Looking for quality, affordable coverage?
This is a great place to start.
Protecting your employees’ health is a big deal. So we’re here to make finding the right group health insurance for your small business simple.
Need assistance getting group health insurance?
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We help make affordable health insurance possible.
Group health insurance should work for your employees and your bottom line. Together, we will guide and help you understand the plan options that work best for you and the amount you want to pay towards your employee premiums (monthly payments). We can even help you see if you qualify for any tax credits (financial help).
You control the coverage
With Access Health CT Small Business, you decide which plans to offer your employees and the amount you pay toward employee premiums (monthly payments).
See if you are eligible for tax credits (financial help)
We can help you see if your small business qualifies for tax credits — in some cases up to 50% of your contributions toward your employees premiums (monthly payments), or up to 35% for non-profits
“Is there a specific enrollment date or timeframe?”
No. Group health insurance is not tied to annual enrollment date. Group health insurance is based on a rolling date and can start any month of the year.
Jerome Chisolm | Contact me
Here are some essential health benefits offered with all of our plans.
Prescription drug coverage
Key preventive and wellness services and chronic disease management
Pediatric (children’s health and well-child care) services, including dental and vision care
Maternity and newborn care
Outpatient services (ambulatory care)
Laboratory services and tests
Emergency services
In-hospital care (hospitalization)
Mental health and substance abuse services, including behavioral health treatment
Rehabilitative and habilitative services and devices
73%
of New England companies with fewer than 50 employees offer medical benefits through small business health insurance plans1.
1 U.S. Bureau of Labor Statistics
38.7%
of Connecticut businesses with fewer than 50 employees offer health insurance of any kind to employees2.
2 Kaiser Family Foundation
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 |
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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
Curious about individual plan options for you or your employees?
While we focus on small businesses with 50 employees or less, you can enroll in the individual marketplace as sole proprietors.
Understanding your options should be simple.
It is important to us that you are confident about your options and the help we can provide. We have answered the most common questions below and can offer 1-on-1 help, as well.
“Can employees who live outside of Connecticut be covered?”
Yes! Employees who live outside of Connecticut can enroll in an Access Health CT Small Business group health plan offered by their employer. Non-resident employees should check the provider directories to make sure they include doctors, hospitals, and other healthcare providers in their home state, otherwise they may have to seek services within Connecticut. They should also review each plan’s payment policies regarding out-of-network care.
Mark A. Spellman Jr. | Contact me
“Which health insurance companies offer group health insurance plans through Access Health CT?”
Access Health CT Small Business offers a choice of plans through Anthem Blue Cross and Blue Shield and ConnectiCare. Anthem Blue Cross and Blue Shield handles both medical and dental coverage, while ConnectiCare only offers medical coverage.
Jerome Chisolm | Contact me
Interested in learning more about health insurance for small businesses?
As insurance industry and government requirements change, our articles, videos and podcast series can help explain what that means for you and the coverage you offer.