UNC Health-Cigna Contract Breakdown Disrupts In-Network Coverage for 65,000 Patients

The failure to renew the contract between UNC Health and Cigna caused a significant network disruption affecting tens of thousands of patients starting December 1, 2025.

UNC Health facilities and providers are now out-of-network for Cigna members, which results in higher out-of-pocket costs for those using these services. This change follows the expiration of a three-year contract on November 30, 2025, with prior warnings issued to approximately 65,000 affected Cigna members about the potential coverage interruption. UNC Health insists that any new agreement must align with the terms they hold with other insurers, maintaining consistency across their payer relationships.

Limited "continuity of care" protections are available for some patients undergoing hospitalization, pregnancy, or active treatments before the contract lapse, although eligibility requires direct coordination with Cigna. The contract talks have been contentious, with Cigna citing UNC Health's demand for an approximate 32% rate increase over three years and accusing the health system of using patient concerns as leverage. Notably, Cigna offered to extend the current contract while continuing negotiations in an attempt to preserve network alignment. 

This dispute occurs amid a broader regional pattern of hospital-insurer contract conflicts impacting network access in the Triangle area of North Carolina. Earlier in the year, UNC Health and UnitedHealthcare nearly faced a similar contract stalemate but resolved it just before the deadline.

Conversely, a recent breakdown between WakeMed and UnitedHealthcare has led to WakeMed becoming out-of-network for most UnitedHealthcare plans starting mid-November 2025.\n\nUNC Health also plans to be out-of-network with Humana, WellCare, and Health Care Service Corp. Medicare Advantage plans by January 1, 2026, potentially complicating coverage for Medicare Advantage enrollees. However, Humana's Medicare Advantage plan for North Carolina state employee retirees remains in-network.

Cigna’s open enrollment period, running from November 1 to December 15, adds urgency for consumers and employers to assess plan options amid these network changes. These contract disputes underline the complexities and financial implications for payers, providers, and insured individuals amidst evolving healthcare market negotiations. The outcomes here will influence contractual benchmarks and payer-provider dynamics in this regional health insurance market.