Cigna Group Health Plans in Illinois

Cigna is a major national health insurer with a strong employer group presence in Illinois. Cigna’s parent company, The Cigna Group, also owns Evernorth, one of the nation’s largest pharmacy benefit management and specialty pharmacy companies. This vertical integration between Cigna medical plans and Evernorth pharmacy services gives Illinois employers access to a coordinated approach to both medical and prescription drug cost management — a significant advantage as specialty pharmacy spend continues to grow as a share of total health benefit costs.

Cigna Group Plan Options in Illinois

Plan Product	Type	Key Characteristics
Open Access Plus (OAP)	PPO	No referrals, broad national network, in- and out-of-network coverage
LocalPlus	Narrow Network HMO/PPO	Curated network of high-value providers, lower premiums than OAP
Connect Plans	HMO	Integrated care model with select health system partners
HDHP	High Deductible / HSA	HSA-compatible, preventive care covered before deductible
Cigna Level Funded (CLF)	Level Funded	For groups 10–149, fixed monthly payment, surplus refund, claims data access

Evernorth: Pharmacy Benefit Management Integration

Evernorth (formerly Express Scripts) is The Cigna Group’s pharmacy benefit management arm and one of the largest PBMs in the United States. For Illinois employers on Cigna group plans, Evernorth manages the prescription drug benefit with a focus on:

• Formulary management: Tiered drug formularies that incentivize use of generics and preferred brand medications over high-cost alternatives
• Specialty pharmacy: Accredo, Evernorth’s specialty pharmacy, manages high-cost biologics and specialty medications with clinical support services
• Prior authorization and step therapy: Programs that require clinical justification before approving high-cost specialty drugs and encourage lower-cost therapeutic alternatives first
• Home delivery pharmacy: 90-day supplies via mail for maintenance medications, typically at lower cost-sharing than retail

Cigna Level Funded (CLF)

Cigna Level Funded is available to Illinois groups with 10 to 149 employees and provides the core benefits of a level funded arrangement: a fixed monthly payment, stop-loss insurance, and the potential for a year-end surplus refund. CLF gives employers access to Cigna’s Open Access Plus or LocalPlus network while providing quarterly claims reporting. The medical underwriting process for CLF evaluates the group’s overall health profile and may result in significantly lower monthly costs than comparable fully insured options for groups with healthy demographics.

Behavioral Health Parity and Virtual Care

Cigna has invested significantly in behavioral health parity compliance and expanded mental health benefits access. All Cigna group plans include parity between mental health/substance use disorder benefits and medical/surgical benefits as required by federal and Illinois law. Cigna also offers virtual therapy access through partnerships with behavioral health platforms, reducing the barrier of long appointment wait times for in-person mental health care.

Virtual primary care and urgent care are available through MDLive, Cigna’s integrated telehealth partner. Employees on Cigna group plans can access MDLive for $0 or low copay urgent care and primary care consultations 24/7, reducing unnecessary ER utilization for non-emergency conditions.

International Coverage for Illinois Employers

For Illinois employers with employees who travel internationally for business, Cigna’s global health coverage options provide a meaningful differentiator. Cigna Global and their international supplemental coverage products ensure that employees working or traveling abroad have access to medical care outside the United States. This is particularly relevant for Chicago-based companies with international business operations in Europe, Asia, or Latin America.

Contact Illinois Health Agents for current Cigna rate quotes for your group size and employee demographics.