Help your clients make their businesses more attractive.
Help your clients find health coverage solutions that are right for their needs—and help grow your book of business with our tools, services, and support.
Are you a broker that would like to get certified with Access Health CT Small Business?
Email us today to get certified: SHOP.AHCT@ct.gov
Access PDFs of our plans | See plans >
Get client forms | Find forms >
We provide support so you can stay focused.
Our Client Relationship Managers can help strengthen your ability to do business by providing unbiased information regarding plan information and details.
Contact Us
To learn more about working with us, you can call us directly at 860-241-8445 or email SHOP.AHCT@ct.gov
“Do rates change?”
Plan rates are locked in for a 12-month period, so there are no surprises.
Franco Barrero | Contact me
Advocating for you
Access Health CT Small Business works hard for brokers and small business owners to protect the health of their businesses and employees alike.
Supporting brokers is mission critical.
It’s our mission to decrease the number of uninsured in Connecticut. A large part of that is providing brokers access to the information, tools, and services they need. According to the Kaiser Family Foundation, there are 61,616 Connecticut private sector for profit and non-profit firms with fewer than 50 employees1—let us help you grow your book of business.
A simplified process.
Through our easy-to-use online portal, you’ll have access to the information, forms, and tools you need to be effective with your clients and prospects.
- Easily enroll individuals and small groups on their behalf.
- Provide plans that offer flexible benefit designs and a variety of ways to ensure savings.
- Manage your entire book of business.
Want to know what plans we offer?
For 2025 Access Health CT Small Business offers four (4) metal tiers of coverage.
Anthem
Anthem Platinum Pathway CT PPO
2025
| Benefit Year: | For Plan Year 2025 |
| Referrals: | Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $20 Copayment per visit |
| Specialist Office Visit | |
| Prescription Drugs | |
| Mail Order Drug | |
| Inpatient Hospital | |
| Emergency Room | |
| Walk-in Urgent Care | |
| Ambulance | |
| Outpatient Surgery | |
| Laboratory Service | |
| Outpatient Diagnostic Tests | |
| Outpatient Diagnostic Imaging | |
| Outpatient Mental Health | |
| Durable Medical Equipment | |
| Individual Deductible | |
| Family Deductible | |
| Out-of-Pocket Maximum | |
| Family Out-of-Pocket Maximum |
Download PDF
Anthem
Anthem Gold Pathway CT PPO
2025
| Benefit Year: | For Plan Year 2025 |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $25 Copayment per visit |
| Specialist Office Visit | $60 Copayment per visit |
| Prescription Drugs | Tier 1: No Cost; Tier 2: $10 Copay; Tier 3: $60 Copay; Tier 4: 30% up to $500; Tier 5: 30% up to $1000 |
| Mail Order Drug | Tier 1: No Cost; Tier 2: $25 Copay; Tier 3: $180 Copay; Tier 4: 30% up to $1500; Tier 5: 30% up to $1000 |
| Inpatient Hospital | No Cost after Plan Deductible is met |
| Emergency Room | 20% Coinsurance after Plan Deductible is met |
| Walk-in Urgent Care | $25 Copayment per visit at a Walk-In Center; $100 Copayment per visit at an Urgent Care Facility (Urgent Care Center) |
| Ambulance | No Cost |
| Outpatient Surgery | $300 Copayment per visit at a Surgical Center; No Cost-Share after Deductible is met at an Outpatient Hospital Facility |
| Laboratory Service | No Cost-Share at Site-of-Service Providers No Cost- Share after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Tests | No cost at site-of-service providers; No cost after deductible at outpatient hospital facility |
| Outpatient Diagnostic Imaging | $75 copay to $375 max at site-of-service providers; No cost after deductible is met at outpatient hospital facility |
| Outpatient Mental Health | No Cost-Share after deductible is met |
| Durable Medical Equipment | 50% Coinsurance after deductible is met |
| Individual Deductible | $2,500 |
| Family Deductible | $5,000 |
| Out-of-Pocket Maximum | $5,000 |
| Family Out-of-Pocket Maximum | $10,000 |
Anthem
Anthem Silver Pathway CT PPO
2025
| Benefit Year: | For Plan Year 2025 |
| Referrals: | Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $50 Copayment per visit |
| Specialist Office Visit | $100 Copayment per visit |
| Prescription Drugs | Tier 1: $0 Copayment; Tier 2: $10 Copayment; Tier 3: $60 Copay; Tier 4: 30% Coinsurance up to $500; Tier 5: 30% Coinsurance up to $1,000 |
| Mail Order Drug | Tier 1: $0 Copayment; Tier 2: $25 Copayment; Tier 3: $180; Tier 4: 30% Coinsurance up to $1,500; Tier 5: 30% Coinsurance up to $1,000 |
| Inpatient Hospital | 25% Coinsurance after Plan Deductible is met |
| Emergency Room | 25% Coinsurance after Plan Deductible is met |
| Walk-in Urgent Care | $50 Copayment per visit at a Walk-In Center; $100 Copayment per visit at an Urgent Care Facility (Urgent Care Center) |
| Ambulance | 25% Coinsurance |
| Outpatient Surgery | $500 Copayment per visit at a Surgical Center; 25% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Laboratory Service | No Cost-Share at Site-of-Service Providers 25% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Tests | No Cost-Share at Site-of-Service Providers; 25% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Imaging | $75 Copayment per service up to an annual maximum of $375 for MRI, MRA, CAT, CTA, PET and SPECT scans at Site-of-Service Providers; 25% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Mental Health | 25% Coinsurance after Deductible is met |
| Durable Medical Equipment | 50% Coinsurance after Deductible is met |
| Individual Deductible | $5,500 |
| Family Deductible | $10,000 |
| Out-of-Pocket Maximum | $9,000 |
| Family Out-of-Pocket Maximum | $18,000 |
Anthem
Anthem Silver Pathway CT PPO w/HSA
2025
| Benefit Year: | For Plan Year 2025 |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $50 Copayment per visit after Plan Deductible is met |
| Specialist Office Visit | $100 Copayment per visit after Plan Deductible is met |
| Prescription Drugs | Tier 1: $0 Copay; Tier 2: $10 Copay; Tier 3: $60 Copay; Tier 4: 30% Coinsurance after Deductible is met; Tier 5: 30% Coinsurance after Deductible is met |
| Mail Order Drug | Tier 1: $0 Copay; Tier 2: $25 Copay; Tier 3: $180 Copay; Tier 4: 30% Coinsurance after Deductible is met; Tier 5: 30% after Deductible is met |
| Inpatient Hospital | 20% Coinsurance after Plan Deductible is met |
| Emergency Room | 20% Coinsurance after Plan Deductible is met |
| Walk-in Urgent Care | Walk-In: $40 Copayment per visit after Plan Deductible Urgent Care: $100 Copayment per visit after Plan Deductible |
| Ambulance | 20% Coinsurance after Plan Deductible is met |
| Outpatient Surgery | $400 Copayment per visit after Deductible is met at a Surgery Center; 20% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Laboratory Service | No Cost-Share after Deductible is met at Site-of-Service Providers 20% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Tests | $75 Copayment per service after Deductible is met at Site-of-Service Providers; 20% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Imaging | $75 Copayment per service up to an annual maximum of $375 at Site-of-Service Providers; 20% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Mental Health | 20% Coinsurance after Deductible is met |
| Durable Medical Equipment | 50% Coinsurance after Deductible is met |
| Individual Deductible | $3,000 |
| Family Deductible | $6,000 |
| Out-of-Pocket Maximum | $7,000 |
| Family Out-of-Pocket Maximum | $14,000 |
Anthem
Anthem Bronze Pathway CT PPO
2025
| Benefit Year: | For Plan Year 2025 |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | No Cost after Plan Deductible is met |
| Specialist Office Visit | No Cost after Plan Deductible is met |
| Prescription Drugs | No Cost after Plan Deductible is met |
| Mail Order Drug | No Cost after Plan Deductible is met |
| Inpatient Hospital | No Cost after Plan Deductible is met |
| Emergency Room | No Cost after Plan Deductible is met |
| Walk-in Urgent Care | No Cost after Plan Deductible is met |
| Ambulance | No Cost after Plan Deductible is met |
| Outpatient Surgery | No Cost after Plan Deductible is met |
| Laboratory Service | No Cost-Share after Plan Deductible is met at an Independent Lab No Cost after Plan Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Tests | No Cost after Plan Deductible is met |
| Outpatient Diagnostic Imaging | No Cost after Plan Deductible is met |
| Outpatient Mental Health | No Cost after Plan Deductible is met |
| Durable Medical Equipment | No Cost after Plan Deductible is met |
| Individual Deductible | $9,000 |
| Family Deductible | $18,000 |
| Out-of-Pocket Maximum | $9,000 |
| Family Out-of-Pocket Maximum | $18,000 |
Anthem
Anthem Bronze Pathway CT PPO w/HSA
2025
| Benefit Year: | For Plan Year 2025 |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | No Cost after Plan Deductible is met |
| Specialist Office Visit | No Cost after Plan Deductible is met |
| Prescription Drugs | No Cost-Share after Deductible is met |
| Mail Order Drug | No Cost-Share after Deductible is met |
| Inpatient Hospital | No Cost after Plan Deductible is met |
| Emergency Room | No Cost after Plan Deductible is met |
| Walk-in Urgent Care | No Cost after Plan Deductible is met |
| Ambulance | No Cost after Plan Deductible is met |
| Outpatient Surgery | No Cost after Plan Deductible is met |
| Laboratory Service | No Cost-Share after Plan Deductible is met at an Independent Lab No Cost after Plan Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Tests | No Cost after Plan Deductible is met |
| Outpatient Diagnostic Imaging | No Cost after Plan Deductible is met |
| Outpatient Mental Health | No Cost after Plan Deductible is met |
| Durable Medical Equipment | No Cost after Plan Deductible is met |
| Individual Deductible | $7,450 |
| Family Deductible | $14,900 |
| Out-of-Pocket Maximum | $7,450 |
| Family Out-of-Pocket Maximum | $14,900 |
Anthem
Anthem Gold Pathway CT PPO
2024
| Benefit Year: | For Plan Year 2024 |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $25 Copayment per visit |
| Specialist Office Visit | $60 Copayment per visit |
| Prescription Drugs | Tier 1: No Cost; Tier 2: $10 Copay; Tier 3: $60 Copay; Tier 4: 30% up to $500; Tier 5: 30% up to $1000 |
| Mail Order Drug | Tier 1: No Cost; Tier 2: $25 Copay; Tier 3: $180 Copay; Tier 4: 30% up to $1500; Tier 5: 30% up to $1000 |
| Inpatient Hospital | No Cost after Plan Deductible is met |
| Emergency Room | 20% Coinsurance after Plan Deductible is met |
| Walk-in Urgent Care | $25 Copayment per visit at a Walk-In Center; $100 Copayment per visit at an Urgent Care Facility (Urgent Care Center) |
| Ambulance | No Cost |
| Outpatient Surgery | $300 Copayment per visit at a Surgical Center; No Cost-Share after Deductible is met at an Outpatient Hospital Facility |
| Laboratory Service | No Cost-Share at Site-of-Service Providers No Cost- Share after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Tests | No cost at site-of-service providers; No cost after deductible at outpatient hospital facility |
| Outpatient Diagnostic Imaging | $75 copay to $375 max at site-of-service providers; No cost after deductible is met at outpatient hospital facility |
| Outpatient Mental Health | No Cost-Share after deductible is met |
| Durable Medical Equipment | 50% Coinsurance after deductible is met |
| Individual Deductible | $2,500 |
| Family Deductible | $5,000 |
| Out-of-Pocket Maximum | $5,000 |
| Family Out-of-Pocket Maximum | $10,000 |
Anthem
Anthem Silver Pathway CT PPO
2024
| Benefit Year: | For Plan Year 2024 |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $50 Copayment per visit |
| Specialist Office Visit | $100 Copayment per visit |
| Prescription Drugs | Tier 1: $0 Copayment; Tier 2: $10 Copayment; Tier 3: $60 Copay; Tier 4: 30% Coinsurance up to $500; Tier 5: 30% Coinsurance up to $1,000 |
| Mail Order Drug | Tier 1: $0 Copayment; Tier 2: $25 Copayment; Tier 3: $180; Tier 4: 30% Coinsurance up to $1,500; Tier 5: 30% Coinsurance up to $1,000 |
| Inpatient Hospital | 25% Coinsurance after Plan Deductible is met |
| Emergency Room | 25% Coinsurance after Plan Deductible is met |
| Walk-in Urgent Care | $50 Copayment per visit at a Walk-In Center; $100 Copayment per visit at an Urgent Care Facility (Urgent Care Center) |
| Ambulance | 25% Coinsurance |
| Outpatient Surgery | $500 Copayment per visit at a Surgical Center; 25% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Laboratory Service | No Cost-Share at Site-of-Service Providers 25% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Tests | No Cost-Share at Site-of-Service Providers; 25% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Imaging | $75 Copayment per service up to an annual maximum of $375 for MRI, MRA, CAT, CTA, PET and SPECT scans at Site-of-Service Providers; 25% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Mental Health | 25% Coinsurance after Deductible is met |
| Durable Medical Equipment | 50% Coinsurance after Deductible is met |
| Individual Deductible | $5,500 |
| Family Deductible | $10,000 |
| Out-of-Pocket Maximum | $9,000 |
| Family Out-of-Pocket Maximum | $18,000 |
Anthem
Anthem Silver Pathway CT PPO w/HSA
2024
| Benefit Year: | For Plan Year 2024 |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $50 Copayment per visit after Plan Deductible is met |
| Specialist Office Visit | $100 Copayment per visit after Plan Deductible is met |
| Prescription Drugs | Tier 1: $0 Copay; Tier 2: $10 Copay; Tier 3: $60 Copay; Tier 4: 30% Coinsurance after Deductible is met; Tier 5: 30% Coinsurance after Deductible is met |
| Mail Order Drug | Tier 1: $0 Copay; Tier 2: $25 Copay; Tier 3: $180 Copay; Tier 4: 30% Coinsurance after Deductible is met; Tier 5: 30% after Deductible is met |
| Inpatient Hospital | 20% Coinsurance after Plan Deductible is met |
| Emergency Room | 20% Coinsurance after Plan Deductible is met |
| Walk-in Urgent Care | Walk-In: $40 Copayment per visit after Plan Deductible Urgent Care: $100 Copayment per visit after Plan Deductible |
| Ambulance | 20% Coinsurance after Plan Deductible is met |
| Outpatient Surgery | $400 Copayment per visit after Deductible is met at a Surgery Center; 20% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Laboratory Service | No Cost-Share after Deductible is met at Site-of-Service Providers 20% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Tests | $75 Copayment per service after Deductible is met at Site-of-Service Providers; 20% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Imaging | $75 Copayment per service up to an annual maximum of $375 at Site-of-Service Providers; 20% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Mental Health | 20% Coinsurance after Deductible is met |
| Durable Medical Equipment | 50% Coinsurance after Deductible is met |
| Individual Deductible | $3,000 |
| Family Deductible | $6,000 |
| Out-of-Pocket Maximum | $7,000 |
| Family Out-of-Pocket Maximum | $14,000 |
Anthem
Anthem Bronze Pathway CT PPO
2024
| Benefit Year: | For Plan Year 2024 |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | No Cost after Plan Deductible is met |
| Specialist Office Visit | No Cost after Plan Deductible is met |
| Prescription Drugs | No Cost after Plan Deductible is met |
| Mail Order Drug | No Cost after Plan Deductible is met |
| Inpatient Hospital | No Cost after Plan Deductible is met |
| Emergency Room | No Cost after Plan Deductible is met |
| Walk-in Urgent Care | No Cost after Plan Deductible is met |
| Ambulance | No Cost after Plan Deductible is met |
| Outpatient Surgery | No Cost after Plan Deductible is met |
| Laboratory Service | No Cost-Share after Plan Deductible is met at an Independent Lab No Cost after Plan Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Tests | No Cost after Plan Deductible is met |
| Outpatient Diagnostic Imaging | No Cost after Plan Deductible is met |
| Outpatient Mental Health | No Cost after Plan Deductible is met |
| Durable Medical Equipment | No Cost after Plan Deductible is met |
| Individual Deductible | $9,000 |
| Family Deductible | $18,000 |
| Out-of-Pocket Maximum | $9,000 |
| Family Out-of-Pocket Maximum | $18,000 |
Anthem
Anthem Bronze Pathway CT PPO w/HSA
2024
| Benefit Year: | For Plan Year 2024 |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | No Cost after Plan Deductible is met |
| Specialist Office Visit | No Cost after Plan Deductible is met |
| Prescription Drugs | No Cost-Share after Deductible is met |
| Mail Order Drug | No Cost-Share after Deductible is met |
| Inpatient Hospital | No Cost after Plan Deductible is met |
| Emergency Room | No Cost after Plan Deductible is met |
| Walk-in Urgent Care | No Cost after Plan Deductible is met |
| Ambulance | No Cost after Plan Deductible is met |
| Outpatient Surgery | No Cost after Plan Deductible is met |
| Laboratory Service | No Cost-Share after Plan Deductible is met at an Independent Lab No Cost after Plan Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Tests | No Cost after Plan Deductible is met |
| Outpatient Diagnostic Imaging | No Cost after Plan Deductible is met |
| Outpatient Mental Health | No Cost after Plan Deductible is met |
| Durable Medical Equipment | No Cost after Plan Deductible is met |
| Individual Deductible | $7,450 |
| Family Deductible | $14,900 |
| Out-of-Pocket Maximum | $7,450 |
| Family Out-of-Pocket Maximum | $14,900 |
Anthem
Anthem Gold Pathway CT PPO
2023
| Benefit Year: | For Plan Year 2023 |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $25 Copayment per visit |
| Specialist Office Visit | $60 Copayment per visit |
| Prescription Drugs | Tier 1: No Cost; Tier 2: $10 Copay; Tier 3: $60 Copay; Tier 4: 30% up to $500; Tier 5: 30% up to $1000 |
| Mail Order Drug | Tier 1: No Cost; Tier 2: $25 Copay; Tier 3: $180 Copay; Tier 4: 30% up to $1500; Tier 5: 30% up to $1000 |
| Inpatient Hospital | No Cost after Plan Deductible is met |
| Emergency Room | 20% Coinsurance after Plan Deductible is met |
| Walk-in Urgent Care | $25 Copayment per visit at a Walk-In Center; $100 Copayment per visit at an Urgent Care Facility (Urgent Care Center) |
| Ambulance | No Cost |
| Outpatient Surgery | $300 Copayment per visit at a Surgical Center; No Cost-Share after Deductible is met at an Outpatient Hospital Facility |
| Laboratory Service | No Cost-Share at Site-of-Service Providers No Cost- Share after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Tests | No cost at site-of-service providers; No cost after deductible at outpatient hospital facility |
| Outpatient Diagnostic Imaging | $75 copay to $375 max at site-of-service providers; No cost after deductible is met at outpatient hospital facility |
| Outpatient Mental Health | No Cost-Share after deductible is met |
| Durable Medical Equipment | 50% Coinsurance after deductible is met |
| Individual Deductible | $2,500 |
| Family Deductible | $5,000 |
| Out-of-Pocket Maximum | $5,000 |
| Family Out-of-Pocket Maximum | $10,000 |
Anthem
Anthem Silver Pathway CT PPO
2023
| Benefit Year: | For Plan Year 2023 |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $50 Copayment per visit |
| Specialist Office Visit | $100 Copayment per visit |
| Prescription Drugs | Tier 1: $0 Copayment; Tier 2: $10 Copayment; Tier 3: $60 Copay; Tier 4: 30% Coinsurance up to $500; Tier 5: 30% Coinsurance up to $1,000 |
| Mail Order Drug | Tier 1: $0 Copayment; Tier 2: $25 Copayment; Tier 3: $180; Tier 4: 30% Coinsurance up to $1,500; Tier 5: 30% Coinsurance up to $1,000 |
| Inpatient Hospital | 25% Coinsurance after Plan Deductible is met |
| Emergency Room | 25% Coinsurance after Plan Deductible is met |
| Walk-in Urgent Care | $50 Copayment per visit at a Walk-In Center; $100 Copayment per visit at an Urgent Care Facility (Urgent Care Center) |
| Ambulance | 25% Coinsurance |
| Outpatient Surgery | $500 Copayment per visit at a Surgical Center; 25% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Laboratory Service | No Cost-Share at Site-of-Service Providers 25% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Tests | No Cost-Share at Site-of-Service Providers; 25% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Imaging | $75 Copayment per service up to an annual maximum of $375 for MRI, MRA, CAT, CTA, PET and SPECT scans at Site-of-Service Providers; 25% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Mental Health | 25% Coinsurance after Deductible is met |
| Durable Medical Equipment | 50% Coinsurance after Deductible is met |
| Individual Deductible | $5,500 |
| Family Deductible | $10,000 |
| Out-of-Pocket Maximum | $9,000 |
| Family Out-of-Pocket Maximum | $18,000 |
Anthem
Anthem Silver Pathway CT PPO w/HSA
2023
| Benefit Year: | For Plan Year 2023 |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $50 Copayment per visit after Plan Deductible is met |
| Specialist Office Visit | $100 Copayment per visit after Plan Deductible is met |
| Prescription Drugs | Tier 1: $0 Copay; Tier 2: $10 Copay; Tier 3: $60 Copay; Tier 4: 30% Coinsurance after Deductible is met; Tier 5: 30% Coinsurance after Deductible is met |
| Mail Order Drug | Tier 1: $0 Copay; Tier 2: $25 Copay; Tier 3: $180 Copay; Tier 4: 30% Coinsurance after Deductible is met; Tier 5: 30% after Deductible is met |
| Inpatient Hospital | 20% Coinsurance after Plan Deductible is met |
| Emergency Room | 20% Coinsurance after Plan Deductible is met |
| Walk-in Urgent Care | Walk-In: $40 Copayment per visit after Plan Deductible Urgent Care: $100 Copayment per visit after Plan Deductible |
| Ambulance | 20% Coinsurance after Plan Deductible is met |
| Outpatient Surgery | $400 Copayment per visit after Deductible is met at a Surgery Center; 20% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Laboratory Service | No Cost-Share after Deductible is met at Site-of-Service Providers 20% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Tests | $75 Copayment per service after Deductible is met at Site-of-Service Providers; 20% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Imaging | $75 Copayment per service up to an annual maximum of $375 at Site-of-Service Providers; 20% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Mental Health | 20% Coinsurance after Deductible is met |
| Durable Medical Equipment | 50% Coinsurance after Deductible is met |
| Individual Deductible | $3,000 |
| Family Deductible | $6,000 |
| Out-of-Pocket Maximum | $7,000 |
| Family Out-of-Pocket Maximum | $14,000 |
Anthem
Anthem Bronze Pathway CT PPO
2023
| Benefit Year: | For Plan Year 2023 |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | No Cost after Plan Deductible is met |
| Specialist Office Visit | No Cost after Plan Deductible is met |
| Prescription Drugs | No Cost after Plan Deductible is met |
| Mail Order Drug | No Cost after Plan Deductible is met |
| Inpatient Hospital | No Cost after Plan Deductible is met |
| Emergency Room | No Cost after Plan Deductible is met |
| Walk-in Urgent Care | No Cost after Plan Deductible is met |
| Ambulance | No Cost after Plan Deductible is met |
| Outpatient Surgery | No Cost after Plan Deductible is met |
| Laboratory Service | No Cost-Share after Plan Deductible is met at an Independent Lab No Cost after Plan Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Tests | No Cost after Plan Deductible is met |
| Outpatient Diagnostic Imaging | No Cost after Plan Deductible is met |
| Outpatient Mental Health | No Cost after Plan Deductible is met |
| Durable Medical Equipment | No Cost after Plan Deductible is met |
| Individual Deductible | $9,000 |
| Family Deductible | $18,000 |
| Out-of-Pocket Maximum | $9,000 |
| Family Out-of-Pocket Maximum | $18,000 |
Anthem
Anthem Bronze Pathway CT PPO w/HSA
2023
| Benefit Year: | For Plan Year 2023 |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | No Cost after Plan Deductible is met |
| Specialist Office Visit | No Cost after Plan Deductible is met |
| Prescription Drugs | No Cost-Share after Deductible is met |
| Mail Order Drug | No Cost-Share after Deductible is met |
| Inpatient Hospital | No Cost after Plan Deductible is met |
| Emergency Room | No Cost after Plan Deductible is met |
| Walk-in Urgent Care | No Cost after Plan Deductible is met |
| Ambulance | No Cost after Plan Deductible is met |
| Outpatient Surgery | No Cost after Plan Deductible is met |
| Laboratory Service | No Cost-Share after Plan Deductible is met at an Independent Lab No Cost after Plan Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Tests | No Cost after Plan Deductible is met |
| Outpatient Diagnostic Imaging | No Cost after Plan Deductible is met |
| Outpatient Mental Health | No Cost after Plan Deductible is met |
| Durable Medical Equipment | No Cost after Plan Deductible is met |
| Individual Deductible | $7,450 |
| Family Deductible | $14,900 |
| Out-of-Pocket Maximum | $7,450 |
| Family Out-of-Pocket Maximum | $14,900 |
ConnectiCare
ConnectiCare Passage Gold POS PCP – For Renewal Only
2023
| Benefit Year: | For Plan Year 2023 |
| Referrals: | Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $30 Copayment per visit |
| Specialist Office Visit | $50 Copayment per visit |
| Prescription Drugs | Tier 1: $10 Copayment; Tier 2: $50 Copayment; Tier 3: 50% up to $250; Tier 4: 50% up to $500 |
| Mail Order Drug | Tier 1: $20 Copayment; Tier 2: $100 Copayment; Tier 3: 50% up to $500 |
| Inpatient Hospital | 20% Coinsurance per admission after INET Plan Deductible is met |
| Emergency Room | 20% Coinsurance per visit after INET Plan Deductible is met |
| Walk-in Urgent Care | $100 Copayment per visit |
| Ambulance | 20% Coinsurance after INET Plan Deductible is met |
| Outpatient Surgery | $500 copayment per visit at an Ambulatory Surgery Center; 20% coinsurance after INET plan deductible is met at an Outpatient Hospital Facility |
| Laboratory Service | Laboratory: $10 copayment |
| Outpatient Diagnostic Tests | $50 copayment per service at freestanding facility; 20% coinsurance per service after INET plan deductible is met at Hospital Facility |
| Outpatient Diagnostic Imaging | $75 copayment per service up to five copayments per year at a Freestanding Facility, then copayment waived; 20% coinsurance per service after INET plan deductible is met at a Hospital Facility |
| Outpatient Mental Health | $50 Copayment per visit |
| Durable Medical Equipment | 50% Coinsurance per equipment/supply |
| Individual Deductible | $3,000 |
| Family Deductible | $6,000 |
| Out-of-Pocket Maximum | $8,500 |
| Family Out-of-Pocket Maximum | $17,000 |
ConnectiCare
ConnectiCare Choice Silver POS – For Renewal Only
2023
| Benefit Year: | For Plan Year 2023 |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $50 Copayment per visit |
| Specialist Office Visit | $75 Copayment per visit |
| Prescription Drugs | Tier 1: $20 copayment; Tier 2: $60 copayment; Tier 3: 50% coinsurance up to $300; Tier 4: 50% coinsurance up to $500 |
| Mail Order Drug | Tier 1: $40 copayment; Tier 2: $120 copayment; Tier 3: 50% coinsurance up to $600 |
| Inpatient Hospital | 40% Coinsurance per admission after INET Plan Deductible is met |
| Emergency Room | 40% Coinsurance after per visit INET Plan Deductible is met |
| Walk-in Urgent Care | $100 Copayment per visit |
| Ambulance | 40% Coinsurance per service after INET Plan Deductible is met |
| Outpatient Surgery | 40% Coinsurance per visit after INET Plan Deductible is met |
| Laboratory Service | 40% Coinsurance per service after INET plan deductible is met |
| Outpatient Diagnostic Tests | 40% Coinsurance per service after INET Plan Deductible is met |
| Outpatient Diagnostic Imaging | 40% Coinsurance per service after INET Plan Deductible is met |
| Outpatient Mental Health | $75 Copayment per visit |
| Durable Medical Equipment | 40% Coinsurance per equipment/supply after INET Plan Deductible is met |
| Individual Deductible | $4,000 |
| Family Deductible | $8,000 |
| Out-of-Pocket Maximum | $9,100 |
| Family Out-of-Pocket Maximum | $18,200 |
ConnectiCare
ConnectiCare Choice Silver POS w/HSA – For Renewal Only
2023
| Benefit Year: | For Plan Year 2023 |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | 25% Coinsurance after Plan Deductible is met |
| Specialist Office Visit | 25% Coinsurance after Plan Deductible is met |
| Prescription Drugs | Deductible then, Tier 1: $10 Copayment; Tier 2: $60 Copayment; Tier 3: 50% up to $300; Tier 4: 50% up to $500 |
| Mail Order Drug | Deductible then, Tier 1: $20 Copayment; Tier 2: $120 Copayment; Tier 3: 50% up to $600; Tier 4: N/A |
| Inpatient Hospital | 25% Coinsurance after Plan Deductible is met |
| Emergency Room | 25% Coinsurance after Plan Deductible is met |
| Walk-in Urgent Care | 25% Coinsurance after Plan Deductible is met |
| Ambulance | 25% Coinsurance after Plan Deductible is met |
| Outpatient Surgery | 25% Coinsurance after Plan Deductible is met |
| Laboratory Service | 25% Coinsurance after Plan Deductible is met |
| Outpatient Diagnostic Tests | 25% Coinsurance after Plan Deductible is met |
| Outpatient Diagnostic Imaging | 25% Coinsurance after Plan Deductible is met |
| Outpatient Mental Health | 25% Coinsurance after Plan Deductible is met |
| Durable Medical Equipment | 25% Coinsurance after Plan Deductible is met |
| Individual Deductible | $3,500 |
| Family Deductible | $7,000 |
| Out-of-Pocket Maximum | $6,900 |
| Family Out-of-Pocket Maximum | $13,800 |
ConnectiCare
ConnectiCare Choice Bronze POS – For Renewal Only
2023
| Benefit Year: | For Plan Year 2023 |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $45 Copayment per visit |
| Specialist Office Visit | $60 Copayment per visit |
| Prescription Drugs | Tier 1: $20 copayment; Tier 2: $60 copayment; Tier 3: 50% coinsurance up to $300; Tier 4: 50% coinsurance up to $500 |
| Mail Order Drug | Tier 1: $40 copayment; Tier 2: $120 copayment; Tier 3: 50% coinsurance up to $600 |
| Inpatient Hospital | 40% coinsurance after INET Plan Deductible is met |
| Emergency Room | 40% coinsurance after INET Plan Deductible is met |
| Walk-in Urgent Care | $100 Copayment per visit after INET Plan Deductible is met |
| Ambulance | 40% coinsurance after INET Plan Deductible is met |
| Outpatient Surgery | $500 copay per visit after INET plan deductible is met at an Ambulatory Surgery Center; 40% coinsurance per visit after INET plan deductible is met at an Outpatient Hospital Facility |
| Laboratory Service | $20 Copayment after INET Plan Deductible is met |
| Outpatient Diagnostic Tests | $50 copayment per service after INET plan deductible is met at Freestanding Facility; 40% coinsurance per service after INET plan deductible is met at a Hospital Facility |
| Outpatient Diagnostic Imaging | $75 copayment per service after INET plan deductible is met up to five copayments per year at a Freestanding Facility, then copayment waived; 40% coinsurance per service after INET plan deductible is met at a Hospital Facility |
| Outpatient Mental Health | 40% coinsurance per visit after INET plan deductible is met |
| Durable Medical Equipment | 40% Coinsurance after INET plan deductible is met |
| Individual Deductible | $7,500 |
| Family Deductible | $15,000 |
| Out-of-Pocket Maximum | $9,100 |
| Family Out-of-Pocket Maximum | $18,200 |
ConnectiCare
ConnectiCare Choice Bronze POS w/HSA – For Renewal Only
2023
| Benefit Year: | For Plan Year 2023 |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | 40% Coinsurance after INET plan deductible is met |
| Specialist Office Visit | 50% Coinsurance after INET Plan Deductible is met |
| Prescription Drugs | Tier 1: $20 copayment; Tier 2: $60 copayment; Tier 3: 50% coinsurance up to $300; Tier 4: 50% coinsurance up to $500 |
| Mail Order Drug | Tier 1: $40 copayment; Tier 2: $120 copayment; Tier 3: 50% coinsurance up to $600 |
| Inpatient Hospital | 50% Coinsurance after INET Plan Deductible is met |
| Emergency Room | 50% Coinsurance after INET Plan Deductible is met |
| Walk-in Urgent Care | 50% Coinsurance after INET Plan Deductible is met |
| Ambulance | 50% Coinsurance after INET Plan Deductible is met |
| Outpatient Surgery | 50% Coinsurance after INET Plan Deductible is met |
| Laboratory Service | 50% Coinsurance after INET Plan Deductible is met |
| Outpatient Diagnostic Tests | 50% Coinsurance after INET Plan Deductible is met |
| Outpatient Diagnostic Imaging | 50% Coinsurance after INET Plan Deductible is met |
| Outpatient Mental Health | 50% Coinsurance after INET Plan Deductible is met |
| Durable Medical Equipment | 50% Coinsurance after INET Plan Deductible is met |
| Individual Deductible | $6,000 |
| Family Deductible | $12,000 |
| Out-of-Pocket Maximum | $7,500 |
| Family Out-of-Pocket Maximum | $15,000 |
Anthem Plans
Review your plan documents, prescription drug formularies and provider directory online for the most up to date information at anthem.com
Deductible is waved for drugs on the preventive Rx drug list
All Access Health CT Small Business Plans have embedded deductibles
Outside of Connecticut coverage – PPO plans have full BlueCard access using the BlueCard PPO network. HMO plans have limited BlueCard access for urgent and emergency coverage only using the Participating Provider Network
All discount programs for small groups apply for on-and off-exchange members
Questions and answers.
We are committed to helping brokers like you understand the benefits of working with Access Health CT Small Business. See some FAQs below.
Are brokers compensated for helping clients find plans to offer their employees through Access Health CT Small Business?
Yes! Brokers may be eligible for commissions for their services from the insurance companies offering plans through Access Health CT Small Business. Questions regarding eligibility for commissions should be directed to the insurance companies offering plans through Access Health CT Small Business.
Kayla Rotondo | Contact me
“How do I enroll clients?”
Working with us, you can either enroll clients through our customer portal or using traditional paper enrollment.
Franco Barrero | Contact me
Additional resources to help you stay informed.
Our resources section features articles, training details, videos, and our new podcast series, all of which address the latest news and changes in the group health insurance industry.