We provide services to individuals covered by Taft-Hartley trusts and Federal Employee Health Benefit (FEHB) plans as part of our Shared Administration Repricing (SAR) program for self-funded administrative services only (ASO) benefit plans.

For these relationships, we provide access to our network, perform medical management and utilization review, reprice claims according to our contracted rates and claims logic, provide clinical appeals management, and handle contract dispute resolution. For some plans, we may also provide stop-loss insurance, disease management services, pharmacy benefits, or behavioral health benefits. Third-party administrators (TPAs) and self-administered plans maintain eligibility, administer benefits, and pay claims for these shared accounts on their own systems.

Additional information about how these plans are managed

• We require our TPA partners to frequently provide eligibility information to help ensure early identification of individuals who are not covered.
• Plans require in-network and out-of-network benefit differentials to encourage individuals to use participating providers.
• We complete a pre-contract checklist to ensure a TPA meets our standards on claim payment accuracy, payment response time, and call statistics (e.g., speed of response). Adherence to these standards is contractually required.
• We audit TPAs on a regular basis to ensure contract standard compliance.
• We retain the relationship with participating providers to resolve contract language and interpretation issues.
• Our staff and the Provider Engagement team support providers and resolve claim inquiries or issues. For appeals, reimbursement issues, and general questions, please call the dedicated SAR provider service telephone number at 800.549.8908, 8:00 a.m.‒6:00 p.m. ET.
• Please contact the TPA or plan administrator directly to enroll in electronic remittance advice (ERA) and electronic funds transfer (EFT).

ID Cards:
ID cards display the:

• Cigna Healthcare logo.
• Submission information for paper and electronic claims.
• Cigna Healthcare telephone number to request precertification.
• TPA contact information for checking eligibility, benefits, and claim status.

Sample SAR ID cards are available in the Quick Guide to Cigna ID Cards. Go to Cigna.com > For Providers > Coverage and Claims > Coverage Policies: ID Cards.

Medical management
Cigna Health Management, Inc./CareAllies provides medical management for inpatient utilization reviews (precertification) for acute, rehabilitation, skilled nursing, and management. A review of outpatient services (e.g., home health care, home infusion, spinal procedures) may also be purchased.

For eligibility, benefits coverage, claim status, and payment information
Please contact the TPA at the telephone number and address on your patient’s Cigna Healthcare ID card.

View the recent list of active Shared Administration accounts.