Cigna policyholders could lose coverage for Hartford HealthCare if deal not struck by Nov. 1 - Insurance News | InsuranceNewsNet

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October 15, 2024 Newswires
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Cigna policyholders could lose coverage for Hartford HealthCare if deal not struck by Nov. 1

Paul Schott, The Hour, Norwalk, Conn.Hour

Oct. 15—Health insurer Cigna and Hartford HealthCare are negotiating a contract renewal, but Cigna policyholders could soon have to pay higher, out-of-network rates if the two organizations do not reach an agreement by the end of this month.

A letter that Bloomfield-based Cigna recently sent to policyholders outlined the consequences if the company's current contract with Hartford HealthCare expires on Nov. 1. In that scenario, policyholders would start paying out-of-network rates for services provided by professional medical groups and other non-hospital services in the HHC network starting in November, while hospital services would switch to non-network rates on Jan. 1, according to the letter.

"We continue to negotiate with Hartford HealthCare in good faith, working towards a reasonable agreement that will keep health care affordable for our local employees, our customers and their families," Cigna officials said on Friday. "We are focused on reaching a mutual agreement by the end of the month to mitigate any potential disruption."

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In their own statement on Monday, HHC officials confirmed that they are still negotiating with Cigna.

"We continue to work diligently through ongoing discussions, and believe we can reach a mutually agreeable contract and resolution," HHC officials said. "Our primary goal is to ensure that our patients are well cared for."

If the contract expires on Nov. 1, Cigna would continue covering all HHC hospital services at in-network rates until Dec. 31, through a 60-day continuation period required by state law, according to the letter. HHC's hospitals include Backus Hospital in Norwich; Charlotte Hungerford Hospital in Torrington; Hartford Hospital, MidState Medical Center in Meriden; St. Vincent's Medical Center in Bridgeport; The Hospital of Central Connecticut in New Britain; and Windham Hospital.

"If Hartford HealthCare system leaves your plan's network, you'll likely pay more for the same services at their hospitals," the letter reads. "For example, you would have to pay: your plan's out-of-network benefit rate plus any charges not covered by your plan, which would cost you more OR 100 percent of the cost (if your plan doesn't have an out-of-network benefit)."

The letter also notes, "emergency care services received at Hartford HealthCare system will be covered at the in-network level under your plan's emergency room coverage."

In addition, according to the letter, "you may qualify for Continuity of Care. It would allow you to continue care at the in-network benefit level at Hartford HealthCare system, for a period of time."

Policyholders might also be eligible for Continuity of Care for some medical and behavioral treatment provided by professional medical groups and other facilities within the HHC network, according to the letter.

Cigna and HHC officials did not respond to a CT Insider inquiry about the number of Cigna policyholders who have received HHC services in the past year.

In comparison with the current round of talks, negotiations for the current contract concluded in early September of 2021 — about two months before the previous pact would have expired.

"Connecticut residents rely on hospitals and health systems to provide access to care 24-hours-a-day, to support world-class medical care that saves lives and helps manage disease, to serve as a safety net provider for vulnerable populations, and to have the resources needed to respond to medical and public health emergencies and disasters," the Connecticut Hospital Association said in a statement on Monday. "Stable and adequate payment from private health insurance companies for care provided is vital to providing high-quality care, innovation, and hospital resiliency."

Based on 2023 revenues, Cigna ranked No. 16 and highest among Connecticut-headquartered companies in this year's edition of the Fortune 500 list of the largest U.S. corporations.

Hartford HealthCare is one of the largest health care systems in the northeast. As of August, it had about 30,000 employees in Connecticut, making it the second-largest private-sector employer in the state after the Yale New Haven Health system.

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(c)2024 The Hour (Norwalk, Conn.)

Visit The Hour (Norwalk, Conn.) at www.thehour.com

Distributed by Tribune Content Agency, LLC.

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