ConnectiCare plans to offer commercial group and individual customers a new line of health plans with preferred primary care providers (PCPs) and hospitals. The new Compass plans, available for start dates of Jan. 1, 2021 and later, are one of the ways we are working to help employers and individuals under age 65 manage their out-of-pocket costs.
Compass plan members who visit “preferred” primary care providers (PCPs) and hospitals will have lower cost shares — copays, coinsurance and/or deductibles — as outlined in their plan documents. Providers in the ConnectiCare commercial network will participate in Compass plans and appear in provider directories published for plan members.
Compass plan preferred providers as of Jan. 1, 2021 will be PCPs who participate in commercial Passage plans and selected hospitals from each county in Connecticut. All specialists and ancillary providers will be preferred providers.
It’s important to note:
- There will be no differences in reimbursement for preferred and participating providers; all will be reimbursed according to their current ConnectiCare contractual fee schedule.
- All non-preferred PCPs and hospitals will be available to members as participating providers.
- Compass plans will not require PCP referrals to specialists.
Designation of preferred PCPs and hospitals was determined through analysis of cost and objective third-party quality data. For hospitals, cost indices included inpatient and outpatient services and were adjusted for case mix.
Compass preferred-provider designations will be reviewed and revised annually. Compass plans will be available to individuals and families enrolled in ConnectiCare plans sold through Access Health CT and plans available to employer groups. Medicare Advantage plans are not affected.
We created Compass plans in response to market forces. Customers are seeking relief from costs while maintaining quality of care.