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United Healthcare Pledges 75-Day Extension for Flagler Clients Despite Hospital Dispute

| August 3, 2010

brain scan

Blame the tumor in that scan on anxiety.

United Healthcare is pledging that all Flagler County residents—not just school district employees and their families—will still be covered at in-network rates at Florida Hospital Flagler and other Florida Hospital facilities for at least 75 days should the hospital and the insurer fail to agree on a new contract by Aug. 15.

United Healthcare and Florida Hospital, a network of 17 hospitals in Central Florida, are at a deadlock in contract negotiations stretching back to November. The current contract ends on Aug. 15. Florida Hospital decided to end its relationship with United Healthcare on that day. That means any individual insured through United Healthcare who goes to a Florida Hospital facility, including Florida Hospital clinics, would have to pay out-of-network charges for most non-emergency services. The charges are significantly more expensive than in-network charges.

Bill Abrahams, a senior account executive with United Healthcare, appeared before the Flagler County School Board Tuesday afternoon and said that the insurer had agreed to two temporary solutions to ease United’s Flagler County clients’ minds: for non-school employees, those covered by United Healthcare will still be able to use Florida Hospital’s services at in-network rates for at least 75 days after Aug. 15. That window may be lengthened after mid-November. It’s not yet clear, however, if that allowance applies to children on Medicaid covered through United Healthcare.

The school board’s contract with United Healthcare kicks in on Sept. 1. (The district previously had contracted with Florida Health Care and Blue Cross Blue Shield). United Healthcare’s Bill Abrahams, a senior account executive with the insurer, told the school board Tuesday afternoon that all school board employees and their dependents will be covered indefinitely at in-network rates at Florida Hospital Flagler and the hospital’s clinics, regardless of the contract dispute between the insurer and the hospital. But United Healthcare reserves the right to give the district a 90-day notice beyond which the insurer would no longer cover employees seeking treatment at Florida Hospital Flagler at in-network rates.  “If we don’t notify you and we don’t have any resolution,” Abrahams told the board, “you’re going to still be treated as in-network at Florida Hospital.”

The school district’s 1,748 employees, most of whom will be covered by United Healthcare, are the insurer’s biggest client in Flagler. United Healthcare doesn’t want to lose the business. Nor is the district keen on switching again.

But board members are nervous about being left in a lurch.  “The charge is with United. Their credibility is on the line with us,” board member Andy Dance said. Fellow-board member Colleen Conklin wanted a pledge from United that the insurer would extend benefit at least through the year. Abrahams was not able to make that pledge. But he said the 90-day notice could simply never be handed down.

That’s not enough for board members, who want options, including possibly renegotiating with Florida Health Care and Blue Cross Blue Shield. The district switched to United Healthcare because coverage through the other insurers was more expensive. The district also has no guarantees that even if it switches to another insurer, that that insurer wouldn’t run into similar contractual issues with Florida Hospital.

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8 Responses for “United Healthcare Pledges 75-Day Extension for Flagler Clients Despite Hospital Dispute”

  1. Charlie says:

    Round 2, Greed versus Greed.

  2. dlf says:

    Why is everyone concerned with this issue, obama care will take care of all our needs the first of the year at no cost, no increase in tax and will do away with all the nasty profit making firms in the US.

  3. Charlie says:

    I’m not so sure, just what your point is. There is no agreement on fees, and the government will not put a hold on what the HMO and other contractors pay the hospital. I can tell you, that you and I as patients/individuals will be paying out of our pockets much more for care and premiums. Obama Care is NOT free,, maybe up to 8% of your income. Not a free ride, unless you are part of the 47%, that presently pay no income tax. ( not a negative comment), but 53% are supporting the government now, via personal taxes paid.

  4. Rick G says:

    Every time I read one of these “disputes” between health care providers and health insurance companies makes me scream SINGLE PAYER AND NOW!!!! We need to get rid of the method we are forced to use for attaining health care and take the profit motive away. And how does Lars (can you really trust a man named Lars?) get away with making $1.1 million for a “non profit” entity?

  5. Anonymous says:

    As the medical insurance provider for PCD as well, United HealthCare really does have a big portion of it’s health insurance members here in Flagler County. If they fail to reach an agreement and UHC decides not to honor in-network rates for Flagler County residents, it will be sad for those people to have to travel 30 miles away for their health care just to stay in-network. Won’t this take away from the revenue generated for our area in a pretty significant manner? I really hope they can come to an agreement soon. As a UHC member myself, I for one would hate to have to travel out of the county tor my medical needs instead of going to the doctor I’ve been seeing here for years. It certainly would be unpleasant to have to start over with a stranger who knows nothing about my history and isn’t guaranteed to have the same bedside manner and excellent staff members that my doctor has. But unfortunately, someone in my situation would have to go elsewhere since there is no way I could afford to pay the out of network costs. Fingers-crossed here for a quick resolution, or that I don’t get sick in the near future!



  7. Amber says:

    I contacted United Healthcare and they knew nothing of this 75 day extension.

  8. anyonymous says:

    I can say with the utmost certainty that this not an issue of greed v greed. UHC was able to contract a very low rate with the Adventist Health System in the past. Now Adventist wants to bump up the rate by 25% or $55 out of pocket per member. Yes I heard that Adventist “only wants what the other insurance companies pay” but that’s the very reason why UHC was so competitive and became such a large force in FL. UHC was able to offer rates lower than what other insurance companies did. The lower contract rates meant lower premiums and lower out of pocket. Next time any of you get an explanation of benefits look at how much your charged by doctors and hospitals BEFORE insurance. $1000 for a five minute ER visit? $150 for a dr’s office visit? Now tell me that the insurance is being greedy.

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