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    • Home Employers Group Health Insurance Medical Plans Health Maintenance Organization (HMO)

    Health Maintenance Organization (HMO) Medical Plans

    Designed around a focused set of quality, cost-effective providers and facilities in certain local service areas.

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    HMO Health Insurance Plan Overview

    HMO plans are available to organizations in select service areas. For most HMO plans, employees' care is coordinated by a Primary Care Provider (PCP), which can help lower costs and improve health outcomes.

    The HMO network is designed around a focused set of quality, cost-effective doctors and hospitals in select service areas. Employees access the HMO network in their local service area.

    Compare HMO Plans

    Your plan will vary based on what you discuss with your local Cigna HealthcareSM* representative, but here is a basic summary of how HMO plans typically work:

    Plan Features
    HMO
    HMO Open Access
    HMO Point of Service
    HMO Point of Service Open Access
    PCP Required
    PCP Auto-Assignment Included
    Referrals to Specialists Required
    Out-of-Network Coverage
    Urgent/Emergent Services Coverage
    Prior Authorization Required
    May be required for hospitalizations and some types of outpatient care
    May be required for hospitalizations and some types of outpatient care
    May be required for hospitalizations and some types of outpatient care
    May be required for hospitalizations and some types of outpatient care
    Fully Insured Funding Option Available
    Option to Offer FSA

    Find in-network providers

    Staying in-network can help your clients lower costs.

    View prescription drug lists

    See which drugs are covered by your plan.

    View more health insurance plans for employers

    Visit our Knowledge Center for helpful information you can share with your employees:

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    Explore Products and Solutions

    *Offered by Cigna Health and Life Insurance Company or its affiliates

    In Utah, plans are offered by Cigna Health and Life Insurance Company. 

    View Cigna Healthcare Company Names

    Product availability may vary by location and plan type and is subject to change. All group health insurance policies and health benefit plans contain exclusions and limitations. For costs and details of coverage, contact a Cigna Healthcare representative.

    Cigna Healthcare products and services are provided exclusively by or through operating subsidiaries of The Cigna Group, including Cigna Health and Life Insurance Company (Bloomfield, CT.) (CHLIC), Connecticut General Life Insurance Company, or their affiliates, and HMO or service company subsidiaries of Cigna Health Corporation, including Cigna HealthCare of Arizona, Inc., Cigna HealthCare of California, Inc., Cigna HealthCare of Colorado, Inc., Cigna HealthCare of Connecticut, Inc., Cigna HealthCare of Florida, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of Indiana, Inc., Cigna HealthCare of St. Louis, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of New Jersey, Inc., Cigna HealthCare of South Carolina, Inc., Cigna HealthCare of Tennessee, Inc. (CHC-TN), and Cigna HealthCare of Texas, Inc. In Utah, all products and services are provided by Cigna Health and Life Insurance Company (Bloomfield, CT). Policy forms: OK – HP-APP-1 et al., OR – HP-POL38 02-13, TN – HP-POL43/HC-CER1V1 et al. (CHLIC); GSA-COVER, et al. (CHC-TN).

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    Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of South Carolina, Inc., and Cigna HealthCare of Texas, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see a listing of the legal entities that insure or administer group HMO, dental HMO, and other products or services in your state). Accidental Injury, Critical Illness, and Hospital Care plans or insurance policies are distributed exclusively by or through operating subsidiaries of The Cigna Group Corporation, are administered by Cigna Health and Life Insurance Company, and are insured by either (i) Cigna Health and Life Insurance Company (Bloomfield, CT). The Cigna Healthcare name, logo, and other Cigna Healthcare marks are owned by The Cigna Group Intellectual Property, Inc.

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    La aseguradora publica el formulario traducido para fines informativos y la versión en inglés prevalece para fines de solicitud e interpretación.

    The insurer is issuing the translated form on an informational basis and the English version is controlling for the purposes of application and interpretation.