Here are some of our most frequently asked questions. Responses are “general” in nature. For complete benefit information, please refer to your Benefit Summary or Membership Agreement. If you have additional questions regarding benefits, please e-mail us at info@connecticare.com or call Member Services at 1-800-251-7722.
What ConnectiCare SOLO plan options are offered and how do they compare?
Why should I choose ConnectiCare over other competing health insurance companies?
How do I find out more information about ConnectiCare SOLO, including rates and how to apply?
I just received a request for proof of my child's student status. What should I do?
What happens if I move out of state?
II. Payments/Premiums
How will I be notified about rate increases?
How and when can I apply for Electronic Funds Transfer (EFT)?
How do I pay my premium by credit card?
Where do I mail my premium payment?
III. Benefit Coverage
What do I do if I am out of the service area and become ill or injured?
If there are changes in my benefits, how and when will they be communicated to me?
IV. Renewal
Can I switch to another plan at renewal time?
V. Adding/Removing Dependents
What if I have a baby? How do I enroll the baby for coverage?
What if I adopt a child? How do I enroll the adoptive child for coverage?
How can I add other dependents?
How can I terminate coverage for a dependent?
We offer a full range of options to choose from, including HMO Open Access, HMO Open Access Up-Front Deductible and Point-of-Service Open Access - Up-Front Deductible Plans. ConnectiCare Solo also offers two High-Deductible Health Plan products that are compatible with Health Savings Accounts (HSAs). HSA compatible products include an HMO Open Access - High-Deductible Health Plan and a Point-of-Service Open Access - High-Deductible Health Plan.
The HMO Open Access plan allows you to see any specialist provider who participates in our network without first obtaining a referral from your primary care physician (PCP).
The HMO Open Access - Up-Front Deductible plan is the same plan described above, but with a calendar year individual deductible and family deductible that must be met before the plan begins to provide benefits. The deductible does not apply to some preventive care or prescription drugs.
The Point-of-Service Open Access - Up-Front Deductible plan provides you with the greatest freedom of choice in-network and out-of-network. You can use our participating providers to receive the highest level of benefits, or you may choose to go out-of-network to visit a doctor of your choice and receive a lower level of benefits. This option has an up-front, in-network plan deductible for individual and family and a separate out-of-network plan deductible for individual and family. These calendar year deductibles must be met before the plan begins to provide benefits. (In-network plan deductible does not apply to some preventive care or prescriptions.)
The HMO Open Access - High-Deductible Health Plan is HSA compatible and allows you to see any specialist provider who participates in our network without first obtaining a referral from your primary care physician (PCP). There is a calendar-year individual deductible and family deductible that must be met before the plan begins to provide benefits. (Deductible does not apply to some preventive care.)
The Point-of-Service Open Access - High-Deductible Health Plan is also HSA compatible and provides the greatest freedom of choice in-network and out-of-network. You can use our participating providers to receive a generally higher level of benefits, or you may choose to go out-of-network to visit a doctor of your choice and receive a generally lower level of benefits. This plan has an up-front in-network plan deductible for individual and family, and a separate out-of-network plan deductible for individual and family. These calendar-year deductibles must be met before the plan begins to provide benefits. (In-network plan deductible does not apply to some preventive care.)
For details and a quote, call your insurance agent or call 1-866-999-SOLO (7656).
ConnectiCare is your health plan solution for the following reasons:
Plan Options as Individual as You
We believe that you should have a full range of options to choose from. That's
why we offer different ConnectiCare Solo plan designs, each featuring a broad
range of benefits and convenient access to the more than 20,000 participating
providers in our network. Working with your agent or broker, you simply pick
the option that best fits your personal needs.
Nationally Recognized Quality
ConnectiCare has been ranked #5 of 250 health plans by U.S. News & World Report/NCQA America’s Best Health Plans 2007. The annual rankings are based on industry standards for quality and customer satisfaction. ConnectiCare has been ranked among the the nation’s top health plans three years in a row and continues to be the highest-ranked plan in Connecticut. In 2006, ConnectiCare received an “Excellent with Distinction in Member Connections” designation from the National Committee for Quality Assurance (NCQA) - the industry standard for quality.
Superior Service
We received the highest member satisfaction score for customer service and claim payments of any health plan in Connecticut, according to the 2006 Consumer Assessment of Health Plans Survey (CAHPS).
Distinguished Health Management
We were one of the first health plans in the nation to receive NCQA accreditation for disease management programs, which help members with asthma, chronic obstructive pulmonary disease (COPD), diabetes, heart disease and high-risk pregnancy (only applies to plans with maternity coverage).
Health-Related Discounts
As a ConnectiCare member you will enjoy discounts on a host of products and
services that help you stay healthy, including LASIK eye surgery, fitness
center memberships, massage therapy, weight management programs, and much more.
Credit Card Acceptance
With ConnectiCare Solo you are able to make your monthly premium payments online for added convenience using VISA© or MasterCard© .
Web Site Resources
We offer an easy-to-navigate member Web site containing many interactive tools
to help you manage your health care benefits. Our expanded ConnectiCare member
site lets you do what used to require a phone call, a letter or a visit - all
from the convenience of a personal computer. To take advantage of the many
interactive tools offered, simply register online. It takes only a minute. Then you can start using our site to find doctors and other health care providers, health news, health trackers, online learning opportunities, and so much more.
Please contact your insurance agent or call 1-866-999-SOLO (7656).
In order to be eligible for coverage with ConnectiCare your overage dependent must be a full time student. You can verify full time student status online by clicking here: Online Student Verification. Or you can complete the Student Verification Form, sign and date it and mail it to the address provided on the form.
What happens if I move out of state?
HMO members who move out of state and are no longer Connecticut legal residents will not continue to be eligible for the HMO plan. POS members who move out of state and are no longer Connecticut legal residents may be able to continue their POS plan. But they will have to pay higher out-of-pocket costs for covered services rendered by non-participating providers.
Premium payment is due and payable on the first of the month for which coverage is applicable. You will receive your premium payment invoice on or around the 15th of the month prior to the payment due date.
We may increase premium rates at the time of renewal or when otherwise mutually agreed upon. We may also increase premium rates if benefits under the Plan are changed due to state or federal mandates. The effective date for such change in premium rates will be the same as the effective date of such change in benefits.
You will be notified in writing at least 30 days in advance, if and when this occurs.
To apply for EFT, you can complete the EFT form and attach a voided personal check. You should send this information to:
| ConnectiCare, Inc. and Affiliates
Attn.: Billing/EFT 175 Scott Swamp Road PO Box 4050 Farmington, CT 06034-4050 | |
Once we have processed the request, we will notify you of the effective date. You must continue to pay your premium by check until you have been notified of the EFT effective date. You can apply for EFT with your application or anytime after you are accepted as a member.
ConnectiCare SOLO members are now able to make their monthly premium payments with VISA or MasterCard. Some health plans accept credit cards for your enrollment premium only, then it’s invoices and checks. But ConnectiCare SOLO makes it easy-you can use your credit card every month!
It’s simple. Just log onto our secure member site and enter your user name and password. (It takes just a minute to register if you’re a new online user.) Under "Get Information About Your Plan" select "Billing Invoice & Credit Card Payment".
Premium payments should be mailed to ConnectiCare, Inc., P.O. Box 30726, Hartford, CT 06150
If you are out of the service area, you are covered for any sudden onset of injury, illness or emergency. You are required to obtain a bill from the doctor. If services are received out of the country, have the bill translated into English and converted into American dollars. Then submit the bill to ConnectiCare for reimbursement, using the Out-of-Area Reimbursement Form.
Changes in benefits will be communicated to you via an amendatory rider to the Plan Membership Agreement or Certificate of Coverage, well in advance of such benefit change.
The plan renews on the annual renewal date—usually January of each year. You will be notified of any rate increases at least 30 days before their effective date. Rate increases and plan changes that will be effective upon the annual renewal will be communicated during the Open Enrollment Period, which is in November of each year for a January effective date.
Each November, during the Open Enrollment period, you will have the option to select a new plan offered by ConnectiCare. If you select a plan with richer benefits, you will be required to complete a new Individual Health Statement, and you will be subject to underwriting review.
You and your covered spouse/domestic partner’s newborn natural child receives coverage for the first 31 days after birth. Coverage for the child will end at the earlier of your termination of coverage or the end of this 31-day period, unless you have submitted an application to us, paid the additional applicable premium, if any, and we have approved such application within 31 days of the birth. If your newborn natural child is not added to the plan within the 31-day period and additional premium is required, you must submit an Individual Health Statement with the Individual Application/Change Form for your new dependent. Acceptance of your dependent is subject to medical underwriting. If approved, coverage will become effective on the first of the month following approval.
You and your covered spouse/domestic partner’s adoptive child receives coverage for the first 31 days after the date of adoption or the date on which you, your spouse, or domestic partner become at least partially legally responsible for the adopted child’s support and maintenance and the child lives with you, even though the adoption has not been finalized. Coverage will end at the earlier of your termination of coverage or the end of this 31-day period, unless you have submitted an application to us, paid the additional applicable premium, if any, and we have approved such application within 31 days of the adoption. If your adopted child is not added to the plan within the 31-day period and additional premium is required, you must submit an Individual Health Statement with the Individual Application/Change Form for your new dependent. Acceptance of your dependent is subject to medical underwriting. If approved, coverage will become effective on the first of the month following approval.
To add a new spouse or domestic partner or other dependent child (other than a newborn or adoptive child), you need to complete an Individual Application/Change Form along with an Individual Health Statement for your new dependent. You must return the forms to your agent/broker or directly to us. Acceptance of your dependent is subject to medical underwriting.
You must notify us immediately of any change that may affect you or your dependents covered under this Plan. You can request these changes on an Individual Application/Change Form, which must be returned to your agent/broker or directly to us. Requests for termination of coverage will be effective on the last day of the month in which we receive your request.
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