May 2019 - In this issue

Commercial

•	Help Connecticut health plans say “no” to public option proposals
•	Brushing up on dental insurance
•	New Fixed Funding Solutions suite
•	Medical and pharmacy preauthorization changes

Medicare Advantage

•	Pharmacy preauthorization changes

For all brokers

•	Events at ConnectiCare centers
•	ConnectiCare in the community
•	We’d love to hear from you

Commercial

Help Connecticut health plans say “no” to public option proposals

The Connecticut General Assembly is considering several “public option” proposals that would open the State Employee/Partnership Plan to small businesses and individuals. We’re asking you to join ConnectiCare in letting legislators know this is not good for our state.

These “public option” proposals would:

•	Permit small businesses to enroll in the Partnership Plan, creating an even larger state-administered health care program.
•	Put state tax dollars at risk by adding nonpublic employers to the state plan and destabilizing the pool.
•	Compete directly with the private-sector market, including ConnectiCare business.
•	Negatively impact the viability of Access Health CT, one of the most successful state-based exchanges in the country.

If you want to oppose these proposals, send a letter to your legislators by visiting Insurance Matters to Connecticut. Click “Take Action” and then “Take Action Now.” Enter your information and the site will provide you a list of your local legislators and a sample letter you can submit to them.

Please note that your participation is voluntary. Reach out to your sales representative if you have any questions.

Brushing up on dental insurance

Dental insurance has grown from a rare fringe benefit to a standard offering in many employee health insurance packages. Learn how preventive dental care can help to improve overall employee health, help employers save money and even affect employee absenteeism.

*NEW* Fixed Funding Solutions suite

Introducing Fixed Funding Solutions, a new suite of self-funded medical plans designed with cost-savings in mind for groups with at least two enrollees. These plans provide the advantages of self-funding with the protections of stop loss insurance and predictable billing.

Fixed Funding Solutions offer your qualified clients comprehensive coverage at savings as much as 25% over traditional fully-insured plans regulated by the Affordable Care Act. This allows your clients to continue to offer their employees vital medical benefits while improving their bottom lines.

With the Fixed Funding Solutions suite, employers' rates are underwritten based on the demographics and risk of their covered employees. This means some groups may not qualify for a Fixed Funding Solutions plan. These plans are available exclusively to members of CBIA. We will automatically determine if an existing CBIA or ConnectiCare client qualifies at the time of renewal. You may have already received information for your clients who are eligible.

Contact your CBIA or ConnectiCare sales representative or account manager to learn more.

Medical and pharmacy preauthorization changes

We’re updating our medical and pharmacy policies to make sure your clients get care in an appropriate — and sometimes less costly — setting. This will affect all fully-insured employer groups and individuals with ConnectiCare commercial plans.

Starting Aug. 1, we’re going to require network doctors to get preauthorization for certain:

•	drugs that are only administered at a doctor’s office or outpatient center, and
•	non-emergency surgical services or procedures that are performed in an outpatient facility — including hospital-owned, off-campus facilities — and/or ambulatory surgical centers. Those procedures include some dermatological, gastrointestinal, gynecological, orthopedic, ophthalmological, and urologic procedures.

Other health plans in Connecticut already have similar policies for the same types of procedures.

We are notifying network doctors about these changes, and doctors are responsible for submitting preauthorization requests to ConnectiCare. We are also asking doctors who may have ordered or scheduled services after Aug. 1, 2019, to make sure they obtain authorizations before services are performed on ConnectiCare members.

We will notify members about these changes through our ConnectiCare member newsletter and website. We will remind them to check with their doctors if they or anyone covered under their plans has a non-emergency surgical procedure scheduled after Aug. 1, 2019.

Medicare Advantage

Pharmacy preauthorization changes

We will require network doctors to get preauthorization for certain injectable drugs that are only administered at a doctor’s office or outpatient center after Aug. 1, 2019. This will affect all ConnectiCare Medicare Advantage clients. We are notifying network doctors about these changes, and doctors will know what to do.

For all brokers

Events at ConnectiCare centers

Upcoming events include the annual Hartford Yard Goats Fan Fest, a presentation on the 10 signs of Alzheimer’s, and a “home alone” course for kids. Check out all that’s happening – and encourage your clients to do the same.

Events at the ConnectiCare center in Manchester

ConnectiCare in the community

Outstanding Individual Contributor - Eric Galvin

Congratulations to our president, Eric Galvin, on receiving the Outstanding Individual Contributor Award from United Way of Central and Northeastern Connecticut!

ConnectiCare members and employees gathered at the Connecticut Food Bank in Bridgeport to pack 832 meal kits for their Kids' BackPack Program. This event was part of Good Deeds with ConnectiCare, a volunteer program that brings together our members and employees in service to create healthier communities.

ConnectiCare employees took part in Habitat for Humanity of Coastal Fairfield County’s Women Build.

A ConnectiCare team ran the Cheshire Road Race in April to support organizations dedicated to helping children and adults with developmental and physical disabilities.

We hosted 38 kids for Bring Your Child to Work Day in April. The day was chock-full of activities, including learning about logo design, following a member journey, and a hosting a donation packing party for Klingberg Family Centers. Chew Chew from the Hartford Yard Goats joined the fun!

Much more to see! Follow us on social media to stay up to date:

Facebook | LinkedIn | Twitter

We’d love to hear from you

Commercial Brokers: For individual or small group broker services, call 800-723-2986 or email us at brokerservices@connecticare.com. Large group (51+ employees) brokers, please contact your sales representative.

Medicare brokers: Give us a call at 877-224-7994, or email us at medicarebrokersupport@connecticare.com.

Keep in Touch

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.