Reducing and filing customer complaints

Take the steps below to help reduce customer complaints and learn how to file them if needed.

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One of the primary objectives at Cigna Healthcare® is to proactively prevent and address complaints to enhance the member experience. By doing so, we can all foster greater customer loyalty and contribute to improved Medicare Star Ratings. As an agent, you play a crucial role and can effectively reduce complaints by:

• Ensuring customers' consent to enrollment.
• Recording the sales presentation.
• Completing a disclaimer disclosure.
• Delivering a full presentation on benefits and plan requirements.
• Providing a confirmation number.
• Avoiding misleading customers with false information.
• Offering accurate provider information.
• Discussing and assigning the requested Primary Care Provider (PCP) and avoid assigning Nurse Practitioners or Specialists on the customer application.
• Using a provider lookup tool for coverage verification.
• Checking provider coverage for plan types (PPO vs. HMO).
• Verifying acceptance of individual vs. group plans.
• Confirming acceptance of Cigna Alliance Medicare (HMO) plan (available in Arizona, Maryland, and Texas), where applicable.

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Addressing/filing complaints

When addressing complaints regarding the health insurance plan or the agent or agency, it's important to route customers to the appropriate contact to file these complaints.

If a customer or their representative has a complaint with any aspect of Cigna's operation or a delegated entity, please instruct them to call the Cigna Medicare Customer Service team, which handles customer complaints, at 800.668.3813.

When Cigna receives an inquiry from an agent or agency alleging that a customer or their representative is dissatisfied, they will first verify whether a grievance or a CTM (Complaints Tracking Module) has been filed. CTMs are complaints filed directly with the Centers for Medicare and Medicaid Services (CMS). If a complaint has already been filed, they will inform the agent or agency that an investigation is currently underway. If no complaint has been filed, they will instruct the agent or agency to have the customer or their representative submit a grievance to our Medicare Customer Service team at 800.668.3813.

As a reminder, agents or agencies inquiring about customer dissatisfaction cannot initiate an investigation; only the customer or their representative can file a complaint.  

Cigna is dedicated to helping you stay in compliance whenever possible and take all complaints and grievances seriously. If you have any questions, please reach out to the Cigna Agent Resource Line (CARL) using the contact information.