Transformation

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Transformation

• Heyward Donigan

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Our Vision
We are passionately committed to making every
experience with CIGNA HealthCare positive and
highly satisfying. For everyone. Every time.
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Today...Delivering the Visionthrough
Transformation

• A 1 billion investment for our customers,
  members, and providers designed to
• simplify their products
• simplify their medical care
• simplify their service

Simply outstanding health care
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Transforming Our Business
Then
Now
15 Medical Claim Systems Four Dental Claim
Systems Multiple P.O. Boxes Multiple ID Cards 30
Inquiry Desktops 1000 Inquiry 800
Numbers Multiple Provider Databases 15
Eligibility Systems Multiple Bills by Product 9
Utilization Mgmt Systems
Two Systems Power MHS Proclaim Three
Systems Dentacom/Proclaim/Webster One P.O Box
per Provider One Standard Offering One Inquiry
Desktop Fewer 800 Numbers One Central Medical
Provider File One System CED/CDB One Integrated
Bill One Utilization Management System
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What This Means for Our...
Members
Employers

• Flexible, modular product set to meet all their
  needs
• Improved account management tools
• Superior account service
• Employer-aligned service centers
• Faster case installation
• Integrated billing and reporting
• Improved collaterals

• Enhanced access to quality health care
• Improved hassle-free service
• Timely and accurate responses to inquiries
• 24 x 7 access to information via the Internet,
  Integrated Voice Response technology, and 24-Hour
  Health Information Line
• Improved collaterals

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What This Means for Our...
Providers
Employees

• Timely and accurate claim payments
• Simplified prior authorization and referrals
• Single point of contact for inquiry and claim
  submissions
• eCommerce to facilitate transaction and
  information exchange
• Information on practice patterns

• New tools to achieve excellence in health care
• Consistent business processes across CIGNA
  HealthCare
• Leading-edge technology to support service
  excellence
• Enabled as advocates for our customers

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Size and Impact of Transformation

• Over 1,400 full-time employees involved in the
  development, training and implementation of
  Transformation
• Almost all CIGNA HealthCare functional areas and
  jobs are changing due to Transformation
• In 2001 alone, 17,500 people in 102 locations
  went through Transformation training
• All of our employer customers, medical members
  and providers will experience improved products
  and services

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Size and Impact of Transformation

• Complexity is magnified by the fact that there
  are 11 categories of changes occurring
  simultaneously

• Office locations (consolidation)
• eCommerce
• Information management (data modeling)
• Service ownership (e.g., single-site ownership,
  implementation management)

• Business process
• Product
• Structuring of cases
• Technologies (e.g. midrange)
• Transaction systems
• Training delivery
• Organization design (includes model office work)

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Industry RecognitionComputer World Honors
Program

• CIGNA HealthCare selected as one of five
  finalists in the Finance, Insurance Real Estate
  category to receive the programs 21st Century
  Innovation Award
• Transformation program recognized as an innovator
  and contributor to the information technology
  revolution
• Most outstanding finalist announced June 3

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Where We Are Today
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Current Status of Transformation

• As of July 2002, we will be servicing 4.5 million
  members on new platforms, representing 2,800
  customer accounts
• New system platforms performing as designed
• Smoothing processes and workflow to finalize new
  environment
• Working closely with customers and providers to
  resolve isolated issues
• Isolated issues have generally been
  account-specific and tied to learning curve
  related to the 80 new or enhanced systems and
  corresponding workflows
• Recent customer satisfaction data shows strong
  improvement
• January 2002 vs. January 2001

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Product and Service Enhancements Delivering
Results

• Auto-adjudication exceeding plan
• First call resolution improved by 12
• 50 of claims submitted through EDI (Electronic
  Data Interchange) Gateway
• 40 of mail processed through new mailroom
• On target for 100 by August 2002

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Lesson Learned
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Lessons Learned

• Isolated account-specific issues have generally
  been tied to the learning curves related to the
  80 new or enhanced systems, corresponding
  workflows, and training
• In many cases, contingency plans developed ahead
  of time helped minimize impact
• We identified opportunities for improvement with
  each of our customer groups (customers, members,
  and providers)

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Lessons Learned

• Allow for more time and additional resources to
  manage process of mapping members from old to
  new systems
• Work with customers to revise schedule for
  delivering eligibility information to allow for
  more time to load this information
• More effectively adjust staffing around effective
  date of upgrade to handle increased call volumes
  from new members
• More effectively adjust authorization and other
  processes around effective date of upgrade to
  handle increased claim volume on new systems

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Lessons Learned

• Extend training periods and expectations for
  learning curves as adapting to new systems and
  processes takes a long period of time to embed
  into everyday workflow
• Initiate proactive communications to alert
  providers that many members will receive ID cards
  with new numbers

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Planned Enhancements
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Rollout Schedule
January 2001
Through 2005
January 2002
July 2001
January 2004
September 2001
Release 2
Release 3
Release 1 Phase I
Release 1 Phase II
Self-funded Product Portfolio (Indemnity, HMO,
POS, PPO)
Fully Insured HMO POS Georgia/Virginia
Fully Insured HMO POS National Rollout - new
clients
Experience- Rated Product Portfolio (Indemnity, H
MO, POS, PPO)
Upgrades Completed
Upgrades begins
Fully Insured HMO POS National Rollout -
existing clients
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Enhancements

• System Scalability
• Dental System Enhancements
• Provider Contract Loading Technology
• Electronic Customer Profile
• Additional Auto Adjudication Improvements

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2002 - 2003Service Initiatives
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Commitment to Industry-Leading Service

• Service Center consolidation
• More efficient operations
• Single service location for both claim and member
  services
• Service Operating Model
• Single points of contact for both claim and
  member services
• Faster resolution on cross-divisional issues
• Improved productivity through integrated use of
  new Transformation-enabled technologies
• Call reduction plan
• Continue to improve one and done rates
• Enkada

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Commitment to Industry-Leading Service

• Quality program
• Increased focus on quality call metrics in
  addition to quantity call metrics
• Leads to improved productivity, less rework, and
  greater customer satisfaction
• Provider loading re-engineering
• Refine process to improve timeliness and quality
  of provider loading

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Our Commitment Remains Strong

• We will continue to work diligently to help
  enhance our customers, members, and providers
  service experience
• We remain committed to delivering consistent,
  satisfying and cost-affordable offerings