Health Maintenance Organization (HMO) Medical Plans
Designed around a focused set of quality, cost-effective providers and facilities in certain local service areas.
HMO Health Insurance Plan Overview
HMO plans are available to organizations in select service areas. For most HMO plans, employees' care is coordinated by a Primary Care Provider (PCP), which can help lower costs and improve health outcomes.
The HMO network is designed around a focused set of quality, cost-effective doctors and hospitals in select service areas. Employees access the HMO network in their local service area.
Compare HMO Plans
Your plan will vary based on what you discuss with your local Cigna Healthcare℠* representative, but here is a basic summary of how HMO plans typically work:
| Plan Features | HMO | HMO Open Access | HMO Point of Service | HMO Point of Service Open Access |
|---|---|---|---|---|
| PCP Required | Yes | No | Yes | No |
| PCP Auto-Assignment Included | Yes | No | Yes | No |
| Referrals to Specialists Required | Yes | No | Yes | No |
| Out-of-Network Coverage | No | No | Yes | Yes |
| Urgent/Emergent Services Coverage | Yes | Yes | Yes | Yes |
| Prior Authorization Required | May be required for hospitalizations and some types of outpatient care | May be required for hospitalizations and some types of outpatient care | May be required for hospitalizations and some types of outpatient care | May be required for hospitalizations and some types of outpatient care |
| Fully Insured Funding Option Available | Yes | Yes | Yes | Yes |
| Option to Offer FSA | Yes | Yes | Yes | Yes |
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*Offered by Cigna Health and Life Insurance Company or its affiliates
In Utah, plans are offered by Cigna Health and Life Insurance Company.
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Product availability may vary by location and plan type and is subject to change. All group health insurance policies and health benefit plans contain exclusions and limitations. For costs and details of coverage, contact a Cigna Healthcare representative.
Cigna Healthcare products and services are provided exclusively by or through operating subsidiaries of The Cigna Group, including Cigna Health and Life Insurance Company (Bloomfield, CT.) (CHLIC), Connecticut General Life Insurance Company, or their affiliates, and HMO or service company subsidiaries of Cigna Health Corporation, including Cigna HealthCare of Arizona, Inc., Cigna HealthCare of California, Inc., Cigna HealthCare of Colorado, Inc., Cigna HealthCare of Connecticut, Inc., Cigna HealthCare of Florida, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of Indiana, Inc., Cigna HealthCare of St. Louis, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of New Jersey, Inc., Cigna HealthCare of South Carolina, Inc., Cigna HealthCare of Tennessee, Inc. (CHC-TN), and Cigna HealthCare of Texas, Inc. In Utah, all products and services are provided by Cigna Health and Life Insurance Company (Bloomfield, CT). Policy forms: OK – HP-APP-1 et al., OR – HP-POL38 02-13, TN – HP-POL43/HC-CER1V1 et al. (CHLIC); GSA-COVER, et al. (CHC-TN).
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