Health Care Options for Employees

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Employees eligible for medical and dental insurance enroll at the time of initial employment. Thereafter, employees can add or change insurance during the annual open enrollment period. Open enrollment generally occurs during May, and elections made at that time are effective July 1. Look for announcements for specific dates and times during the spring each year.

Learn More
Visit http://www.carecompass.ct.gov for details about the Health Enhancement Program, medical and dental plan summaries, and payroll deductions.

2022-2023 Health Insurance Open Enrollment

The 2022 - 2023 annual Health Insurance Open Enrollment for the State of Connecticut employees will be held from May 2, 2022 through May 27, 2022.  Any changes made will during Open Enrollment will be effective on July 1, 2022.

No action is required if you wish to remain enrolled in your current coverage; your current elections will automatically continue (but under the new plan name listed below).

Please note the following important changes:

  • There are some new Anthem medical plan names:
Prior Plan Name New Plan Name
State BlueCare Prime Plus POS Quality First Select Access
State BlueCare POE Plus Primary Care Access
State BlueCare POE Standard Access
State BlueCare POS Expanded Access
State Preferred POS (current members only) State Preferred POS (no change)
Out-of-Area Out-of-Area (no change)
  • Dependent children can now be covered on dental insurance until the end of the calendar year in which age 26 is reached.  Any dependent child who had previously aged off of the coverage can be added back on to the coverage during this open enrollment period.  Please note that a copy of the full-length birth certificate will be required.

Additional information is available as follows:

  • Information on plan offerings, rates, and changes for the upcoming year is available on the Care Compass website - https://carecompass.ct.gov/openenrollment/.
  • The Health Navigator tool is available via telephone, web, and online messenger chat; this tool is designed to help anyone on the state plan navigate their health benefits, including finding doctors/facilities, answering questions about benefits, and troubleshooting issues.
  • The Office of the State Comptroller will sponsor a series of live virtual events with the insurance vendors during the annual Open Enrollment period; details and recorded presentations are available at https://carecompass.ct.gov/openenrollment/#events (scroll to bottom of page).

    During open enrollment, you may change medical and/or dental plans, add or drop coverage for your eligible family members, or enroll if you previously waived coverage. You may also enroll in the Health Enhancement Program (HEP) if you previously waived enrollment.

    Employees who wish to make changes during this open enrollment period may enter changes directly in CORE-CT until May 27, 2022.  No action is required if you wish to remain enrolled in your current coverage; your current elections will automatically continue (but under the new plan name).

    If a dependent is being added to insurance, a copy of supporting documentation (i.e. marriage license, long form birth certificate, etc.) is also required.  Instructions for entering changes and uploading supporting proof documentation into CORE-CT are available in the Open Enrollment Job Aid.

    Affordable Care Act Notice

    The Affordable Care Act requires us to inform all employees about the Health Insurance Marketplaces, which were set up to make it easier for consumers to compare plans and enroll in health insurance coverage. If you are eligible for employee health benefits through the State of Connecticut you will most likely not save money by purchasing coverage through the Marketplace. However, if you are not eligible for job-based health benefits, you may want to consider purchasing coverage through the Marketplace as explained here in the New Health Insurance Marketplace Coverage Options and Your Health Coverage notice.

    Child Eligibility Rules

    In accordance with the “Affordable Care Act” medical/prescription drug eligibility rules are revised to allow enrollment of the subscriber's natural, adopted child, or stepchild who are:

    1. Up to age 26;

    2. Any age if permanently and totally disabled, and who are enrolled as a dependent in the state plan or an equivalent plan at the time the disability occurred;

    3. And, whether or not they are:

    a. Married (a dependent's spouse or the employee's grandchildren are still not eligible for coverage);
    b. Living in Connecticut;
    c. Living with the employee;
    d. In school;
    e. Financially dependent on the employee; or
    f. Eligible to enroll in their employer's health coverage.

    Health Enhancement Program

    The Health Enhancement Program (HEP) has several important benefits. When you and your enrolled family members participate in the HEP and meet the program's requirements, you pay lower monthly premiums and have no deductible for in-network care for the plan year.

    If an individual is not already enrolled in HEP, and does not elect to enroll during this open enrollment, the next opportunity to join will be next year’s open enrollment period. If an individual does not participate in the Health Enhancement Program, the premiums will be $100 per month higher and there will be an annual $350 per individual ($1,400 per family) in-network medical deductible.

    Care Management Solutions, an affiliate of ConnectiCare, is the administrator for the HEP. You can visit www.cthep.com to:

    • View HEP requirements and download HEP forms
    • Check your HEP compliance status
    • Exchange messages with HEP Nurse Case Managers and professionals.

    Care Management Solutions representatives can be reached at 877-687-1448, Monday to Friday, 8 a.m. to 5 p.m. If an individual is not already enrolled in HEP, and does not elect to enroll during this open enrollment, the next opportunity to join will be next year’s open enrollment period. If an individual does not participate in the Health Enhancement Program, the premiums will be $100 per month higher and there will be an annual $350 per individual ($1,400 per family) in-network medical deductible.

    Adding/Dropping Dependents Outside of the Open Enrollment Period

    Once you choose your medical and dental plans, you cannot make changes during the plan year (July 1 to June 30) unless you experience a separate qualifying status change and contact Human Resources within 31 days of the event. Qualifying status changes include:

    Legal Marital/Civil Union Status
    Any event that changes your legal marital/civil union status, including marriage, civil union, divorce, death of a spouse, and legal separation.

    The State and SEBAC have reached an agreement to clarify the allowable coverage in the event of legal separation, divorce and legal guardianship at age 18. When any of these events occur after July 1, 2012, an employee is required to notify the Benefits Unit within 31 days of the event.

    Legal Separation
    An employee who is granted a legal separation can either terminate spousal coverage or will be permitted to provide spousal coverage, subject to the following:

    The employee must report the legal separation by submitting Comptroller's Form CO-1319 to the Benefits Unit 31 days of the judgment;

    The employee must pay 100% of the cost of individual coverage for the spouse under the selected vendor and plan (includes both the employee and the state portion); and

    The spouse's coverage will continue for three years or until either party remarries, whichever first occurs.

    Divorce
    In general, entry of a divorce decree requires that the former spouse be removed as a dependent under the plan within 31 days from the effective date. However, the laws of some states and certain divorce decrees require an employee to continue group medical plan coverage for a former spouse.

    Employees required by state law or divorce decree to provide health benefit coverage for an ex-spouse will be allowed to continue coverage for a former spouse under the state plan, provided:

    The employee must report the legal separation by submitting Comptroller's Form CO-1319 to the Benefits Unit 31 days of the judgment;

    Coverage of the former spouse may continue for up to three years or until either party remarries, whichever comes earlier; and

    The employee must pay 100% of the cost of individual coverage for the former spouse under the selected vendor and plan (includes both the employee and the state portion).

    Where there is no court order or statute requiring continuation of coverage for a former spouse or member fails to provide timely notice of a marital status change, continuation coverage for the former spouse will be available under COBRA.

    Legal Guardianship at Age 18
    Under our medical/dental plan, an employee who has been named by the court as legal guardian of a minor child is permitted to cover that child as a dependent while the guardianship is in place. Most legal guardianship ends at age 18.

    An employee who has been providing medical benefits to a child for whom he or she is the legal guardian must now identify that child as a ward (or temporary ward) - not as a "son" or "daughter" - and must provide employing agency with a copy of the legal guardianship order. Everyone who is providing coverage for a child who is currently (or was formerly) subject to legal guardianship must update the child's status by submitting a CO-1318 for each individual to Benefits Unit.

    If an employee has been providing medical plan coverage to an individual after legal guardianship has ended (for example, a grandchild between the ages of 18 and 26) the employee must update the child's status by July 1, 2012 by submitting a CO-1318 and by providing further information to be used to determine the tax treatment of benefits provided. There are two possibilities.

    For federal income tax purposes, for coverage after guardianship ends (children between 18 and 26), if the child continues to be the member's dependent, then the benefit should not be taxable to the employee. Form CO-1048 QR should be used by the employee to document the individual's status as a dependent for tax purposes. While employees are permitted to cover a former ward who is not a tax dependent, the fair market value of the benefit will be taxable. Form CO-1048 NQ should be filled out by the employee to designate individuals under the age of 26 who are covered under the plan but do not qualify as a dependent for federal tax purposes.

    Number of Dependents
    Any event that changes your number of dependents, including birth, death, adoption, and legal guardianship.

    Employment Status
    Any event that changes your, your spouse/civil union partner's, or another dependent's employment status, resulting in gaining or losing eligibility for coverage such as:

    • Beginning or ending employment
    • Stating or returning from an unpaid leave of absence
    • Changing from part time to full time or vice versa

    Dependent Status
    Any event that causes your dependent to become eligible or ineligible for coverage under their current status as a dependent child, qualifying relative (child) or non-qualified child because of a change in age, student status, status as an IRS dependent, or similar circumstances.

    Residence
    A significant change in your plan of residence that affects your ability to access network providers (i.e., moving out of state).

    All changes must be made within 31 days from the qualifying event. Employees must contact the HR Employee Resource Center at 860-679-2426 within 31 days for the appropriate paperwork and for additional instructions for submitting required supporting documentation (i.e., marriage license or full-length birth certificate). The change made must be consistent with the qualifying status change (i.e., getting married would allow an employee to add a spouse, but would not allow an employee to change plans).

    Special Payroll Insurance Rates

    Effective July 1, 2022

    Medical Insurance Monthly Rates

    Dental Insurance Monthly Rates

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    Insurance Options

    For specific choices, coverage and rate information, please visit the State website.

    2021-2022 Health Care Options Planner

    2019-2020 Health Care Options Planner

    2018 Health Care Options Planner

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    Health Enhancement Program

    Enter the HEP Portal

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    Affordable Care Act Notice

    New Health Insurance Marketplace Coverage Options and Your Health Insurance

    Access Health CT: Connecticut's Official Health Insurance Exchange

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    Contact

    For questions, contact:

    HR Employee Resource Center
    860-679-2426