C O N N E C T I C A R E
C H O O S I N G
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B E N E F I T S
T H E
T H E
C O N N E C T I C A R E
sourcebook
One of America’s highest-rated health plans
Why is ConnectiCare the right
choice in health plans?
WE HAVE INDUSTRY-LEADING
SERVICE CAPABILITIES
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WE SPECIALIZE IN HIGH-QUALITY
CARE MANAGEMENT
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WE ’RE RESPONSIVE AND ACCESSIBLE
Flexibility is built into our product portfolio
Our plans are designed to fit your needs
Large-group market
Most fully-insured large-group
clients (with 51 or more
employees) have access to our
diverse line of products that
include an array of ConsumerDriven Health Plans (CDHPs)
such as high-deductible health
plans, upfront deductible plans
and hospital deductible plans.
These plans offer large groups
the advantages of low-cost, highquality solutions. We are in the
process of developing a suite of
ConnectiCare® FlexPOS plans
that allow for in-network
coinsurance and/or a combination
of copayment/coinsurance features
to help reduce health care costs.
These will initially be available to
Connecticut large groups. We
also offer a variety of HMO,
POS and PPO plans. And, each
large group has a dedicated
account management team.
We also provide benefit plan
administration solutions for
those companies who choose to
self-insure their employees’
medical expenses through
Administrative Services Only
(ASO) arrangements.
ConnectiCare can help companies
to structure and customize plans
and benefits to fit their needs.
ConnectiCare Dental Plans are
also available for large groups
with more than 50 eligible
employees. Our plans offer
comprehensive coverage at
competitive prices, and can be
customized, like our medical
plans, to fit each group’s needs.
For more information turn to
page 3.
Small-group market
Small-group clients (50 or fewer
employees in Connecticut and
Massachusetts, 2-50 employees in
New York) also have access to
our varied product portfolio.
Connecticut small groups may
soon be able to take advantage
of the benefits and cost savings
associated with the new suite of
ConnectiCare® FlexPOS plans.
In addition, some of our solutions
for small businesses are unique.
ConnectiCare Dental Plans are
also available for small groups
with 10-50 enrolling employees.
Small-group members will enjoy
the same level of benefits as large
groups with our comprehensive
coverage and competitive pricing.
Soon we will also be introducing
a low-option product for five to
nine enrolling members to be
combined in a package with
small-group medical benefits. For
more information turn to page 3.
CIT Program
Small-business owners may
increase their health benefits
buying power, while searching
for lower-priced plans, by participating in one of the chambers in
Connecticut and Massachusetts
associated with the Chamber
Insurance Trust (CIT/CIP).
Our program with the CIT/CIP
provides members the opportunity
to purchase low-cost, high-quality
health plans, such as CDHPs.
Special programs are also available
to small-group employers, with
10 or more eligible employees,
through CIT/CIP, including our
innovative Worksite Wellness
programs. Learn more about
these small-group options by
calling 1-800-953-4467.
CBIA Program
Our relationship with The
Connecticut Business and
Industry Association (CBIA)
provides employers with 3-100
employees access to attractive
ConnectiCare HMO and POS
benefit plans through CBIA’s
Health Connections, Health
Connections 2 and Health
Connections 51 Plus programs.
For more information contact
CBIA at 1-860-244-1900.
• All ConnectiCare plans feature
easy access to participating
providers within our network,
comprehensive coverage and
worry-free customer service.
• Your employees are free to
choose from more than 22,500
participating providers —
including specialists — and 79
acute care hospitals thanks to
our expanded hospital and
provider networks.
All of our plans feature easy access
to providers within our network,
comprehensive coverage and worryfree customer service.
• ConnectiCare covers your
employees and their families
worldwide for emergencies —
wherever they go. We also
cover students away at school
for their emergency or urgent
care needs.
• Expanded online features
include the ability to change
your Primary Care Physician
(PCP), your address, search
our online directory for a
specific physician, and order
replacement ID Cards, all by
visiting our Web site,
www.connecticare.com.
1
ConnectiCare Overview of Products
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Plan Descriptions
Consumer-Driven Health Plans (CDHPs)
These plans can be combined with Health Reimbursement
Arrangements (HRAs) or Health Savings Accounts (HSAs) in
accordance with Department of the Treasury regulations.
•High-Deductible Health Plans (HDHPs)
These are plans in which the plan deductible is applied on a
combined basis for Medical and Pharmacy expenses. These plans
can be used with Health Savings Accounts (HSAs).
•Hospital Deductible Plan
A plan in which, after the hospital deductible is met, benefits
will be paid subject to the member’s payment of his or her costshare amount for ambulatory services (outpatient) and inpatient
hospitalization services. For most other covered health services,
members have a copayment cost-share.
•Upfront Deductible Plan
A plan in which, after the plan deductible is met, benefits will
be paid subject to the member’s payment of their cost-share
amount. Also, some types of preventive care are exempt from the
plan deductible.
ConnectiCare® FlexPOS Plans
These are a series of POS Upfront Deductible Plans that allow for
in-network coinsurance and/or a combination of copayment and
coinsurance features to help reduce health care costs. These plans can
also be combined with Health Reimbursement Arrangements (HRAs).
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HMO Personal Care Plan
A referral from the member’s Primary Care Physician (PCP) or a
delegated program is necessary before using the services of other
participating practitioners and provider facilities.
HMO Open Access Plan
No referral is necessary as long as the member is seeking care from
participating practitioners, including facilities in our network.
Point-of-Service (POS) Personal Care Plan
A referral from the member’s PCP or a delegated program to a
participating provider is necessary in order to receive the highest
level of benefits.
Point-of-Service (POS) Open Access Plan
Members don’t need a referral before seeking services, however, by
choosing participating practitioners and provider facilities within
the network the member will be assured the highest level of benefits.
OOA Plan
ConnectiCare also offers 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 receive a lower, out-of-network level of benefits.
Helping to control premium
costs through CDHPs
We have a selection of Health
Reimbursement Arrangement
(HRA) compatible plans and
Health Savings Account (HSA)
compatible plans that may help
to reduce your premium payments
and empower you to make
decisions on your health care
spending. ConnectiCare has
selected First HSA, one of the
nation’s leading administrators of
health savings accounts, as our
preferred vendor to manage,
administer and service the
HSA plans.
Individual Plans
ConnectiCare® SOLO, our
individual product, offers the
same award-winning personal
service and choice of doctors as do
our group plans. Our individual
products are available for sole
proprietors and small business
owners, part-time and seasonal
employees, even those seeking an
alternative to COBRA. We have
a choice of HMO and POS
open access plans as well as highdeductible products compatible
with HSAs.
Dual and triple options
Dual option
Dual option programs offer the
combination of any two of our
benefits plans to companies with
2-50 eligible employees.
Triple option
Through this expanded product
offering, there’s even greater
flexibility for groups of three or
more enrolled employees. These
groups now have the ability to
choose any three of our health
plan options. (Some exclusions
may apply for groups over
50 employees.)
For more information on any of
these offerings, please contact our
large- or small-group Account
Executives.
ConnectiCare Dental Plans
ConnectiCare Dental Plans offer
familiar PPO-style, open access
to broad participating provider
networks. Whether seeking
dental benefits for large- or smallgroups, ConnectiCare Dental
Plans provide comprehensive
plan designs, including out-ofnetwork benefits and competitive
rates. We also offer three costeffective network options.
For large groups of more than 50
eligible employees, ConnectiCare
can customize our Dental plan
designs. ConnectiCare Dental
Plans also offers the option of
self-funded dental plans for
large-group sponsors.
ConnectiCare Dental Value
Network — our most economical
network
ConnectiCare Dental Plus
Network — the mid-level plan
that adds improved provider access
ConnectiCare Dental Premium
Network — the plan for those
who want the broadest access
Any of the three network options
can be matched with our four
plan options ($1,000 annual
maximum, $1,000 annual
maximum with orthodontia,
$1,500 annual maximum, and
$1,500 annual maximum with
orthodontia) to provide a level
of benefits and coverage to fit
employers’ needs.
Voluntary products —
Life, Disability and Dental
options that can enrich
benefit portfolios
Producer Partners, Inc. (a
ConnectiCare affiliate) has
entered into an arrangement
with Boston Mutual Life
Insurance Company that allows
us to offer a number of Boston
Mutual’s industry-leading
voluntary products to our
producers and clients. These
benefits are available to groups
of 25 or more eligible employees
and include permanent and
term life insurance coverage,
short- and long-term disability
income protection and voluntary
dental plans down to two lives.
Boston Mutual Life Insurance
Company
Boston Mutual has been at the
forefront of the Worksite marketplace for almost three decades.
With a history rooted in the
provision of traditional and
voluntary benefits to a wide
variety of employer groups,
it is well situated to meet
the unique demands of the
contemporary Worksite
marketing environment.
These products include
permanent and term life
coverage, short and long term
disability income protection
and voluntary dental. We
are pleased to note that the
life and disability plans also
carry the endorsement of
the American Hospital
Association.
As the demand for voluntary
benefits grows, we are
committed to providing
producers, employers and
employees access to the best
products and services. Our
efforts with Boston Mutual
promise to take us a long way
toward achieving that goal.
We provide a variety of prescription drug
plans to meet our members’ needs
Note: All prescriptions must be obtained through a participating pharmacy or mail order. For
more information on covered prescription drugs, call Member Services at 1-800-251-7722.
Prescription Drugs
Employers committed to providing their employees with quality medical coverage know how
important it is to select the correct prescription drug plan. ConnectiCare does too.
• ConnectiCare offers comprehensive plans for obtaining prescriptions through a nationwide
network of participating pharmacies.
• ConnectiCare’s small-group prescription drug plans cover a 30-day supply of medication when
prescriptions are filled through a participating retail pharmacy.
• Ninety-eight percent of all pharmacies in the United States participate in our participating
pharmacy network.
• Members who require a 90-day supply of maintenance medications may fill their prescriptions
at a participating pharmacy or through our mail-order service, Express Scripts.
• To determine where your prescription falls on our tiered coverage list, visit our Web site at
www.connecticare.com.
Express Scripts®
Express Scripts’ mail-order pharmacy service provides a convenient alternative for filling
members’ prescriptions. Members will enjoy the convenience of home delivery within 14 days of
ordering. In addition, this service provides free drug interaction screening, answers to questions
with access to a pharmacist 24-hours-a-day, and round-the-clock refill order placement by
touch-tone phone. Members can find out more by calling 1-800-369-0675 or by visiting the
Express Scripts Web site, www.express-scripts.com.
3
Achievements in quality
Choosing a health care plan for
your company takes careful
consideration. You read about the
companies in the marketplace.
You compare the reviews. What
makes one health plan
stand out from among
all others?
Commitment.
ConnectiCare is
committed to all of
its members.
At ConnectiCare
we offer a variety of
health plans. We
provide award-winning,
superior customer service.
We have quality benefit
options. We also have solid
financial power — power to
deliver quality health benefits
management, and to be counted
on to deliver the best service,
throughout our service area. All
of this is combined with the best
people to do the job — people
who truly seek to provide each
and every member with the
personal attention he or she
deserves. This is what distinguishes
ConnectiCare from other health
plans. It’s also why our reputation
has remained strong for more
than two decades. But don’t take
our word for it. Here’s what
some of our toughest critics have
to say about us.
HealthLeaders Magazine selects
ConnectiCare’s senior team as
2006 top leaders
The Top Leadership Team Award
celebrates the outstanding
teamwork in health care
organizations and highlights
what makes top leadership teams
successful. ConnectiCare was
chosen among health plans
throughout the nation.
HealthLeaders said, “ConnectiCare
is recognized as a health plan that
has created a companywide
culture of teamwork that has
helped the company earn high
ranks for quality and service.”
HealthLeaders Magazine is the
leading strategic health care
publication for more than 40,000
senior-level health care decision
makers.
2005 U.S. News & World
Report ranks
ConnectiCare, Inc. sixth
in the nation
ConnectiCare, Inc is
the only Connecticut
plan to rank in
the top 10 nationally.
ConnectiCare of
Massachusetts, Inc. is
ranked tenth in the nation.
2005 Consumer Assessment
of Healthcare Providers and
Systems (CAHPS)*
ConnectiCare maintains high
member satisfaction scores for
customer service and claims
processing in the Connecticut
and Massachusetts service area.
Customer Service — 80.6%
(CT) and 76.2% (MA); Claims
Processing — 94.6% (CT) and
94.1% (MA). Also, overall
member satisfaction with
ConnectiCare as a health plan
was 72.2% (CT) and 63.5%
(MA). Compare ConnectiCare
to our regional competitors and
you’ll discover why we’re one of
America’s highest-rated health
plans.
Seven-Time Winner, Connecticut
Quality Improvement Gold and
Silver Awards (CQIA)
Entry-level CQIA Innovation
Prize for excellence in managing
quality improvement
Double Award Winner,
American Association of
Health Plans (AAHP) Award
— 2002
• Exemplary Practice Award
for our asthma program,
BREATHE
• Third place in Innovative
Quality Improvement for
our Adult Immunization
Program
What do we do best?
We take our members’ needs
personally!
• Industry-leading service
capabilities
• High-quality care
management
• Responsiveness and
accessibility
By far the highest quality
around
Is there a health plan that’s
brilliant at the basics?
ConnectiCare has received
high marks when it comes
to assuring access to routine
office visits that keep employees
healthy; immunizations,
preventative cancer and
cholesterol screenings,
prenatal care, behavioral
health services, checkups and
wellness care.
Access and Service, Qualified
Practitioners, Staying Healthy,
Getting Better and Living with
Illness. In addition ConnectiCare
has maintained an Excellent
Accreditation Status from the
NCQA since this category was
established in 1999. ConnectiCare
also received a 100% score for its
on-site review, and combined
with our HEDIS and CAHPS
scores earned 99.95 out of a
possible 100 points. For more
information, go to www.ncqa.org.
Understanding our members’
needs and caring for our
members continues to be our
primary vision and what we
strive to maintain. Our
philosophy of commitment
can only be achieved with
strong leadership. This is why
ConnectiCare always places
service and quality first.
In addition to serving our
individual members, we aim
to continually strengthen our
relationship with employers.
We listen and are committed
to meeting or exceeding your
needs through the delivery of
exceptional customer service
breadth of choice, expanding
plan options, and convenience.
The National Committee for
Quality Assurance (NCQA)
ConnectiCare is ranked
among the top 10 health
plans in the nation —
and in the top five
regionally — for the
2005 HEDIS
Effectiveness of Care,
(Quality) rates according to the NCQA. The
NCQA also publishes
Health Plan Report Cards,
and has given ConnectiCare
four stars in all categories:
You can choose ConnectiCare with confidence!
* Quality awards and other recognition do not include data for the New York service area or individual products as they were not included in the assessments.
4
Staying ahead of the curve
What’s the best way to keep your workforce well, productive and on the job? ConnectiCare offers these solutions,
each with a proven track record.
ConnectiCare Health Management Programs receive NCQA accreditation
ConnectiCare is one of only four health plans in the nation to receive a full three-year NCQA accreditation
of all of its health management programs (high-risk pregnancy, asthma, coronary artery disease, heart failure,
and diabetes). ConnectiCare scored a perfect 100 percent compliance with all standards in all categories
demonstrating our commitment to improving the quality of life for our members with high-risk health
conditions, and showing that health management is an important part of our core business strategy.
The NCQA health management accreditation signifies that ConnectiCare’s health management programs, developed
and operating since 1995, are recognized as the highest quality, most effective programs by the leading independent
authority (NCQA) in evaluating and measuring quality in managed health care.
The BREATHE Program. Over 15 million Americans, including 5 million children, have asthma. BREATHE is an educational
program that helps members with asthma understand and control their symptoms. Through mailings and phone contact,
our asthma nurse case managers provide education about asthma and answer members’ questions about anything from
medication to common triggers for asthma attacks. Members receive the tools they need to help them better manage their
asthma. Free classes are available for adults, parents and children with asthma, where the members receive a peak flow meter and educational
kit just for attending.
Introducing … ConnectiCare’s new BREATHE program for people with Chronic Obstructive Pulmonary Disease (COPD)
The BREATHE – COPD program is designed to help those with COPD better understand their condition and feel better. Registered nurse
case managers provide support through regular telephone contact and educational mailings on topics related to COPD. Your Nurse Case
Manager can help you with:
• setting up a quit plan to help you quit smoking;
• learning what you can do to prevent respiratory infections;
• identifying your triggers (things that make your symptoms worse);
• taking steps to reduce your exposure to triggers;
• knowing what to discuss with your doctor;
• understanding how to take your medications and why your doctor prescribed them;
• learning more about breathing and relaxation techniques; and
• knowing where to find emotional support.
For more information you may visit our Web site at www.connecticare.com and click on Health Information.
The DiabetiCare Program. Careful management of diabetes can greatly reduce the possibility of complications. So our
case managers contact members diagnosed with diabetes and invite them to take part in DiabetiCare. DiabetiCare
participants benefit from educational mailings, classes on diabetes and the opportunity to test their blood sugar levels
at home with a free glucose monitor. A nurse case manager is available to assist them in managing their diabetes
with their physician.
The HeartCare Program. Having heart disease can make everyday activities difficult. HeartCare offers two programs
that tend to the varied needs of our members with heart problems.
HeartCare Heart Failure provides support in coping with this chronic disease as well as helping members to recognize
the symptoms of worsening heart failure.
HeartCare Coronary Artery Disease (CAD), provides education and support for members who must establish the necessary lifestyle
modifications to lower their risk of cardiac events.
Both programs assist members in developing a greater understanding of their complex and sometimes
“Pregnancy can be
overwhelming disease.
The Birth Expectations Program. Moms-to-be receive the help and
information they need to monitor their pregnancy in order to prevent a
premature birth. Eating right, keeping prenatal care appointments and
knowing the signs of premature labor are steps we encourage for all
moms-to-be. We also offer free educational classes. But with high-risk pregnancies, we also provide phone
contact with a nurse case manager. Our case managers will arrange for covered services needed that can help
a mom carry her baby to full-term. (Home uterine monitoring, for instance.)
For more information on any of our Health Management Programs please visit www.connecticare.com
and choose the Health Information tab from the home page.
ConnectiCare is committed to remaining rigorously competitive in every category. In addition to our awardwinning programs, we also have initiatives that address depression, influenza immunization and men’s and
women’s health. These programs demonstrate our commitment to improving the health of our members.
You can be sure that as our membership grows, our offerings will keep pace.
a difficult time for
anybody. It’s just
nice to know there’s
someone out there
to answer questions
for you.”
— ABBY SICIGNANO,
BIRTH EXPECTATIONS
PARTICIPANT
5
Worksite Wellness
ConnectiCare’s approach to a healthier workforce
ConnectiCare’s Worksite Wellness
Program, established in 1990,
helps employers encourage
healthy living among their most
valuable asset: the employee.
Our Worksite Wellness mission
is to educate employees about
lifestyle behaviors and how they
influence health, quality of life
and use of health care. We offer
onsite education, with seminars,
risk assessments and screenings.
Our staff has experience in the
fields of nursing, exercise science
and nutritional science.
Providing a comprehensive
menu of wellness offerings to
employees, our program is
designed to have a positive impact
on employees’ productivity and
6
employers’ profitability. This
type of diverse approach to
worksite wellness is supported by
the 2002 Hewitt Associates
study, Health and Productivity
Programs Continue to Grow in
Popularity As Health Care Costs
Rise. Our Worksite Wellness
offerings include the following:
Large-group access
ConnectiCare offers all large,
fully-insured employer groups an
opportunity to receive three free
wellness programs as a new
group. When the group renews
with ConnectiCare, it receives
two additional free wellness
programs during the course
of the renewing year.
Small-group access
ConnectiCare will provide one
free wellness group program to
any employer group with 10 or
more employees, that also sign
up for a ConnectiCare health
plan through the Chamber
Insurance Trust program.
Staying focused on members’ needs
means staying in touch with them
Member services provides all our
members access to answers about
benefits, claims coverage and
referrals through two convenient
phone numbers (1-800-251-7722
and 1-860-674-5757). We also
publish a variety of materials to
help keep members up-to-date
with regard to their benefits.
However, a friendly, personal
contact is always just a phone
call or e-mail away.
Most of our members never need
to file a claim. Our guidebook,
numerous flyers, postcards and
Web site all help to educate and
inform members on important
health issues such as selecting a
PCP or using benefits. Members
also receive some of the most
useful news regarding current
health care issues through
our engaging, informative
publications.
We continually work to provide
the best quality in benefits and
services for the most reasonable
cost. Our experienced nurse case
managers work to assist
members who may require
home care, and provide useful
information to those with
chronic illnesses. Our case
managers help members to
obtain access to the care they
need in the appropriate
environment. They also make
sure member’s needs are being
met by making follow-up calls
and staying in touch.
We continually work to give the best quality
and affordability to our members.
7
We also work closely with
employers helping to determine
their unique requirements,
jointly developing plans and
providing information that will
help them to obtain appropriate
benefits for their employees.
As ConnectiCare’s
Participating Provider
network grows,
members gain more
access and choice
ConnectiCare began offering its
HMO and Point-of-Service
health plans in 2005 to small
groups of 2-50 employees in
New York and it continues to
grow its participating provider
network.
In the New York service area of
Orange, Putnam, Rockland and
Westchester counties,
ConnectiCare already has more
than 3,750 participating
providers and has added the
Mount Kisco Medical Group.
ConnectiCare continues to add physician
groups and facilities to our network.
Access to a broad network
High-quality health care cannot
happen without the dedication
and commitment of the doctors
and specialists in our network.
We value the role of our
participating physicians and
encourage their compliance with
the National Committee for
Quality Assurance’s (NCQA)
highest standards. We want our
members to receive superb care
and we monitor key indicators
such as childhood immunizations.
8
Also, we routinely meet face-toface with our network providers.
We visit hospitals, physician’s
offices and other facilities to
verify that records, facility safety
measures — even access to
parking — all meet our
standards. We continually add
physicians to our growing
network. This is essential to help
each and every member gain easy
access to care, in their area, at
their convenience.
ConnectiCare also received
regulatory approval from the
Massachusetts Department of
Insurance to begin marketing its
products in nearly all of
Berkshire county. This expansion
adds to our service area which
now comprises most of western
Massachusetts. In addition to
portions of Berkshire county,
ConnectiCare has been serving
the three county area of
Hampden, Hampshire and
Franklin counties for a number
of years.
Members are now free to choose
from more than 22,500 providers
— including specialists — and
79 acute care hospitals.
Better Technology
It’s easier than ever to do
business with us!
Using the latest technology to
help improve the health of our
members is a large part of
ConnectiCare’s eBusiness mission.
We’re constantly looking for
ways to make it easier for you
to do business with us. This
includes:
• providing online tools that
help producers;
• servicing accounts more
efficiently;
• giving members access to our
convenient self-service center;
and
• providing these capabilities
24-hours-a-day, seven-daysa-week.
Producers
Outstanding customer service is
one of the most effective tools
you have to build a loyal client
base. However, as more and more
employer groups depend on you
to help administer their plans,
providing consistently high-level
customer service can be a challenge. ConnectiCare can help
with our Post-Sale Maintenance
tools and online rate book.
With ConnectiCare’s Producer
Online Services, access to
eligibility, billing, rating and plan
information is just a click away.
You can perform simple maintenance tasks at any time. Need a
small-group medical or dental
quote, or a ConnectiCare® SOLO
quote in a hurry? No problem.
You can obtain quotes, create a
proposal and e-mail or fax them
with ease — along with the
appropriate benefit summaries —
directly from your desk to your
client’s.
Want to renew your current
small-group book of business
online? Now you can. Using
ConnectiCare’s Renewal Manager
or SOLO renewal tool, you can
renew your business with a click
of your mouse.
And, the online rate book takes
things a step further. Small-group
medical and dental rates are now
at your fingertips. It’s quick, easy
and convenient. You can access
current rates for any small-group
plan design.
With the online rate book you can:
• print the entire booklet or just
a specific portion of it;
• search plans/rates by rating
region or by ZIP code;
• search by group size; or
• narrow your search to view only
the plan designs you want to see.
The Post-Sale Maintenance tools
and online rate book are valuable
reference tools for you and your
staff.
Employers
Advanced tools are now available
at your fingertips. ConnectiCare’s
newly expanded Employer Web
site offers a variety of convenient,
timesaving tools that enable you
to manage your business and
service your employees’ needs
more efficiently. You now have
the ability to service your group
online by performing a variety of
transactions in the secure
“Administering My Accounts”
section of the Web site. With
just a few keystrokes you can:
• check on eligibility;
• delete a subscriber and/or
dependent(s);
• enter a new PCP for a
subscriber or dependent;
• change a subscribers’ name and
address;
• order new ID cards;
• verify rates and account
balances;
• download member rosters
to an excel spreadsheet;
• download a variety of forms;
• view your invoice online; and
• new for 2006 — view your
billing transaction history
online.
Updates to the site also allow
you to:
• search our provider directory;
• look up a specific drug on our
drug list;
• access a “how to” guide on
Electronic Data Interchange
(EDI); and
• explore our newly revised
Employer Administrative
Guide online.
And with the addition of
iSearch®, members have greater
capability to review participating
providers, online, anytime.
iSearch saves you time and offers
frequent updates with fewer
clicks to get the information
needed. It’s an improved online
Provider Directory found at
www.connecticare.com.
Decision making
made easy
Subimo Healthcare Advisor™ and PharmaAdvisor™
These tools are for anyone facing an important health
care decision or for those needing to learn more about
how to manage a particular condition. This combined
suite of tools is available to ConnectiCare members at no
charge and offers a number of references including a
Decision Guide to help you address and act on key
health-related decisions.
Personal Health Manager
(target availability — September 2006)
The Personal Health Manager provides members with
online information, resources and tools to help them to
take charge of their health. Members can use it to:
• Complete a Health Risk Assessment;
• Create an electronic Personal Health Record;
• Receive targeted wellness information;
• Set up reminders about appointments and screenings;
and more.
New PlanCompare & CostCompare upgrades now
allow you to do more
Choosing the right health benefit plan is important but
it can sometimes be a daunting task. That’s why
ConnectiCare has contracted with WebMD, to provide a
decision support tool that can help you sort through an
array of benefit and price comparisons.
New features added in May of 2006 allow for personalized
input providing a better analysis of your total costs
including the ability to:
• provide your paycheck frequency to help calculate
your annual premium deductions;
• enter the employee-contribution amount to gain a
better assessment of your total cost-share; and
• enter the employee’s and/or the employer’s annual
HSA or HRA contribution, if applicable.
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Members can save and print the
results of their provider search in
a more user-friendly, personalized
format. iSearch also links you
to more information than ever
about providers and their
practices, including:
• extended office hours that may
be available;
• handicap accessibility;
• maps and driving directions;
and
• where the doctor attended
medical school.
Plus, in many cases, members
can connect directly to a
physician’s own Web site, where
they’ll find still more information.
This is made possible through
ConnectiCare’s connectivity with
MedemTM, the country’s largest
online physician network.
By providing these capabilities
for our members, we ultimately
reduce the amount of paperwork
that will clutter their homes.
By giving members access to
interactive tools that can keep
them informed, healthy and
working, we help to increase
their productivity, efficiency and
your profitability — key reasons
why it's easier than ever to do
business with ConnectiCare.
We’re confident that our
online services truly distinguish
ConnectiCare and the insurance
professionals that represent
us. Visit our Web site,
www.connecticare.com today,
and let us know what you think!
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Healthy Alternatives
Expanded Discounts on Health-Related Products and Services
For many people, good health
means more than a regular
doctor’s exam. It means actively
seeking out a wide range of sources
to enhance their well being —
from alternative therapies and
nutritional supplements to weight
management programs and
fitness centers. If this describes
your outlook, you’ll value and
enjoy all the discounts you
can receive through Healthy
Alternatives.
Discounts for all Healthy
Alternatives products and
services are up to 30% of the
provider’s usual and customary
fee. (This is the fee that an
individual provider most
frequently charges for the
specific product or service.)
Check with your provider for
specific discount amounts that
may apply to each program or
service.
American WholeHealth
participating providers
To receive discounts on the
following services you must
use an American WholeHealth
provider from the Healthy
Alternatives Provider List.
American WholeHealth
administers the Healthy
Alternatives provider network.
For the most recent changes
to the Healthy Alternatives
Provider List, visit
www.connecticare.com
(go to the “Member” page, then
click on “Health Information,”
then “Staying Healthy” and
“Healthy Alternatives.”) Or,
call 1-877-243-2998.
Fitness Centers
Exercise is easier when it’s
convenient. That’s why, we have
arranged to provide you discounts
to certain fitness centers located
throughout New England and
across the country — an added
convenience if you’re traveling for
business or pleasure. Pick any
facility participating in our
discount program and check it
out. If you choose to sign up,
present your ConnectiCare ID
card and receive a discounted
rate for yourself and covered
family members. (Special
restrictions apply so check with
the fitness center.)
Exercise/Movement/
Fitness (including Yoga,
Pilates, Qi Gong and
Tai Chi)
Led by an experienced instructor,
you can relieve stress and feel great
by moving your body through a
gentle series of exercises that
increase flexibility and strength.
Studies show that Yoga, Pilates,
Qi Gong and Tai Chi may have
certain healing qualities, besides
their contribution to overall
wellness and good health. Please
consult with your doctor before
starting an exercise/movement/
fitness program to discuss how it
might meet your health needs.
To receive the discount from
a participating American
WholeHealth provider, present
your ConnectiCare ID card at
the exercise facility.
counselor, you can identify ways
to modify your diet, whether it’s
to control a chronic illness like
diabetes, or to simply shed a few
pounds. To receive the discount
on nutritional counseling from
a participating American
WholeHealth provider, just
present your ConnectiCare ID
card at your appointment.
Please note: Your ConnectiCare
health plan also provides limited
coverage for nutritional counseling
services (two visits per member,
per calendar year). However,
the nutritional counseling services
must be for an illness requiring
therapeutic dietary monitoring,
and must be rendered by a
dietician in a physician’s office in
order to be covered.
Spa Services
Members are offered a variety of
spa services at discounted rates
through participating American
WholeHealth locations. For more
information, and to arrange a
complement of services of interest
to you, call the participating spa
directly.
Massage/Body Work
Holistic Practitioners
Who hasn’t felt the need for
a good massage every now and
then? A licensed massage therapist
can skillfully manipulate your
body to help improve blood flow
and even stimulate natural
painkillers. Even people who
exercise regularly need to give
their bodies a break, and massage/body work is an excellent
way to help recover from the
muscle-tightening effects of
stress. To receive the discount
from a participating American
WholeHealth provider, present
your ConnectiCare ID card at
your appointment.
Using a variety of Western or
non-Western treatment techniques,
a holistic practitioner will look
at the whole person — body,
mind, and spirit. Working closely
with their patients, a holistic
practitioner encourages them to
learn how to reduce risks of
illness and to choose therapies
that they’re comfortable with.
Acupuncture, for example, is a
centuries-old Chinese healing
method used to treat disorders
like migraines, muscle spasms,
asthma, arthritis and certain skin
diseases. To receive the discount
from a participating American
WholeHealth provider, present
your ConnectiCare ID card at
your appointment.
Nutritional Counseling
With your full schedule, finding
the time to eat a well balanced
diet can be a challenge. Working
with a trained nutritional
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WholeHealthMD.com
Important
benefit change
information
may be
communicated
via our
newsletter,
HouseCall,
so be sure to
remind your
clients to read
each and
every issue.
Healthy Alternatives gives
you access, at no additional
member cost, to American
WholeHealth’s award-winning,
online education tools via
www.wholehealthMD.com.
Here you’ll find a wealth of healthrelated resources, including:
• The Healing Kitchen, a
collection of healthy recipes
specifically designed to meet
the dietary needs of common
medical conditions.
• A comprehensive Reference
Library containing nutritional
information on foods, supplements, prescriptions and
over-the-counter medications,
as well as discussions on
traditional and alternative
health and wellness therapies.
• A News & Perspectives
section that features articles on
fitness, exercise, and
complementary medicine, as
well as reviews of popular wellness books and products.
• An online search feature for
finding a health or wellness
facility, or a doctor who
specializes in services for
seniors.
Discounts on other
well known products
and services
LASIK Eye Surgery Discounts
LASIK is a surgical procedure
intended to reduce a person’s
dependency on glasses or
contact lenses. Laser vision
correction is an FDA-approved
procedure used by ophthalmologists to treat nearsightedness,
farsightedness and astigmatism.
Using a laser, the procedure
permanently changes the shape
of the cornea and has shown
positive results for many
individuals over the past several
years. ConnectiCare members are
eligible to receive a discount of
up to 25% of the provider’s usual
and customary fees or up to 5%
off “any advertised special” at all
providers affiliated with Davis
LASIK. (Check with your
provider to confirm the discount
prior to your appointment.)
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To find the nearest Davis Vision
LASIK provider, call
1-800-584-2866 or go to
www.connecticare.com. Check
with your doctor to determine
if LASIK may be right for you.
Please note that LASIK eye
surgery is not a covered benefit
under your ConnectiCare plan.
Davis Vision LASIK providers
may not be ConnectiCare
participating providers, and
ConnectiCare does not credential
Davis Vision LASIK providers.
Weight Management
The Rob Nevins Plan
This customized healthy eating
plan helps you lose weight and
keep it off through education
about sound nutritional eating.
There are no pills, powders or
prepackaged foods to buy — you
learn to control your weight
using everyday foods. First,
you’ll receive a complementary
45-minute initial, no-obligation
consultation with a trained
nutritional counselor. If you
decide to sign up, you’ll receive
a 15% discount for being a
ConnectiCare member. To enroll,
call 1-800-Y-FAT-LOSS or go to
The Rob Nevins Program Web
site at www.robnevins.com.
Weight Watchers®
Providing information, knowledge,
tools and motivation, Weight
Watchers helps you make the
right decisions about nutrition and
exercise. The registration fee to
attend Weight Watchers meetings
is waived for ConnectiCare
members. To find the nearest
meeting location, call
1-800-651-6000 or visit
www.weightwatchers.com.
Priceless results
When you take a more active role
in your health, the results can be
priceless. As a ConnectiCare
member, it can also mean
significant savings, thanks to
Healthy Alternatives. Why not
start taking advantage of these
health- and wellness-related
discounts today?
One of America’s highest-rated health plans
CONNECTICARE PRODUCER, SALES AND
CUSTOMER SERVICE LINE
1-800-723-2986
www.connecticare.com
One of America’s highest-rated health plans
Coverage is provided by and services are administered as follows: In Connecticut: Group HMO and POS coverage, and Individual HMO is underwritten
by ConnectiCare, Inc.; Individual POS is underwritten by ConnectiCare Insurance Company, Inc. In Massachusetts: Group HMO and POS coverage is
underwritten by ConnectiCare of Massachusetts, Inc. In New York: HMO and POS is underwritten by ConnectiCare of New York, Inc. FlexPOS, PPO
coverage, ASO/Self-funded services, and Dental products are administered or underwritten by ConnectiCare Insurance Company, Inc. Voluntary
products are distributed by Producer Partners, Inc., and coverage is underwritten by Boston Mutual Insurance Company.
SB 08/06