In 1981, ConnectiCare was born with the mission of establishing a health plan that would truly care about improving the health of its members. ConnectiCare still lives by that same mission, serving more than 240,000 individuals in Connecticut and Western Massachusetts.

ConnectiCare offers a full range of health insurance products including newer ones such as health savings accounts and individual insurance. We continually develop new products to meet the changing demands of consumers, government, and business.

About ConnectiCare

ConnectiCare’s focus is on meeting customers’ needs. They’re introducing innovative products, delivering strong customer service and providing easy-to-understand information. The result: a wide range of health and benefits options that deliver a valuable difference.

ConnectiCare is the only Connecticut health plan ranked in the top 10 (they are also the only for-profit health plan in the top 10), and in 2007, ConnectiCare was ranked #5 on the U.S. News and World Report/NCQA list of America’s Best Health Plans. They aim to remain one of the best plans in America and continue to provide our customers with an exceptional customer experience.

ConnectiCare, Inc.

Corporate Headquarters:
175 Scott Swamp Road
P.O. Box 4050
Farmington, CT 06034-4050
CEO:
Mickey Herbert
Employee Number:
500+
2008 Revenue:
$860 million

Product Types Offered

Individuals

ConnectiCare offers Health Products for individuals, families and sole proprietors under the age of 65 and not eligible for Medicare.

HMO Open Access
No referral is necessary, as long as you're seeking care from participating practitioners and provider facilities in their network.

Point-of-Service (POS) Open Access Plan
Although you don't need a referral before seeking services, choosing participating practitioners and provider facilities in their network will assure you of the highest level of benefits.

HMO Open Access High Deductible Health Plan (HSA Compatible)
Allows you to see any specialist provider who participates in their network without first obtaining a referral from your primary care physician. There is a calendar-year or contract year deductible that must be met before the plan begins to provide benefits. The deductible does not apply to some preventive care services.

POS Open Access High Deductible Health Plan (HSA Compatible)
This product provides you with the greatest freedom of choice in-network and out-of-network along with HSA compatibility. You can use their participating providers to receive a higher 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. There is a calendar-year or contract year, in-network deductible and a separate out-of-network calendar-year or contract year deductible. These deductibles must be met before the plan begins to provide benefits. The in-network deductible does not apply to some preventive care services.

ConnectiCare Flex POS Plans
These are a series of POS plans that allow for in-network coinsurance and/or a combination of copayment and coinsurance features to help reduce health care costs.

ConnectiCare Network USA
PPO Plan This Preferred Provider Organization (PPO) Plan gives you the freedom to choose any doctor from the PPO participating provider network and receive a higher "in-network" level of benefits. You also have the option of choosing non-participating providers, although you will receive a lower, "out-of-network" level of benefits. In either case, no referral is required.

Employers

A primary business focus is meeting the insurance needs of small group employers. To accomplish this, ConnectiCare works closely with the Chambers of Commerce and the Chamber Insurance Trust to develop products that offer a variety of affordable plan options.

ConnectiCare plans are designed to fit your needs. Through their association with brokers and business organizations, they’re able to offer uncommonly affordable and flexible plans. All ConnectiCare plans feature easy access to participating providers within our network, comprehensive coverage and worry-free customer service.

ConnectiCare offers the following plans:

HMO Open Access (HMO-OA)
With this plan members can see any specialist provider within our network without first obtaining a referral from their primary care physician.

HMO Personal Care Plan (HMO-PCP)
Members must select a PCP and obtain a referral to seek specialty services in-network. If you're looking for the best value for your health plan dollar, this is one option worth looking into.

Point-Of-Service Open Access Plan (POS-OA)
This plan provides members with the greatest freedom of choice in-network and out-of-network. Members can use our participating providers to receive the highest level of benefits, or they may choose to go out-of-network to visit a doctor of their choice and receive a lower level of benefits. In either situation, no referral is required.

Point-Of-Service Personal Care Plan (POS-PCP)
In this plan members must receive a referral form a participating physician when they seek specialty services in-network to ensure they receive the highest level of benefits. If a member receives services without a referral or obtains services from a nonparticipating provider, they'll receive a lower level of benefits.

ConnectiCare Network USA (PPO Plan)
ConnectiCare is pleased to also provide a PPO plan, for Connecticut-based employers that provides ConnectiCare value and service beyond our borders. The ConnectiCare Network USA - PPO plan is available to large and small-group employers alike. Members have the option to choose any doctor from the PPO participating provider network, without a referral, and receive maximum coverage. Members will also have access to out-of-network providers; however, they may receive a lower, out-of-network level of benefits.

Medicare Plans

Consumers looking for a Medicare Advantage product will find many options to match their health insurance needs from ConnectiCare. Individuals, who enroll in our Medicare Advantage plans, will receive all the benefits of original Medicare plus benefits such as disease management programs, health and wellness support, limited dental benefits and more. The program called “ConnectiCare VIP Medicare” will have a range of product and pricing options including HMO, Private Fee-For-Service, and a Diabetes Special Needs Plan.

Provider Network

ConnectiCare has one of the Connecticut’s biggest provider networks. You can use ConnectiCare’s online provider directory, to learn more about doctors, hospitals, other medical services, dentists, vision care providers and pharmacies that work with your ConnectiCare plan.

Network Facts

ConnectiCare, Inc. serves approximately 240,000 members along with its affiliates:

• ConnectiCare of Massachusetts, Inc.
• ConnectiCare Insurance Company, Inc.

They serve in the following areas:

• Connecticut
• Western Massachusetts in Berkshire, Hampshire, Hampden, and Franklin Counties

ConnectiCare’s provider network includes:

• 33,869 health care providers
• 127 hospitals
• All 30 Connecticut hospitals

Recent News

Here are some of the most recent news regarding ConnectiCare:

ConnectiCare Launches Web Tool for Doctors and Hospitals
“Provider Connections” gives instant answers to your patient questions

Farmington, CT – ConnectiCare has launched a real-time information web tool for providers called “Provider Connections.” The web portal was built to better communicate patient benefit information and reduce administrative tasks for participating providers, doctors and hospitals. Provider Connections is now available to providers at our website - www.connecticare.com.

Provider Connections gives providers direct access to critical information 24 hours a day. The web portal is an easy way to access and verify member eligibility, member benefits, claim status, submit new referral requests, inquire about an existing referral, view explanation of payment statements, seek credentialing for new doctors, and view ConnectiCare medical and pharmacy policy criteria.(Continue Reading)

Rating

ConnectiCare’s rating, as rated by A.M. Best Company. A.M. Best Company is a full-service credit rating organization dedicated to serving the financial services industries, including the banking and insurance sectors.

Financial Strength Rating
Rating: B (Fair)
Financial Size Category: VIII ($100 Million to $250 Million)
Outlook: Negative
Action: Downgraded
Effective Date: May 29, 2009