Health Insurance Companies in CT Comparison Guide

Choosing the right health insurance company in Connecticut can be overwhelming, but with a little research, you can make an informed decision. Anthem Blue Cross and Blue Shield is one of the largest health insurance companies in CT, offering a wide range of plans to suit different needs and budgets.

Aetna, another prominent health insurance company in CT, has a strong reputation for providing quality coverage and excellent customer service. Their plans often include discounts for gym memberships and healthy eating programs, which can be a great incentive for those who want to stay active and healthy.

ConnectiCare is a local health insurance company that offers affordable plans to individuals and families. They have a unique approach to healthcare, focusing on preventive care and community-based programs to promote overall well-being.

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In Connecticut, you have a few options when it comes to health insurance companies. Four companies offer exchange and off-exchange plans in the state.

These companies include Anthem Blue Cross Blue Shield, ConnectiCare, ConnectiCare Insurance Company, and ConnectiCare Benefits. You can choose from these options to find a plan that suits your needs.

Here are the four companies that offer health insurance plans in Connecticut:

The Patient Protection Act of 2010, also known as the Affordable Care Act or Obamacare, became law in 2010 and has had a significant impact on health insurance in Connecticut.

The law requires most U.S. citizens and legal residents to have qualifying health care coverage or pay an annual tax penalty for every month they go without insurance.

This is called the "individual mandate", and there's a grace period through March 31, 2014, before penalties kick in.

The penalty for not having qualifying coverage is $95 per adult and $47.50 per child or 1% of your taxable income; whichever is higher (up to $285 per family).

The penalty increases annually through 2017 and beyond.

Here's a breakdown of the penalty amounts:

Connecticut has made significant strides in expanding healthcare access to its residents.

In 2010, the Affordable Care Act was signed into law, leading to a 48.3% decline in the number of uninsured individuals in the state between 2013 and 2016.

Connecticut was the first state to expand Medicaid enrollment to low-income adults who earn up to 133% of the federal poverty level.

This expansion made an estimated 45,000 adults eligible for public health aid.

You can choose from several health insurance companies in Connecticut, including Anthem Blue Cross Blue Shield, ConnectiCare, ConnectiCare Insurance Company, and ConnectiCare Benefits.

These four companies offer exchange and off-exchange plans in the state.

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Choosing a Plan can be overwhelming, but it doesn't have to be. With so many options available, it's essential to understand the basics of each plan type. You can choose from Bronze, Silver, Gold, and Platinum plans, each with a different metal level indicating the percentage of healthcare costs the plan will cover.

Bronze plans cover 60% of healthcare costs, while Silver plans cover 70%, Gold plans cover 80%, and Platinum plans cover 90%. This means you'll pay 40%, 30%, 20%, and 10% of the costs respectively. For example, if you have a Bronze plan, you'll pay 40% of the costs, and the insurance company will cover 60%.

To make it easier to compare costs and benefits, the Affordable Care Act designates that all qualifying plans be one of these four metals. This way, you can easily see which plan is right for you.

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Choosing Anthem for your small business health insurance needs can be a great decision. Anthem features one of the broadest networks in the nation, with access to 95% of doctors and 96% of hospitals in the U.S.

Their network is impressive, with one in three Americans carrying a Blue Cross Blue Shield card – over 106 million members. This means your employees will have a wide range of healthcare options available to them.

One of the benefits of choosing Anthem is the convenience of their online tool, EmployerAccess. This secure platform allows you to review your account, enroll members, check eligibility, and order ID cards – all in one spot, saving you valuable time.

Your employees will also appreciate the 24/7 online visits with board-certified doctors, access to quality providers within 10 miles of their home, and the Sydney Health mobile app that lets them access their health plan anytime, anywhere.

Here are some key benefits of choosing Anthem:

In Connecticut, we have a strong presence with over 1.1 million members, 1,549 associates, and 88 years of experience in the local market.

Our associates are deeply rooted in the communities we serve, with many living and working alongside our members.

We're proud to have supported Connecticut communities and local nonprofits through donations and volunteer hours.

In 2023, we donated $654,599 in open community giving activity, making a tangible impact on the lives of those we serve.

Our associates also contributed $243,126 through donations and volunteer hours, demonstrating their commitment to giving back.

The dedication of our associates is truly inspiring, with 3,863 employee volunteer hours recorded through Anthem’s Dollars for Doers program in 2023.

Under the Affordable Care Act, no one can be denied coverage or charged significantly higher premiums because of past health history or gender. This is known as the guaranteed issue provision.

Guaranteed issue applies to all non-grandfathered plans, which means you can't be turned down for coverage or charged more because of a pre-existing condition. This is a huge relief for people with chronic health issues.

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Policies are effective on issue, so you can start using your coverage right away. There are no look-back or waiting periods imposed.

Plans can only be canceled for non-payment of premiums or fraud. This means you can rely on your coverage as long as you pay your premiums on time.

Here's a quick rundown of the tiers of Obamacare plans and how they work:

Medicaid is a great option for those who need health insurance but can't afford it. As of January 2021, 921,000 people in Connecticut were covered under Medicaid, also known as HUSKY Health.

HUSKY Health provides coverage to a wide range of people, including children, pregnant women, parents, older adults, and adults with disabilities. It covers most health services, such as hospital stays, lab tests, nursing care, prescription medications, and medical equipment.

Income restrictions apply to Medicaid, and the amount you can make depends on your family size and situation. For example, if you're an adult without minor children, your income limit is $20,608 or less for a family of one.

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Here are the income limits for a family of 1 to 5:

If you're eligible for Medicaid, you can visit the website at www.ct.gov/husky to learn more or apply.

If you're an individual looking for health insurance, there are several options available to you. You can purchase individual coverage through the federal Health Insurance Marketplace, specifically through the state-run exchange, Access Health CT, in Connecticut.

This type of insurance is often referred to as Obamacare or the Affordable Care Act (ACA), and it's an excellent option if you have a chronic health issue because Obamacare plans can't exclude you based on preexisting conditions.

You can choose from different tiers of plans, including Bronze, Silver, Gold, and Platinum. Bronze plans are the cheapest, with the insurance company paying 60% and you paying 40% of healthcare costs.

Here's a breakdown of the different tiers:

As you can see, the more you pay, the higher the percentage of healthcare costs that the insurance company will cover.

In Connecticut, health insurance companies must offer a range of benefits to ensure you're covered in case of an emergency or ongoing medical needs. All small business medical insurance plans in the state feature integrated pharmacy coverage, allowing physicians and medical professionals to deliver the right care at the right time.

Some of the standardized essential benefits you can expect to find in qualifying plans include ambulatory patient services, emergency services, hospitalization, and maternity and newborn care. These benefits are mandated by the Affordable Care Act and must be offered by private insurers.

Here are the 10 standardized essential benefits, as mandated by the Affordable Care Act:

In addition to these standardized benefits, some Connecticut health insurance companies offer extra benefits that exceed ACA requirements. For example, they may cover accidental ingestion of controlled drugs, bone marrow testing, or clinical trials. These extra benefits are mandated by the state and can provide additional peace of mind.

Medical and pharmacy coverage is a crucial aspect of health insurance. All small business medical insurance plans feature integrated pharmacy coverage.

Plans are designed to work seamlessly together, allowing physicians and medical professionals to deliver the right care at the right time. This integrated approach ensures that medical and pharmacy coverage are aligned to provide comprehensive care.

In-network preventive care coverage is included at 100% in compliance with the Affordable Care Act. This means that you won't have to pay a dime for certain preventive services.

Our plans are powered by CarelonRx, a custom-built pharmacy benefits manager. This advanced technology helps us provide efficient and effective pharmacy coverage.

Here are the 10 standardized essential benefits that all qualifying plans must offer:

These benefits are designed to provide comprehensive coverage for a wide range of health services.

In Connecticut, the frequency of doctor visits varies depending on your insurance type. Residents with group and individual coverage tend to visit doctors at a frequency close to the national average.

Medicare Advantage enrollees, on the other hand, have a higher than average frequency of doctor visits. This suggests that they may have more comprehensive coverage that encourages them to seek medical care.

The state of Connecticut does not measure doctor visits for Medicaid patients, so we don't have data on how often they visit doctors.

Residents with group and individual insurance in Connecticut have a slightly higher rate of using non-physician care compared to other states.

Non-physician care, which includes visits to nurses, physical therapists, and counselors, tends to be an expensive form of treatment.

Many non-physician visits take place at outpatient facilities, which are often owned and operated by hospitals.

Medicare Advantage patients have a significantly higher rate of using non-physician health care than the U.S. average.

Data on non-physician visits for Medicaid patients in Connecticut is not available.

Non-physician care visits to outpatient facilities can be more expensive than a doctor visit, despite being less expensive than a hospital stay.

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In Connecticut, the average number of days residents with group, individual, and Medicare Advantage insurance spend in the hospital is similar to the national average.

The number of days in the hospital is counted starting with the day the patient is admitted, and the last day is not counted unless the first and last day are the same.

Data on days spent in the hospital for Medicaid patients in Connecticut is not measured, which might be due to differences in healthcare systems or data collection methods.

Overall, understanding the average hospital stay can help individuals plan for their medical expenses and choose the right insurance plan for their needs.

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In Connecticut, the average cost of health insurance is $8,153 per person, with a family of four paying $32,612. This is $1,172 per person above the national average.

The cost of health insurance in Connecticut can vary significantly based on the cost of care and the population insured. For example, group insurance is based on 297,882 enrollees, while individual insurance is based on 147,675 enrollees.

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The premium for a 40-year-old purchasing insurance through the Marketplace would pay $570 per month, on average, for the second-lowest-cost silver plan. This is a $95 increase over the cost of the average benchmark premium for 2020.

Here are the factors that may affect your premium:

In Connecticut, the average cost of health insurance is $8,153 per person, which is $1,172 above the national average.

The cost of health insurance can vary significantly based on the type of insurance and the population insured. For a family of four, the average cost is $32,612.

The state of Connecticut approved a 0.01% increase in individual plan premiums for the 2021 coverage year, which is essentially a flat rate from the previous year.

A 40-year-old purchasing insurance through the Marketplace would pay $570 per month on average for the second-lowest-cost silver plan, a $95 increase over the 2020 average benchmark premium.

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Premiums for health insurance in Connecticut are based on several factors, including your age, tobacco use, where you live, and the number of family members enrolling with you.

Here's a breakdown of the factors that can affect your premium:

Deductibles can significantly increase the cost of healthcare for people who file insurance claims.

In Connecticut, residents with group, individual, and Medicare health plans often have deductibles that must be met before insurance coverage kicks in.

Individual insurance plans typically have larger deductibles than other plans.

A person on an individual plan paying $5,083 with a $6,000 deductible, for example, has an effective price of over $11,000 if they use their insurance.

This means that if you have a high deductible, you may end up paying a lot more out of pocket for medical expenses.

In states with CON boards, health care costs are significantly higher due to reduced competition. The average cost for health care in states with CON requirements is $664 more per person insured than in states without these boards.

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Some states with CON requirements include Alabama, Alaska, Arkansas, and Florida, among others. In total, 28 states have CON board certification requirements.

States without CON boards tend to have lower health care costs. New Hampshire and Wisconsin are exceptions, but even they haven't seen a significant impact on costs due to recent modifications in their CON laws.

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