Ballad Health Provides Update on Negotiations with Cigna Health Plan

The following is a letter Ballad Health is sending to members of the community who have Cigna health insurance. This letter provides important updates regarding our ongoing negotiations with Cigna and the potential impact on your coverage.

In an ongoing effort to be transparent with the communities we serve, Ballad Health is providing an update to our ongoing discussions with Cigna for renewed agreement for the following plans:

• Cigna Commercial (which includes Cigna individual and employer-based plans)
• Evernorth behavioral health
• Marketplace Exchange (Affordable Care Act insurance exchange for individuals; Cigna Connect/IFP)

All three plans expire on December 31, 2024.

If an agreement between Ballad Health and Cigna is not reached for each of these plans by December 31, 2024, Ballad Health facilities and providers will be out-of-network for all Cigna Commercial health plans, Evernorth Behavioral Health members, and Cigna Marketplace Exchange members (Connect/IFP). For non-emergency services, being out-of-network may impact out-of-pocket costs for Cigna members. Emergency department care at Ballad Health facilities will remain covered at in-network rates.

Ballad Health has proposed to extend Cigna's Commercial plan under the latest terms presented by Cigna, ensuring that community members with individual or employer-based Cigna Commercial coverage can continue accessing Ballad Health facilities and services at in-network rates. Cigna has rejected this offer.

Unfortunately, Cigna is withholding their agreement on their commercial plan as a tactic to demand terms for Cigna's Marketplace Exchange (Connect/IFP) product, which is a product unrelated to their commercial plans. Cigna is the only insurer Ballad Health has negotiated with that has attempted to leverage local employers to seek more favorable terms for itself in the Marketplace Exchange.

Because being out-of-network may impact out-of-pocket costs for Cigna members, Ballad Health encourages Cigna members to evaluate their health plan options carefully. If an employer has multiple plan offerings, Cigna members should follow their employers' procedures for changing plans. Consumers in the Marketplace Exchange have until January 15, 2025, to choose from multiple other plan options that offer Ballad Health facilities and services in the network.

Ballad Health has successfully reached favorable agreements with other major insurers, including Blue Cross/Blue Shield of Tennessee, Anthem, UnitedHealthcare, and Humana, for all health plan types, including Medicare Advantage, Exchange, and commercial, if offered by the health plan. Similarly, Ballad Health has agreements in place with multiple health plans in the Marketplace Exchange, including Blue Cross/Blue Shield, Ambetter, and Anthem. Ballad Health is in-network for these plans.

Cigna is the only major insurer that has yet to reach an agreement with Ballad Health.

Ballad Health has made significant investments in our nurses and physicians to maintain care access during a time of national shortages in critical medical professions. While other major insurers have responsibly supported these efforts by participating in covering these costs, Cigna has not agreed. The result of Cigna's position is that employers, including local taxpayers, will be left with an increased burden. Ballad Health will not agree to this. Also, along with other hospital systems throughout the nation, Ballad Health opposes insurer policies, which add administrative barriers to physicians who must make decisions for patient care based on the needs of their patients, especially if those administrative barriers add costs for patients and their providers.

Ballad Health is committed to reaching a fair agreement with Cigna just as it has with the other insurers covering consumers in our region.

We will keep our community updated as negotiations progress.