A look at Cigna's international NGO health plans

Cigna has more than 15 million members in the U.S. But plenty of people might not realize an additional 1.5 million of the insurance giant's members live abroad—some of whom are in some of the most dangerous regions of the world.

This growing market is where Angela Rooney, who is Cigna’s nongovernmental organizations (NGOs) director, specializes.

Cigna has been in the business of insurance for NGOs doing humanitarian work worldwide for 60 years, Rooney said in an interview with FierceHealthcare in June during an NGO workshop hosted by the insurer in Washington, D.C. That includes being available to meet the needs of NGO workers around the clock.

Cigna’s NGO team could be assisting a member with a snakebite one day and helping with another group in a war zone the next, Rooney said. 

“Their missions are very important to us,” Rooney said. 

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Because the circumstances NGOs are operating in can be so varied, Rooney said that Cigna builds benefits packages for each that are tailored to the region they’re working in. For example, a group in a remote location with limited or no internet access may not be able to fully take advantage of telehealth. 

The healthcare infrastructure in these regions can also be quite different, she said. Cigna builds a coverage network around where NGOs are located when they contract for benefits. 

"It's duty of care at its extreme,” Rooney said. "Everyone who works at Cigna for our NGOs thinks it’s so fulfilling because you’re helping people in desperate need and doing some good for the world.” 

The insurer operates such plans in more than 100 countries and provides local case managers to NGOs in Kenya, South Africa, Chile, Belgium, Spain and Malaysia. Stateside case managers are also based in Miami, Florida. 

Cigna also operates an international medical board in several countries and is directly contracted with more than 1,550 providers in Africa alone. The continent is a key growth target for the insurer, Rooney said; Cigna has offered insurance products in Africa since 2008 but significantly expanded its scope with the launch of Hollard Cigna Health in 2016, which is a partnership with Hollard Insurance Group, another payer active in Africa.

Cigna's membership on the continent has grown to more than 200,000 people.

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A crucial focus for Cigna’s NGO team is the mental health of workers in the field, Rooney said. Burnout is a risk, she said, and many of these workers are in dangerous situations. A key solution is including video counseling visits in benefits packages, which can be easier for workers to keep up with than in-person therapy. 

Mental health checks are also built into the onboarding and offboarding processes, both for Cigna’s plan specifically and within most NGOs, Rooney said. 

“They’re so committed that they don’t really want to break assignment to leave,” Rooney said. “So, the more we can offer support and tech processes, they can remain in that location.” 

Pre- and post-international work also includes routine physicals and health checks. Cigna deploys physicians who specialize in tropical diseases where needed and works with local specialty doctors as well when possible. 

Rooney said she and her team never know when they’ll get that call about an emergency situation—but they’re always ready. 

“This is when NGOs need you and you’ve got to be there,” she said.