UHC/HHC FAQ 2025

UHC/HHC FAQ 2025 Contract Negotiation 

1. When does the Hartford Healthcare (HHC) and UnitedHealthcare (UHC) contract end?

   The current contract remains in effect through March 31, 2025. If the parties are unable to reach a mutually agreeable resolution for a new contract, HHC hospitals, facilities and physicians will be out of network beginning April 1, 2025. 

    

2. Are HHC and UHC still negotiating?
   
   

   It is reported that the parties are still negotiating, and both have a goal of reaching a long-term agreement before there is a contractual lapse. 

   
   
3. How does this impact consumers?

   For UHC/Oxford commercial plan members[1]:  UHC indicates that consumers will continue to have access to HHC’s hospitals through May 31, 2025, through the Connecticut “cooling off requirements.”   This cooling off period only applies to HHC’s hospitals. Should the contract with HHC end, any services received at other HHC providers and non-hospital facilities would be considered out of network beginning April 1, 2025, unless a member was previously approved for continuity of care (see below). 

   For Medicare Advantage, including Group Retiree and Dual Special Needs Plans (DSNP) members: The cooling off period does not apply to Medicare Advantage, including Group Retiree or DSNP members. This means any non-emergent care from a HHC hospital, facility or physician would be considered out of network for Medicare Advantage, including Group Retiree and DNSP members, beginning April 1, 2025, unless previously approved for continuity of care (see below). 

   Note: Consumers who are members of Medicare Advantage Employer Group Waiver Plans (EGWPs) who may find HHC out of network beginning April 1, 2025, may still experience the same out of pocket cost sharing responsibility as if HHC was in network. Consumers should check with their Medicare Advantage EGWP plan administrators to confirm.

    

4. I am an enrollee of an individual Medicare Advantage plan; can I change plans?

   Medicare Advantage enrollees may be eligible to change their individual Medicare Advantage plan until March 31^st.  If a consumer feels the termination of the UHC/HHC agreement will be impactful, they may wish to consider changing to original Medicare (no provider networks) or another Medicare Advantage plan. Connecticut CHOICES, Medicare experts affiliated with the Connecticut Aging and Disability Services, is a good resource to help consumers evaluate if other plans may be best suited for their circumstance. Consumers should be aware, however, that changing to another Medicare Advantage plan does not guarantee that the new plan will not face a similar potential contract dispute with your providers in the future. If that were to happen after March 31^st, consumers would likely need to wait until the next Medicare open enrollment period to change plans again, which would be effective January 1, 2026. (CHOICES phone: 1-800-994-9422; or website: CHOICES)

5. What is the “cooling off” provision?
   
   

   If “cooling off requirements” apply (see FAQ #3), in Connecticut, the “cooling off” provision requires both the insurance carriers and hospitals to abide by the terms of the ending contract for a period of sixty days beyond the termination date of the contract. This short extension is intended to help with a smoother transition for plan members and enables additional negotiation time for the parties.

6. Why does the “cooling off” period not apply to Medicare plans?

   The cooling off requirement is applicable to plans subject to the Connecticut insurance law. Medicare is a federal program and is not subject to state laws. Federal law does not have a “cooling off” requirement.

    

7. What is Continuity of Care and how do I ask UHC to be preapproved for it?

   Continuity of care (sometimes called Transitional Care) is a provision that may enable individuals who are undergoing a course of treatment to continue to see their provider at an in-network benefit level for a limited period of time after their provider leaves the network. Continuity of care rights are typically outlined in a person’s plan documents. If you have providers who you are currently getting treatment from, you may want to contact UHC and request continuity of care. Because the process of requesting continuity of care can take some time, and you may have limitations on how long you have to make the initial request, it is better to reach out as soon as possible to request it.

   (Continuity of care rights can vary by plan design so please check your plan documents or call the number on the back of your ID card and speak to UHC to confirm.)

    

8. What are the typical minimum Continuity of Care requirements for Connecticut Fully Insured Commercial Plans[2]?

   Individuals who are in an active course of treatment with a treating provider may request continuity of care. ("Treating provider" means a covered person's treating health care provider or a facility at which a covered person is receiving treatment.)

   An “Active course of treatment” means:

   • A medically necessary, ongoing course of treatment for a life-threatening condition (“Life-threatening condition" means a disease or condition for which the likelihood of death is probable unless the course of such disease or condition is interrupted.)
   • A medically necessary, ongoing course of treatment for a serious condition, (“Serious condition" means a disease or condition that requires complex ongoing care such as chemotherapy, radiation therapy or postoperative visits.)
   • Medically necessary care provided during the second or third trimester of pregnancy, or
   • A medically necessary, ongoing course of treatment for a condition for which a treating health care provider attests that discontinuing care by such health care provider would worsen the covered person's condition or interfere with anticipated outcomes.

    

   How long will continuity of care last?

   1. For a covered person who is in the second or third trimester of pregnancy, the continuity of care period extends through the postpartum period.

       

   2. For a covered person who is undergoing an active course of treatment the period extends to the earliest of the following:
      • Termination of the course of treatment by the covered person or the treating provider,
      • Ninety days after the date the participating provider is removed from or leaves the network, unless the health carrier's medical director determines that a longer period is necessary,
      • The date that care is successfully transitioned to another participating provider,
      • The date benefit limitations under the health benefit plan are met or exceeded, or
      • The date the health carrier determines care is no longer medically necessary.

    

9. What are the typical Continuity of Care minimum requirements for Medicare Advantage Plans?

   “Continuing care patients” may be eligible to get care from their provider at in-network rates for up to 90 days. This includes patients that:

   • Are undergoing treatment for a serious and complex illness 
   • Are undergoing institutional or inpatient care
   • Are scheduled to get non-elective surgery
   • Are pregnant and undergoing treatment 
   • Are terminally ill

    

10. What are practical steps you can take to prepare if the termination occurs?

               For Commercial Consumers[3]:

    We recommend that consumers request continuity of care for any provider if they are having ongoing treatment. Consumers can request continuity of care by calling the number on the back of their ID card.

    We also recommend consumers check whether their plan has out of network coverage. (Be sure to also confirm reimbursement levels for out of network care. Typically, in the out of network scenario you will pay more for care, and you may be balance billed up to the amount charged by the provider.)

    You should confirm other providers who will be available to you should the termination occur by looking at your member portal provider directory. You can also call the health plan and request a listing of providers in your area. If there are no other providers available, you may be able to request a network gap exception.

    For Medicare Consumers[4]:

    We recommend that consumers request continuity of care for any provider if they are having ongoing treatment. They can request continuity of care by calling the number on the back of their ID card.

    We also recommend consumers check whether their plan has out of network coverage. (Be sure to also confirm reimbursement levels for out of network care. Typically, in the out of network scenario you will pay more for care, and you may be balance billed up to the amount charged by the provider in some circumstances.) 

    You should confirm other providers who will be available to you should the termination occur by looking at your member portal provider directory. You can also call the health plan and request a listing of providers in your area.  If there are no other providers available, you may be able to request a network gap exception.

    Individual Medicare Advantage plan enrollees may be eligible to change their plan until March 31^st.  If a consumer feels the termination of the UHC/HHC agreement will be impactful, they may wish to consider changing to original Medicare or another Medicare Advantage plan. Connecticut CHOICES, Medicare experts affiliated with the Connecticut Aging and Disability Services, is a good resource to help consumers evaluate if other plans may be best suited for their circumstance. Consumers should be aware, however, that changing plans does not guarantee that the new plan will not face a similar potential contract dispute with your providers in the future. If that were to happen after March 31^st, consumers would likely need to wait until the next Medicare open enrollment period to change plans again, which would be effective January 1, 2026. (CHOICES phone: 1-800-994-9422; or website: CHOICES)

     

11. Where can I find information on the negotiations?

    UHC and Hartford Healthcare have both set up sites to provide updates on the negotiation and provide answers to frequently asked questions (“FAQ”).

    https://www.uhc.com/hhc/faqs

    https://hartfordhealthcare.org/united

     

12. What is the Office of the Healthcare Advocate (OHA) doing to help Connecticut residents?

    OHA continues to provide information and advice regarding the potential contract termination. If you are having difficulty enforcing your rights under your plan or understanding your options, please reach out, and we may be able to help.  OHA is committed to educating Connecticut residents on their rights under their health plans and to help voice the concerns of Connecticut residents regarding the availability and affordability of health care.

     

13. What HHC facilities/providers are impacted?

    Please see HHCs FAQ “What Hartford HealthCare facilities/physicians are affected for commercial plans?” and “What Hartford HealthCare facilities/physicians are affected for Medicare Advantage plans?” for information on impacted providers.

    United | hartfordhealthcare.org | Hartford HealthCare | CT

     

14. Where else can Consumers get in-network treatment?

Please see UHC’s FAQ “Where else can people go for care if HHC leaves UnitedHealthcare’s network?”

FAQs about our negotiation with HHC | UnitedHealthcare