Call center workers at Cigna, one of the largest health insurance corporations in the US, are reporting poor working conditions driven by high production demands, fear of being fired, lack of training, and long processing times for customers to receive reimbursement for Covid-19 testing costs.

The unrest comes as Cigna’s profits in 2020 increased to $8.5bn from $5.1bn in 2019. David Cordani, the CEO of Cigna, received nearly $79m in compensation in 2020, a raise of $13.4m from the previous year. In March 2021, Cigna announced plans to increase expenditures on stock buybacks to $8bn over the next four years.

Cigna is closing offices around the US, switching several positions and departments to remote work permanently.

Several months ago, workers started an online petition demanding Cigna improve working conditions, including lifting a pay raise freeze, stopping constant harassment of workers to meet production metrics and providing a way for workers to report abusive callers.

“Customer management requires us to handle phone calls within a specific amount of time,” said a call representative at Cigna in the midwest who requested to remain anonymous for fear of retaliation. “The numbers are hardcore. They’re constantly on you about them and to me, that doesn’t really meet the customers’ needs. The phone call metrics could go down if customer service advocates were trained better and we had better resources.”

The worker explained they often receive phone calls from customers who have called repeatedly without any resolution to their problem, and that they are constantly being monitored by apps and prompted to move on to the next call.

“I always get pressured on every end. There were days that I would almost be in tears before I would even log in for work, I just mentally, emotionally and physically cannot handle that anymore,” the representative added. “There were times when I was the sixth customer service advocate that they’ve talked to in the last couple of weeks, and nothing is getting resolved. Nothing. This is a customer who has called multiple times and they’re upset. This is their health insurance. This is something that’s important. And when you can’t resolve it for either lack of training or lack of time because you’re having to meet metrics, that gets old.”

A second customer service advocate in the midwest explained a whole new set of issues arose once the Covid-19 pandemic hit and workers were allowed to work from home. Paid time off was taken from workers for any technical issues they experienced while working remotely, and staff handled a huge volume of calls from customers irritated about the delays in processing Covid-19 testing reimbursement claims.

“The process was unbelievable. It could have been six months before reimbursement and it was going to be in a multitude of checks. We’re given 15 minutes to make outbound phone calls to doctor offices, provider offices, and they get taken away because of the call volume metrics,” the worker said. “The numbers are constantly driven down your throat. Email, after email, after email – check your numbers, make sure you hit your numbers and everything. Our manager would post our numbers daily so everybody on your team knows whether or not you’re meeting your metrics.”

In addition to the increased workloads and frustrating processes, the worker explained that customer service advocates did not receive a raise this year.

“After a year of Covid, and all of us making adjustments for Covid and everything. They were like, ‘Well, sorry, you’re not getting a raise, you know, you’re just out of luck this year,’” one worker said.

Workers said human resources held focus groups in response to the online petition, but that nothing has changed. Several workers have quit.

“Burnout is very high and these jobs, the metrics they have to meet in many cases are impossible to meet, particularly if they’re talking to a health plan enrollee who has a complicated case. But they’re on the clock and there’s an expectation they will handle a certain number of calls in a day,” said Wendell Potter, who worked at Cigna from 1993 until he retired in 2008 as vice president of corporate communications and became a whistleblower on the industry.

Potter added: “You have to deal with people who are in a difficult spot and in many cases angry, trying to figure out their health plan, benefits and why something was denied or why they had to get prior authorization for something. In my view, it’s one of the most stressful jobs in a health insurance company.”

Jordyn Emeree, who worked as a call representative at Cigna in Illinois for two years, quit last month over the stressful working conditions and because she says a manager discriminated against her for being a transgender woman, telling her that she shouldn’t expect everyone at work to accept her transition.

“In the two years being with Cigna I never got a bonus as we’re supposed to get one every quarter. I had to fight for my yearly raise last year as it was not given to me,” said Emeree. “They let the members emotionally abuse us and we can’t do anything about it besides wait for a supervisor to become available to take the call.”

A Cigna spokesperson declined to comment on any individual complaint, but said in an email, “Cigna takes all feedback seriously, including external petitions such as this one. We have a wide range of tools to ensure our employees’ voices are heard. We regularly survey all employees covering topics like workload, conditions, and stress, host town halls, conduct focus groups, and actively encourage our managers to have open and honest discussions with their teams about how we can better support our colleagues. We’re proud of the culture we’ve created, but know there’s always room to improve, so appreciate all feedback we receive.”