FAQs

General
What is Access Health CT?
Access Health CT is Connecticut’s official health insurance marketplace. It offers residents and small employers a range of qualified health care coverage options from health insurance carriers and public health care programs. You can get the coverage you need online, over the phone or in person.

Access Health CT is also the only place in Connecticut where individuals, families, and small businesses can get financial help with their health insurance costs, if they qualify.

Access Health CT was established to meet the requirements of the federal Health Care Reform law (or Affordable Care Act), which requires that states have a “health insurance exchange” (or marketplace) in place by January 1, 2014.

Can anyone use Access Health CT?
Access Health CT is open to all legal residents of Connecticut who do not have access to affordable health insurance through their employer. To buy health insurance through Access Health CT, you must live in the United States, be a U.S. citizen or lawfully present, and cannot currently be incarcerated.

Access Health CT is for you if:

  • You need healthcare coverage
  • Your employer doesn’t insure you or doesn’t offer affordable coverage
  • You’re self-employed
  • You’ve been denied insurance due to a pre-existing condition
  • You’re insured but looking for cost savings
When I call Access Health CT (855-805-4325), why am I asked for my social security number and date of birth?
It helps us to serve you better. With this information, we can keep a secure and confidential record of your calls and questions, which benefits you in two important ways:

  1. You will not need to repeat the same information each time you call.
  2. Our representatives can quickly see what issues are important to you and focus their responses on those topics and related topics.
Enrollment
When can I enroll in Access Health CT?
You can enroll now through March 31, 2014. There will be an annual open enrollment period going forward.
How long will the enrollment process take?
On average, for individuals or small households, it will take about 30–45 minutes to apply, review all the plans available, and complete the enrollment process. For larger households, or those with complex situations or eligibility issues, it may take a little longer.
How do I find a plan, apply and enroll through Access Health CT?
There are several convenient ways. You can:

  • Apply in person through a trained and certified insurance broker or In-Person Assister – either at an Enrollment Center or at one of our Enrollment Fairs throughout Connecticut.
  • Call us at 855-805-4325 to talk with a trained specialist who can answer your questions and guide you through the enrollment process – in many different languages.
  • Use our website to see if you qualify for financial help or certain public health care programs; compare available health plans; and complete a single application that may be used to apply for any plan or program.

 

Coverage
Can I really get coverage if I have a pre-existing health condition?
Yes. Coverage for those with pre-existing conditions was one of the big changes made possible by the federal government’s Affordable Care Act. Starting in 2014, you can not be denied coverage or charged more just because you have a pre-existing health condition. Your cost will be calculated based on your age, geographic location and the plan you choose. No other factors will be considered.
Will I be able to get a plan with a strong network of doctors and clinics?
Yes. For insurance carriers to be included in Access Health CT, Connecticut’s health insurance marketplace, they must meet certain requirements. One is that their plans include a strong network of doctors and clinics.
Tax penalties
What are the tax penalties for individuals and small businesses that do not sign up for health care coverage?
As of January 1, 2014, most U.S. residents will be required to have health care coverage. The federal government has set the following tax penalties for individuals who do not have coverage:

  • For 2014, $95 or 1% of your gross household income over the federal income tax filing threshold – whichever is greater. (The federal income tax filing threshold is $9,500 for an individual or $19,500 if married filing jointly.)
  • For 2015, $325 or 2% of your gross household income over the federal income tax filing threshold – whichever is greater.
  • For 2016, $695 or 2.5% of your gross household income over the federal income tax filing threshold – whichever is greater.

The law provides exemptions for certain individuals, including those below a certain income and those who cannot afford the coverage that’s available.)

If you are a business owner with fewer than full-time-equivalent (FTE) employees, you will not have to pay a penalty if you do not provide insurance to your employees. If you have more than 50 FTE employees and do not provide insurance to your employees, you may be subject to penalties beginning in 2014.

Financial help
How do subsidies work for individuals and small businesses?
Individuals who earn up to $45,960 a year may qualify for subsidies to help cover their monthly health insurance payments. Families may also be eligible, depending on income and size. For example, a family of four earning up to $94,200 a year might qualify. These subsidies, which come in the form of tax credits or cost-sharing reductions, are applied toward your health insurance costs.

Small businesses that qualify may benefit from subsidies in the form of a tax credit. To qualify, a small business must contribute at least 50% of each employee’s insurance premium, pay an average annual wage of less than $50,000, and have fewer than 25 full-time-equivalent (FTE) employees. Businesses will receive this credit when they file their income taxes in 2015 for the 2014 calendar year.

How do I know whether I qualify for Medicaid or a subsidy for health insurance?
It will depend on your income. Connecticut residents in households under a certain income level may be eligible for Medicaid. Connecticut residents above this income level may be eligible for subsidies for a qualified health plan purchased through Access Health CT. Thanks to an expansion of Medicaid under the Affordable Care Act, eligibility for Medicaid is expanding in many states, including Connecticut.

When you fill out an application with Access Health CT, you’ll learn if you or your children qualify for free or low-cost coverage through Medicaid or the Children’s Health Insurance Program (CHIP).

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Step By Step

Now: Start preparing for enrollment

Change is coming. On October 1, you can begin using Access Health CT to find coverage for yourself and your family. Here’s what you can do right now to get ready:

1. Get to know us.

You’ve already taken this step by visiting our site! Be sure to read our FAQs. Check back often between now and October, as we’ll be adding sneak previews of plans and other helpful information.
Download the “What is Access Health CT” flyer [PDF]

October 1, 2013: Access Health CT opens

2. Visit AccessHealthCT.com.

Come back to this site in October to begin exploring your health insurance options. If you prefer, get expert help by phone, or meet with an insurance agent or community partner trained by us.

3. See what kind of coverage you can get.

We can help you quickly determine if you qualify for financial help for a health plan, Medicaid or other insurance programs. All we need is some basic financial information.

4. Shop for a health plan.

The name-brand plans we offer have all met State standards for quality and value. We make it easy to do apples-to-apples comparisons online so you can find the right one for you.

5. Enroll in a plan.

With just one simple application, you can enroll in any plan we offer, from any insurance company, as well as apply for financial help.
Download the “How to enroll” handout [PDF]

January 1, 2014: Coverage begins
6. Get coverage to avoid a penalty.

It’s the law. All U.S. citizens and legal residents must have healthcare coverage by the start of the year. If you do not, you could face a tax penalty.

Tax Penalties for 2014–2016

2014 2015 2016
$95 per person
or 1% of household income
, whichever is greater*
$325 per person
or 2% of household income
, whichever is greater*
$695 per person
or 2.5% of household income
, whichever is greater*

* The percentage penalty is imposed on gross household income over the federal income tax filing threshold. Certain people may not be subject to a penalty, such as those whose gaps in coverage are less than a continuous three month period in a single year. In addition, the penalty may be subject to a cap.

For more information on the tax penalty, visit the Kaiser Family Foundation.

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Benefits

Many individuals and families will be able to lower their healthcare costs.

With Access Health CT, it’s easier than you may think to get coverage for yourself or your family. If you make under $45,960 or your family makes under $94,200, you could get a real break on health insurance costs – with financial help available only through Access Health CT. You may even qualify for free coverage through Medicaid, which you can also get through Access Health CT.

Eligible for Medicaid* Eligible for Financial Help*
Single Income up to $15,856 Income from $15,857 up to $45,960
Family of 4 Income up to $32,499 Income from $32,500 up to $94,200
* Eligibility will depend on actual annual household income level and household size

You can’t be turned down for health reasons.

Here’s more good news for you and your family. Under new health reform laws, you can no longer be denied healthcare coverage for a pre-existing condition. Even better, you can feel confident that the plan you buy will meet your healthcare needs. All Access Health CT plans have met high standards for quality set by the State. And all offer preventive care at no cost and wellness programs to keep you healthy.

Shop around without going to multiple places.

When our online health insurance marketplace opens in October, shopping for health coverage will be easier than ever. You’ll be able to quickly compare quality health insurance plans from name-brand insurance companies, find out if you’re eligible for financial help, and enroll in coverage – all in one place. You can also get expert help over the phone, or in person from an insurance agent or a specially trained Access Health CT partner.

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