Northeast Georgia Medical Center will become "out of network" for Cigna health insurance policyholders if a new managed care contract can't be worked out by Nov. 30.

"Although we have come to terms financially with Cigna, we continue to disagree on a language position that has the potential to restrict patients' full-benefit access to the comprehensive range of services provided by the health system," states a Nov. 7 letter to Cigna patients from Carol H. Burrell, the hospital's president and CEO.

"Additionally, patients' choice of providers would be limited, meaning they could be required to leave the area where they are presently receiving services to receive services from alternate providers."

Burrell's letter goes on to say that while the hospital is "hopeful Cigna will reconsider" its position, "if no further progress is made," the contract with Cigna would end Nov. 30.

Cathy Bowers, spokeswoman for the Northeast Georgia Health System, said Thursday the hospital is "still actively negotiating a new contract," but she declined to give further details on the talks.

She did say Cigna patients make up about 2 percent of the hospital's business and about 6 percent of commercially insured patients.

"I can't tell you the actual patient numbers because (the hospital) really doesn't capture them until they've actually been here and billed for (their) services," Bowers said.

Kathleen Keenan, a Cigna spokeswoman, said the company continues "to work diligently with Northeast Georgia Health System regarding our current contract and are hopeful that we will reach an agreement soon."

The negotiations could potentially affect employees of the Hall County school system, which offers two primary carriers, Cigna and United Healthcare.

"This is starting to turn into an annual event for us, where insurers and our local hospital ... seem to come to these loggerheads too often," Superintendent Will Schofield said.

School officials have kept track of the latest contract issue "for the last several weeks, knowing that they were having some challenges," he said.
"But our experience has been that ... they usually come to some kind of 11th-hour agreement, so we were resisting letting our people know till the last minute, so as not to cause consternation."

However, with open enrollment — the time employees can select insurance and other benefits — ending at 5 p.m. Wednesday and talks at an impasse, "we shifted into a different gear and made sure that our folks ... could change their election from Cigna to United Healthcare."

He said most employees have United Healthcare. He didn't have exact numbers, including the number of people who switched last minute from Cigna.

Some employees of The Times also are Cigna members.