Connecticut
Beech Street Corp.
173 Technology, Irvine, Calif. 92618; 800-233-2478 or 714-727-1353; fax: 714-727-1319
Staff/Facilities
Primary practitioners227
Specialists886
Hospitals11
Users: Group Health
Single coverage16,431
Family coverage64,297
Employees & dependents164,314
Users: Workers Compensation
Single coverage2,128
Total Users166,442
Operational date: 1992.
Service area: Connecticut: Fairfield, Hartford, Litchfield, Middlesex, New Haven, New London, Tolland and Windham counties.
See Beech Street Corp. consolidated listing under California.
Blue Care
Health Plans
370 Bassett Road, North Haven, Conn. 06473; 203-239-4911; fax: 203-985-7917
Staff/Facilities
Primary practitioners1,882
Board-certified91%
Specialists4,101
Hospitals35
Pharmacies651
Primary care locations2,330
Users
Employer/payer groups3,401
Single coverage26,988
Family coverage31,892
Employees & dependents126,377
Medicare1,593
Medicaid64,163
Total317,739
Revenues
First-half 1997$301,328,172
1996$256,806,970Parent: Anthem Blue Cross & Blue Shield of Connecticut.
Operational date: April 1993.
Licensed in: Connecticut.
NCQA fully accredited.
Model type: Direct contract.
For profit.
Service area: Connecticut.
Member of HMO New England, Blue Cross & Blue Shield of New England Plans and HMO Blue USA.
Contracts with Wellpoint for prescription drug in Connecticut; Psych Management Inc. for mental health in Connecticut.
Services: General medical, dental, vision, prescription drug, mental health. May be customized to meet employer specifications.
Rating options: Community rating by class; adjusted community rating.
Offers self-insured products.
Point-of-service contracts: 28.4% of members are enrolled.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries.
Officers: Harry J. Tovello, president/CEO-Anthem Blue Cross & Blue Shield of Connecticut; Frank J. Duzy, CFO/treasurer; Robert T. Brown, secretary; Guy W. Marszalek, chief actuary; Dr. Robert Scalettar, chief medical officer.
Contact: Albert May, 203-239-8381.
CNA Managed Care-Connecticut
CNA Plaza, Chicago, Ill. 60685; 312-822-5000; fax: 312-822-1690
Staff/Facilities
Practitioners3,815
Hospitals20
Service area: Connecticut.
See CNA Managed Care PPO consolidated listing under Illinois.
CareSys Inc.
15 River Road, Suite 100, Wilton, Conn. 06897; 800-992-5531; fax: 203-761-7311
Staff/Facilities
Primary practitioners*910
Board-certified89%
Hospitals32
Pharmacies700
Users: Workers Compensation
Employer/payer groups20
Single coverage80,000
Total Users80,000
Ownership: Anthem Blue Cross Blue Shield of Connecticut.
Operational date: September 1993.
For profit.
Service area: Connecticut: statewide.
Services: Workers compensation. Services available unbundled. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by per diem, discount off customary rates; is compensated by TPAs; charges flat fee per employee, by percent of savings.
UR: Standard procedures.
UR provided by the PPO, by outside contractors.
Officers: Richard Holdt, president/CEO; Brenda Gates Calia, COO; Carlos Navarro, vp-managed care operations; Donald Olson, vp-sales/marketing; Janet Trager, director-provider systems.
Contact: Janet Trager.
*Figure includes specialists.
Century Preferred
370 Bassett Road, North Haven, Conn. 06517; 203-239-4911; fax: 203-985-7917
Staff/Facilities
Primary practitioners2,326
Board-certified91%
Specialists5,426
Hospitals35
Pharmacies651
Ownership: Anthem Blue Cross & Blue Shield of Connecticut.
Operational date: April 1987.
Service area: Connecticut.
Contracts with Wellpoint Pharmacy for prescription drug in Connecticut.
Services: General medical, dental, vision, prescription drug, mental health. May be customized to meet employer specifications.
Compensation: Negotiates hospital charges by per diem; is compensated by employers/payers; charges flat fee per employee.
UR: Standard procedures, excluding second surgical opinion. UR provided by the PPO.
Officers: Harry J. Torello, president/CEO; Frank J. Duzy, CFO/treasurer; Robert T. Brown, secretary; Guy W. Marszalek, chief actuary; Dr. Robert Scalettar, chief medical officer.
Contact: Albert May, director-corporate communications, 203-239-8381.
ChiroSource Inc.
P.O. Box 130, Clayton, Calif. 94517; 510-672-5333; fax: 510-672-6657
Specialty: chiropractic
Staff/Facilities
Primary practitioners27
Service area: Connecticut: statewide.
See ChiroSource Inc. consolidated listing under California.
CIGNA HealthCare*
900 Cottage Grove Road, Hartford, Conn. 06152; 860-726-6000
Staff/Facilities
Primary practitioners56,640
Specialists118,470
Hospitals1,986
Pharmacies49,920
Users
Employer/payer groups37,014
Employees & dependents4,424,408
Medicare81,382
Total5,700,000Parent: Connecticut General Life Insurance Co.
For profit.
Service area: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Colombia, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri, New Jersey, New Hampshire, New Mexico, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, West Virginia, Wisconsin.
Contracts with Health First Partners Inc. in Washington; Preferred Health Partners in Tennessee; Vintage Select in Oregon; Managed Care Consultants Inc. in Nevada; Community Health Plans in Kentucky.
Services: General medical, vision, prescription drug, mental health. Services available unbundled. May be customized to meet employer specifications.
Offers self-insured products.
Officers: H. Edward Hanway, president-CIGNA HealthCare; Patricia L. Rowland, senior vp-sales/marketing/middle market; Joseph M. Fitzgerald, senior vp/chief underwriting officer; William M. Pastore, senior vp-national services organization; Dr. W. Allen Schaeffer, senior vp-managed care operations; William Atwell, senior vp-field operations; John C. Langenus, senior vp-sales/national accounts.
**Figures are consolidated, including all HMO/POS plans in this organization.
CIGNA HealthCare*
900 Cottage Grove Road, Hartford, Conn. 06152; 860-726-6000
Staff/Facilities
Primary practitioners61,000
Specialists137,342
Hospitals2,535
Users: Group Health
Employer/payer groups21,360
Total Users1,500,000
Ownership: Connecticut General Life Insurance Co.
For profit.
Service area: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Michigan, Missouri, New Jersey, New Hampshire, New Mexico, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, West Virginia.
Contracts with Prime Health Mobil in Alabama; HealthCare Preferred in Florida; Comprecare Alliance and Centre Care in Kentucky; Preferred Care in Minnesota; Managed Care Consultants Inc. in Nevada; Vantage Select in Oregon; Preferred Health Partnership in Tennessee; Ethix in Texas; Health First Partners in Washington; HealthCare Network of Wisconsin in Wisconsin.
Services: General medical, dental, vision, prescription drug, mental health. Services available unbundled. May be customized to meet employer specifications. Individual enrollment is allowed.
Compensation: Negotiates hospital charges by per diem, discount off customary rates; is compensated by employers/payers; charges flat fee per employee.
UR: Standard procedures, excluding precertification, hospital bill audits and outpatient service predetermination. UR provided by the PPO.
Officers: H. Edward Hanway, president-CIGNA HealthCare; Patricia L. Rowland, senior vp-sales/marketing/middle market; Joseph M. Fitzgerald, senior vp/chief underwriting officer; William M. Pastore, senior vp-national services organization; Dr. W. Allen Schaeffer, senior vp-managed care operations; William Atwell, senior vp-field operations; John C. Langenus, senior vp-sales/national accounts.
**Figures are consolidated, including all PPO plans in this organization.
CIGNA HealthCare
of Connecticut
900 Cottage Grove Road, Hartford, Conn. 06152; 860-726-2300; 860-769-2398
Staff/Facilities
Primary practitioners1,427
Board-certified83
Patients/practitioner107.9
Specialists3,415
Hospitals28
Pharmacies654
Users
Employer/payer groups890
Total154,023Operational date: January 1986.
Federally qualified.
Licensed in: Connecticut.
NCQA fully accredited.
Model type: IPA.
Service area: Connecticut: Fairfield, Hartford, Litchfield, Middlesex, New Haven, New London, Tolland and Windham counties.
Point-of-service contracts: 79.8% of members are enrolled.
Non-federally qualified programs.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries. Individual enrollment is allowed.
Officers: Joanne Steffen, executive director/general manager; Dr. Donald Grossman, medical director; Vicki McPadden, director/manager-operations; Mary Procopio, provider relations manager; Maureen Torrence, government programs director/manager.
Contact: Alanna Sultar.
See CIGNA Healthcare HMO/POS consolidated listing under Connecticut.
CIGNA PPO-Connecticut
900 Cottage Grove Road, A-118, Hartford, Conn. 06152; 860-726-2300; 860-769-2398
Staff/Facilities
Primary practitioners1,462
Board-certified81.8%
Patients/practitioner24.3
Specialists3,402
Hospitals32
Users: Group Health
Employer/payer groups459
Total Users35,642
Operational date: January 1993.
Service area: Connecticut: Fairfield, Hartford, Litchfield, Middlesex, New Haven, New London, Tolland and Windham counties.
Officers: Joanne Steffen, executive director/general manager; Vicki McPadden, director/manager-operations; Dr. Donald Grossman, medical director; Mary Procopio, manager-provider relations; Donna Martin, planning/analysis-medical economics.
Contact: Andrew Green, 860-726-3586.
See CIGNA HealthCare PPO consolidated listing under Connecticut.
ConnectiCare Inc.
30 Batterson Park Road, Farmington, Conn. 06032-2574; 860-674-5837; fax: 860-674-2011
Staff/Facilities
Primary practitioners1,494
Board-certified85.4%
Patients/practitioner128
Specialists2,871
Hospitals25
Pharmacies690
Users
Employer/payer groups5,400
Total191,210
Revenues
First-half 1997*$111,362,763
1996$250,559,500Operational date: April 1982.
Federally qualified.
Licensed in: Connecticut, Massachusetts.
NCQA one year accredited.
Model type: IPA.
Not for profit.
Service area: Connecticut: statewide. Massachusetts: Hampden County.
Services: General medical, vision, prescription drug, mental health. Services available unbundled. May be customized to meet employer specifications.
Rating options: Community rating by class.
Offers self-insured products.
Point-of-service contracts: 16.9% of members are enrolled.
Non-federally qualified programs.
Enrollment options: Contracts with HCFA to enroll Medicare beneficiaries. Individual enrollment is allowed.
Officers: Marcel Gamache, CEO/president; Dr. Paul Bluestein, vp-health services; Dr. Ron Blumenfeld, medical director; Wade Broughman, vp-finance/operations; Eric Kaplan, vp-sales/account management.
Contact: Carolyn DuBois-Lamb, 860-674-5700.
**As of 3/97.
CorVel Corp.
1920 Main St., Suite 1090, Irvine, Calif. 92714; 714-851-1473; fax: 714-851-1469
Staff/Facilities
Primary practitioners978
Board-certified95%
Specialists6,454*
Hospitals30
Service area: Connecticut.
**Includes ancillary providers.
See CorVel Corp. consolidated listing under California.
FOCUS Healthcare Management Inc.
7101 Executive Center Drive, Suite 375, Brentwood, Tenn. 37207; 800-873-0055 or 615-377-9936; fax: 615-661-4042
Specialty: workers compensation
Staff/Facilities
Primary practitioners809
Specialists3,764
Hospitals30
Total Users592,896
Operational date: September 1993.
Service area: Connecticut: Fairfield, Hartford, Litchfield, Middlesex, New Haven, New London, Tolland and Windham counties.
See FOCUS Healthcare Management Inc. consolidated listing under Tennessee.
HealthCare COMPARE Corp.
3200 Highland Ave., Downers Grove, Ill. 60515; 630-241-7900; fax: 630-241-7856
Staff/Facilities
Primary practitioners*544
Specialists987
Hospitals**11
Service area: Connecticut: statewide.
**Includes some specialists. ***Includes specialty hospitals.
See HealthCare COMPARE Corp./The AFFORDABLE Medical Networks consolidated listing under Illinois.
Healthcare Value Management Inc.
100 River Ridge Drive, Suite 101, Norwood, Mass., 02062; 617-762-5511; fax: 617-762-5318
Staff/Facilities
Primary practitioners789
Specialists2,671
Hospitals23
Users: Group Health
Employees & dependents21,000
Service area: Connecticut: statewide.
See Healthcare Value Management Inc. consolidated listing under Massachusetts.
Healthsource Connecticut Inc.*
40 Stanford Drive, Farmington, Conn. 06032; 860-674-9922; fax: 860-674-9924
Staff/Facilities
Primary practitioners557
Board-certified90%
Specialists1,020
Hospitals18
Pharmacies555
Users
Employer/payer groups165
Single coverage391
Family coverage1,588
Employees & dependents2,430
Total2,836
Revenues
First-half 1997$2,212,759
1996$283,567Parent: CIGNA HealthCare*.
Operational date: May 1996.
Licensed in: Connecticut.
Model type: IPA.
For profit.
Service area: Connecticut: Fairfield, Hartford, Litchfield, New Haven, New London and Tolland counties.
Services: General medical, vision, prescription drug, mental health. May be customized to meet employer specifications.
Rating options: Community rating: $181.68 single, $472.37 family; community rating by class; adjusted community rating.
Offers self-insured products.
Point-of-service contracts: 40% of members are enrolled.
Officers: Steven T. Burnett, CEO; Chester S. Way, sales manager.
Contact: Kim Gianoni, 800-377-4728.
**Healthsource Inc. was acquired by CIGNA HealthCare in June 1997.
HealthStar Inc.
983 Old Eagle School Road, Suite 615, Wayne, Pa. 19087; 610-225-3288; fax: 610-225-3294
Staff/Facilities
Primary practitioners29
Specialists56
Hospitals3
Operational date: 1996.
Service area: Connecticut: New Haven and Tolland counties.
See HealthStar Inc. consolidated listing under Illinois.