Brokers

FAQs

FAQs

Get answers to your health care coverage questions.

What is Access Health CT Small Business?

Access Health CT Small Business is Connecticut’s official health insurance marketplace for small businesses, established to satisfy the requirements of the federal Affordable Care Act. Our goal is to lower costs, promote health, and eliminate obstacles to getting health care coverage for employees of small businesses.

What happens if a company doesn’t offer coverage to its employees?

If a business has fewer than 50 full-time equivalent employees (FTEs), it is not required to offer coverage and there is no penalty. These employees can get health care coverage from an employer sponsored SHOP plan or from Access Health CT’s individual marketplace if they choose to.

If a company has 50 or more FTEs, it may have to pay tax penalties. Businesses with more than 100 FTEs will pay a penalty if they fail to provide affordable minimum essential health coverage to its FTEs. Beginning in 2016, for employers with at least 50 but fewer than 100 full-time will also be subject to a penalty if they fail to provide such coverage.

Can employees outside of Connecticut be covered by Access Health CT Small Business?

It depends in part on the carrier chosen. Encourage employees who don’t live in Connecticut to check the provider directories for the plans they are interested in to make sure they include doctors, hospitals, and other health care providers in their home state. These employees should also review each plan’s payment policies regarding out-of-network care.

What health insurance company offers small business coverage through AHCT?

We currently offer medical and dental coverage through:

  • Anthem (medical coverage and dental coverage)
What kind of plan choices are offered?

There are four basic categories of coverage offered through Access Health CT– Platinum, Gold, Silver and Bronze. Different plan categories will cover different percentages of an individual’s medical expenses (see chart below). Health insurance plans that cover more expenses will typically have a higher monthly premium.

Plan Tier Expenses paid by plan Expenses paid by individual
Platinum 90% 10%
Gold 80% 20%
Silver 70% 30%
Bronze 60% 40%

Through Access Health CT Small Business, employers can offer plans from a single insurance carrier covering all four metal tiers or a single plan from a single carrier.

How does the small business tax credit work?

Small businesses that qualify may receive a tax credit worth up to 50% of their contribution to their employees’ premiums (up to 35% for qualifying non-profits). The small business tax credit will be available for two consecutive years beginning in 2014. For the 2014 calendar year, businesses will receive the tax credit when they file their income taxes in 2015.

To qualify, a small business must do the following:

  • Have no more than 25 full-time-equivalent (FTE) employees
  • Contribute at least 50% of each employee’s insurance premium, or in the case of a tax-exempt small business employer, 35% of each employee“s insurance premium
  • Pay an average annual wage of less than $51,000

Sole proprietors, partners, shareholders of more than 2% of an “S” corporation and owners of more than 5% of other businesses (and any family members of these owners) are not counted as employees and their incomes and hours worked are not factored into any calculations relating to the tax credit.

For more information, click here to see our Tax Savings Calculator.

How is the number of full-time-equivalent (FTE) employees calculated for purposes of qualifying for the tax credit?

For purposes of qualifying for the small business tax credit, the number of FTE employees is generally based on the total hours that employees put in, not the number of people employed. Calculate this number by first totaling the hours of service for which the business paid wages to its employees. (No time worked over 2,080 hours by any employee is included when totaling the number of hours worked.) Then the total hours is divided by 2,080 (2,080 is the number of hours worked in 40-hour work week for a single year), and the result is rounded down to the nearest whole number.

When determining FTEs and average annual wages, seasonal employees – that is, those who work 120 or fewer days a year – do not count, nor do certain business owners (sole proprietors, shareholders of more than 2% of an “S” corporation and owners of more than 5% of other businesses), partners in a partnership, or the families of these business owners.

For more information, click here to see our Tax Savings Calculator.

Do the plans cover prescription drugs?

Our offered plans all include prescription drug coverage.

What businesses are eligible to use Access Health CT Small Business?

Access Health CT Small Business is open to all Connecticut-based small businesses that have at least 1 employee who is not a business owner or spouse of a business owner. The business cannot have more than 50 full-time equivalent employees, and it must offer coverage to all of its full-time employees (generally, those working 30 or more hours per week on average).

Can a husband and wife (only) business be considered eligible?

If the owners are husband and wife and the business has no other employees, then under the Affordable Care Act, the business will not qualify for participation in Access Health CT Small Business. However, these individuals could enroll in the individual marketplace as sole proprietors.

Is there a membership fee?

There are no membership fees associated with using Access Health CT Small Business.

How can Access Health CT Small Business help save money?

The health care coverage premiums for coverage offered through Access Health CT Small Business are competitive, and the employer may qualify for additional tax credits not available outside of Access Health CT Small Business. This applies to both for-profit and non-profit groups.

How many bills are sent if an employer offers multiple carriers to its employees?

Employers will receive only one simple bill. Access Health CT Small Business takes care of forwarding payment to the carriers.

When can a business enroll in Access Health CT Small Business?

We encourage enrollment by the 15th of the month. By enrolling by the 15th, coverage for the 1st day of the following month is guaranteed.