
Initial reports will be available by May 15. Following reports will be updated on or around the 15th of each month.
How often does the group need to act after making the reports available?
The clients will only need to post the Cigna provided link one time on their website. There is no additional action needed by the client after that as the original link will direct to the most updated reports.
