Alerts Center

Alerts for the Bloomington, Illinois Area

Hospital & Home Care Contract with Caterpillar Expiring

Sep 16, 2019 - Caterpillar patients with UHC insurance will be considered out-of-network if they use OSF hospitals and home care after September 30, 2019.

The hospital and home care agreement between Caterpillar and OSF HealthCare expires on September 30, 2019.

While we have engaged in negotiations in good faith for several months, we have not been able to develop a new agreement with Caterpillar at this time.

Therefore, the agreement will expire at 11:59 p.m. on September 30, 2019. This expiration includes all OSF facilities, OSF Aviation and OSF Home Care in the UHC Caterpillar Network.

Frequently Asked Questions

  • Why did OSF terminate the Caterpillar Hospital and Home Care agreement?

  • OSF did not terminate the Caterpillar hospital and home care agreement. The hospital and home care agreement between Caterpillar and OSF expires on October 1, 2019 and the parties were unable to renew with provisions that align with OSF’s Ministry’s current strategy. We value our relationship with Caterpillar, and fully intended to renegotiate contract language and reach agreement with Caterpillar, but this has not been accomplished to date.

  • What Caterpillar products were affected?

  • The Caterpillar network that applies to the UHC PPO, UHC CDHP Choice and UHC CDHP Max products were all part of the expired agreement.

  • When is the Caterpillar hospital and home care agreement expiration effective?

  • Effective October 1, 2019, all OSF hospitals, OSF Aviation, and OSF Home Care Services in the Caterpillar service area will no longer be included in Caterpillar’s UHC PPO network.  OSF’s agreement with Caterpillar for physician services continues and is not affected.

  • Which of OSF hospitals in Illinois are part of this termination?

  • The following hospitals are affected by the Caterpillar termination:

    • OSF HealthCare Saint Francis Medical Center (Peoria)
    • OSF HealthCare St. Joseph Medical Center (Bloomington)
    • OSF HealthCare Saint James-John W. Albrecht Medical Center (Pontiac)
    • OSF HealthCare St. Mary Medical Center (Galesburg)
    • OSF HealthCare Saint Anthony Medical Center (Rockford)
    • OSF HealthCare Saint Elizabeth Medical Center (Ottawa)
    • OSF HealthCare Saint Paul Medical Center (Mendota)

    Our other OSF hospitals are outside of the Caterpillar service area and may continue to see Caterpillar patients through their direct UHC agreements:

     

    • OSF HealthCare Heart of Mary Medical Center (Urbana)
    • OSF HealthCare Holy Family Medical Center (Monmouth)
    • OSF HealthCare Sacred Heart Medical Center (Danville)
    • OSF HealthCare Saint Anthony’s Health Center (Alton)
    • OSF HealthCare Saint Luke Medical Center (Kewanee)
  • Are the OSF physician providers still participating in the Caterpillar network?

  • The separate OSF physician agreement with Caterpillar does not expire, but some physicians may be unable to participate in the Caterpillar network based upon the hospitals where they have admitting privileges. OSF physicians can continue referring Caterpillar patients to OSF hospitals only in accordance with these patients’ out-of-network benefits. Only Caterpillar can determine which, if any, physicians will be impacted based on their network policies.

  • Is OSF Home Care Services still participating in the Caterpillar network?

  • OSF Home Care locations that are currently in the Caterpillar network will not be in network as of October 1, 2019 (Rockford, Ottawa, Pontiac, Normal, Peoria, and Galesburg.) 

  • Does the Caterpillar agreement expiration affect OSF’s participation with United Healthcare?

  • No, OSF will continue to participate in United Healthcare’s other plans. 

  • Can Caterpillar patients utilize the United Healthcare national network for services at the affected hospitals?

  • Caterpillar patients can continue to utilize the affected hospitals, but their out-of-network benefits will apply. This may mean higher out of pocket expenses for these patients than what they are currently seeing.

  • Does this agreement expiration also affect outpatient hospital services?

  • Yes, the expiration will affect all outpatient hospital departments and locations of the affected hospitals, including, but not limited to diagnostic testing, sleep studies, rehabilitation, and ambulatory surgery.  

  • Can I change my health plan?

  • During Caterpillar’s open enrollment period, held annually in November, employees can choose the same plan they currently have or they can choose a different plan offered that includes OSF providers.

    The BCBS EPO plan was offered in 2019 and only Caterpillar can determine what plans will be offered in 2020. Caterpillar members may also check with their employer to see if they will be allowed to change plans on October 1, 2019.

  • If I want to continue receiving care by my OSF provider, what do I need to do?

  • If you are a Caterpillar patient who still wishes to use the affected OSF hospitals and OSF Home Care services, you may continue to use OSF using your out-of-network benefits or other applicable coverage you may have.

    However, you may see higher out of pocket expenses after September 30, 2019, when we are no longer in contract.

    You can also choose another Caterpillar option (BCBS EPO) that OSF is participating in during your open enrollment period which would then be effective on January 1, 2020.

  • What other Caterpillar insurance options does OSF participate with?

  • OSF participates in the BCBS CAT EPO plan. 

  • What if I am currently getting treatment that will go past September 30, 2019?

  • If you are currently receiving treatment that is scheduled to go past September 30, 2019, you will need to call Caterpillar at (800) 447-6434 or (309) 494-2363 to get approved for continuation of care at OSF.

    If you need to switch providers, OSF will work collaboratively with Caterpillar and the new provider to ensure a safe and clinically appropriate transition of care.

  • What happens if I am hospitalized on or before September 30, 2019, and require inpatient care on October 1, 2019 or beyond?

  • Any patient admitted prior to October 1, 2019, may be covered under continuation of care. You should call Caterpillar to verify coverage.

  • How does it work on the outpatient side?

  • If you are scheduled for an outpatient appointment, like a sleep study or an appointment at a pain center, your out-of-network benefits will be applied which may result in higher copayments, co-insurance and deductibles.

  • What about specialty care?

  • Patients requiring ongoing care (example – diabetes management) may be covered under continuation of care. You should call Caterpillar to verify coverage.

  • What about home health?

  • Patients requiring ongoing care may be covered under continuation of care. You should call Caterpillar to verify coverage.

  • What about OSF HealthCare Children’s Hospital of Illinois? If I have a high-risk pregnancy and am due to deliver at OSF Saint Francis because of their neonatology unit and NICU, will this be covered?

  • If you are currently receiving treatment that is scheduled to go past September 30, 2019, unless you have other potentially applicable coverage, you will need to contact Caterpillar to find out if they will continue to cover treatment at our facilities as part of in-network benefits.

    After October 1, 2019, Caterpillar patients using the NICU at OSF Children’s Hospital will have to pay in accordance with their plan’s out-of-network benefits, but may continue to utilize their services.

  • Are services considered out-of-network on or after October 1, 2019, if I go to an affected OSF facility or home care?

  • Caterpillar must cover emergency services even at out-of-network facilities in accordance with all state and federal laws.

    However, absent special authorization by Caterpillar, all other services, use of OSF facilities and OSF Home Care services will be considered out-of-network and out-of-network benefits will be applied resulting in higher out of pocket expenses for the patient. OSF physicians remain in-network.

  • How will this affect my co-payment and deductibles?

  • The Caterpillar network does have out-of-network benefits. Starting October 1, 2019, you may have higher out of pocket costs in order to utilize services at an affected OSF entity.

  • If I need to have a procedure, can my doctor send me to my local OSF hospital that was affected by this agreement expiration?

  • Yes, the your doctor can refer you to an OSF facility, however you will need to be educated and willing to accept your out of pocket costs in order to utilize an OSF entity for services scheduled for October 1, 2019, or later.

  • How can I, as a Caterpillar member, request that Caterpillar allow participation of the affected OSF hospitals?

  • We appreciate the desire to have access to all of our OSF hospitals and to the entire OSF HealthCare system of coordinated care that takes seriously the quality, cost, and experience for each one of our patients.

    You may contact Caterpillar’s HR Service Center at (800) 447-6434 or (309) 494-2363.

    It is our hope that Caterpillar will realize the value of having OSF hospitals and home care in its network for its members, and enter into a new agreement sometime in the future.

  • Do you anticipate coming to agreement with Caterpillar prior to the expired agreement?

  • OSF is open to future discussions with Caterpillar. It is our hope that Caterpillar will realize the value of having OSF hospitals and home care in its network for its members, and enter into a new agreement sometime in the future.

  • What if I, as a Caterpillar patient, still wish to utilize the affected OSF hospitals?

  • You may continue to utilize OSF hospitals and home care for your services but will have to pay your out-of-network benefit.

    You may contact Caterpillar’s HR Service Center (800) 447-6434 or (309) 494-2363 to express any concerns.

  • What if I have the Caterpillar network as my secondary insurance?

  • Individuals should review the Caterpillar network website for determination of benefits and eligibility of coverage.

    Specific plan information can be obtained by dialing the phone number on the back of your insurance card. If you have other coverage, such as through a spouse’s employer or a government benefits program, OSF may be participating with that other insurance coverage.

    Therefore, you may be able to access OSF hospitals and home care services on an in-network basis through that other coverage.