Cigna transforms onboarding with Pega

The Business Issue

Cigna is a global health benefits provider with 178 million customers in more than 30 countries. Despite this reach, their legacy systems were fragmented and inefficient – causing delays in onboarding and reducing satisfaction among key stakeholders, including brokers, employers, and employees alike.

Research into their current processes revealed critical pain points:

• Brokers sought simplicity: 90% of brokers reported ease of use as a key factor influencing their recommendations.
• Employees lacked clarity: employees felt their insurers could better explain benefits, and they expected personalized recommendations based on their situations.
• Integrated platforms were in demand: Employers increasingly sought comprehensive health benefits platforms over disconnected point solutions.

With this in mind, Cigna set out to double new business sales and improve client retention by 50% by transforming its onboarding process into an integrated, streamlined experience.

The Solution

To address these challenges, Cigna partnered with implementation partner TCS to deliver an enterprise-grade solution built on the Pega Platform™. This multi-year initiative focused on building a connected, cloud-native platform that replaced manual workflows and siloed systems.

Key features of the solution:

• Simplified, modular applications:
  • Four core applications – Intake, Quote, Build, and Install – streamlined workflows from initial onboarding to claim readiness.
  • Each app caters to specific user roles, making processes intuitive and reducing errors.
• Orchestration layer for integration:
  • Built on Pega’s UI, the orchestration layer connected legacy systems across business units, enabling seamless data flow between silos.
  • Users could perform all tasks on a single screen, avoiding the need to switch between multiple systems.
• Automated workflows:
  • Email bots automated the ingestion of hundreds of daily emails with dozens of attachments, eliminating manual document sorting and entry.
  • Integrated e-signatures and document generation further reduced delays.
• Cloud-native scalability:
  • Hosted on AWS’s Elastic Kubernetes Service (EKS), the platform ensured optimal performance during peak seasons and cost efficiency during downtime.
• Reusable patterns for future growth:
  • Standardized processes allowed new applications to be built on the same framework in under nine months, reducing time-to-value for other business lines.

The Results

Operational improvements:

• Faster onboarding: Reduced response times and enabled clients to file claims immediately after plan activation.
• Increased capacity: Business teams processed higher volumes without adding headcount, directly supporting sales growth.
• Streamlined workflows: Users interacted with a single interface instead of juggling 100+ systems, boosting productivity.

Stakeholder satisfaction:

• Broker feedback: Brokers praised the platform’s ease of use, prompting greater adoption and higher sales potential.
• User testimonials: Initial skepticism gave way to appreciation as users saw tangible improvements in efficiency and functionality.

Business impact:

• Improved ROI: The platform delivered measurable returns by unlocking new business value, improving operational efficiency, and accelerating deal closures.
• Scalability and innovation: With a reusable architecture, Cigna expanded the platform to additional business lines, ensuring sustainable growth.