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Group connections

Create group connection to manage groups through Noyo. In the group_data object for the create endpoint, use Cigna’s group ID (also called the master agreement number) for the carrier_group_id. The format expected is an 8-digit string. You will also need to submit the group’s FEIN, which is a 9-digit number.

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Sandbox testing

Use the following special Cigna carrier_group_ids to simulate different group connection statuses. Test group connections with these IDs will asynchronously update with the corresponding status within 10 seconds of submission.

Only the first three characters are evaluated to figure out the target status (e.g. 989 means noyo_review). Since group connections should be unique by a carrier ID and carrier group ID combination, you may use the final characters to iterate and test this interaction further.

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Carrier configurations

Group, plan, and member configurations are where Noyo shares and receives details that are unique to a carrier. Every other part of Noyo’s payloads are standardized, but the configurations hold the unique fields and classifications that change from connection to connection. As part of preparing to connect to a new carrier, you need to understand the contents of each configuration and be sure your system is able to send the required data for each member.

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Get the group configuration from Noyo

The Get carrier configuration by group list returns information about how the group is labeled and categorized within the carrier’s system. You can also see this data in the Command Center on a group’s detail page by clicking one of their carrier connections.

Cigna groups will be configured with a master_agreement_number string, which is the primary group identifier, along with a list of one or more identifiers to categorize employees enrolling in coverage.

Cigna has two internal systems that require slightly different identifiers, so you may see configuration requirements differ slightly between groups and plans.

Most groups will be configured with a list of subgroups and benefit_classes.

Other groups will be configured with a list of accounts, branches, and networks. Occasionally, groups may have their coverage split across both configurations (commonly medical with one configuration, and dental/vision with another).

{
    "group_id": "da8d32cc-ce9d-4cf3-9360-733ee0023f1f",
    "carrier_id": "cfcce776-9193-42b8-a361-d202546516c9",
    "configuration": {
        "master_agreement_number": "12345678",
        "benefit_classes": [
            {
                "benefit_class_identifier": "A001",
                "benefit_class_name": "All Other Employees"
            },
            {
                "benefit_class_identifier": "A002",
                "benefit_class_name": "TX Employees"
            }
        ],
        "subgroups": [
            {
                "subgroup_identifier": "0001",
                "subgroup_name": "Acme Co"
            }
        ],
        "accounts": [
            {
                "account_identifier": "12345678",
                "account_name": "AcmeCo"
            }
        ],
        "branches": [
            {
                "branch_identifier": "A001",
                "branch_name": "All Active Employees"
            },
            {
                "branch_identifier": "C001",
                "branch_name": "All COBRA Employees"
            }
        ],
        "networks": [
            {
                "network_identifier": "Net01",
                "network_name": "Network A"
            }
        ]
    }
}

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Get the plan configuration from Noyo

The details in Get group plan list should be used to map each Noyo plan to the corresponding plan in your own system. Importantly, each plan configuration has details about which populations are connected to an individual plan. Groups with multiple populations may link a plan with one or more of them.

Most Cigna plans will include a plan_configuration block with benefit_class_identifiers and subgroup_identifiers fields containing lists of string identifiers. The benefit class identifiers and subgroup identifiers will match the benefit classes and subgroups in the group’s carrier configuration respectively, and describe which benefit classes and subgroups are eligible to enroll in the plan.

• subgroup_identifier: commonly represents any employment divisions; many groups will have only a single value
• benefit_class identifier: commonly represents employment state

Some Cigna plans will instead include account_identifiers, branch_identifiers, and network_identifiers fields containing lists of string values.

• account_identifier (7 digits): commonly the group’s master agreement number, but may differ
• branch_identifier (6 digits): commonly represents Active / COBRA status and any employment divisions
• network_identifier (5 digits): commonly blank/not required for a majority of coverages

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Send the member configuration to Noyo

Each member snapshot sent to Noyo can contain a configuration section. Depending on each carrier’s requirements, you may need to use this section to include carrier-specific identifiers like classes, subdivisions, or bill groups. These go in the coverage block’s carrier_config section and ensure that members are enrolled in the correct coverages. Member snapshots missing a carrier_config section or with incorrect config data will result in a 422 error.

For plans that include benefit classes and subgroups, snapshots must include a benefit_class_identifier and subgroup_identifier that matches the corresponding values in the group carrier configuration.

{
    "benefit_class_identifier": "A001",
    "subgroup_identifier": "0001"
}

For plans that include accounts, branches, and networks, snapshots must include an account_identifier, branch_identifier, and occasionally a network_identifier that matches the corresponding values in the group carrier configuration.

{
    "account_identifier": "1234567",
    "branch_identifier": "A001",
    "network_identifier": "Net01"
}

If the caller omits any values included for the plan, Noyo will attempt to resolve the correct identifier cases where only one option is available for the employee.

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Carrier-specific requirements

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Validations

Noyo will validate the following based on the member snapshot carrier configuration:

1. The provided benefit class, subgroup, branch, account, and network identifiers are valid for the group
2. The provided benefit class, subgroup, branch, account, and network identifiers are valid for the plans specified in the relevant coverages
3. Requests to add or modify coverage contain plans that are available to the subgroup, benefit class, branch, account, and network fields specified

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COBRA

To send a COBRA request, follow the special enrollment scenarios.

When a member is enrolled in COBRA coverage, Cigna requires a COBRA qualifying event reason to be sent in the qualifying_event_reason of the cobra_details block.

Cigna requires that coverage termination dates are proactively sent whenever enrolling a member in COBRA coverage. Send the future 18 or 36 month COBRA eligibility end date in the enrolled_member.effective_end_date.

Should the member end their COBRA coverage earlier than this 18 or 36 month window, send the new date in enrolled_member.effective_end_date.

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Latest change effective dates

All snapshots should include a latest_change_effective_date, which for Cigna can reflect either the date the member last changed subgroups or the date the member last changed benefit classes, whichever is more recent.

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Connection Basics

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Getting groups connected

New groups can be connected to Cigna after you or your group/broker has contacted your account manager to request an EDI Connection. The account manager will need the Group ID and group name. You should include EDI@noyo.com and your own point of contact on the email as well.

After this request has been sent to the carrier, submit a group connection request to Noyo. The carrier will then reach out to us and we’ll begin building the group’s connection. We’ll manage testing with the carrier and return member-level discrepancies for your review. Cigna prefers 95% accuracy of group data prior to going live.

For net new groups you can submit the group connection request but we cannot start testing the file until the account structure is built in Cigna’s system.

For groups with existing Cigna coverage, we will work with Cigna on the file and let you know when to retire existing data exchange methods. No changes need to be made with Cigna if the group is only changing their broker of record.

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Processing member changes

If you make changes directly with Cigna while Noyo is managing the group, you also need to update your system with those changes so they are sent to us for inclusion on the file. Otherwise, the file we send will overwrite the changes.

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File delivery and discrepancy reporting

Once a group has been approved for production, transactions will be queued and delivered via EDI file to Cigna on a weekly cadence. Cigna will return a discrepancy report to your specified contact weekly, one day after Noyo delivers the EDI file. Reporting contacts will be established when the connection is set up.

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Managed changes

The following types of changes are not included on the file and will be managed by Noyo through the carrier’s preferred method. Processing times for these changes may be longer.

• SSN changes
• Requests for an effective date that is more than 60 days (2 months) prior to the date on which Cigna received the change.

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Dependent requirements

Cigna requires that a separate form be completed for disability situations.

Cigna automatically propagates the subscriber address for all dependents. Dependent addresses that legally need to be different will need to be requested by the group directly with their Cigna eligibility specialist.

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Open enrollment

Cigna has a blackout period 30-45 days before the renewal. Noyo will handle current-year changes during the blackout window, but processing times for these changes may be longer.