As a result of their relationship with IHRM and the TriZetto Premier Partnership Program, Group Insurance Service Center, a TPA based in Pembroke, Massachusetts, gained access to the GWH-CIGNA National PPO Network in late 2009. GISC immediately began incorporating the available discounts into their January 2010 renewals and the results were very exciting.

Finally National Network Access for Smaller Groups

While national health plans and big employer groups have traditionally enjoyed very deep discounts from large carrier networks, these discounts have seldom been made available to smaller groups – those with 100 to 500 members and more. A unique partnership between Cigna and TriZetto has made it possible for IHRM member administrators to access this true national PPO network and pass the discounts along to their clients. As a result of the network and its integrated cost management measures, GISC has encountered more aggressive stop loss markets. According to Denise Lynch, Vice President of GISC, lower claims costs and lower loss funds are creating a win-win for self-funded clients and the trusted advisors they depend on. 

The GWH-CIGNA PPO Network has contracted with more than 600,000 doctors, hospitals and specialists nationwide. By integrating CIGNA facility contracts, national lab contracts and selected health care professionals, average available discounts have recently been in the area of 45 percent.

Employers Encouraged by Positive Trends

The first groups GISC enrolled in the GWH-CIGNA Network began seeing positive trends after the first six months of claims activity were reviewed with clients in July of 2010. “While we have only seen two quarters of activity, the results we reviewed with our clients were right on target with their expected costs. This means that six months into the plan year, these groups are receiving the discounts they were expecting,” stated Denise Lynch of GISC.

According to Denise Lynch, after years of rising health plan costs, employers are looking for solutions and offering the GWH-CIGNA National PPO Network has leveled the playing field and enabled GISC to provide a brand name national network with highly competitive discounts. When combined with 30+ years of experience in self-funded health plan design and administration, GISC is renewing existing groups and competing successfully throughout the New England marketplace.