ConnectiCare offers two basic product lines, and a number of plan designs within each of the product lines. Our product lines are as follows:

Employer (Group) HMO Open Access: With this plan, members can go anywhere within our network without first obtaining a doctor referral. Members are asked to choose a PCP.

Employer (Group) Point-of-Service Open Access (POS-OA): This plan gives members the greatest freedom of choice inside our and beyond our network. They can use our participating providers to receive the highest level of benefits, or go out-of-network for a lower level of benefits. In either case no referral is required.

Employer (Group) ConnectiCare Network USA - PPO: This plan is designed for Connecticut based employers with employees who do not have access to ConnectiCare's network. The members can go to providers who are in a national Preferred Provider Organization (PPO) network to receive the highest level of benefits, or go out-of-network and receive a lower level of benefits. The ConnectiCare Network USA plan has a preferred network of providers in many locations.

SOLO (Individual - CT residents only) HMO Open Access: With this plan, members can go anywhere within our network without first obtaining a doctor referral.

SOLO (Individual - CT residents only) Point-of-Service Open Access (POS-OA): This plan gives members the greatest freedom of choice inside and beyond our network. They can use our participating providers to receive the highest level of benefits, or go out-of-network for a lower level of benefits. In either case, no referral is required.

In all products, members are covered for emergency and urgent care both in-network and out-of-network

To review our Small Group (less than 50 employees) Benefit Summaries, click here.

For information on ConnectiCare Dental Plans, please click here.

ConnectiCare utilizes extensive medical management/quality improvement programs, including:

Preventive Services: Members and providers are educated about the importance of regular preventive services through ongoing communications programs. These include reminder card programs and member newsletters.

Health Management: We have introduced comprehensive health management programs for asthma, congestive heart failure, diabetes and high-risk pregnancy. These programs include treatment protocols for providers, extensive member education and telemonitoring.

Worksite Wellness: (Available to large-group employers (51+ employees) only.) There's almost no end to the variety of wellness programs we offer at ConnectiCare. All programs and seminars are led by our dedicated staff of health professionals, who bring them to work sites at convenient times. "Lunch & Learn" is one of our most popular segments, offering serious fare in an easily digested format.

High Marks on Quality Measures for ConnectiCare
The National Committee for Quality Assurance (NCQA), is a private, not-for-profit organization dedicated to assessing and reporting on the quality of managed care plans.

What is NCQA accreditation?
Commonly recognized as an industry "seal of approval," NCQA accreditation enables managed health care consumers to make knowledgeable decisions based on quality of services. For an organization to become accredited by NCQA, it must undergo a rigorous survey and meet certain standards designed to evaluate the health plan's clinical and administrative systems. In particular, NCQA's accreditation surveys look at a health plan's efforts to continuously improve the quality of care and service it delivers.

ConnectiCare's accreditation survey involved a review against more than 60 different standards, each of which focuses on an important aspect of the managed health care organization. These standards fall into six broad categories:

Quality Management and Improvement: Does ConnectiCare fully examine the quality of care given to its members? How well does ConnectiCare coordinate all parts of its delivery system? What steps does it take to make sure members have access to care in a reasonable amount of time? What improvements in care and service did ConnectiCare demonstrate?

Utilization Management: Does ConnectiCare use a reasonable and consistent process when deciding what health services are appropriate for member's needs? Does ConnectiCare protect against under-utilization? Are decisions made by individuals with sufficient expertise?

Credentialing and Recredentialing: Does ConnectiCare meet specific NCQA requirements for investigating the training and experience of all physicians in its network? Does ConnectiCare keep track of all physicians' performance and use that information for its periodic evaluations?

Members' Rights and Responsibilities: How clearly does ConnectiCare inform members about how to access services, how to choose a physician or change physicians, and how to make a complaint?

Preventative Health Services: Does ConnectiCare encourage members to have preventative tests and immunizations? Does ConnectiCare support physician efforts to deliver preventative services? Is there evidence of monitoring of the success of preventative care? Is there evidence of improvement, where monitoring suggests an opportunity?

Medical Records: How consistently do the medical records kept by ConnectiCare's physicians meet NCQA standards?

What does this mean to you?
In order to be awarded accreditation, a plan must have a well-established quality improvement program in place, and meet NCQA's rigorous standards. So, by choosing ConnectiCare, you are choosing an organization recognized for delivering quality health benefit plans to employers throughout Connecticut.

¹ - Not all product lines are available in all states.