First Quarter 2010

GOING GLOBAL: Cigna’s Quarterly Newsletter for Expatriates and Their Families

Andrew KieltyAndrew Kielty joined Cigna International Expatriate Benefits (Cigna) in its Claymont, Delaware home office in December 2009 as Senior Vice President and Managing Director.  Kielty, originally from the United Kingdom, has been an expatriate since 1993.  He has lived on four continents and has traveled extensively throughout the world.  He comes to Cigna after seven and a half years in Australia where he served as Managing Director of BUPA’s operations in Asia.

Kielty has accepted all of his international assignments thus far with his family and says that he finds being an expatriate to be culturally stimulating. 

“I find that once my family feels secure and happy in the new environment, then we can feel comfortable in the new location and begin to take advantage of the opportunity to enrich our lives,” Kielty says.

Kielty’s strategy to get accustomed to a new location is to identify and recognize the cultural differences and then to immerse himself completely into his new surroundings. In his one month in the United States, he observes the cultural differences are meeting his expectations, so nothing has been shocking.  However, he admits that learning a new variation of the English language is always a bit challenging.

Kielty has had his share of medical emergencies while on assignment. He has awoken in the middle of the night to find his six-year-old’s face swollen due to an allergic reaction to an insect bite, and he has waited in an emergency room with his sick child where he did not know the local language. He is familiar with the feeling of being completely isolated and needing guidance. Kielty has dealt with the challenges of being an expatriate and that is why he is now leading Cigna, to serve you, our customers, around the clock, 24 hours a day, 365 days a year.

A Personal Message from Andrew Kielty

It is a privilege to be of service to you.  Customers are at the center of what we do and we truly value the relationship we have with you.  Cigna is determined to continuously improve our interactions through the feedback you provide. We look forward to serving you in 2010. 

I know first-hand what it is like to face a medical emergency in an unfamiliar location.  Cigna offers 24/7 customer service; you can depend on us anytime day or night whether you have a benefits question or are experiencing a medical emergency. We have customers in 190 countries, and we understand what it is like to be in an unfamiliar environment and need access to quality health care and someone to depend on for routine or crisis situations. 

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Though international assignments have the potential to cause stress and uncertainty, Cigna offers Cigna Compass, available on Cigna Envoy, to make it easier for you to understand and utilize your Cigna health benefits program.  Cigna Compass is a valuable supplement to your Expatriate Benefits Kit and allows you to explore the services available to you through your Cigna benefits. 

Cigna Compass will teach you how to access CignaEnvoy.com and its health and wellness tools, how to contact the International Service Center and obtain a referral, and how to file claims and reference claims history. 

We hope that Cigna Compass will help to alleviate the stress you may have regarding accessing care in an unfamiliar location and using your Cigna health benefits.  Also check out the Cigna Envoy web tutorial on CignaEnvoy.com for more information on how to use the customer website.

Novel H1N1 influenza is a new virus of swine origin that first caused illness in Mexico in March 2009.  It was initially isolated by the Centers for Disease Control and Prevention (CDC) in the United States on April 15, 2009.  The illness is similar to the seasonal flu and spreads from person to person.  On June 11, 2009, the World Health Organization (WHO) raised the Novel H1N1 pandemic to level 6, which signifies the presence of widespread human infection1.  Though the rate of infection has declined in Western Europe and North America, the transmission of H1N1 in Central and Eastern Europe and southern Asia remains intense2.  To see a timeline and map of the geographic spread of the H1N1 pandemic, click here.

Flu viruses are spread mainly from person-to-person through coughing or sneezing.  Most adults may be able to infect others beginning one day before symptoms develop and up to five days after becoming sick3. The CDC and the UK National Health Service (NHS) recommend that people with influenza-like illnesses remain at home until at least 24 hours after they are free of fever or signs of a fever without the use of fever-reducing medications. 

In most countries, national health authorities have made the H1N1 vaccine available free-of-charge, though there may be an administration cost that is expected to be covered by health plans.  Cigna will cover the cost of the administration of the Novel H1N1 vaccine for all customers at 100%.  If the national health authority or public health system of a country does not provide the vaccine free-of-charge, Cigna will cover the cost of the vaccine for covered individuals at 100%.  Shipping charges will not be covered.  Groups identified at higher risk are likely to be given first priority. 

The WHO recommends that health workers be given first priority for vaccination to protect themselves and their patients, and keep health systems functioning as the pandemic evolves.  National authorities will develop vaccination plans based on circumstances within the country; however, according to the WHO, high-risk groups include pregnant women, and children 6 months or older with one or more chronic medical conditions.

Customers are advised to check with local health authorities or local doctors and hospitals to determine where and how the vaccine is available.  The WHO Director-General has called for international solidarity to provide fair and equitable access to pandemic influenza vaccines for all countries.  So far, the WHO has helped secure significant donations of vaccines from countries and partners for 95 low- and middle-income countries. 

According to the WHO, it is safe to travel, however it is recommended that you delay travel if you are ill. The WHO is not recommending travel restrictions.  Since the pandemic influenza virus has already spread globally, there is no scientific reason to delay international travel to reduce the spread of infection4

If you do not receive the H1N1 vaccine, you can protect yourself and others by following simple prevention practices:

  • Keep a distance from those who may be coughing or sneezing. 
  • Cover your coughs and sneezes. 
  • Wash your hands with soap and water.
  • Avoid touching your eyes and mouth as much as possible. 

Cigna is not able to assist in procuring the H1N1 vaccine nor is it able to advise where and how the vaccine is available country-by-country.

References
1. Centers for Disease Control and Prevention. Novel H1N1 Flu: Background on the Situation.
2. McKay, B. Swine Flu Wanes, But Challenges Stay. The Wall Street Journal. 31 December 2009.
3. World Health Organization. What is pandemic (H1N1) 2009? 11 June 2009.
4. World Health Organization. Frequently Asked Questions: Travel. 27 November 2009.


Cigna is forging a new relationship and expanding network access into several African countries with CignaLinks Africa in partnership with Medical Services Organisation (MSO).  MSO focuses on medical risk management through preventive care and condition management, and the organization relies on its joint venture with Global Access Health Network for access to health care facilities throughout Africa. 

The new relationship will expedite claims processing for individuals covered under a CignaLinks Africa plan and reduce their out-of-pocket expenses when visiting health care facilities within the CignaLinks network.  Customers will retain a single point-of-contact with Cigna, while network health care facilities will work directly with Global Access Health Network to obtain preauthorization for inpatient services and to settle claims. 

Prior to establishing the relationship with MSO and the Global Access Health Network, Cigna’s Global Health Solutions team sent staff, including Cigna Medical Director, Dr. Lyndon Laminack, to Africa to visit network doctors and hospitals to ensure adequate standards of care in the health care facilities available through the Global Access Health Network and to dig deeper into MSO capabilities and processes. 

Dr. Laminack and the Global Health Solutions staff coordinated a meeting while in Africa to review communication processes, medical review, and case management to figure out how to best serve Cigna customers with MSO’s offering.  MSO’s infrastructure to support claim processing is efficient and has met Cigna’s stringent data privacy requirements. 


Cigna has expanded its international direct pay network in Russia to include 4,000 hospitals and clinics, growing its already-extensive network. Cigna offers access to more than 124,000 global health care professionals, delivering access to care to you and your family.

The Russia network provides significant discounts and a direct pay option, offering the convenience of cashless settlement of claims. Health care professionals are strategically

located in areas with a high concentration of expatriates, such as Moscow and St. Petersburg, to further facilitate access to health care.

Additionally, the network expansion will provide health care facilities with access to the Cigna Envoy Provider Portal, an industry-leading web portal that allows doctors and hospitals access to instant eligibility verification and benefit details at the point-of-service.


Heart disease is a major killer of men and women globally.  There are several ways to reduce your risk factors for heart disease or other heart conditions. 

Don’t Smoke
The risk of heart attack increases significantly depending on how many cigarettes you smoke per day.  Smokers who smoke a pack of cigarettes per day have more than twice the risk of heart attack than nonsmokers1.  The nicotine contained in cigarettes decreases the level of oxygen that reaches your heart, increases blood pressure and heart rate, increases the risk for blood clots, and can damage cells that line coronary arteries and other blood vessels. 

Also, be aware of local and national smoking regulations in your home and assignment countries.  Second-hand smoke is also a health hazard that can contribute to the risk for heart conditions.

Exercise Regularly
A sedentary or inactive lifestyle is a risk factor that can contribute to heart disease. According to the Cleveland Clinic, regular exercise positively affects heart rate, blood pressure, and the body’s oxygen use, reducing fatal and non-fatal heart attacks and other heart conditions like thrombosis and arrhythmias.  To get the best benefit from regular exercise, it is recommended that you do aerobic exercise (this includes walking, jogging, jumping rope, bicycling, cross-country skiing, skating, and rowing) for 20 to 30 minutes at least three to four times per week2.  Be sure to talk to your doctor before starting a new routine for physical fitness.

Consume Alcohol in Moderation
Drinking alcohol in excess can raise blood pressure and even lead to heart failure or stroke3.  If you choose to drink alcohol, drink in moderation to minimize health risk (no more than one drink per day for women, and two drinks per day for men).

Maintain a Healthy Weight
Excess weight can place a burden on your heart.  The Cleveland Clinic recommends keeping a food journal and choosing foods low in saturated and trans fats, and also those low in cholesterol.  Eat at least five servings of fruits and vegetables per day.  Drink plenty of water and don’t skip meals – eating three meals plus snacks each day is essential4.  Be sure to get enough fiber – at least 25 to 30 grams per day by choosing whole-wheat pasta and rice over white and including more dried beans. 
 
Manage Blood Pressure
In addition to maintaining your weight and exercising regularly, managing stress and anger and limiting sodium intake will help you keep your blood pressure under control5

To manage stress, set realistic goals of what you can accomplish each day, and take time each day to relax.  Learn how to best manage your time.

Be aware of how much sodium you consume each day; sodium intake should be no more than 2,400 milligrams per day.  Sodium is found commonly in preserved foods, canned foods, luncheon meats and cheese. 

If your doctor has prescribed medication to keep your blood pressure under control, follow your doctor’s orders, and do not stop taking your medications without first talking to your doctor. 

Visit the Cleveland Clinic website for some heart healthy recipes. 

References
1. WebMD. Smoking Cessation Health Center: Smoking and Heart Disease.
2. WebMD. Heart Disease: Exercise for a Healthy Heart.
3. MyCleveland Clinic. Preventing and Reversing Cardiovascular Disease.
4. MyCleveland Clinic. Weight Management Tips.
5. The Mayo Clinic. 10 ways to control high blood pressure without medication.


Bangkok Post - October 28, 2009 - US-based Cigna Insurance, which specialises in affinity marketing and alternative distribution channels, aims to step up sales in provincial areas to expand its presence in the rural market.

Philadelphia Business Journal - October 30, 2009 - In this article about how employers are preparing for flu this season, Allen Koski, director of Cigna, says global corporate clients are interested in what their competitors are doing to address H1N1 and where their workforces can get the H1N1 vaccine. Employer flu plans so far revolve around "social distancing": they urge sick employees to stay home, Koski said.

Hartford Business Journal - November 30, 2009 - Six years after establishing a foothold in China, health insurer Cigna will offer its first comprehensive health care product in that country as the company seeks to expand its international business amid a backdrop of uncertainty in the U.S. market.

MOBILITY Magazine - January 2010 - The health of an organization’s most important resource—its human capital—is of utmost importance in today’s complicated and challenging fiscal environment. Vaughan outlines key considerations facing international employers in the face of a global pandemic.

Cigna Compass Helps Expatriates Navigate Through Health Care Around the World - Cigna (NYSE:CI) Cigna has released an interactive web-based tool that gives expatriates and their families ready access to their benefit information and provides helpful guidance to keep themselves healthy.

Cigna is the First Health Insurer to offer podcasts to customers through Apple iTunes – Cigna (NYSE:CI) Cigna launched informational podcasts through Apple iTunes, free-of-charge, to their customers and clients.

Andrew Kielty Named Senior Vice President of Cigna – Cigna (NYSE:CI)  Andrew Kielty was named senior vice president and managing director of Cigna.  Kielty joins Cigna from BUPA, where he spent more than 25 years in a variety of leadership positions in Europe and Asia-Pacific.

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