Provider Networks and Member Benefits
For plan details and complete lists of the commercial plans offered, see:
- 2024 Summary of Companies, Lines of Business, Networks, and Benefit Plans
- 2023 Summary of Companies, Lines of Business, Networks & Benefit Plans
For some ConnectiCare benefit plans, members are allowed to see some providers contracted with EmblemHealth using their in-network benefits. Similarly, some EmblemHealth benefit plans let their members see certain ConnectiCare providers using their in-network benefits. The summaries linked above indicate which networks and benefit plans this reciprocity applies to.
To easily determine if you or a provider you work for is in-network for a ConnectiCare or EmblemHealth member, use the Check Provider Network Status tool in the Member Management section of the provider portal.
New in 2024: Value Network
Starting Jan. 1, 2024, ConnectiCare will launch a new tailored network called “Value” that will be offered to commercial large group and individual members who purchase health benefit plans from ConnectiCare Insurance Company, Inc. through Access Health CT.
Our Value Network features a tailored network that is a subset of our commercial Choice Network. It may be the right solution for individuals who can choose care options within a more localized area. All Value Network providers are located in Connecticut. There is no reciprocity with EmblemHealth’s networks.
ConnectiCare member ID cards will clearly indicate whether a member has selected the Value Network. Members do not need a primary care provider (PCP) and do not need referrals to see specialists in this network.
Choice Network
The benefit plans that use the Choice Network let members manage their health their way. They may use any of the doctors, hospitals, labs, and facilities in our large network covering Connecticut.
Members do not need a PCP and do not need referrals to see specialists in this network.
FlexPOS Network
The benefit plans that use the Flex Network give members the most flexibility with state, regional, and national network coverage through First Health.
First Health is the national provider network for FlexPOS benefit plans, giving members coverage where they live, work, and travel.
Members do not need a PCP and do not need referrals to see specialists in this network.
Compass Network
With plans that use the Compass Network, members can lower their out-of-pocket costs by visiting preferred PCPs and hospitals within the network. All others are designated as participating. Members can visit participating PCPs and hospitals too, but they may pay more.
PCPs, preferred and participating, can see the members assigned to them by running a PCP Member Panel report in the provider portal.
Passage Network
The plans that use the Passage Network rely on PCPs to actively manage the care of an assigned panel of members. PCPs can see the members assigned to them by running a PCP Member Panel report in the provider portal.
Referrals to specialists through the provider portal are required for certain specialty care. See Provider FAQs: Passage Plans to learn more about managing members within the Passage Network.
See: Creating Referrals using Member ID or Name for the steps to create a referral and Search Referrals by Member ID or Name for the steps to find a referral in the provider portal.
