Subscribers caught in between dispute over insurance rates

Many in Gainesville may understand the reasons why businesses and professional organizations that are party to contracts may understand the motivation to dispute them if such groups believe their terms to be disadvantageous. However, when such disputes involve service providers who serve a large number of customers or subscribers, pressure can soon begin to mount when such parties are deprived of those services. From an outside prospective, some may even believe that the parties involved in these types of contract disputes rely in such pressure to achieve their aims. 

That is exactly what state employees in Connecticut are accusing a regional healthcare organization of. An ongoing dispute between the organization and the health insurance carrier Anthem has left these employees facing the prospect of having to pay exponentially more for their healthcare. In the past, their insurance benefits have only required small co-pays and fees between $5-$40 for outpatient services and medications. Yet since the healthcare organization has yet to reach an agreement with Anthem on its service rates, its providers are now considered to be out-of-network for state employees. This could leave them being forced to pay as much as 20 percent of the charges for the services they receive. 

State employee representatives claim that the organization is using them as pawns in their negotiations. Yet the organization has responded by saying that they have operated in good faith with Anthem. Its request for a rate increase coincidentally comes just after the state of Connecticut approved rate increases between 25-31 percent for individual and group health plan coverage for Anthem. 

While no service provider wants to see its subscribers suffer, such companies may also need to fight for contractual terms that help achieve their business objectives. Those need to launch such a dispute may want to first seek reliable legal counsel.  

Source: Yankee Institute for Public Policy "Contract dispute between Hartford HealthCare and Anthem draws ire of state employee unions" Fitch, Marc, Nov. 07, 2017

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