Tenet Healthcare (Conifer Health Solutions) Layoff 2026: What Employees Need to Do This Week

A layoff notice from Tenet Healthcare (Conifer Health Solutions) starts five time-sensitive clocks that most employees do not know about. On September 10, 2026, Tenet announced it is cutting more than 1,000 positions at Conifer, its revenue cycle management subsidiary, after CommonSpirit Health ended one of the largest contracts in Conifer's history. If you are one of those employees, the decisions you make in the next few days will affect your income, your health coverage, and your taxes for the rest of this year.

What happened

Tenet Healthcare announced on September 10, 2026 that Conifer Health Solutions is laying off more than 1,000 employees. The cuts follow CommonSpirit Health's decision to end its contract with Conifer, one of the subsidiary's largest revenue cycle management agreements. Conifer handles medical billing, coding, and patient financial services for hospital systems across the country. The loss of the CommonSpirit contract forced Tenet to reduce Conifer's workforce significantly.

What should you do about unemployment first?

Unemployment insurance is a state benefit that replaces a portion of your wages while you look for work. In Texas, you apply through the Texas Workforce Commission.

File the same day you are separated, or the morning after. Texas unemployment benefits are not retroactive to your last day of work -- they start from the week you file. Every week you delay is a week of benefits you do not get back.

Here is how to file:

• Online: ui.texasworkforce.org (fastest option)
• Phone: 800-939-6631 (expect hold times after a large layoff announcement)

Texas's maximum weekly unemployment benefit is $577, according to the Texas Workforce Commission.¹ Your actual benefit depends on your prior wages. TWC calculates it using your highest-earning quarter in the base period -- generally the first four of the last five completed calendar quarters before you file.

A few things to have ready when you apply: your Social Security number, your Tenet employee ID or last pay stub, the name and address of your employer, your reason for separation (reduction in force / layoff), and your bank account information for direct deposit. Texas requires identity verification through TWC's online portal. Have a government-issued ID ready.

If Tenet is paying you severance, it may affect your benefit amount depending on how it is structured. Lump-sum severance generally does not reduce Texas UI benefits, but salary continuation payments can. Ask TWC directly when you file -- do not guess.

What should you do about your severance agreement?

A severance agreement is a contract. In exchange for a payment, you typically waive certain legal claims against the company. Do not sign it the day you get it.

Because Conifer is laying off more than 1,000 employees at once, this qualifies as a group termination program under the Older Workers Benefit Protection Act (OWBPA). If you are 40 or older, federal law requires that Tenet give you at least 45 days to review the agreement before you sign.² That is not a courtesy -- it is a legal requirement. An agreement signed under a shorter deadline is not enforceable.

If you are under 40, there is no federally mandated review period, but you should still take time to read it carefully before signing.

After you sign, you have 7 more days to change your mind. The 7-day revocation window applies to workers 40 and older and cannot be waived.² The agreement does not become legally effective until those 7 days pass.

What to look for in the agreement:

• The payment amount and when it arrives
• Which claims you are releasing (broad waivers are common -- get specifics)
• Non-disparagement and non-compete clauses
• Whether Tenet is paying for COBRA continuation or offering anything toward health coverage
• What happens to any accrued PTO

Severance terms at Tenet have not been publicly disclosed for this layoff. That means nothing is off the table for negotiation -- particularly COBRA contribution, outplacement services, or an extended benefits period. HR can rescind informal verbal promises, so get any changes in writing before you sign. You can find a post-layoff checklist at Layoff HQ that covers what to look for section by section.

What should you do about health insurance?

COBRA (Consolidated Omnibus Budget Reconciliation Act) lets you keep your current employer-sponsored health coverage for up to 18 months after you leave. You do not have to re-enroll in a new plan right away.

You have 60 days from the date you lose coverage -- or from the date the COBRA notice arrives, whichever is later -- to elect COBRA.³ If you wait and then decide you want it, coverage applies retroactively to your separation date. That means if you have a medical expense before you elect, you can still elect COBRA and have it covered. Just do not miss the 60-day window.

The cost is real, though. The average COBRA premium for individual coverage in 2026 runs about $703 per month, according to KFF -- that covers the full premium (the share your employer used to pay plus your share) plus a 2% administrative fee.⁴ Family coverage costs significantly more.

Your alternative is the Health Insurance Marketplace. Losing employer coverage triggers a Special Enrollment Period of 60 days, meaning you can sign up for a Marketplace plan outside the normal open enrollment window.⁵ Go to healthcare.gov to compare plans. If your income drops significantly after the layoff, you may qualify for subsidies that make a Marketplace plan cheaper than COBRA.

The practical decision: if you have ongoing prescriptions or upcoming procedures, COBRA keeps you on the same plan with the same network. If you are generally healthy and cost is the priority, price out Marketplace options before you decide. You have 60 days -- use them.

What about severance taxes?

Severance is ordinary income. The IRS taxes it the same way it taxes your paycheck.

When Tenet pays out your severance, it will withhold federal income tax at the supplemental wage rate of 22% -- that is the flat withholding rate for supplemental wages under $1 million, per IRS Publication 15.⁶ If your total income for 2026 pushes you into a higher bracket, 22% withholding may not be enough, and you could owe more at tax time.

The Q3 2026 estimated tax payment was due September 15, 2026.⁷ If you received a lump-sum severance payment and you think you are underwithheld, talk to a tax preparer about whether you need to make an additional payment before January 15, 2027 (the Q4 deadline) to avoid an underpayment penalty.

Texas does not have a state income tax, so you do not need to worry about state-level withholding on your severance. Federal withholding is your only income tax exposure here.

One more thing: if Tenet offers to pay out unused PTO or accrued vacation in a lump sum, that amount is also subject to the 22% supplemental withholding rate. Plan accordingly.

What should you do with your 401(k)?

Your vested 401(k) balance is yours. You have four options when you leave Conifer, and the timing on one of them matters.

Option 1: Leave it in the Tenet/Conifer plan. You can generally keep your money in the plan after you leave, as long as your balance meets the plan's minimum threshold. Check the plan documents -- some plans require you to move funds if the balance is below a certain amount.

Option 2: Direct rollover to an IRA. A direct rollover moves money straight from the Tenet plan to your IRA. No taxes, no penalties, no 60-day clock. This is the cleanest option for most people.

Option 3: Direct rollover to a new employer's plan. If you already have a new job lined up, check whether the new plan accepts rollovers. Same rules as the IRA rollover -- direct transfer, no tax consequences.

Option 4: Indirect rollover (take the distribution yourself). Tenet sends you a check for the balance, minus 20% mandatory withholding. You then have 60 days to deposit the full original amount (including the 20% that was withheld) into a qualified account.⁸ If you do not make up that 20% out of pocket and deposit the full amount within 60 days, the IRS treats the shortfall as a taxable distribution -- and if you are under 59.5, it adds a 10% early withdrawal penalty on top of income taxes. The indirect rollover is rarely the right move. Use a direct rollover if you can.

Do not cash out. The tax hit plus early withdrawal penalty makes a cash-out one of the most expensive decisions you can make during a layoff.

Deadlines and rules described here reflect federal law and general state guidelines as of the article date.

The Layoff Guide

The deadlines above apply whether or not you are tracking them. The Layoff Guide from Layoff HQ is a 33-page field guide that covers all twelve post-layoff deadline events in the order they arrive: unemployment, the severance review and revocation windows, COBRA and the Marketplace, your FSA, your equity window, your 401(k), and your taxes. Each event comes with timed checkpoints, the decision math, and the one mistake that costs people the most, plus a fill-in worksheet that turns your last day worked into your complete personal deadline calendar. One-time purchase. No subscription. Instant download, with a 14-day full refund if it is not useful.

Get The Layoff Guide, $39 or build your free Decision Calendar.