Plans that support the health of your employees. And your business.
In 2022 and 2023 Access Health CT Small Business offers three basic categories for coverage – Gold, Silver and Bronze – from Anthem and ConnectiCare.
Need assistance getting group health insurance?
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 2022 and 2023 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
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 |
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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
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
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
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
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
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
Anthem Gold Pathway CT PPO
2022
| Benefit Year: | For Plan Year 2022 |
| 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 | $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 | $25 Copayment per visit |
| Durable Medical Equipment | 50% Coinsurance after deductible is met |
| Individual Deductible | $2,500 |
| Family Deductible | $5,000 |
| Out-of-Pocket Maximum | $4,500 |
| Family Out-of-Pocket Maximum | $9,000 |
Anthem
Anthem Silver Pathway CT PPO
2022
| Benefit Year: | For Plan Year 2022 |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $40 Copayment per visit |
| Specialist Office Visit | $80 Copayment per visit |
| Prescription Drugs | Tier 1: $5 Copayment; Tier 2: $50 Copayment; Tier 3: 30% Coinsurance up to $500; Tier 4: 30% Coinsurance up to $1,000 |
| Mail Order Drug | Tier 1: $13 Copayment; Tier 2: $150 Copayment; Tier 3: 30% Coinsurance up to $1,500; Tier 4: 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 | $40 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 | $400 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 | $40 Copayment per visit |
| Durable Medical Equipment | 50% Coinsurance after Plan Deductible is met |
| Individual Deductible | $5,500 |
| Family Deductible | $11,000 |
| Out-of-Pocket Maximum | $8,700 |
| Family Out-of-Pocket Maximum | $17,400 |
Anthem
Anthem Silver Pathway CT PPO w/HSA
2022
| Benefit Year: | For Plan Year 2022 |
| 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 Copayment; Tier 2: $50 Copayment; Tier 3: 30%; Tier 4: 30% |
| Mail Order Drug | Deductible then, Tier 1: $13 Copayment; Tier 2: $150 Copayment; 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 Plan 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 | 20% Coinsurance after Deductible is met |
| 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 |
| Family Deductible | $6,000 |
| Out-of-Pocket Maximum | $7,000 |
| Family Out-of-Pocket Maximum | $14,000 |
Anthem
Anthem Bronze Pathway CT PPO
2022
| Benefit Year: | For Plan Year 2022 |
| 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 | $8,700 |
| Family Deductible | $17,400 |
| Out-of-Pocket Maximum | $8,700 |
| Family Out-of-Pocket Maximum | $17,400 |
Anthem
Anthem Bronze Pathway CT PPO w/HSA
2022
| Benefit Year: | For Plan Year 2022 |
| 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 Copayment; Tier 2: $75 Copayment; Tier 3: 40%; Tier 4: 40% |
| Mail Order Drug | Deductible then, Tier 1: $63 Copayment; Tier 2: $225 Copayment; 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 |
| Family Deductible | $13,800 |
| Out-of-Pocket Maximum | $7,000 |
| Family Out-of-Pocket Maximum | $14,000 |
ConnectiCare
ConnectiCare Passage Gold POS PCP
2022
| Benefit Year: | For Plan Year 2022 |
| 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 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; 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 | $500 at ambulatory facility; 20% coinsurance after deductible is met at hospital facility |
| Laboratory Service | Laboratory: $10 copayment |
| Outpatient Diagnostic Tests | $50 copayment at freestanding facility; 20% coinsurance after 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% conisurance per service after INET plan deductible is met at a hospital facility |
| Outpatient Mental Health | $50 Copayment per visit |
| Durable Medical Equipment | 50% Coinsurance |
| Individual Deductible | $3,000 |
| Family Deductible | $6,000 |
| Out-of-Pocket Maximum | $6,800 |
| Family Out-of-Pocket Maximum | $13,600 |
ConnectiCare
ConnectiCare Choice Silver POS w/HSA
2022
| Benefit Year: | For Plan Year 2022 |
| 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 Silver A POS
2022
| Benefit Year: | For Plan Year 2022 |
| 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: $10 copayment; Tier 2: $60 copayment; Tier 3: 50% coinsurance up to $300; Tier 4: 50% coinsurance up to $500 |
| Mail Order Drug | Tier 1: $20 copayment; Tier 2: $120 copayment; Tier 3: 50% coinsurance 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 | $10 Copayment per service |
| 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 |
| Durable Medical Equipment | 50% Coinsurance after Plan Deductible is met |
| Individual Deductible | $4,800 |
| Family Deductible | $9,600 |
| Out-of-Pocket Maximum | $8,500 |
| Family Out-of-Pocket Maximum | $17,000 |
ConnectiCare
ConnectiCare Choice Silver B POS
2022
| Benefit Year: | For Plan Year 2022 |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $30 Copayment per visit |
| Specialist Office Visit | $75 Copayment per visit |
| Prescription Drugs | Tier 1: $10 copayment; Tier 2: $50 copayment; Tier 3: 50% coinsurance up to $300 after deductible; Tier 4: 50% coins up to $500 after deductible |
| Mail Order Drug | Tier 1: $20 copayment; Tier 2: $100 copayment; Tier 3: 50% coinsurance up to $600 after deductible; 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 |
| Ambulance | 40% Coinsurance after Plan Deductible is met |
| Outpatient Surgery | 40% Coinsurance after Plan Deductible is met |
| Laboratory Service | 40% Coinsurance after Plan Deductible is met |
| Outpatient Diagnostic Tests | 40% Coinsurance after Plan Deductible is met |
| Outpatient Diagnostic Imaging | 40% Coinsurance after Plan Deductible is met |
| Outpatient Mental Health | $30 Copayment per visit |
| Durable Medical Equipment | 40% Coinsurance after Plan Deductible is met |
| Individual Deductible | $3,000 |
| Family Deductible | $6,000 |
| Out-of-Pocket Maximum | $8,650 |
| Family Out-of-Pocket Maximum | $17,300 |
ConnectiCare
ConnectiCare Choice Bronze POS
2022
| Benefit Year: | For Plan Year 2022 |
| Referrals: | Not Required |
| Preventative Adult Exams: | No Cost |
| PCP Office Visit: | $40 Copayment per visit |
| Specialist Office Visit | $60 Copayment per visit |
| Prescription Drugs | Deductible, then Tier 1: $10 copayment; Tier 2: $60 copayment; Tier 3: 50% coinsurance up to $300; Tier 4: 50% coinsurance up to $500 |
| Mail Order Drug | Deductible, then Tier 1: $20 copayment; Tier 2: $120 copayment; Tier 3: 50% coinsurance 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 Plan Deductible is met |
| Outpatient Surgery | Deductible, then ambulatory facility: $500; Outpatient hospital: 40% coinsurance |
| Laboratory Service | $10 Copayment after Plan Deductible is met |
| Outpatient Diagnostic Tests | Deductible, then $50 copayment freestanding facility; 40% coinsurance at a hospital facility |
| Outpatient Diagnostic Imaging | Deductible, then $75 copayment per service up to five copayments per year at a freestanding facility, then copayment waived; 40% coinsurance at a hospital facility |
| Outpatient Mental Health | $60 Copayment per visit |
| Durable Medical Equipment | 40% Coinsurance after Plan Deductible is met |
| Individual Deductible | $7,000 |
| Family Deductible | $14,000 |
| Out-of-Pocket Maximum | $8,300 |
| Family Out-of-Pocket Maximum | $16,600 |
ConnectiCare
ConnectiCare Choice Bronze POS w/HSA
2022
| Benefit Year: | For Plan Year 2022 |
| 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 copayment; Tier 2: $60 copayment; Tier 3: 50% coinsurance up to $300; Tier 4: 50% coinsurance up to $500 |
| Mail Order Drug | Deductible, then Tier 1: $20 copayment; Tier 2: $120 copayment; Tier 3: 50% coinsurance 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 |
| Family Deductible | $11,500 |
| Out-of-Pocket Maximum | $7,050 |
| Family Out-of-Pocket Maximum | $14,100 |
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
Providing guidance and solutions.
A lot goes into finding the right affordable group health insurance that protects the health of your employees and business. We want to make that process as clear and easy as possible.
Coverage starts at any time
Your group health insurance can start any month of the year. If you and your employees enroll by the fifteenth of the month, coverage can begin on the first of the following month.