SMH returns to network coverage for Cigna commercial insurance plans

The two-year contract extends in-network coverage for SMH and First Physicians Group providers

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• Sarasota Memorial Health Care System will be in-network with Cigna Healthcare starting October 1, 2025.
• The new two-year agreement restores access for Cigna members after the hospital system went out-of-network in 2020.
• Cigna commercial plan members will have access to Sarasota Memorial’s hospitals, outpatient centers, and physicians.
• The previous contract ended after negotiations between the hospital and the insurer stalled in 2019.

Sarasota Memorial Health Care System will be in-network with Cigna Healthcare, as of Oct. 1, when a new, two-year contract went into effect.

Sarasota County’s public hospital system has been an out-of-network provider with Cigna since April 30, 2020.

The new agreement reestablishes and solidifies the relationship between Cigna, Sarasota Memorial and First Physicians Group. 

Under the agreement, Cigna Healthcare commercial plan members will benefit from access to:

• Sarasota Memorial’s two acute-care hospitals

• Comprehensive network of outpatient and urgent care centers

• Primary and specialty physicians and affiliated providers employed by SMH’s First Physicians Group.

Why was Sarasota Memorial out of network with Cigna?

SMH and Cigna parted ways April 30, 2020 but that was actually a four-month contract extension so patients weren’t left in the lurch while finding a new healthcare provider.

Contract talks between SMH and Cigna stalled in mid-2019 and ultimately the hospital and insurance company were at an impasse.

At that time, municipal employees in the cities of Sarasota and North Port, as well as Sarasota County Sheriff’s deputies were all covered by Cigna insurance.

Insurance companies and medical providers enter contracts for in-network coverage reimbursement rates, as well as scope of services that are covered by an insurance provider.

When the two sides can’t agree, all or part of the medical services offered may be ruled as out-of-network by a provider.

What’s next?

The contract primarily covers Cigna commercial plans – typically employer plans, an SMH spokeswoman said.

In January 2024, Health Care Service Corporation, the country’s largest customer-owned health insurer, announced the purchase of Cigna’s Medicare business for $3.7 billion, according to USA Today.

An SMH news release urged individual to contact their insurance company’s member services to determine coverage, since health insurance coverage can differ from plan to plan, even under the same insurer.