{"id":435849,"date":"2025-12-09T15:20:17","date_gmt":"2025-12-09T15:20:17","guid":{"rendered":"https:\/\/www.europesays.com\/us\/435849\/"},"modified":"2025-12-09T15:20:17","modified_gmt":"2025-12-09T15:20:17","slug":"ct-health-system-insurer-at-odds-a-week-after-contract-ends","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/us\/435849\/","title":{"rendered":"CT health system, insurer at odds a week after contract ends"},"content":{"rendered":"

A week after UConn Health\u2019s contract with a major health insurer expired \u2014 leaving as many as 15,000 patients potentially facing significantly higher out-of-pocket costs \u2014 both sides in the contentious negotiations<\/a> are standing their ground.<\/p>\n

Both UConn Health<\/a> and Hartford-based insurer Aetna<\/a> \u2014 owned by health care giant CVS Health Corp.<\/a> \u2014 say they hope to reach an agreement that would extend the contract, but each side has accused the other of not making a fair proposal.<\/p>\n

Without a new contract, most patients with Aetna coverage seeking treatment from UConn Health\u2019s hospital, clinics and doctors no longer have \u201cin-network\u201d status.<\/p>\n

At issue in the negotiations are the reimbursement rates for services that Aetna pays to Farmington-based UConn Health \u2014 the parent of John Dempsey Hospital, a network of clinics and more than 700 providers.<\/p>\n

In a statement, Aetna said UConn Health \u201ccontinues to demand significantly higher reimbursement rates. Their proposal would significantly increase health care costs for Connecticut families, employees and retirees.\u201d<\/p>\n

\u201cAetna has engaged in good faith efforts to reach a fair agreement that keeps health care affordable for our employers and members, and we continue to await a reasonable proposal from UConn Health and the opportunity to engage in a collaborative dialogue.\u201d<\/p>\n

\"UConn<\/p>\n

Mark Mirko\/The Hartford Courant<\/p>\n

UConn Health is in the midst of contract negotiations with Hartford-based health insurance giant Aetna. (Courant File Photo)<\/p>\n

For its part, UConn Health argued in a post on its website that Aetna \u201cdid not present a proposal that adequately supports the cost of delivering high-quality health care\u201d and the health system was \u201cdeeply disappointed that an agreement has not been reached.\u201d<\/p>\n

In a statement Tuesday, UConn Health said: \u201cWhile Aetna\u2019s profits continue to grow, here in Connecticut Aetna pays the only public academic medical system some of the lowest commercial rates in the state.\u00a0 To be clear, that imbalance means the state \u2013 and its taxpayers \u2013 are left to fill the gap. This is no longer sustainable, and Connecticut cannot continue subsidizing one of the nation\u2019s most profitable insurers.\u201d<\/p>\n

\u201cAt UConn Health our focus is on our patients, and we will continue to actively negotiate in good faith with Aetna for a fair agreement that will return our hospital and providers back into the Aetna network as soon as possible,\u201d UConn Health said.<\/p>\n

According to\u00a0healthinsurance.org<\/a>, depending on the health plan \u201cexpenses incurred for services provided by out-of-network health professionals may not be covered at all unless it\u2019s an emergency. Or they may be covered but with higher out-of-pocket costs than the member would pay for same care received from an in-network provider.\u201d<\/p>\n

In addition, \u201cthe federal cap on out-of-pocket costs only applies to in-network care (and only care that\u2019s considered an essential health benefit). So out-of-pocket costs for covered out-of-network care can be much higher, or even unlimited. And, it\u2019s important to understand that out-of-network providers can and do balance bill patients for the remainder of the charges after the insurance company has paid its share.\u201d<\/p>\n

Consumers who find themselves out-of-network may be forced to find new health care providers that are in-network.<\/p>\n

State of Connecticut retirees and Aetna Medicare PPO Extended Service Area patients are excluded from termination. An ESA is a plan that allows members to seek out-of-network providers.<\/p>\n

In addition, patients that are in active treatment or have a scheduled procedure may qualify to continue care at in-network rates for up to 90 days. Emergency care always is covered at in-network rates, UConn Health said.<\/p>\n

UConn Health \u2014 an arm of the\u00a0University of Connecticut\u00a0<\/a>\u2014 is starting to play hardball in contract negotiations with insurers.<\/p>\n

Earlier this year, the health system took out\u00a0billboards<\/a> along I-84 and I-91\u00a0pressuring another health insurer, Farmington-based ConnectiCare, to increase its reimbursement rates for medical services. ConnectiCare was acquired by California-based Molina Healthcare in February.<\/p>\n

UConn Health subsequently negotiated a new agreement with ConnectiCare after the current contract had expired.<\/p>\n

This story was updated at 9:40 a.m. on Dec. 9, 2025 to include a statement from UConn Health.<\/p>\n

Kenneth R. Gosselin can be reached at kgosselin@courant.com.<\/p>\n","protected":false},"excerpt":{"rendered":"A week after UConn Health\u2019s contract with a major health insurer expired \u2014 leaving as many as 15,000…\n","protected":false},"author":3,"featured_media":435850,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[46411,17963,12192,33382,51254,7000,48592,66324,201817,7001,210,1141,88637,1142,201815,62943,728,201814,201816,201818,23320,157981,67,132,12569,68],"class_list":{"0":"post-435849","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health-care","8":"tag-aetna","9":"tag-connecticut-news","10":"tag-contract","11":"tag-contract-negotiations","12":"tag-ct","13":"tag-ct-news","14":"tag-cvs","15":"tag-cvs-health","16":"tag-emergency-room-visits","17":"tag-hartford-courant","18":"tag-health","19":"tag-health-care","20":"tag-health-system","21":"tag-healthcare","22":"tag-in-network","23":"tag-insurance-coverage","24":"tag-local-news","25":"tag-max-image-preview","26":"tag-out-of-network","27":"tag-reimbursement-rates","28":"tag-uconn","29":"tag-uconn-health","30":"tag-united-states","31":"tag-unitedstates","32":"tag-university-of-connecticut","33":"tag-us"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@us\/115690289752118265","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/435849","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/comments?post=435849"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/435849\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media\/435850"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media?parent=435849"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/categories?post=435849"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/tags?post=435849"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}