Askew said Tennova "has agreements in place with all other major health plans in our area," including BlueCross BlueShield, Cigna, Aetna and Humana. UnitedHealthcare members may have access to Tennova hospitals through other networks, including Beech Street, Multiplan and PHCS, said the letter, which urged patients to call United's sales director to "express your dissatisfaction with their decision." UnitedHealthcare and Mercy Health Partners, former owner of Tennova, failed to reach a rate agreement before, in 2010. After Mercy was sold to Florida-based Health Management Associates, HMA and UnitedHealthcare forged a new contract in 2011.