UPDATED: Report on the Consultative meeting between UNICEF and Cigna International 18-21 March 2024 Budapest : Souleymane Diabate
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| For the full results of the survey, see below |
Editor's Note: Updated - an earlier version of this post dropped two pages of the report, including the conclusions. These have now been added. Our apologies for any confusion caused.
On 5 March we published the invitation for all members to complete a survey on CIGNA's health insurance. The survey was intended to provide data for the meeting organized by DHR with CIGNA from 18 to 21 March at the GSSC Budapest. Souleymane Diabate had been invited by DHR to represent views of retirees. If you missed the survey and would still like to offer your views Click here.. You can also contact Souleymane by email at souledia@gmail.com. Below is Souleymane's report on the meeting and the summary of the survey results. We thank Souleymane for representing the retirees and for his thorough report.
From Souleymane Diabate
I am sharing with you here attached my report, as well as my PPP and the results of the survey conducted so far.
I wish to thank UNICEF retirees for the contributions made to the above meeting recently held to address the concerns staff/retirees on the performance of Cigna. I have prepared the summary below that describes the process and results and recommendations made. All the issues were not fully addressed, however the concerns raised were used by active staff and retirees to illustrate the challenges and generate active discussion.
I am sharing with you here attached my report, as well as my PPP and the results of the survey conducted so far.
I wish to thank UNICEF retirees for the contributions made to the above meeting recently held to address the concerns staff/retirees on the performance of Cigna. I have prepared the summary below that describes the process and results and recommendations made. All the issues were not fully addressed, however the concerns raised were used by active staff and retirees to illustrate the challenges and generate active discussion.
Special thanks to Global Shared Service Center (GSSC) for extending an invitation to the retirees and to the retirees for taking the time to complete the questionnaire and share the challenges they individually faced. The content of the questionnaires and emails assisted me in articulating the special needs of the retirees. While attending the Workshop, I learned that three (03) retirees had remotely attended as well.
I wish to take this opportunity to thank you personally and the XUNICEF Members who participated in this exercise. I remain available to respond to your queries if needed.
Looking forward to hearing from you. Very best. Souleymane
Report on the Consultative meeting
1. Process and Outcome:
UNICEF Global Staff Association and the Retirees, participated in a global consultation exercise. The findings were summarized and presented on the first day of the meeting. The two processes yielded similar findings, clearly indicating the need for:
a) clarification of benefits, (local, international staff also affecting retirees at retirement)
b) country level weakness on the Cigna coverages by all parties (UNICEF HR, staff, beneficiaries, and service providers).
c) Discussions were also held on the role of the UN doctor as a coordinator of services, vs service provider, vs updating the specialist services at country level. d) Confusion also existed on the Cigna benefits based on the UNICEF contract (National and International staff), when it came to care away from the duty station or place of recruitment.
e) Several of the concerns raised were used as case studies to illustrate both the work processes and the benefits. Cigna shared a sample of their work processes, and the audience noted the extensive work processes.
f) Delays in processing claims and when processing begins Cigna has many questions for clarification prior to payment and in some cases the reimbursement is less than 80%, without a clear explanation.
g) Guarantee of Payments (GOPs) take prolong times, and this delays the start of treatment.
h) Claims settlement by Cigna has been seen as taking prolong period of times (In some cases up to 7 months).
i) Staff obtaining medical care away from the duty station being reimbursed at the rate of the duty station and not at the place where care is rendered, causing considerable expenditure to the staff member (more common with National staff seeking care away from duty station).
j) In the case of retirees, when seeking care away from home country, may have to reach the out-of-pocket expenditure before Cigna will cover 80% of reasonable costs.
k) Cigna coverage is very low, compared to the population served (senior retirees). l) Role of Cigna supporting diagnostic efforts for prevention interventions/activities. m) Cigna presented interesting information of disease profiles based on payments and what seemed to be an emerging issue that required more attention. While the data was interesting, it was not possible to determine the disease burden by region as it was based on location of payment and not totally on beneficiary origin. Although it was based on payments made, it still provided a bird's eye view of the disease burden by region.
2. Conclusion and Recommendations:
a. Cigna has hired 11 focal points, grouped by countries as a resource to UNICEF. b. Staff/retirees must be fully conversant with the coverage and benefits. In addition to the coverage, the limits of the coverage. National staff have local contracts and seek care outside of the country, the reimbursement will be in the country of origin and not in the country where care has been received. This decision by UNICEF is based on the type of contract the staff member has/had. c. Staff/retirees are not prohibited from purchasing travel insurance, with a medical component, particularly in the case of national staff on stretch assignment outside of their duty station.
d. The need to increase communication with service provider. Staff, retirees, and the UN medical doctor, has created the need for Webinars/Town Hall meetings at least once a year; this will be organized by UNICEF. The proposal is that this is done regionally and at least once a year.
e. The use of the customer service line is ineffective and at some point costly to the beneficiary and health care provider, delays in processing of payments, and what appears to be lack of continuity/follow up by Cigna and language barriers on the service line and other forms of communication.
Cigna expressed concerns for using an open network to communicate as medical information is confidential and as such should be protected. In some cases, document sharing is compromised (long files, poor internet service and band-with).
Suggestions to be address by Cigna:
-Use of existing tools such as WhatsApp as the information is
encrypted.
-Special coded email that can be used for transmission
-Cigna will re-look at the long detailed work process to see how it can best be streamlined, maintaining confidentiality and the integrity of the honor system
d. UNICEF HQ to engage the UN medical services in clarifying the role of the UN doctor to ensure that a complete list of medical services available and updated at the country level. With the passing of time and increasing medical specialization at the country level, a mechanism for reviewing and updating service availability is essential.
e. At the country level, county teams support this effort by ensuring the beneficiaries are able to access comprehensive care, when available at the country level.
f. At the time of retirement, staff are provided with information on ASHI and enrolled in the relevant health care package at the country of residence. This package should also include Life Insurance if the staff member has contributed ten or more years of continues service.
g. Retirees should discuss with ASHI other health insurance carriers at country level that will meet higher health coverage (note that premiums may be higher (e.g. USA, Canada).
h. Staff on separation should submit all medical claims within a short time of separation to ensure they are processed before the retiree leaves the plan.
i. UNICEF in partnership with Cigna will launch a health prevention campaigns. These campaigns will be coupled with screening to avoid doing business as usual. The dates to be used are the established dates, and shared at the meeting (e.g. Breast Cancer awareness month – October, Malaria, Water, etc etc.) The Health Prevention Campaign will be managed and targeted by Cigna based on disease profile developed by region.
3. Next Steps:
⮚ UNICEF, through DHR will communicate to staff changes related to Cigna agreed mechanisms.
⮚ Global Staff Association to arrange staff information sessions, done through the HR sections at country level.
⮚ Cigna will communicate to the retirees, through ASHI changes in coverage and/ or new program areas.
⮚ Encourage staff and retirees to be knowledgeable on the insurance coverage and limits annually.
⮚ Cigna has agreed to take a deeper look on: Prevention, Communication, Mental health (critical but not yet well addressed)
⮚ Review of recommendations will also be done taking into account its implications on other UN agencies
Results of the Survey of XUNICEF Members - (click the arrow to view the pdf in full screen)
Report on the Consultative meeting
1. Process and Outcome:
UNICEF Global Staff Association and the Retirees, participated in a global consultation exercise. The findings were summarized and presented on the first day of the meeting. The two processes yielded similar findings, clearly indicating the need for:
a) clarification of benefits, (local, international staff also affecting retirees at retirement)
b) country level weakness on the Cigna coverages by all parties (UNICEF HR, staff, beneficiaries, and service providers).
c) Discussions were also held on the role of the UN doctor as a coordinator of services, vs service provider, vs updating the specialist services at country level. d) Confusion also existed on the Cigna benefits based on the UNICEF contract (National and International staff), when it came to care away from the duty station or place of recruitment.
e) Several of the concerns raised were used as case studies to illustrate both the work processes and the benefits. Cigna shared a sample of their work processes, and the audience noted the extensive work processes.
f) Delays in processing claims and when processing begins Cigna has many questions for clarification prior to payment and in some cases the reimbursement is less than 80%, without a clear explanation.
g) Guarantee of Payments (GOPs) take prolong times, and this delays the start of treatment.
h) Claims settlement by Cigna has been seen as taking prolong period of times (In some cases up to 7 months).
i) Staff obtaining medical care away from the duty station being reimbursed at the rate of the duty station and not at the place where care is rendered, causing considerable expenditure to the staff member (more common with National staff seeking care away from duty station).
j) In the case of retirees, when seeking care away from home country, may have to reach the out-of-pocket expenditure before Cigna will cover 80% of reasonable costs.
k) Cigna coverage is very low, compared to the population served (senior retirees). l) Role of Cigna supporting diagnostic efforts for prevention interventions/activities. m) Cigna presented interesting information of disease profiles based on payments and what seemed to be an emerging issue that required more attention. While the data was interesting, it was not possible to determine the disease burden by region as it was based on location of payment and not totally on beneficiary origin. Although it was based on payments made, it still provided a bird's eye view of the disease burden by region.
2. Conclusion and Recommendations:
a. Cigna has hired 11 focal points, grouped by countries as a resource to UNICEF. b. Staff/retirees must be fully conversant with the coverage and benefits. In addition to the coverage, the limits of the coverage. National staff have local contracts and seek care outside of the country, the reimbursement will be in the country of origin and not in the country where care has been received. This decision by UNICEF is based on the type of contract the staff member has/had. c. Staff/retirees are not prohibited from purchasing travel insurance, with a medical component, particularly in the case of national staff on stretch assignment outside of their duty station.
d. The need to increase communication with service provider. Staff, retirees, and the UN medical doctor, has created the need for Webinars/Town Hall meetings at least once a year; this will be organized by UNICEF. The proposal is that this is done regionally and at least once a year.
e. The use of the customer service line is ineffective and at some point costly to the beneficiary and health care provider, delays in processing of payments, and what appears to be lack of continuity/follow up by Cigna and language barriers on the service line and other forms of communication.
Cigna expressed concerns for using an open network to communicate as medical information is confidential and as such should be protected. In some cases, document sharing is compromised (long files, poor internet service and band-with).
Suggestions to be address by Cigna:
-Use of existing tools such as WhatsApp as the information is
encrypted.
-Special coded email that can be used for transmission
-Cigna will re-look at the long detailed work process to see how it can best be streamlined, maintaining confidentiality and the integrity of the honor system
d. UNICEF HQ to engage the UN medical services in clarifying the role of the UN doctor to ensure that a complete list of medical services available and updated at the country level. With the passing of time and increasing medical specialization at the country level, a mechanism for reviewing and updating service availability is essential.
e. At the country level, county teams support this effort by ensuring the beneficiaries are able to access comprehensive care, when available at the country level.
f. At the time of retirement, staff are provided with information on ASHI and enrolled in the relevant health care package at the country of residence. This package should also include Life Insurance if the staff member has contributed ten or more years of continues service.
g. Retirees should discuss with ASHI other health insurance carriers at country level that will meet higher health coverage (note that premiums may be higher (e.g. USA, Canada).
h. Staff on separation should submit all medical claims within a short time of separation to ensure they are processed before the retiree leaves the plan.
i. UNICEF in partnership with Cigna will launch a health prevention campaigns. These campaigns will be coupled with screening to avoid doing business as usual. The dates to be used are the established dates, and shared at the meeting (e.g. Breast Cancer awareness month – October, Malaria, Water, etc etc.) The Health Prevention Campaign will be managed and targeted by Cigna based on disease profile developed by region.
3. Next Steps:
⮚ UNICEF, through DHR will communicate to staff changes related to Cigna agreed mechanisms.
⮚ Global Staff Association to arrange staff information sessions, done through the HR sections at country level.
⮚ Cigna will communicate to the retirees, through ASHI changes in coverage and/ or new program areas.
⮚ Encourage staff and retirees to be knowledgeable on the insurance coverage and limits annually.
⮚ Cigna has agreed to take a deeper look on: Prevention, Communication, Mental health (critical but not yet well addressed)
⮚ Review of recommendations will also be done taking into account its implications on other UN agencies
Results of the Survey of XUNICEF Members - (click the arrow to view the pdf in full screen)
XUNICEF Members' Feedback on ASHI Administration
Summary table of Issues - CIGNA
Click here to read the table of issues.
Appreciate informing if Cigna is used by only UNICEF retirees only? What is the process in UNDP, WHO etc. Thanks for your response.
ReplyDeleteOne of the recommendations on the report was about taking in consideration the experience and implications on other UN sister agencies. In addition to that and to my knowledge, all the retirees from UNICEF are not part of CIGNA insurance Medical Plan.
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