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Cigna is a global health insurance provider and offers health insurance in 12 U.S. States: Arizona, California, Colorado, Connecticut, Florida, Georgia, Maryland, Missouri, North Carolina, South Carolina, Tennessee, and Texas. It has an “A (Excellent)" financial strength rating from A.M. Best. Its preferred provider network includes more than 500,000 participating physicians. No referrals are necessary to see an out-of-network provider although greater savings are realized by using an in-network provider.