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Information Required for a Quote

25 or More Covered Lives 

  • Account Information:
    • Account Name
    • Account Address
    • Requested Effective Date
    • Due Date
    • Bid Strategy/Reason Out to Bid
    • 5-Year Carrier History (Carrier Name/Number of Years) 
  • Locations:
    • Where company headquartered
    • Where benefits are administered
    • Where employees are located 
  • Census: (Must include - Excel format preferred)
    • Eligible Employees
    • Age or Date of Birth
    • Gender
    • Tier Structure (Single, Employee + 1, Family, etc.)
    • Employee Zip Code or Address with City, State & Zip
    • Plan Election (if more than one medical/dental product are offered)
    • Total number of employees on benefit plan
    • Volume (for life, disability, etc.)
    • Employee Classification (Hourly/Salary, Union/Non-Union, Retiree, etc.) 
  • Plan Design Information:
    • Current carrier
    • Current renewal date
    • Current premium rates (if currently insured)
    • Current specific/aggregate rates (if currently self-funded)
    • Renewal premium rates (if currently insured)
    • Renewal specific/aggregate rates (if currently self-funded)
    • Copy of current plan design
    • Requested changes to current design
    • Eligibility requirements 
  • Claims Experience:
    • Monthly enrollment and claims experience, by plan for the most recent 24 months
    • For claims greater than $25,000 or >50% of specific stop loss attachment point during the experience period, include dollar amount, diagnosis and claim status (active/resolved) and prognosis. 
  • Rates/Fees: (Current and Renewal)
    • List administration fees, specific and aggregate stop loss rates and claim factors
    • Specify if rates and fees includes commissions 
  • Current Network(s)


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Toll free: 888-646-2429
Local: 989-839-1629
Fax: 989-839-1626
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Certified by NCQA since 2007

NCQA Certified Utilization Management"Achieving Utilization Management Certification from NCQA demonstrates that ConnectCare has the systems, process and personnel in place to conduct utilization management in accordance with the strictest quality standards." -- Margaret E. O'Kane, President, NCQA

NCQA has reviewed and certified ConnectCare's Utilization Management functions only. For complete details on the scope of this review, visit