Frequently asked questions about health insurance
coverage options in Connecticut
Access Health CT is a successful state-run exchange (marketplace) that dodged many of the technical problems that plagued other exchanges over the first few years of operation. The exchange is used by individuals, families, and small businesses that need to purchase health insurance coverage.
Individual market policies are purchased by people who are self-employed, retired prior to age 65, or employed by a small business that doesn’t provide health benefits. People who purchase these individual market plans through the exchange are able to obtain financial assistance (premium subsidies and cost-sharing reductions) depending on their household income. These subsidies reduce monthly premium costs as well as out-of-pocket medical costs.
To give residents an opportunity to take advantage of the American Rescue Plan’s (ARP) enhanced premium subsidies, AccessHealth CT is offering an enrollment window that runs from May 1 to August 15, 2021.
This window is available to anyone eligible to use the marketplace, including uninsured residents, people who have coverage outside the exchange and would like to transition to the exchange (the only place the subsidies are available), as well as current exchange enrollees who would like to switch to a different plan.
Open enrollment for 2021 coverage in Connecticut was extended through January 15, 2021. To address the COVID pandemic, AccessHealth CT also offered an enrollment window that began February 15 and continued through April 15, 2021, during which people who weren’t already enrolled in a plan through AccessHealth CT could sign up for coverage.
Outside of the open enrollment period, Connecticut residents normally need a qualifying event in order to enroll or make a change to their coverage. But that’s not necessary during the ARP-related enrollment window in 2021, nor was it necessary during the earlier COVID-related enrollment window.
As of 2019, pregnancy is a qualifying event that allows a woman to enroll in ACA-compliant individual market coverage in Connecticut.
(The open enrollment window does not apply to small-group plans; employers can select a plan at any time during the year in order to provide health benefits to employees, and will then establish an open enrollment period during which employees sign up for coverage for the next plan year.)
Two health insurance companies – Anthem and ConnectiCare – offer both individual/family and small group coverage through Access Health CT. Both insurers have a statewide service area.
For individual market plans, average approved rate changes for 2021 were a slight decrease for ConnectiCare and a 1.9 percent increase for Anthem. And for the small-group market, the average rate changes were a 4.1 percent decrease for ConnectiCare and a 2.6 percent increase for Anthem.
Most of the insurance companies that sell small-group plans in Connecticut do so outside the exchange. For 2021, most of these insurers raised their premiums by an average of 4 to 11 percent. Small businesses purchasing coverage for their employees can use Access Health CT, with a choice between plans offered by Anthem or ConnectiCare, or can shop directly with one of the eight insurance companies that offer plans outside the exchange.
See more information about Connecticut’s health insurance marketplace.
Enrollment for 2021 coverage through Access Health CT reached 104,946 people during the open enrollment period for 2021 coverage. This was down from 107,833 people the year before, and was the lowest enrollment had been since 2014.
Although enrollment declined from 2020 to 2021, this has to be considered in conjunction with the fact that Medicaid enrollment in the state increased by more than 70,000 people from February to November 2020, as a result of job/income losses during the pandemic.
In early March 2021, AccessHealth CT reported that more than 2,000 people had signed up for coverage during the marketplace’s COVID-related enrollment window, which had begun February 15. That window continued through mid-April, and a new enrollment window runs from May 1 to August 15, 2021. These extended enrollment opportunities, combined with the American Rescue Plan’s additional premium subsidies, are likely to drive enrollment higher in 2021.
Connecticut opted for a state-based exchange, Access Health CT, and expanded Medicaid under the Affordable Care Act. The state’s uninsured rate has dropped considerably since the ACA was implemented.
In 2017, Connecticut’s uninsured rate was among the lowest in the country, though the number of uninsured crept back up in 2018 and again in 2019. According to official US Census data, the uninsured rate in Connecticut was 9.4 percent in 2013 and stood at 5.9 percent in 2019.
As of mid-2020, there were more than 103,000 people enrolled in private health plans through Access Health CT; Obamacare’s essential health benefits are covered for all of them, with no lifetime or annual caps on the benefits. And 70 percent of these enrollees were receiving premium subsidies, which help to make monthly premiums affordable.
The Affordable Care Act – or Obamacare – was unanimously supported by Connecticut’s delegation to the U.S. Congress. Sen. Christopher Dodd, a Democrat, and Joseph Lieberman, an Independent, both voted to pass the Affordable Care Act in 2010, as did all five of Connecticut’s Democratic representatives.
Both senators have since left office, with Dodd replaced by Richard Blumenthal and Lieberman replaced by Chris Murphy. Both Blumenthal and Murphy are Democrats and supportive of the ACA. All five of the state’s Representatives are still Democrats as of 2021.
Connecticut state lawmakers passed legislation authorizing a state-run health insurance marketplace in 2011, and then Gov. Dan Malloy signed the bill into law on July 1, 2011. Malloy was re-elected in 2014. Current Governor, Ned Lamont, who is also a Democrat, took office in 2019.
The state health insurance marketplace was named Access Health CT in December 2012. Access Health CT has been one of the country’s most successful marketplaces, with few technical problems and robust enrollment. Access Health CT’s first CEO, Kevin Counihan, was named CEO of Healthcare.gov in August 2014.
In 2010, Connecticut was the first state to adopt Medicaid expansion, and it again expanded Medicaid eligibility criteria for the program at the beginning of 2014.
Between February and November 2020, enrollment in HUSKY Health (Connecticut’s Medicaid and CHIP program) grew by about 70,000 people, reaching a total of more than 920,000.
Read more about Medicaid eligibility and the ACA’s Medicaid expansion in Connecticut.
In 2018, the Trump administration relaxed the rules on the duration of short-term health insurance policies, but the rules allow states to continue to impose more strict restrictions, and Connecticut does.
The state already limited short-term coverage to no more than six months in duration, and prohibited renewals. Starting in 2019, Connecticut began requiring short-term health plans to cover essential health benefits. As a result, there are no longer any insurers offering short-term plans in the state.
Read more about short-term health insurance in Connecticut.
Connecticut Medicare enrollment reached 694,283 as of November 2020. About 46 percent of those enrollees had private Medicare Advantage plans, while the other 54 percent were covered under Original Medicare. Most Medicare beneficiaries in Connecticut are eligible for Medicare due to age, but 13 percent are under 65 and are eligible because of a long-term disability, ALS, or end-stage renal disease.
Read more about Medicare in Connecticut, including the state’s rules for Medigap plans, and options for private Medicare Advantage and Part D prescription coverage.
Learn about how Medicaid supports one in five Medicare beneficiaries. (Medicaid in Connecticut is HUSKY Health)
Got questions about the annual Medicare open enrollment period? Our guide can help.
- Access Health CT — Website that Connecticut residents use to enroll in private individual market or small group coverage, or income-based Medicaid/CHIP coverage.
- Connecticut CHOICES Program – free enrollment counseling and assistance for Medicare beneficiaries
- Connecticut Insurance Department — Regulates and licenses health insurance companies, brokers, and agents; responds to consumers’ questions and complaints about entities that are regulated by the Department.
- Husky Healthcare — health coverage for Connecticut residents with low and modest incomes.
- Medicare Rights Center — A national service that provides assistance and information to Medicare beneficiaries and their caregivers.
Prior to the reforms the ACA brought to the individual health insurance market, coverage was underwritten in nearly every state, including Connecticut. That left people with pre-existing conditions often unable to purchase a plan at all, or only eligible for coverage that excluded pre-existing conditions or charged premiums significantly higher than the standard rates.
The Connecticut Health Reinsurance Association (HRA) was created in 1976 to give people an alternative if they were ineligible to purchase individual health insurance because of their medical history. (Only Minnesota has a high risk pool as old as Connecticut’s.)
Since January 2014, all new major medical policies in the individual market have been guaranteed issue, thanks to the ACA. This means that there is no longer a need for high-risk pools the way there was in the past. Connecticut’s HRA board voted to discontinue new member enrollment at the end of 2013, but they did not immediately cancel coverage for existing members. Ultimately, HRA plans remained in effect throughout 2017, but were terminated at the end of 2017. All remaining HRA members needed to switch to new plans for 2018.