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Major PPO Changes Ahead: What You Need to Know About New Shared
Agreements

The PPO landscape is shifting quickly, with new shared agreements between major carriers set to roll out over the next few months. These agreements can directly affect reimbursements, participation, and patient flow in ways many practices don’t anticipate. At PPO Advisors, our mission is to help you stay ahead of these changes and make confident, informed decisions.

Here’s a breakdown of the three major updates you need to know:

1. Aetna–MetLife Shared Agreement (September 1, 2025)
2. Cigna–Humana Shared Agreement (November 1, 2025)
3. Cigna–Ameritas Shared Agreement (November 1, 2025)

Aetna and MetLife: A Two-Way Shared Network (Effective September 1,
2025)
On September 1, 2025, Aetna and MetLife will launch a two-way shared network agreement:

– If you’re contracted with Aetna but not MetLife, you’ll begin seeing MetLife patients processed under your Aetna fee schedule.
– If you’re contracted with MetLife but not Aetna, the reverse will apply.
– This process is automatic unless you choose to opt out manually.
Because reimbursements may default to the lower fee schedule, this shift could impact revenue.

PPO Advisors tip: Audit both your Aetna and MetLife contracts now to decide if participating in both is beneficial—or if opting out will protect your reimbursements.

Cigna and Humana: A Confirmed Two-Way Share (Effective November 1,
2025)
Starting November 1, 2025, Cigna and Humana will implement a confirmed two-way shared agreement.

Here’s what this means:
– Providers in Cigna’s Shared Administration Network (SAN) will automatically gain access to Humana members.
– Humana patients will appear as in-network under your Cigna participation, processed according to your Cigna contract terms.
– This share has been confirmed as two-way: if you hold a direct Humana contract, you may now also pick up Cigna patients through your Humana participation.
– As always with the SAN, you cannot pick and choose. If you want to avoid participation, you must opt out of Cigna’s SAN entirely.

Why this matters:
– Practices without direct Humana contracts may see new Humana patient flow through their Cigna participation.
– Practices with a direct Humana contract could see additional Cigna patients routed through their Humana participation.
– Restacking may occur, meaning the carriers may prioritize the SAN or your direct/umbrella contracts depending on reimbursement rates.

PPO Advisors tip: Review both your Humana and Cigna contracts closely. This new two-way share could increase patient volume, but it’s critical to confirm how fee schedules will apply.

Cigna and Ameritas: Another Shared Agreement (Effective November 1,
2025)
Also beginning November 1, 2025, Cigna and Ameritas will launch a new shared agreement.

How Cigna’s SAN Impacts This Arrangement:
If you are in Cigna’s Shared Administration Network (SAN), you are automatically included in this new Ameritas partnership. There’s no option to selectively decline Ameritas while keeping other shares—you’d need to leave the SAN entirely.

What It Means for Practices:
– If you don’t directly contract with Ameritas: You’ll begin appearing in-network for Ameritas patients through your Cigna SAN participation.
– If you already contract with Ameritas (direct or umbrella): Ameritas may restack contracts to prioritize the Cigna SAN arrangement, which could change which fee schedule applies to your Ameritas patients.

Ameritas has not yet issued a public announcement, and it’s still unclear whether this will become a two-way share like Cigna–Humana. PPO Advisors will update once confirmation is available.

Final Thoughts

These three developments—Aetna–MetLife, Cigna–Humana, and Cigna–Ameritas—are significant shifts that will reshape how providers interact with major PPO networks.

Action steps for your practice:
👉 Audit your Aetna and MetLife contracts ahead of September.
👉 Evaluate your Cigna SAN participation to prepare for both the Humana and Ameritas shares in November.
👉 Stay tuned for updates from Ameritas on whether that agreement becomes a two-way share.

At PPO Advisors, we’re here to help you cut through the complexity. Our role is to ensure you understand exactly how these agreements impact your practice’s reimbursements—and to position you for success in a changing PPO environment.

By Shelley DeGroff, Founder of PPO Advisors