When Brad Jacobsen, a retired St. Paul police officer, was informed by his doctor at Regions Hospital that his November medical appointment would have to be rescheduled, he asked for a date early next year. HealthPartners, his medical system, denied the request.

“I asked to reschedule in January and they said no, because my insurance wouldn’t be accepted,” said Jacobsen, a former president of the St. Paul Police Federation and current secretary of the St. Paul Police Retirement Association. “I’ve gone to Regions Heart Center since 2000, when I had my heart attack. I’ll need to find a different cardiologist now.”

Jacobsen isn’t alone. Thousands of fellow public retirees insured by UnitedHealthcare may soon be in the same boat.

“From our end on the retirement association, we’ve had three people — myself included — that were denied appointments in 2025,” he said.

Impasse shows no sign of ending

In July, HealthPartners notified some 30,000 seniors enrolled in UnitedHealthcare’s Medicare Advantage program that it will no longer accept their insurance next year, effectively excluding them from sites such as Regions Hospital in St. Paul and Lakeview Hospital in Stillwater. Come January, even established patients who show up willing to pay extra for out-of-network care with their long-standing doctors will be turned away, according to the health care provider.

That news sent a chill through thousands of retired public employees who have earned retirement benefits through Ramsey County, the city of St. Paul, St. Paul Public Schools and the Metropolitan Council, among other public employers. Bloomington-based HealthPartners has accused UnitedHealthcare, a Minnesota-based for-profit health insurer, of aggressively denying claims at rates up to 10 times greater than other insurers, while offering limited reimbursement for medical services.

UnitedHealthcare and others have raised the possibility that the hospital network is bluffing and will not turn anyone away in 2025. But the impasse has shown no signs of thawing. A spokesperson for HealthPartners said Wednesday that he had no information to add to the statement issued in July.

In an email Thursday, UnitedHealthcare spokesman Cole Manbeck said: “We recently met with HealthPartners. We continue to remain at the negotiating table with the goal of renewing our relationship. We hope HealthPartners continues to engage with us and works toward a new agreement that ensures continued access to the health system for people enrolled in our Medicare Advantage plans.”

Essentia Health, a Duluth-based health system, announced in recent weeks that it also would drop UnitedHealthcare come January.

“For patients who are covered by UnitedHealthcare’s Medicare Advantage plan, we will no longer schedule any appointments that occur after Dec. 31,” reads Essentia’s announcement, which was posted this month to its website. “In evaluating UHC’s Medicare Advantage plan, we found excessive prior authorizations and denial rates for patients who are covered by the plan.”

District, teachers ask AG to intervene

With few other options, the St. Paul school district sent its retirees a four-page letter this month, dated Sept. 9, urging them to contact the Minnesota Attorney General’s Office and ask state powers to intervene. The letter, signed by Patricia Pratt-Cook, executive chief of human resources, noted the school district’s retiree benefits are backed by $15 million in taxpayer funds, and switching insurance providers is a complicated process that involves a request for proposals and some eight to 12 months of administration.

About 2,300 out of 3,500 retired St. Paul Public Schools employees are impacted by the impasse between HealthPartners and UnitedHealthcare, according to the district.

The school district did explore the possibility of issuing an expedited request for proposals.

“Even with a compressed timeline, we would not be able to complete the process prior to January 1,” reads the letter. “We’ve also asked that our retirees reach out to the Minnesota Attorney General’s Office because the volume of your many voices carries weight.”

The school district also shared with retirees a side-by-side comparison between their Medicare Advantage and a Medicare Supplement plan, which would offer the group fewer benefits for higher premiums.

“I’ll be honest. It’s frightening for our seniors,” said John Thein, the school district’s interim superintendent, in an interview Friday. “There are some options, but those are not exactly what our retirees would want.”

St. Paul Retired Teachers Inc., a charitable nonprofit led by former teachers, also began circulating a form letter on Sept. 13 for retirees to send to the attorney general’s office and their state senator or state representative.

“(St. Paul Public Schools) retirees were promised a certain level of healthcare benefits, often in exchange for accepting smaller salary increases during our working years,” reads the letter. “We also paid higher premiums than many surrounding districts to ensure access to quality healthcare in retirement.”

“Many of us have been with the same healthcare providers for over a decade, during which time our health conditions have become more complex,” it goes on to say. “These doctors know our medical histories intimately and are crucial to managing our ongoing health needs. … It is unfair to force retirees to abandon trusted providers simply because of insurance coverage changes.”

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St. Paul, Ramsey County retirees also impacted

Of the 2,190 city of St. Paul retirees using the UnitedHealthcare Medicare Advantage plan, 1,000 of them selected HealthPartners/Park Nicollet as their provider, according to the mayor’s office, and those 1,000 retired workers represent all city departments. The city is contracted with UnitedHealthcare through 2025.

“For the two largest healthcare networks in our state and region to walk away from negotiations without a solution for our retirees is unacceptable,” said St. Paul Mayor Melvin Carter, in a written statement last month. “We count on our partnership with UnitedHealthcare and HealthPartners and expect them to go back to the table to keep their promises to our retirees.”

The plan also insures a total of 2,480 former Ramsey County workers and their spouses, and 45% of them visited a HealthPartners provider this year, according to data provided by the county.

Ramsey County Board Chair Victoria Reinhardt, who is about three months from retirement, said the county is in negotiations toward solutions on all sides.

“We care about our retirees. We are working on what that would look like. Honestly, we don’t have answers to that. But we are working on it,” Reinhardt said. “What would be the really best thing is if UHC and HealthPartners came to a solution.”

Legal fights, protests dog UnitedHealthcare

City and county retirees have noted that switching insurance providers on their own during open enrollment — which runs from Oct. 15 through Dec. 7 for Medicare beneficiaries — can have huge consequences, including losing benefits they’ve accrued through years, if not decades, of public employment.

“If I take on an insurance plan or insurance supplement on my own, I permanently lose my retirement health coverages currently received through the city,” said Rick Anderson, a retired employee from the city of St. Paul. “I am bound to take whatever plan the city chooses.”

“As the end of the year approaches, it is more concerning each week,” Anderson added. “HealthPartners is my primary provider for health care, so losing my ability to use them is upsetting, to say the least. For retirees, continuity of care is extremely important to us.”

Controversy surrounding UnitedHealthcare isn’t new. The Minnetonka-based for-profit multinational corporation is one of the world’s largest companies by revenue, and its practices have drawn tough scrutiny from the U.S. Department of Labor and other interested parties.

National health insurance carriers like UnitedHealthcare entered the Minnesota market after the Republican-controlled Legislature lifted the 40-year-old state ban on for-profit health insurance in 2017. A new state law takes effect next year re-implementing a key aspect of the ban — barring for-profit HMOs from running Medicaid health plans — though UnitedHealthcare has filed suit against the state to prevent its enforcement.

The U.S. Department of Labor last year sued UMR, a third-party administrator and UnitedHealthcare subsidiary, for allegedly denying thousands of patients’ payments for emergency room services and urinary drug screenings. The lawsuit was filed in U.S. District Court for the Western District of Wisconsin.

Also in 2023, patients enrolled in a UnitedHealth Medicare Advantage plan and their families filed a class-action lawsuit against UnitedHealthcare and its subsidiary NaviHealth for cutting off payment for rehab care based on what they alleged was faulty direction from the company’s artificial intelligence software, known as “nH Predict.” The lawsuit, which could potentially involve thousands of patients, was filed in the U.S. District Court for Minnesota.

In July, 11 people were arrested for blocking the street outside the UnitedHealthcare headquarters in Minnetonka during a sizable street demonstration against claim denials. The People’s Action Institute’s “Care Over Cost” campaign drew some 150 protesters.

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The Lynx were right around 50-1 odds to win the WNBA championship at the start of this season.

Which added up. Minnesota was a sub-.500 team a year ago that was bounced out of the first round of the playoffs. The pieces were present on the roster to have a good year in 2024, but certainly not to compete with the league’s “super teams” like New York and Las Vegas.

But then the Lynx won the Commissioner’s Cup — beating the Liberty, no less — and downed the Aces in convincing fashion in Vegas. Minnesota opened the season 13-3.

And, since coming out of the Olympic break, the Lynx have been even better. Frankly, they’ve been the best.

Subtract their loss in the season finale Thursday, in which they heavily managed minutes with their playoff seed secure, and the post-Olympic Lynx went 13-1 with the WNBA’s second-best offense (108 points per 100 possessions), third-best defense (97) and second-best net rating (11.0, which trailed only New York).

It was exactly the push Minnesota (30-10) needed to lock up the No. 2 seed heading into the WNBA playoffs, which open at home at 4 p.m. Sunday for Game 1 of a best-of-3 first-round series against with Phoenix.

Should the Lynx simply take care of business at home over the first two rounds of the postseason, they would find themselves in the WNBA Finals.

How did they get here?

Minnesota has just one superstar player — and an underrated one at that in Napheesa Collier, who might be the game’s premier two-way player.

But all of the surrounding pieces have perfectly snapped into the puzzle, from the shooting of Kayla McBride and Bridget Carleton to the playmaking of Courtney Williams and the toughness of Alanna Smith. Everyone on the roster defends at a high level, and everything else seems to fall into place.

That’s a beautifully rare occurrence in basketball, one made far more plausible by the relationships established within the roster.

“It’s really fun to be on this team,” Collier said.

More specifically, it’s the most fun the 27-year-old forward has had in the WNBA. She quickly realized upon her arrival in the pros that “hangouts” wouldn’t be nearly as frequent as they were in college, when those types of gatherings are all-but mandatory. Nothing is forced in Minnesota, but the bonding this season is similar for Collier to the experience garnered at the amateur level.

“With us, we’re always going to dinner or we have barbecues or we’re just hanging out together,” she said. “I think that just shows how much we genuinely like each other.”

Those off-the-court relationships translate onto the court. McBride can feel it in the team’s connection in the huddles and within the flow of the games. If a problem arises, players solve it together.

“There’s never anybody pointing fingers or anything like that. Everybody is very selfless, we’re all here for the same mission, which is to go out and win each and every game we play,” McBride said. “That becomes a lot of fun, because you’re just competing your (butts) off for 40 minutes, and hopefully you come out on top. That’s what we’re doing, and we’re having a lot of fun doing it and enjoying playing with each other, and that’s the best part.”

Both McBride and Collier believe it’s that chemistry that’s allowed the Lynx to exceed outside expectations and insert themsolves smack dab in the center of championship contention.

And it’s also what could potentially help the Lynx navigate what they anticipate — and hope — will be a marathon WNBA postseason run that awaits them.

“We want this so bad for each other,” Collier said, “because we genuinely just really love and like each other.”

Amy Lindgren

How long is too long for a job search to go on? The answer is personal, but I can almost guarantee that no one’s ideal is four years. Or two years, or even one. Nor would I find many takers if I said: You’ll have a job, but you might need 2,200 applications to do it.

These are the kinds of numbers presented in recent Business Insider articles by Tim Paradis, where he interviewed what he calls “job-search long-haulers” — individuals whose job searches have dragged on without success.

As a backdrop to the personal stories, Paradis cites contributing factors, such as the change in employer hiring patterns and the impact of inflation on the job market. He also describes recruiter practices that can thwart job seekers, such as the use of fake postings and excessively long interview cycles.

These points are well-taken but they are not the crux of the problem. The stories themselves are heartbreaking, so I’m not going to describe what any particular person might have done “wrong” in racking up enormous numbers of applications or years in the search. They undoubtedly did and are doing what they think best.

But most job search strategists can tell you pretty quickly that something is indeed wrong with a search that produces so little after so long. Everyone has a suggestion, so I’ll tell you mine. If your job search is dragging on — which I would count as anything past about three months — it’s time to look under the hood and start tinkering.

First, yes, I did say three months. I’ve been doing this work through good times and bad, recessions and boom eras and I’ll stick by that timeline. A job search can be successfully completed in three months. But if you want that outcome, you’ll need to revisit the concept of the search itself.

It will help to start calling your search a project. Or, a job search project if you prefer.

Why? Because a project, by definition, has an end. It’s driven by process and guided by an initial assessment of resources, timeline and goals. You don’t need the modern language of project management to adopt the concept. Just think “beginning, middle, end.”

Beginning encompasses the planning stage, when the direction for the project is set, along with parameters such as timeline and resources. Middle is the primary period of implementation, when the project is underway. It should be punctuated with milestones or review points, to ensure things are still headed in the right direction or to accommodate new information, such as the effectiveness of specific steps. And the end is the wrap-up stage, where the objective is in hand or in sight.

Now to parse the concept of process. Process is based on strategic, productive steps that are repeated in a consistent and measurable manner. When process meets project management, it becomes the engine pushing the project forward.

And this matters to job search why? Because too often candidates will try to move forward with only half the formula. But process alone is really just unguided activity, while project alone is just a set of ideas. Without a plan and the steps to make it happen, the search will likely fail, or yes, drag on interminably.

Once you’ve committed to job search as a process-driven project, you can adopt the concept of milestones as well. These checkpoints provide the opportunity / obligation to pause so you can assess how things are going.

That sounds simple, but it’s a key step that is largely missing when candidates plow forward without a plan. With a project mindset, you’re deciding in advance that you’ll review your situation in x weeks. When that time comes, if you haven’t hit one of the goals you’ve set, stopping to troubleshoot is built into your plan.

Time is also a critical measure because it connects to the job seeker’s stamina. In a long search, things begin to grind down. The candidate’s energy shifts, their confidence drops, their contacts grow weary, the market changes, and, frustratingly, credentials and related experience fade in relevance.

Stopping to review in a timely fashion — and then adjusting course — is one of the best ways I know to keep a job search from ballooning into hundreds of applications or years of effort.

Next week’s column will take a closer look at the actual project and process of job search, from the initial plan to the troubleshooting. This will help demonstrate how a job search can switch from a life sentence to a short-term project.

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Amy Lindgren owns a career consulting firm in St. Paul. She can be reached at alindgren@prototypecareerservice.com.