What you need to know
You’re not alone if you’ve received notice that your health care provider(s) may be leaving the Cigna network when their contract expires. The BAE Systems team actively advocates for Cigna and its providers to come to an agreement, which they most often do. But even if things work out, potential changes can be unsettling. The information below can help you navigate the situation and obtain the care you need.
The big picture about network negotiations
With the rise of inflation and other ongoing economic pressures, many health care providers are demanding double-digit price increases for their services. These increases are often not in line with the local health care market, and they are not reasonable for you or BAE Systems to pay. This difference of opinion has resulted in more challenging Cigna network provider negotiations, which are often extending up to provider contract termination dates, or even beyond.
When existing healthcare provider agreements are set to expire and a new agreement has not yet been reached, Cigna is required to send notifications 30 days in advance to ensure impacted participants are aware of the potential network change. BAE Systems also has an established practice to reach out to affected employees who are enrolled in our Cigna medical plans and live or work in the impacted provider’s region.
Our stance on this issue
Please be assured that the BAE Systems team takes these potential network disruptions seriously, and we actively advocate for Cigna and the providers to come to an agreement well before their contracts are due to expire. However, we also want the parties to come to an agreement that balances increasing health care costs with the need to keep health care affordable for you and your covered family members. This often results in negotiations being conducted up to the last day of their current contract before both parties come to a middle ground.
No immediate action is required of you. However, you may want to proactively identify options for your affected provider or facility. The information and resources shared below can help you prepare for potential network changes.
Answers to some frequently asked questions
What is a network?
Insurance companies negotiate discounted rates under contracts with certain health care providers and facilities to create a network. When covered participants use these in-network providers, it can help lower their health care costs.
If BAE Systems is self-insured, why are network changes a possibility?
While BAE Systems is self-insured, the company does not negotiate directly with health care providers. Instead, we contract with plan administrators, such as Cigna and Delta Dental, to do this on our behalf.
This benefits us in multiple ways, including reducing our health care management costs and keeping our monthly premiums lower. It also allows us to leverage our diverse workforce of about 32,000 U.S. employees, so you and your families may obtain quality in-network medical care at a competitive and more affordable cost.
What does it mean that BAE Systems health care plans are self-insured?
Being self-insured is a relatively common practice among larger corporations. For BAE Systems, this means that Cigna or other plan administrators (such as Delta Dental) process claims on our behalf, while BAE Systems pays the actual claim costs, rather than paying an insurance provider a fixed amount that is estimated to cover the cost of claims. Employees who enroll in our plans contribute a portion of our actual claim payments through their monthly premiums. This is why our collective focus on improved health and wellness helps to reduce our total costs as a self-insured employer.
What can happen during negotiations
We understand your concerns about this unsettling situation where the outcome is difficult to predict. It’s important to remember that a negotiation between your provider and Cigna may still be reached, allowing the provider to stay in the network.
When negotiations are particularly contentious, you may also receive a letter directly from an affected doctor, specialist, or facility that you’ve recently used, asking you to urge BAE Systems to keep the medical group or facility as an in-network provider.
Be assured that BAE Systems is closely monitoring all our ongoing Cigna negotiations, and the Benefits team consistently and strongly encourages Cigna and the providers to reach a fair agreement as quickly as possible.
Resources that can help
If you receive a letter from Cigna, it includes resources to help you find care, key points to keep in mind in the event of a network change, as well as answers to some commonly asked questions. For ease of reference, we’ve included a number of these here.
Finding alternative in-network options
Call the toll-free number on your Cigna ID card or 1 800 530 1314. For TRS or TTY services, dial 711 when you call. Cigna Customer Service Advocates are available 24/7/365 and can help you:
- Find an in-network provider or hospital in your area
- Navigate other transitions, such as getting new referrals, prescriptions, and Continuity of Care
Key points to know if your provider leaves the Cigna network
- If a provider or hospital leaves your Cigna network, you’ll likely pay more for the same services at their facilities. For example, you would have to pay:
- Your plan’s out-of-network benefit rate plus any charges not covered by your plan, which could cost you much more OR
- 100% of the cost (if your plan doesn’t have an out-of-network benefit)
- If you need emergency care services and receive them from a provider or facility that leaves the network, these services will be covered at the in-network level under your plan’s emergency room coverage.
- If you are receiving ongoing treatment at the time of a network change, you may qualify for Continuity of Care that could allow you to continue care at the in-network benefit level, but only for a period of time (generally up to 90 days). You must complete the Continuity of Care request form and obtain approval.
- Go to myCigna.com, scroll to the bottom of the page, and click on Find a Form.
- Select Medical, and then choose Transition of Care/Continuity of Care Form.
- Call a Customer Service Advocate at 1 800 530 1314 to determine your eligibility for Continuity of Care and for help completing the request form.
- Even if you’ve been pre-approved for services that will begin after an existing provider’s agreement expires, you will likely need to get approval for treatment at another facility to obtain in-network services, unless you are eligible for Continuity of Care.
- If you or a covered family member is terminally ill, treatment can be continued with your provider, despite a network change, until the time of death.
If you have additional questions about a potential network change or alternative health care facilities and providers, contact Cigna at 1 800 530 1314.