Even with medical records going online, the health business still kills a lot of trees. One reason is all those explanation-of-benefits letters (EOBs) insurers send. The problem was especially acute for Cigna Global Health Benefits, a $343 million subsidiary of Cigna Corp. that serves "globally mobile employees" of client firms, including the U.S. military, since it sends EOB documents abroad, adding international postage costs.

To tackle this problem and try to go green with EOBs, a 13-member team headed by treasury manager Joanne Hart was charged with developing an online system that would be simple, easy to read, and available worldwide on a Web site called Cigna Envoy. The first step was to survey customers to find out what they wanted, which turned out to be simplicity and the ability to opt-out and continue getting paper documents in the mail.

Hart explains that the decision to go green with the EOBs was "no easy task" and involved much communication with healthcare providers. "Our process for generating the EOBs and for issuing checks had to be completely re-evaluated," she says. In addition, only about 40% of overseas customers have ready access to the Web.

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