Protestors advocate for healthcare reform in Athens, Georgia on Thursday, March 29, 2018. (Photo/Jason Born)

Midnight on March 31 has come and gone, and the contract between BlueCross BlueShield and Piedmont has expired, leaving nearly 577,000 state of Georgia employees wondering what to do next.

Contracts expiring between health insurance providers and health care facilities is routine. However, in most cases it is expected that an agreement will be reached before the expiration date. This time, an agreement was not reached, and Georgia state employees with BCBS health insurance are now out of network at Piedmont facilities.

Because an agreement wasn’t reached, University of Georgia employees, among the hundreds of thousands of other state employees, will have to either pay out-of-pocket expenses at Piedmont facilities, where many of their doctors are, or find new doctors.

“I think it’s disastrous for all employees who hold that insurance in the state of Georgia,” said Annelie Klein, student affairs professional II in the College of Pharmacy, in a previous The Red & Black interview.

Piedmont is based in Atlanta and has an urgent care and hospital in Athens.

"This does not in any way mean that Piedmont physician wont see [BCBS members]," said Matt Gove, chief consumer officer with Piedmont. "This just means that the BCBS member has a higher out-of-pocket cost."

BCBS is Georgia’s biggest health insurer and is the suggested health insurance for University of Georgia employees.

The last time the two had trouble reaching an agreement was in 2006, which resulted in a lawsuit brought on by Piedmont against BCBS of Georgia.

"It's important to be sure that our physicians are fairly reimbursed for the cost of care," said Nina Montanaro, a Piedmont spokesperson, in the Atlanta Business Chronicle in 2006. "In some cases the rates that BCBSGa has offered did not even cover the cost of care."

In both 2006 and 2018, Piedmont said it couldn’t reach an agreement because BCBS was not fairly reimbursing physicians, among some other concerns.

Piedmont “will not agree to anything with Anthem Blue Cross that does not fairly compensate and recognize how integral physicians are to [their] mission,” they said on their website during the 2018 negotiations.

Klein is also a steering committee member for the United Campus Workers of Georgia, a union of UGA employees. She and others gathered at the Arch for a protest against the uncertain healthcare situation on March 29.

“We are not customers, we are patients. There is a very big difference,” said Dina Canup, public relations and student services specialist in UGA department of theatre and film studies, at the protest.

Canup’s daughter, who has autism, has been hospitalized three times in the past year and has established relationships with her doctors and therapists at Piedmont Athens Regional.

“This week … we said goodbye to her occupational therapist," Canup said at the protest. "She’s made great strides with that therapist, [but] we don't know when she'll be able to see her again."

Canup and her daughter are one example of how the negotiations between BCBS and Piedmont have affected and will continue to affect Georgians.

Despite the passed deadline, negotiations are still underway to reach an agreement. 

"We will continue to work with BCBS to get a new contract done," Gove said. "We are not going to stop working on this just because the deadline has passed. We know that patients rely on us, so we hope that [BCBS] will bring the same energy to the conversation." 

Hunter Riggall contributed to this article.