In 2018, Cigna CEO David Cordani said the U.S. healthcare system devoted “the majority of our money and resources addressing people once they’re sick,” adding that more investment was needed in “identifying people who are at risk of health events and lowering those health risks.”
Six years later, Cigna has introduced one of its most notable product changes reflecting that view, an AI-enabled, copay-only health plan that removes deductibles and coinsurance and is designed to simplify pricing for employers and members. The plan is built around a tiered copay model and five employer design packages, each offering up to four in-network tiers and one out-of-network tier. All plan designs run on Cigna Healthcare’s Open Access Plus network, which preserves broad provider access.
Clearity offers upfront copay pricing for office visits, diagnostic tests, imaging, physical therapy and surgical procedures. Members can also view verified patient reviews and provider insights, along with cost information through new digital tools built by Cigna. The plan includes an AI-powered virtual assistant that answers questions about benefits, claims and care options using conversational language. Natural language search tools allow members to find providers and view total out-of-pocket costs before receiving care.
Eva Borden, chief product officer for Cigna Healthcare’s U.S. Employer business, said Clearity is “a simpler, more predictable way for customers to get the health care they need.” Erin Lenox, president of national accounts, said the plan supports members who prefer pay-as-you-go models as well as those who avoid care because of high deductibles.
Cigna Expands AI Tools Beyond Clearity
Cigna has also incorporated AI into other areas of its health services. The company recently added AskEllyn, an AI companion based on a breast cancer survivor’s lived experience, to its Breast Cancer Community. AskEllyn is designed to offer guidance and emotional support to people navigating breast cancer and is now available within Cigna’s digital care ecosystem.
AskEllyn’s creators describe it as the first AI companion shaped directly by the personal journey of a breast cancer survivor, and its integration into Cigna’s platform marks the tool’s first deployment within a major health benefits environment.
Employers Face Sustained Medical Cost Increases
The launch of Clearity comes amid persistent increases in employer medical spending. WTW’s 2026 Global Medical Trends report projects U.S. healthcare costs to rise 9.6% in 2026 after a 9.7% increase in 2025. More than half of payers expecting increases believe costs will continue to rise for several years.
Premiums are also increasing. KFF’s 2025 Employer Health Benefits Survey shows the average annual family premium for employer-sponsored coverage reached nearly $27,000 after a 6% rise this year, with workers contributing about $6,850.
Alternative plan models have gained traction as employers seek more predictable cost structures. McKinsey & Company reports that copay-only designs can reduce employer spending by 6% to 8%. UnitedHealthcare’s Surest plan, which also uses a copay-only model, is now offered by more than one in four of its largest employer clients, up from one in nine in 2023.
Stop-Loss Claims Add Pressure for Employer Plans
Cigna’s stop-loss division which protects employers’ self-funded health plans from catastrophic claims has seen rising claim activity. The company said this trend has affected the broader stop-loss market over the past year.
Brian Evanko, Cigna’s chief operating officer, said the division “is performing in line with expectations” and is not being overwhelmed by sophisticated provider billing systems. Both Evanko and CEO David Cordani said they have observed increased use of technology by providers to bill at higher reimbursement levels.
“We engage in that in terms of hospital contracting and provider contracting engagement modifications,” Cordani said.
Cordani also said Cigna is increasing its own use of AI and other technologies. “Some of those capabilities help us to counteract, address and proactively engage very differently with some of the forces we’re seeing,” he said, adding that affordability pressures are affecting employers and employees. Rising cost concerns, he said, have contributed to employer interest in “what may have been deemed to be more disruptive solutions.”
Cigna’s Clearity plan incorporates AI tools for provider search, cost estimation and benefit review, using natural language processing to return copay information across multiple tiers. The company said the tools were developed in response to internal research showing many consumers feel overwhelmed by benefits information, have difficulty determining costs beforehand and may delay care due to uncertainty.
Cigna stated that the majority of members with access to the AI assistant have used the tool proactively. The assistant has been used to help members locate providers, understand coverage details and review claims.
Clearity will be offered to employers seeking copay-based designs while retaining broad-network access through the OAP network. Cigna said the plan was developed in response to demand for predictable costs, transparent pricing and expanded digital support.
