Do you want what’s best for your clients?
So do we.
Our tools, services, and support allow you to focus on finding quality, affordable group health insurance to fit your clients’ needs and new opportunities to grow your book of small business.
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 >
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We provide support so you can stay focused.
Our Customer 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 the plan rates change?”
All plan rates may adjust once a year, on an annually basis. This means the rates are locked in for a 12-month period.
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.
For us, collaboration is key.
Part of decreasing the number of uninsured in Connecticut is increasing brokers’ access to the information, tools, and services they need. See what some of our certified brokers have to say about working with us.
64,567
Connecticut private sector for profit and non-profit firms with fewer than 50 employees1.
This does not include people who are self employed or businesses with no employees.
1 Kaiser Family Foundation
Simplify the process with our online portal.
Through our robust and easy to use online portal, you will have access to the information, forms, and tools you need.
- 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?
In 2020 Access Health CT Small Business offers four basic categories of coverage – Platinum, Gold, Silver and Bronze. In 2021 Access Health CT Small Business offers three basic categories for coverage – Gold, Silver and Bronze – from Anthem and ConnectiCare.
Looking for group dental plans? We can help.
Anthem
Gold Pathway CT PPO
2021
| Benefit Year: | Contract |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $25 Copayment per visit |
| Specialist Office Visit | $50 Copayment per visit |
| Prescription Drugs | Tier 1: $5 Copay; Tier 2: $50 Copay; Tier 3: 30% up to $500; Tier 4: 30% up to $1000 |
| Mail Order Drug | Tier 1: $13 Copay; Tier 2: $150 Copay; Tier 3: 30% up to $1500; Tier 4: 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 | Walk-In: $25 Copayment per visitUrgent Care: $100 Copayment per visit |
| Ambulance | No Cost |
| Outpatient Surgery | Freestanding Facility: $300; Hospital: No Cost after Deductible is met |
| 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 | Freestanding Facility: $0; Hospital: No Cost after Deductible is met |
| Outpatient Diagnostic Imaging | Freestanding Facility: $75; Hospital: No Cost after Deductible is met |
| Outpatient Mental Health | $25 Copayment per visit |
| Durable Medical Equipment | 50% Coinsurance after Plan Deductible is met |
| Individual Deductible | $2,500.00 |
| Family Deductible | $5,000.00 |
| Out-of-Pocket Maximum | $4,500.00 |
| Family Out-of-Pocket Maximum | $9,000.00 |
Download PDF
Anthem
Silver Pathway CT PPO
2021
| Benefit Year: | Contract |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $40 Copayment per visit |
| Specialist Office Visit | $80 after Plan Deductible is met |
| Prescription Drugs | Tier 1: $5 Copay; Tier 2: $50 Copay; Tier 3: 30% up to $500; Tier 4: 30% up to $1000 |
| Mail Order Drug | Tier 1: $13 Copay; Tier 2: $150 Copay; Tier 3: 30% up to $1500; Tier 4: 30% up to $1000 |
| Inpatient Hospital | 25% Coinsurance after Plan Deductible is met |
| Emergency Room | 25% Coinsurance after Plan Deductible is met |
| Walk-in Urgent Care | Walk-In: $40 Copayment per visitUrgent Care: $100 Copayment per visit |
| Ambulance | 25% Coinsurance |
| Outpatient Surgery | Freestanding Facility: $400 Copayment per visitHospital : 25% coinsurance after Deductible |
| Laboratory Service | No Cost-Share at Site-of-Service Providers 25% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Tests | Freestanding Facility: $0; Hospital: 25% coinsurance after Deductible |
| Outpatient Diagnostic Imaging | Freestanding Facility: $75 Copayment per visit Hospital : 25% after Deductible is met |
| Outpatient Mental Health | $40 Copayment per visit |
| Durable Medical Equipment | 50% Coinsurance after Plan Deductible is met |
| Individual Deductible | $5,500.00 |
| Family Deductible | $11,000.00 |
| Out-of-Pocket Maximum | $8,500.00 |
| Family Out-of-Pocket Maximum | $17,000.00 |
Anthem
Silver Pathway CT PPO w/HSA
2021
| Benefit Year: | Contract |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $40 Copayment per visit after Plan Deductible is met |
| Specialist Office Visit | $80 Copayment per visit after Plan Deductible is met |
| Prescription Drugs | Deductible then, Tier 1: $5 Copay; Tier 2: $50 Copay; Tier 3: 30%; Tier 4: 30% |
| Mail Order Drug | Deductible then, Tier 1: $13 Copay; Tier 2: $150 Copay; Tier 3: 30%; Tier 4: 30% |
| 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 | 20% Coinsurance after Deductible is met |
| Laboratory Service | No Cost-Share after Deductible is met at an Independent Lab 20% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Tests | Deductible then, Freestanding Facility: No Cost Hospital : 20% coinsurance ; X-ray: 20% coinsurance |
| Outpatient Diagnostic Imaging | 20% Coinsurance after Deductible is met |
| Outpatient Mental Health | No Cost after Deductible is met |
| Durable Medical Equipment | 50% Coinsurance after Deductible is met |
| Individual Deductible | $3,000.00 |
| Family Deductible | $6,000.00 |
| Out-of-Pocket Maximum | $7,000.00 |
| Family Out-of-Pocket Maximum | $14,000.00 |
Anthem
Bronze Pathway CT PPO
2021
| Benefit Year: | Contract |
| 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 | $8,500.00 |
| Family Deductible | $17,000.00 |
| Out-of-Pocket Maximum | $8,500.00 |
| Family Out-of-Pocket Maximum | $17,000.00 |
Anthem
Bronze Pathway CT PPO w/HSA
2021
| Benefit Year: | Contract |
| 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 | Deductible then, Tier 1: $25 Copay; Tier 2: $75 Copay; Tier 3: 40%; Tier 4: 40% |
| Mail Order Drug | Deductible then, Tier 1: $63 Copay; Tier 2: $225 Copay; Tier 3: 40%; Tier 4: 40% |
| 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 | $6,900.00 |
| Family Deductible | $13,800.00 |
| Out-of-Pocket Maximum | $7,000.00 |
| Family Out-of-Pocket Maximum | $14,000.00 |
ConnectiCare
ConnectiCare Passage Gold POS PCP
2021
| Benefit Year: | Contract |
| Referrals: | Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $30 Copayment per visit (Deductible waived) |
| Specialist Office Visit | $50 Copayment per visit (Deductible waived) |
| Prescription Drugs | Tier 1: $10 Copay; Tier 2: $50 Copay; Tier 3: 50% up to $250; Tier 4: 50% up to $500 |
| Mail Order Drug | Tier 1: $20 Copay; Tier 2: $100 Copay; Tier 3: 50% up to $500; Tier 4: N/A |
| Inpatient Hospital | 20% Coinsurance after Plan Deductible is met |
| Emergency Room | 20% Coinsurance after Plan Deductible is met |
| Walk-in Urgent Care | $100 Copayment per visit |
| Ambulance | 20% Coinsurance after Plan Deductible is met |
| Outpatient Surgery | 20% Coinsurance after Plan Deductible is met |
| Laboratory Service | $10 Copayment per visit |
| Outpatient Diagnostic Tests | Freestanding Facility : $50, Hospital : 20% after Plan Deductible |
| Outpatient Diagnostic Imaging | Freestanding Facility : $75; Hospital : 20% after Plan Deductible |
| Outpatient Mental Health | $50 Copayment per visit |
| Durable Medical Equipment | 50% Coinsurance after Plan Deductible is met |
| Individual Deductible | $3,000.00 |
| Family Deductible | $6,000.00 |
| Out-of-Pocket Maximum | $6,800.00 |
| Family Out-of-Pocket Maximum | $13,600.00 |
ConnectiCare
ConnectiCare Choice Silver POS
2021
| Benefit Year: | Contract |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $40 Copayment per visit (Deductible waived) |
| Specialist Office Visit | $60 Copayment per visit (Deductible waived) |
| Prescription Drugs | Tier 1: $10 Copay; Tier 2: $60 Copay; Tier 3: 50% up to $300; Tier 4: 50% up to $500 |
| Mail Order Drug | Tier 1: $20 Copay; Tier 2: $120 Copay; Tier 3: 50% up to $600; Tier 4: N/A |
| Inpatient Hospital | 35% Coinsurance after Plan Deductible is met |
| Emergency Room | 35% Coinsurance after Plan Deductible is met |
| Walk-in Urgent Care | $100 Copayment per visit |
| Ambulance | 35% Coinsurance after Plan Deductible is met |
| Outpatient Surgery | 35% Coinsurance after Plan Deductible is met |
| Laboratory Service | 35% Coinsurance after Plan Deductible is met |
| Outpatient Diagnostic Tests | 35% Coinsurance after Plan Deductible is met |
| Outpatient Diagnostic Imaging | 35% Coinsurance after Plan Deductible is met |
| Outpatient Mental Health | $60 Copayment per visit (Deductible waived) |
| Durable Medical Equipment | 50% Coinsurance after Plan Deductible is met |
| Individual Deductible | $4,750.00 |
| Family Deductible | $9,500.00 |
| Out-of-Pocket Maximum | $8,400.00 |
| Family Out-of-Pocket Maximum | $16,800.00 |
ConnectiCare
ConnectiCare Choice Silver POS w/HSA
2021
| Benefit Year: | Contract |
| 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 Copay; Tier 2: $60 Copay; Tier 3: 50% up to $300; Tier 4: 50% up to $500 |
| Mail Order Drug | Deductible then, Tier 1: $20 Copay; Tier 2: $120 Copay; 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 Deductible is met |
| Individual Deductible | $3,500.00 |
| Family Deductible | $7,000.00 |
| Out-of-Pocket Maximum | $6,900.00 |
| Family Out-of-Pocket Maximum | $13,800.00 |
ConnectiCare
ConnectiCare Choice Bronze POS
2021
| Benefit Year: | Contract |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $40 Copayment per visit (Deductible waived) |
| Specialist Office Visit | $60 after Plan Deductible is met |
| Prescription Drugs | Tier 1: $10 Copay; Deductible then, Tier 2: $60 Copay; Tier 3: 50% up to $300; Tier 4: 50% up to $500 |
| Mail Order Drug | Deductible then, Tier 1: $20; Tier 2: $120; Tier 3: 50% up to $600; Tier 4: N/A |
| Inpatient Hospital | 40% Coinsurance after Plan Deductible is met |
| Emergency Room | 40% Coinsurance after Plan Deductible is met |
| Walk-in Urgent Care | $100 Copayment per visit after Plan Deductible is met |
| Ambulance | 40% Coinsurance after Deductible is met |
| Outpatient Surgery | Deductible then, Freestanding Facility : $500; Hospital : 40% Coinsurance |
| Laboratory Service | $10 Copayment per visit after Plan Deductible is met |
| Outpatient Diagnostic Tests | Deductible then, Freestanding Facility: $50 Hospital : 40% Coinsurance |
| Outpatient Diagnostic Imaging | Deductible then, Freestanding Facility : $75 up to $375 max ; Hospital : 40% coinsurance |
| Outpatient Mental Health | $60 Copayment per visit (Deductible waived) |
| Durable Medical Equipment | 40% Coinsurance after Plan Deductible is met |
| Individual Deductible | $7,000.00 |
| Family Deductible | $14,000.00 |
| Out-of-Pocket Maximum | $8,300.00 |
| Family Out-of-Pocket Maximum | $16,600.00 |
ConnectiCare
ConnectiCare Choice Bronze POS w/HSA
2021
| Benefit Year: | Contract |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | 50% Coinsurance after Plan Deductible is met |
| Specialist Office Visit | 50% Coinsurance after Plan Deductible is met |
| Prescription Drugs | Deductible then, Tier 1: $10 Copay; Tier 2: $60 Copay; Tier 3: 50% up to $300; Tier 4: 50% up to $500 |
| Mail Order Drug | Deductible then, Tier 1: $20 Copay; Tier 2: $120 Copay; Tier 3: 50% up to $600; Tier 4: N/A |
| Inpatient Hospital | 50% Coinsurance after Plan Deductible is met |
| Emergency Room | 50% Coinsurance after Plan Deductible is met |
| Walk-in Urgent Care | 50% Coinsurance after Plan Deductible is met |
| Ambulance | 50% Coinsurance after Plan Deductible is met |
| Outpatient Surgery | 50% Coinsurance after Plan Deductible is met |
| Laboratory Service | 50% Coinsurance after Plan Deductible is met |
| Outpatient Diagnostic Tests | 50% Coinsurance after Plan Deductible is met |
| Outpatient Diagnostic Imaging | 50% Coinsurance after Plan Deductible is met |
| Outpatient Mental Health | 50% Coinsurance after Plan Deductible is met |
| Durable Medical Equipment | 50% Coinsurance after Plan Deductible is met |
| Individual Deductible | $5,750.00 |
| Family Deductible | $11,500.00 |
| Out-of-Pocket Maximum | $7,000.00 |
| Family Out-of-Pocket Maximum | $14,000.00 |
Anthem
Anthem Platinum Pathway X PPO
2020
| Benefit Year: | Contract |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $10.00 |
| Specialist Office Visit | $30.00 |
| Prescription Drugs | Tier 1: $5; Tier 2: $50; Tier 3: 30% up to $500; Tier 4: 30% up to $1000 |
| Mail Order Drug | Tier 1: $13; Tier 2: $150; Tier 3: 30% up to $1500; Tier 4: 30% up to $1000 |
| Inpatient Hospital | $500/Day up to $1000 |
| Emergency Room | $250.00 |
| Walk-in Urgent Care | Walk-In: $10; Urgent Care: $100 |
| Ambulance | $0.00 |
| Outpatient Surgery | Fac: $300; Hosp: $400 |
| Laboratory Service | No Cost-Share at Site-of-Service Providers $10 Copayment per service at an Outpatient Hospital Facility |
| Outpatient Diagnostic Tests | Fac: $0; Hosp: Lab: $10, X-ray: $40 |
| Outpatient Diagnostic Imaging | $75.00 |
| Outpatient Mental Health | $10.00 |
| Durable Medical Equipment | 50% |
| Individual Deductible | $0.00 |
| Family Deductible | $0.00 |
| Out-of-Pocket Maximum | $2,500.00 |
| Family Out-of-Pocket Maximum | $5,000.00 |
Anthem
Anthem Gold Pathway X PPO
2020
| Benefit Year: | Contract |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $25.00 |
| Specialist Office Visit | $50.00 |
| Prescription Drugs | Tier 1: $5; Tier 2: $50; Tier 3: 30% up to $500; Tier 4: 30% up to $1000 |
| Mail Order Drug | Tier 1: $13; Tier 2: $150; Tier 3: 30% up to $1500; Tier 4: 30% up to $1000 |
| Inpatient Hospital | No Cost after Deductible is met |
| Emergency Room | 20% after Deducitible is meet |
| Walk-in Urgent Care | Walk-In: $25; Urgent Care: $100 |
| Ambulance | $0.00 |
| Outpatient Surgery | Fac: $300; Hosp: No Cost after Deductible is met |
| 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 | Fac: $0; Hosp: No Cost after Deductible is met |
| Outpatient Diagnostic Imaging | Fac: $75; Hosp: No Cost after Deductible is met |
| Outpatient Mental Health | $25.00 |
| Durable Medical Equipment | 50% after Deductible is met |
| Individual Deductible | $2,500.00 |
| Family Deductible | $5,000.00 |
| Out-of-Pocket Maximum | $4,500.00 |
| Family Out-of-Pocket Maximum | $9,000.00 |
Anthem
Anthem Gold Pathway X HMO
2020
| Benefit Year: | Contract |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $25.00 |
| Specialist Office Visit | $50.00 |
| Prescription Drugs | Tier 1: $5; Tier 2: $50; Tier 3: 30% up to $500; Tier 4: 30% up to $1000 |
| Mail Order Drug | Tier 1: $13; Tier 2: $150; Tier 3: 30% up to $1500; Tier 4: 30% up to $1000 |
| Inpatient Hospital | No Cost after Deductible is met |
| Emergency Room | 20% after Deducitible is meet |
| Walk-in Urgent Care | Walk-In: $25; Urgent Care: $100 |
| Ambulance | $0.00 |
| Outpatient Surgery | Fac: $300; Hosp: No Cost after Deductible is met |
| 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 | Fac: $0; Hosp: No cost after Deducitible is meet |
| Outpatient Diagnostic Imaging | Fac: $75; Hosp: No cost after Deducitible is meet |
| Outpatient Mental Health | $25.00 |
| Durable Medical Equipment | 50% after Deducitible is meet |
| Individual Deductible | $2,750.00 |
| Family Deductible | $5,500.00 |
| Out-of-Pocket Maximum | $4,000.00 |
| Family Out-of-Pocket Maximum | $8,000.00 |
Anthem
Anthem Silver Pathway X PPO
2020
| Benefit Year: | Contract |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $40.00 |
| Specialist Office Visit | $80 after Deductible is met |
| Prescription Drugs | Tier 1: $5; Tier 2: $50; Tier 3: 30% up to $500; Tier 4: 30% up to $1000 |
| Mail Order Drug | Tier 1: $13; Tier 2: $150; Tier 3: 30% up to $1500; Tier 4: 30% up to $1000 |
| Inpatient Hospital | 25% after Deductible is met |
| Emergency Room | 25% after Deductible is met |
| Walk-in Urgent Care | Walk-In: $40; Urgent Care: $100 |
| Ambulance | 25% |
| Outpatient Surgery | Fac: $400; Hosp: 25% after Ded |
| Laboratory Service | No Cost-Share at Site-of-Service Providers 20% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Tests | Fac: $0; Hosp: 25% after Ded |
| Outpatient Diagnostic Imaging | Fac: $75; Hosp: 25% after Ded |
| Outpatient Mental Health | $40.00 |
| Durable Medical Equipment | 50% after Deductible is met |
| Individual Deductible | $5,500.00 |
| Family Deductible | $11,000.00 |
| Out-of-Pocket Maximum | $8,150.00 |
| Family Out-of-Pocket Maximum | $16,300.00 |
Anthem
Anthem Silver Pathway X PPO w/HSA
2020
| Benefit Year: | Contract |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $40 after Deductible is met |
| Specialist Office Visit | $80 after Deductible is met |
| Prescription Drugs | Ded then, Tier 1: $5; Tier 2: $50; Tier 3: 30%; Tier 4: 30% |
| Mail Order Drug | Ded then, Tier 1: $13; Tier 2: $150; Tier 3: 30%; Tier 4: 30% |
| Inpatient Hospital | 20% after Deductible is met |
| Emergency Room | 20% after Deductible is met |
| Walk-in Urgent Care | Ded then, Walk-In: $40; Urgent Care: $100 |
| Ambulance | 20% after Deductible is met |
| Outpatient Surgery | 20% after Deductible is met |
| Laboratory Service | No Cost-Share afer Deductible is met at an Independent Lab 25% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Tests | Ded then, Lab: Fac: $0, Hosp: 20%; X-ray: 20% |
| Outpatient Diagnostic Imaging | 20% after Deductible is met |
| Outpatient Mental Health | No Cost after Deductible is met |
| Durable Medical Equipment | 50% after Deductible is met |
| Individual Deductible | $3,000.00 |
| Family Deductible | $6,000.00 |
| Out-of-Pocket Maximum | $6,850.00 |
| Family Out-of-Pocket Maximum | $13,700.00 |
Anthem
Anthem Silver Pathway X HMO w/HSA
2020
| Benefit Year: | Contract |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $40 after Ded |
| Specialist Office Visit | $80 after Ded |
| Prescription Drugs | Ded then, Tier 1: $5; Tier 2: $50; Tier 3: 30%; Tier 4: 30% |
| Mail Order Drug | Ded then, Tier 1: $13; Tier 2: $150; Tier 3: 30%; Tier 4: 30% |
| Inpatient Hospital | 20% after Deductible is met |
| Emergency Room | 20% after Deductible is met |
| Walk-in Urgent Care | Deductible then, Walk-In: $40; Urgent Care: $100 |
| Ambulance | 20% after Deductible is met |
| Outpatient Surgery | 20% after Deductible is met |
| Laboratory Service | No Cost-Share afer Deductible is met at an Independent Lab 20% Coinsurance after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Tests | Deductible then, Lab: Fac: $0, Hosp: 20%; X-ray: 20% |
| Outpatient Diagnostic Imaging | 20% after Deductible is met |
| Outpatient Mental Health | No Cost after Deductible is met |
| Durable Medical Equipment | 50% after Deductible is met |
| Individual Deductible | $3,000.00 |
| Family Deductible | $6,000.00 |
| Out-of-Pocket Maximum | $6,850.00 |
| Family Out-of-Pocket Maximum | $13,700.00 |
Anthem
Anthem Bronze Pathway X PPO
2020
| Benefit Year: | Contract |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | No Cost after Deductible is met |
| Specialist Office Visit | No Cost after Deductible is met |
| Prescription Drugs | No Cost after Deductible is met |
| Mail Order Drug | No Cost after Deductible is met |
| Inpatient Hospital | No Cost after Deductible is met |
| Emergency Room | No Cost after Deductible is met |
| Walk-in Urgent Care | No Cost after Deductible is met |
| Ambulance | No Cost after Deductible is met |
| Outpatient Surgery | No Cost after Deductible is met |
| Laboratory Service | No Cost-Share afer Deductible is met at an Independent Lab No Cost after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Tests | No Cost after Deductible is met |
| Outpatient Diagnostic Imaging | No Cost after Deductible is met |
| Outpatient Mental Health | No Cost after Deductible is met |
| Durable Medical Equipment | No Cost after Deductible is met |
| Individual Deductible | $8,150.00 |
| Family Deductible | $16,300.00 |
| Out-of-Pocket Maximum | $8,150.00 |
| Family Out-of-Pocket Maximum | $16,300.00 |
Anthem
Anthem Bronze Pathway X PPO w/HSA
2020
| Benefit Year: | Contract |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | No Cost after Deductible is met |
| Specialist Office Visit | No Cost after Deductible is met |
| Prescription Drugs | No Cost after Deductible is met |
| Mail Order Drug | No Cost after Deductible is met |
| Inpatient Hospital | No Cost after Deductible is met |
| Emergency Room | No Cost after Deductible is met |
| Walk-in Urgent Care | No Cost after Deductible is met |
| Ambulance | No Cost after Deductible is met |
| Outpatient Surgery | No Cost after Deductible is met |
| Laboratory Service | No Cost-Share afer Deductible is met at an Independent Lab No Cost after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Tests | No Cost after Deductible is met |
| Outpatient Diagnostic Imaging | No Cost after Deductible is met |
| Outpatient Mental Health | No Cost after Deductible is met |
| Durable Medical Equipment | No Cost after Deductible is met |
| Individual Deductible | $6,850.00 |
| Family Deductible | $13,700.00 |
| Out-of-Pocket Maximum | $6,850.00 |
| Family Out-of-Pocket Maximum | $13,700.00 |
Anthem
Anthem Bronze Pathway X HMO w/HSA
2020
| Benefit Year: | Contract |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | No Cost after Deductible is met |
| Specialist Office Visit | No Cost after Deductible is met |
| Prescription Drugs | Deductible then, Tier 1: $5; Tier 2: $50; Tier 3: 30%; Tier 4: 30% |
| Mail Order Drug | Deductible then, Tier 1: $13; Tier 2: $150; Tier 3: 30%; Tier 4: 30% |
| Inpatient Hospital | No Cost after Deductible is met |
| Emergency Room | No Cost after Deductible is met |
| Walk-in Urgent Care | No Cost after Deductible is met |
| Ambulance | No Cost after Deductible is met |
| Outpatient Surgery | No Cost after Deductible is met |
| Laboratory Service | No Cost-Share afer Deductible is met at an Independent Lab No Cost after Deductible is met at an Outpatient Hospital Facility |
| Outpatient Diagnostic Tests | No Cost after Deductible is met |
| Outpatient Diagnostic Imaging | No Cost after Deductible is met |
| Outpatient Mental Health | No Cost after Deductible is met |
| Durable Medical Equipment | 50% after Deducitible is meet |
| Individual Deductible | $6,500.00 |
| Family Deductible | $13,000.00 |
| Out-of-Pocket Maximum | $6,850.00 |
| Family Out-of-Pocket Maximum | $13,700.00 |
ConnectiCare
CTCare Passage Gold POS PCP
2020
| Benefit Year: | Contract |
| Referrals: | Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $30.00 |
| Specialist Office Visit | $50.00 |
| Prescription Drugs | Tier 1: $10; Tier 2: $50; Tier 3: 50% up to $250; Tier 4: 50% up to $500 |
| Mail Order Drug | Tier 1: $20; Tier 2: $100; Tier 3: 50% up to $500; Tier 4: N/A |
| Inpatient Hospital | 20% after Deductible is met |
| Emergency Room | 20% after Deductible is met |
| Walk-in Urgent Care | $100.00 |
| Ambulance | 20% after Deductible is met |
| Outpatient Surgery | Fac: $500; Hosp: 20% after Ded |
| Laboratory Service | Laboratory $10 |
| Outpatient Diagnostic Tests | X-ray: Fac: $50, Hosp: 20% after Ded |
| Outpatient Diagnostic Imaging | Fac: $75; Hosp: 20% after Ded |
| Outpatient Mental Health | $50.00 |
| Durable Medical Equipment | 50% |
| Individual Deductible | $3,000.00 |
| Family Deductible | $6,000.00 |
| Out-of-Pocket Maximum | $6,800.00 |
| Family Out-of-Pocket Maximum | $13,600.00 |
ConnectiCare
CTCare Choice Silver POS
2020
| Benefit Year: | Contract |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $40.00 |
| Specialist Office Visit | $60.00 |
| Prescription Drugs | Tier 1: $10; Tier 2: $60; Tier 3: 50% up to $300; Tier 4: 50% up to $500 |
| Mail Order Drug | Tier 1: $20; Tier 2: $120; Tier 3: 50% up to $600; Tier 4: N/A |
| Inpatient Hospital | 30% after Deductible is met |
| Emergency Room | 30% after Deductible is met |
| Walk-in Urgent Care | $100.00 |
| Ambulance | 30% after Deductible is met |
| Outpatient Surgery | 30% after Deductible is met |
| Laboratory Service | 30% after Deductible is met |
| Outpatient Diagnostic Tests | 30% after Deductible is met |
| Outpatient Diagnostic Imaging | 30% after Deductible is met |
| Outpatient Mental Health | $60.00 |
| Durable Medical Equipment | 50% after Deductible is met |
| Individual Deductible | $4,250.00 |
| Family Deductible | $8,500.00 |
| Out-of-Pocket Maximum | $8,150.00 |
| Family Out-of-Pocket Maximum | $16,300.00 |
ConnectiCare
CTCare Choice Silver POS HSA
2020
| Benefit Year: | Contract |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | 25% after Deductible is met |
| Specialist Office Visit | 25% after Deductible is met |
| Prescription Drugs | Ded then, Tier 1: $10; Tier 2: $60; Tier 3: 50% up to $300; Tier 4: 50% up to $500 |
| Mail Order Drug | Ded then, Tier 1: $20; Tier 2: $120; Tier 3: 50% up to $600; Tier 4: N/A |
| Inpatient Hospital | 25% after Deductible is met |
| Emergency Room | 25% after Deductible is met |
| Walk-in Urgent Care | 25% after Deductible is met |
| Ambulance | 25% after Deductible is met |
| Outpatient Surgery | 25% after Deductible is met |
| Laboratory Service | 25% after Deductible is met |
| Outpatient Diagnostic Tests | 25% after Deductible is met |
| Outpatient Diagnostic Imaging | 25% after Deductible is met |
| Outpatient Mental Health | 25% after Deductible is met |
| Durable Medical Equipment | 25% after Deductible is met |
| Individual Deductible | $3,500.00 |
| Family Deductible | $7,000.00 |
| Out-of-Pocket Maximum | $6,900.00 |
| Family Out-of-Pocket Maximum | $13,800.00 |
ConnectiCare
CTCare Choice Bronze POS
2020
| Benefit Year: | Contract |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | Sanitas: $0; Other: $40 |
| Specialist Office Visit | $60 after Deductible is met |
| Prescription Drugs | Tier 1: $10; Ded then, Tier 2: $60; Tier 3: 50% up to $300; Tier 4: 50% up to $500 |
| Mail Order Drug | Tier 1: $20; Ded then, Tier 2: $120; Tier 3: 50% up to $600; Tier 4: N/A |
| Inpatient Hospital | 40% after Deductible is met |
| Emergency Room | 40% after Deductible is met |
| Walk-in Urgent Care | $100 after Deductible is met |
| Ambulance | 40% after Deductible is met |
| Outpatient Surgery | Deductible then, Fac: $500; Hosp: 40% |
| Laboratory Service | $10 after Deductible is met |
| Outpatient Diagnostic Tests | Deductible then, Lab: $10; X-ray: Fac: $50, Hosp: 40% |
| Outpatient Diagnostic Imaging | Deductible then, Fac: $75; Hosp: 40% |
| Outpatient Mental Health | $60.00 |
| Durable Medical Equipment | 40% after Deductible is met |
| Individual Deductible | $6,750.00 |
| Family Deductible | $13,500.00 |
| Out-of-Pocket Maximum | $8,150.00 |
| Family Out-of-Pocket Maximum | $16,300.00 |
ConnectiCare
CTCare Choice Bronze POS HSA
2020
| Benefit Year: | Contract |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | 50% after Deductible is met |
| Specialist Office Visit | 50% after Deductible is met |
| Prescription Drugs | Ded then, Tier 1: $10; Tier 2: $60; Tier 3: 50% up to $300; Tier 4: 50% up to $500 |
| Mail Order Drug | Ded then, Tier 1: $20; Tier 2: $120; Tier 3: 50% up to $600; Tier 4: N/A |
| Inpatient Hospital | 50% after Deductible is met |
| Emergency Room | 50% after Deductible is met |
| Walk-in Urgent Care | 50% after Deductible is met |
| Ambulance | 50% after Deductible is met |
| Outpatient Surgery | 50% after Deductible is met |
| Laboratory Service | 50% after Deductible is met |
| Outpatient Diagnostic Tests | 50% after Deductible is met |
| Outpatient Diagnostic Imaging | 50% after Deductible is met |
| Outpatient Mental Health | 50% after Deductible is met |
| Durable Medical Equipment | 50% after Deductible is met |
| Individual Deductible | $5,500.00 |
| Family Deductible | $11,000.00 |
| Out-of-Pocket Maximum | $6,900.00 |
| Family Out-of-Pocket Maximum | $13,800.00 |
ConnectiCare Plans
Review your plan documents, prescription drug formularies and provider directory online for the most up to date information at Connecticare.com
All Access Health CT Small Business Plans have embedded deductibles
All discount programs for small groups apply for on-and off-exchange members
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
Get answers to your questions.
With a new relationship comes new opportunities, which is why we are helping brokers like you understand the benefits of working with Access Health CT Small Business.
“Am I compensated for helping clients?”
Yes. Brokers are compensated through commissions paid by the insurance companies.
Jerome Chisolm | 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.