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January 2019 - In this issue
Commercial Plans
Medicare Advantage Plans
For All Brokers
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Expanded services in 2019
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We speak to our members and employer-customers every day. We listen to concerns and do what we can to address them. Here are three developments for 2019 that we think you’ll be interested in.
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Public-sector clients who want to compare options? Contact us!
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We’d welcome your requests for proposals for public-sector clients. We can offer ASO plans with embedded stop-loss coverage as well as fully-insured options. Our experience insuring employees of towns and cities, boards of education and other public agencies goes back to our roots here in Connecticut. Contact your sales representative today!
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Combating surprise charges
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Surprise charges from out-of-network providers and labs are a top complaint from patients. We’ve directed providers who refer members to out-of-network health care providers to alert those members to the possibility they’ll be charged higher costs. This process will start in February.
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We’ve directed doctors who refer members to an out-of-network doctor, specialist or facility to present and have members sign a form explaining the possibility they’ll pay higher charges. Members who sign the form acknowledge they understand that they are using an out-of-network provider and may, as a result, have to pay more out of pocket. Members will get a copy of the signed form, and the doctor keeps one, too.
Members won’t have to review this form in emergency situations or when a member and doctor have already sought out and received preauthorization to use an out-of-network provider.
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A new approach to payer-provider relationships in CT
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The Connecticut Health Council's Value Based Relationships work group is trying to change payer-provider relationships. This work group is led by our president, Eric Galvin, and Jess Kupec, president and CEO of St. Francis Healthcare Partners. Learn how the work group is leading the way and testing a new approach to collaboration in our state.
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2018 proof-of-coverage tax documents
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Proof of health insurance documentation for 2018 is on its way.
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Members who bought plans through Access Health CT, Connecticut's official health insurance marketplace, will receive Form 1095-A by mail in February. They can also get it on the Access Health website.
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Members with ConnectiCare SOLO plans and fully-insured groups will be mailed their IRS Form 1095-B by February. They will also be available on the portal in February.
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SilverSneakers: national advertising and mobile app
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Medicare Advantage members may notice more advertising for SilverSneakers®, a wellness and fitness program included in their ConnectiCare Medicare plan.*
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SilverSneakers is spreading the word about its exercise facilities, fitness courses and more with new direct mail and national TV ad campaigns. Their #FindYourPlace campaign highlights a variety of program benefits, including specially-tailored fitness classes, access to high-quality facilities and the friendship of other SilverSneakers members. Watch the TV commercial on the SilverSneakers YouTube channel.
New for members: The SilverSneakers GO™ app is now available in the iTunes App store and Google Play store. With the app, members can find SilverSneakers locations, tailor workouts to their fitness levels, track their progress and more.
*SilverSneakers is not included with Passage Dual (HMO SNP) plans and some group Medicare plans. Members should check their evidence of coverage to see if they are eligible for SilverSneakers.
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Medicare Advantage welcome kits available online
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Medicare Advantage members can view and print benefits-at-a-glance and a health plan owner’s guide that are part of the new welcome kits we created for 2019. New members and renewing members who changed their plans already received the kits by mail. We’re also planning to mail kits to renewing Passage and Flex 3 plan members.
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The owner’s guide summarizes key information for members to get the most from their plan. The “benefits at a glance” is a quick reference guide to basic information, such as copays and coinsurance. These materials are an excellent reference for Medicare Advantage members throughout the year.
The materials are available with all critical plan information all in one place at connecticare.com/medicare/documents.
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Outreach to veterans
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As a reminder, we are reaching out to selected Medicare Advantage members to ask if they’ve received services from the Veterans Administration (VA).
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Members who confirm their veteran status and that have received VA care are asked to sign a release of medical records from the VA to ConnectiCare.
Letters are continuing to go out, and this month follow-up phone calls will begin to anyone who didn’t reply to the letter. We’re asking these questions to help see that our Medicare members’ care is being coordinated among all the health care providers they may use. It is up to members if they want to respond.
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New in-home palliative care services
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Commercial and most Medicare Advantage members with serious illness may receive an offer to receive palliative care services – at no added cost to them.* These services are provided by Aspire Health, the nation’s largest provider of non-hospice, community-based palliative care. There is no cost to members who accept an offer of palliative care.
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Palliative care teams include clinicians — doctors, nurse practitioners and nurses — plus social workers, chaplains and patient care coordinators. They provide experienced, compassionate “eyes and ears in the home” of patients with serious illness. They are on-call for patients and their families 24 hours a day, seven days a week.
Members who may benefit from palliative care will receive a letter and then a phone call. Doctors may also refer patients who are ConnectiCare members for palliative care.
Aspire will notify doctors when a patient has accepted the offer of palliative care, give doctors detailed reports about all visits and help coordinate care.
*Please note, this new program will not be offered to our members with ConnectiCare Medicare Advantage Passage Dual (HMO SNP) plan.
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ConnectiCare in the community
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A team of ConnectiCare members and employees sorted 6,450 pounds of donated meat and packed 400 boxes of food for low-income seniors in the state. The project was sponsored by Good Deeds with ConnectiCare, a volunteer program that brings together our members and employees in service to create healthier communities.
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Chief Sales and Marketing Officer Roberta Wachtelhausen was a guest on the MetroHartford Alliance Pulse of the Region radio show. She discussed how employers can help employees get and stay healthy.
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Homes for the Brave provides housing, vocational training, and life skills coaching to help veterans rise out of homelessness. This December, ConnectiCare delivered bags with blankets, alarm clocks and other household items to help people transition to having homes.
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Much more to see! Follow us on social media to stay up to date:
Facebook | LinkedIn | Twitter
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© 2019 ConnectiCare | 175 Scott Swamp Road | Farmington, CT 06032 | Privacy Policy| Social Media Policy
Tivity Health, SilverSneakers and SilverSneakers FLEX are registered trademarks or trademarks of Tivity Health, Inc., and/or its subsidiaries and/or affiliates in the USA and/or other countries. ©2019 Tivity Health, Inc.
ConnectiCare, Inc. is an HMO/HMO-POS plan with a Medicare contract. Enrollment in ConnectiCare depends on contract renewal.
ConnectiCare Insurance Company, Inc. is an HMO SNP plan with a Medicare contract and a contract with the Connecticut Medicaid Program. Enrollment in ConnectiCare depends on contract renewal.
Coverage is provided by and services are administered as follows: In Connecticut: Group HMO and POS coverage, and Individual HMO coverage is underwritten by ConnectiCare, Inc.; Group coverage for coinsurance plans and Individual POS coverage is underwritten by ConnectiCare Insurance Company, Inc. In Massachusetts: Group HMO and POS coverage is underwritten by ConnectiCare of Massachusetts, Inc. FlexPOS, PPO coverage, ASO/Self-funded services, and Dental products are administered or underwritten by ConnectiCare Insurance Company, Inc.
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