More North Country HealthCare employees speak out, as CEO promises ‘transparency’ in health insurance situation

Following the Arizona Daily Sun's report last week that North Country HealthCare had abruptly terminated the health care plan for its hundreds of employees -- while facing a federal lawsuit alleging the organization collected paycheck deductions for premiums but never paid the insurer -- CEO Anne Newland wrote to staff on Sunday, Nov. 30, promising "full transparency."

But Newland's words rang hollow to some of the dozen current and former North Country employees who have spoken to the Arizona Daily Sun in the past week alleging persistent dysfunction and mismanagement at the organization's community health clinics.

"I've heard it before," the spouse of a current employee said. "I've seen variations of that letter. I believe it as far as I can throw it."

Newland's letter, which the Arizona Daily Sun viewed, did not directly address the issues of vanishing paycheck deductions or employees' unexpected claim denials and medical bills. Nor did it clearly state whether the company would reimburse employees for those unanticipated costs, which have risen to tens of thousands of dollars for some.

The letter did say that North Country is in "an unprecedented situation," with "serious financial challenges" and that the organization has retained "restructuring professionals" ahead of a potential Chapter 11 bankruptcy filing.

And for the first time, Newland named the buyer North Country has been courting: El Rio Health, a community health provider operating in 16 locations throughout Tucson. "El Rio is exploring the possibility of a potential acquisition of certain of NCHC's assets," Newland wrote.

Newland also said the company would launch an individual coverage health reimbursement arrangement (ICHRA) in order "to ensure employees have immediate and long-term access to health coverage."

An ICHRA allows an employer to provide reimbursements to employees who purchase their own health care coverage, up to a limit determined by the employer.

Newland did not specify whether this new arrangement would include retroactive compensation for the unplanned medical bills some employees have accumulated since North Country allegedly stopped paying its insurer, Blue Cross Blue Shield, sometime earlier this year.

She concluded her letter with a promise that "a major update with specific details on the long-term plan to ensure financial stability" would be coming in the next two weeks, no later than Dec. 15.

One person who still works for North Country said the letter was similar to what they'd heard in prior meetings when Newland "just kept talking in circles and trying to candy-coat things."

"You're not taking ownership of your part, and it doesn't answer anything," they added.

Confusion, fear and anger

To protect the individuals who have reached out to discuss their experiences at North Country -- some of whom are still employed with the organization and others of whom are already employed elsewhere or seeking new employment -- the Arizona Daily Sun will not be publishing their real names or other identifying information.

Multiple people said the cancellation of employees' health insurance and aggressive cost-cutting efforts are having an impact on morale at North Country's clinics, creating a huge emotional strain on employees and their families.

"The tension is high," said one recent former employee, "Jessica," who still has friends working for North Country. "No one knows what's happening."

A current employee, "Mary," said she had canceled some upcoming doctor's appointments after learning that her insurance coverage was effectively moot.

"It's really hard to focus on taking care of other people when you thought you were being taken care of and you're not," Mary said.

Another current employee, "Elizabeth," said she was concerned the company might not be able to cover payroll.

"I really feel very distracted," Elizabeth said. "I'm not very focused right now, and I'm trying my best to focus on the patient. … I'm just not with it."

She's facing multiple thousands of dollars in unexpected medical expenses, along with the uncertain prospect of trying to find new employment. She is experiencing "moments of depression" as a result, "and it's scary as hell."

Quitting has become a common topic of discussion. Some employees might be able to move on relatively easily. But for others, the values that motivated them to work at North Country in the first place make it more difficult to let go.

"We're the safety net of the community," Mary said. "We take care of the most vulnerable people."

That sense of mission, purpose and even community obligation can weigh on employees' decision-making.

"Susan" has a spouse who is currently employed with North Country and said that was a major factor he was weighing as he tries to decide whether to look for a new job. "He values his patients," Susan said. "He knows he is the last line of defense, essentially, for hundreds of people, and walking away from that is not something he is taking lightly."

That leaves them in the difficult position of trying to balance their family's immediate needs against the needs of the larger community.

"What do we prioritize? What can fall by the wayside for a little bit?" Susan said, describing their thinking. "Can we scale something back?"

With her health insurance cut off and refills on her current daily medications coming due, she's considering asking friends in southern Arizona to buy medications on her behalf at pharmacies across the border in Mexico.

Her children are young enough that they don't fully comprehend the situation -- which she's grateful for. "They know Mom and Dad are stressed," Susan said. "We just tell them it's Dad's work."

Many of North Country's employees were receiving student loan repayment assistance through multiyear contracts with the National Health Service Corps (NHSC), a program of the federal Health Resources and Services Administration. To remain in good standing with the program, they need to work for an NHSC participating provider.

At the time of writing, North Country was the only NHSC-qualified provider with job openings in Flagstaff.

"Some of us are stuck," Jessica said, adding that for employees in that situation, "there's really no option outside of riding it out and seeing how things fall."

That might leave them in the position of trying to find a new insurance plan through the Health Insurance Marketplace created by the Affordable Care Act (ACA). But it's a bad time to be shopping for plans, given that tax credits to reduce the cost of Marketplace plans are expiring at the end of this month. Premiums for ACA health care plans in 2026 are expected to be more than double what they were in 2025 for the average purchaser.

Newland's promise of a new ICHRA did not reassure Elizabeth, who said she no longer trusts the company. North Country still has not given any answers about what happened to the deductions from employees' paychecks that were supposed to pay for their previous insurance, Elizabeth emphasized.

"Give my money back to me if you didn't pay my insurance," she said.

To add insult to injury, some of the medical bills employees are now facing have come from North Country itself. Many employees visited North Country's clinics for their own appointments and were confused to learn their company-provided insurance was not being accepted by their own company.

"Our own billing was contacting our own employees to say, 'You owe us money,'" Mary said.

That only compounded the feeling of betrayal by the institution that many employees described.

One former employee, "Sarah" -- who also said North Country unexpectedly fired her while she was undergoing treatment for cancer -- was swept into the insurance debacle through her purchase of temporary continuation coverage after her dismissal (known as "COBRA" coverage).

The claim denials she received this fall said her employer had not paid its portion of the premium.

"I said, that's interesting, because I don't have an employer," she recalled.

Blue Cross Blue Shield has been helpful, she said, but North Country would not respond when she reached out for clarification.

She's now on a Marketplace plan and has a secondary plan to assist with the cost of her ongoing cancer care, but she is still waiting to resolve the bureaucratic tangle of previously denied claims.

"They've drug me into their dirt," she said.

The whole experience, Sarah said, renewed the emotions she felt at the time of her firing, including anger, stress and anxiety. But in the long run, she said, she's actually grateful she was fired.

"I have to be honest with you, it's been a blessing," Sarah said. "Because it was difficult to work for an organization … that went against my morals, my values and my beliefs."

'There is and has always been dysfunction'

Current and former employees said their frustrations with North Country predated the insurance issue. They described a "tone-deaf administrative culture," pressure on providers to increase revenue and a vicious cycle of high turnover.

"There's a general understanding that there is and has always been dysfunction within the organization," Jessica said. But she stressed -- as did other sources -- that front-line employees, "the majority of the people at North Country," should not be blamed for the company's problems.

"The internal chaos was not caused by front-line workers," another former employee, "Laura," wrote in an email. "It was caused by leadership decisions and financial errors that ordinary staff had no control over. And yet, the people who paid the price were the ones who showed up every day to keep clinic doors open and ensure patients received care."

She described the organization during her time there as "a system collapsing under mismanagement, fear and decisions that put finances above patient care."

Yet another former employee, "Tim," said he felt the company's leaders "weren't really paying attention to the community" or to employees. "We felt like we weren't really heard," he said.

He said in the last four months, employee safety had become a major concern for him. North Country had cut back on security staffing despite prior incidents in which intoxicated or aggressive patients threatened employees, he claimed.

"I feel like safety wasn't really prioritized," Tim said. But, he added, "The real concern that I had, or have, is just the lack of care they had for the patients."

A former provider, "Patricia," recalled a workload that she summarized as "deeply insane."

"We were drowning in administrative work," she said. "I was routinely working 60 hours," despite being scheduled for only 40.

The stress led to burnout and resignations, she said, and the remaining providers were left scrambling to care for even more patients than before.

"You don't know the patient, you don't know the context, and something important has to happen for them … and it was unrelenting, because everybody was quitting all the time," Patricia said.

The news of North Country's apparent health insurance fiasco left her "disappointed and deeply saddened, but not surprised at all," she said.

"I'm really sad it came to this … but that place has not served its mission because of the way it's treated its staff for an extremely long time," Patricia continued. "I think this is a crisis that needs to happen so [North Country] can be reborn."

The remaining employees are weathering the storm as best they can, another person said -- "trying to continue being there for their communities, working with whatever they could come up with for the patients and helping each other cope."

But there is not yet a clear resolution in sight, and rumors of mounting operational problems -- delayed document shredding and unpaid bills for supplies such as towels and gowns -- continue to trickle out.

In court, meanwhile, there have been no new filings in the lawsuit against North Country since last week, and North Country still has not formally responded to any of the allegations it contains.

Despite Newland's attempts at reassurances, it is clear some internal dissent is brewing. Her letter referenced an "email circulating among NCHC employees" calling on her to resign. (One of the employees who contacted the Arizona Daily Sun reported that this email had been deleted from the company's servers almost immediately after it was sent.)

Until there is a clear path forward -- and the details of how the organization allowed itself to get into this situation are revealed -- many employees will likely be considering the question posed by one source for this article: "Am I going to get on one of these lifeboats, or am I going to go down with the ship?"

If you are a current or former employee of North Country HealthCare and would like to share your story, contact the reporter (from a personal device) via email at [email protected], or via Signal at mclaughlin.42.