Promise Hospital v. Cigna Corp. CA2/8

FACTS AND PROCEDURAL HISTORY

This dispute arises from two separate contracts – each signed by pairs of separate parties – that concerned providing healthcare benefits to employees of the City of Long Beach. The first contract was signed in March 2007 by Great-West Healthcare, Inc., and Promise Hospital of East Los Angeles, LP. It was labeled a hospital services agreement and, in general terms, obligated the hospital to provide healthcare services to persons covered under health care insurance plans that were offered or administered by other entities. The second contract was signed in the latter part of 2008 by the City and Great- West Life & Annuity Insurance Co.1 Under this administrative services contract, Great- West Life agreed to serve as administrator of the City’s self-funded health insurance plan for City employees and secure the services of healthcare entities to provide medical care under that plan. Pursuant to its agreement with Great-West Healthcare under the hospital service agreement, Promise provided healthcare services to City employees who were covered by the City’s employee healthcare plan. This dispute arose when Great-West Life denied Promise’s $1.5 million…