Beginning Oct. 1, 2017, all Hartford HealthCare Hospitals, ancillary providers and employed physicians are considered Out of Network for patients with Anthem commercial, exchange and Medicare Advantage plans.
What Does This Mean?
Any services provided by Hartford Hospital will be considered Out of Network Services; Services will apply to out of network deductibles, out of network coinsurance and may result in overall higher out of pocket costs.
Hartford Hospital (Hartford)
The Hospital of Central Connecticut (New Britain and Southington)
MidState Medical Center (Meriden)
Backus Hospital (Norwich)
Windham Hospital (Willimantic)
The Institute of Living
Hartford HealthCare Medical Group
Hartford HealthCare at Home
Hartford HealthCare Rehabilitation Network
Southington Care Center
Continuation of Care through Hartford HealthCare Hospital:
Patients in an ongoing treatment program can request approval from Anthem to continue receiving services under their Continuation of Care program. If you think you qualify, call the number on the back of your insurance card or download the forms. You or your provider must mail or fax the completed request for continuation of care to Anthem.
While Hartford Hospital is out of Anthem’s network, Hartford HealthCare will send a bill directly to you for services you receive. You will be responsible for paying this amount.
Alternative Facilities of Care:
Anthem has published a document compiling alternative facilities where you may receive care.
Anthem will be sending letters to members in the mail conveying this information.
In March, we posted Connecticare's decision to change the age for Preventive (No cost) Mammogram Screenings. ConnectiCare has since reversed this decision. Preventive mammogram screenings for women age 40 and over will continue to be exempt from all cost-shares.
Disability Contracts have a lot of moving parts. Look for these Enhancements When Comparing Plans:
“Or” definition of disability – “Or” definition provides comprehensive income protection, with a focus on returning to work. Using the “or” definition, employees qualify for benefits by meeting either of the following criteria:
Unable to perform the majority of substantial duties of their own job (for STD) or own occupation (for LTD) or
Unable to earn 80% of their pre-disability income while working in a modified capacity
“Own job” definition – When it comes to returning to work, many disability insurance carriers have “own occupation” language in their contracts for both STD and LTD, while some contracts provide an “own job” definition for STD. Own Job means the carrier looks at the job the employee was performing on the date of the disability – not the occupation. Why is this key? STD coverage is typically purchased as a replacement for or supplement to sick leave – or as a salary continuance benefit – with the expectation that the employee will return to his or her original job. So, the “own job” definition is a significant distinction.
“Unable to earn 80%” language – Some disability contracts require a “20% income loss” to start paying disability benefits while other contracts require an employee be “unable to earn 80%” of their pre-disability income.
What’s the difference? It can be considerable. Disabled employees whose income is based partially or totally on commissions, services or billable hours may not experience an immediate income loss. The “20% income loss” language doesn’t recognize the immediate impact of a disability because payments from these sources can continue to be received after the disability begins. The “unable to earn 80%” feature in the Principal contract acknowledges the impact of the disability immediately, and allows the employee to qualify for benefits sooner.
Example: Isaac, a real estate agent, sells his usual share of new business in May and June. In July, he’s diagnosed with a disabling illness. As part of his treatment schedule, he’s restricted to a 20-hour work week. He continues to receive commission checks during this time from sales made in May and June. As a result, “20% income loss” is not realized for the first two months of his disability. The Principal contract recognizes that Isaac is “unable to earn 80%” of his pre-disability income because his treatments have restricted him to work at 50% capacity, even though he continues to receive income from sales prior to the disability. This provision allows Isaac to begin qualifying for disability benefits sooner than he would under a contract with the “20% income loss” language.
Nation’s 2nd largest PPO network* – More than 120,000 unique dentists**
Better local access
In-network cost savings – Out-of-pocket costs can be reduced in most cases by at least 30% for covered services
If your dentist is not in SunLife's network, they offer local dental network recruiters that are available to help recruit dentists into the network. See how the Assurant Dental Network® compares to other networks in your area with our easy-to-use tool.
*The Ignition Group, L.L.C. data as of December 2016 based on unique dentist count. For more information, please visit www.netminder.com. **The Assurant Dental Network® includes 120,000+ unique dentists under access arrangements with Dental Health Alliance, L.L.C.® (DHA®) and other dental PPO networks.