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What the Premier, UnitedHealthcare contract means for you

Published: Wednesday, January 03, 2018 @ 12:01 PM
By: Kaitlin Schroeder - Staff Writer

Premier Health and UnitedHealthcare have agreed to a new contract, ending a seven-month dispute that affected nearly 200,000 health insurance policy holders in the region.

The two companies had been unable to reach a new contract deal last May and the dispute dragged on through the end of 2017, leaving patients with Premier doctors and UHC insurance scrambling to either find a new doctor, switch insurers or pay more for out-of-network care.

PREVIOUS COVERAGE:

No deal in sight between Premier and UnitedHealthcare contract talks

Timeline: How Premier, UHC dispute unfolded in 2017

Why the Premier-UHC dispute could hit region harder in 2018

The new contract deal was announced Tuesday and was effective starting Jan. 1.

Here’s what the agreement mean for you:

If you got out-of-network care during the contract dispute:

The status of those health care bills likely doesn’t change, since the care was delivered while Premier and UHC didn’t have a contract.

A temporary agreement let patients pay with $25 co-pays for primary care.

Also, if you got out-of-network care, you’re not alone. Already by August, more than 1,000 patients with UnitedHealthcare went to a Premier emergency room, according to the health network. While patients weren’t typically responsible for the full bill, the final bills were likely higher than what it would be for in-network care.

If your company stayed with UnitedHealthcare during open enrollment season:

Companies had to make tough decisions over whether to stick with Unitedhealthcare for 2018, which may have been the best choice for their bottom line but also put employees with Premier doctors in a bind.

For those employers that stuck with UnitedHealthcare, the contract deal solidifies that it was a good decision to stay, said Scott McGohan, CEO of McGohan Brabender, a Dayton-area employee benefits broker.

McGohan said employers with UnitedHealthcare coverage want to run their business, they don’t want to manage problems that had been created for their employees their by the dispute.

“For employers that have UnitedHealthcare, what this does is it doesn’t disrupt their workforce,” he said.

If you already switched insurance companies:

You have the insurance coverage for all of 2018 unless you have a major life event.

If you already switched doctors:

If you switch back to Premier, you’ll be back in-network for UnitedHealthcare.

If you have a Medicare Advantage plan managed by UHC:

Your health care coverage should not have been interrupted if you had UHC-managed Medicare Advantage last year and this year. A temporary deal extended coverage until Jan. 1, which is when the new contract went in place.

If you live in Miami County and have UnitedHealthcare:

You have a shorter drive to get in-network care now that Premier-affiliated Upper Valley Medical Center near Troy, the only hospital in the county, is back in-network.

Miami County Commissioner John Evans said it was a difficult time for the residents during the contract dispute and the county government had ended up switching insurers from UHC to Medical Mutual in case the dispute carried on into 2018.

Being out-of-network also affected Upper Valley from a business standpoint. It’s one of the largest employers and economic forces in the county.

“Obviously it’s a great thing that they finally got this worked out and got back together,” Evans said, adding that he wished the news had happened a month or two ago before insurance enrollment decisions had to be made.