What is managed care?

Common terms in managed care

Benefit Outline:

• External Appeals Process
• Consumer Report Card on Health Insurance in Connecticut
• Expedited Review Process
• Plan disclosure requirements to enrollees
• New filing requirements with the Insurance Department
• Emergency room "prudent layperson" standard
• Prohibition of "Gag" clauses in provider contracts

Frequently asked Questions

Utilization Review:

• Utilization Review License Application (PDF)

Preferred Provider Networks: 

• C.G.S 38a-479aa An Act Concerning Preferred Provider Networks
• C.G.S 38a-479aa An Act Concerning Preferred Provider Networks - PPN License Application and Instructions

Lists:

• Health Maintenance Organizations
• Managed Care Organizations

• Managed Care Report Card Survey - Cover Letter (Portable Document Format - PDF)
• Managed Care Report Card Survey - Part 1 (Word Document Format - DOC & Portable Document Format - PDF)
• Managed Care Report Card Survey - Part 2 (Word Document Format - DOC & Portable Document Format - PDF)
• Report Card Addendum (all networks) (Word Document Format - DOC & Portable Document Format - PDF)
• Consumer Report Card Survey – Network Adequacy Certification (Word Document & PDF form)

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