Connecticut Health Insurance

Connecticut (CT)

Individual Health Insurance Regulations

Health coverage is one indispensible option that one cannot afford live without. Being the earning member of the family, your main interest lie in the protection of your family against unforeseen circumstances through a suitable health coverage. Before choosing a particular policy, a detailed evaluation of your family's healthcare needs and your personal finances is obligatory. If you reside in Connecticut, you have the option to choose from various alternatives. The Connecticut Insurance Department regulates the legislature under which the Connecticut health insurers can sell private plans to individuals and families.
Connecticut law allows insurance companies offering medical insurance to "medically underwrite" any application from residents of the state. This means that they can base their decision on providing you with health coverage based on your current and past medical history. There are no set guidelines and insurance companies may deny you coverage for any medical reason. Premiums for individual health insurance are not regulated in Connecticut and insurance companies may charge whatever rate they deem fit. The insurance company may also place exclusionary riders on new applicants for pre-existing medical conditions. Creditable coverage must be considered on any pre-existing condition waiting period that is not included on an exclusionary rider. Insurance premiums are based on age, gender, health care costs in that region, health status, health history and zip code of residence. The health insurer may look back in your 12-month health history to determine any pre-existing medical conditions and, if found any, can impose exclusionary period of 12 months for those health conditions.
Search for plans and the costs associated with them using the search box above. We provide individual, family, Medicare supplemental, group and student health plan quotes for you to compare on all states and zip codes. Remember that having coverage leads to a healthier lifestyle as you are able to get regular doctor checkups and therefore a low-cost premium.

Connecticut (CT)

Small Group Health Insurance Regulations

A small group can range from 1 to 50 employees. Insurance companies are mandated by the state law to provide "guaranteed issue" insurance to the applicants. This means that they can't be denied coverage, regardless of the overall health status or history of the employees that they wish to include on the group plan. Income tax documentation from the previous quarter may be required from the insurance company to verify which employees are eligible for coverage. Two employees must be present for half of the preceding calendar quarter and work 20 hrs/week for coverage. In addition, over half of the eligible employees must reside within the state of Connecticut. A self-employed business owner may be able to obtain group health coverage in Connecticut, but is subject to medical review. If they meet the medical guidelines of the insurance carrier, they may select any health plan that is available to larger groups. If they do not meet medical review, they will be offered a selection of a couple of plans that are offered on a "guaranteed issue" basis to one man groups. Enrollment in a one man group health plan may also be subject to bi-annual enrollment periods. Depending on the size of the group, insurance companies may adjust the standard published premium according to the Modified Community Rate. The look-back period for the determination of pre-existing conditions is 6 months for the group health plan and the exclusion period for those conditions is 12 months.

Connecticut COBRA and Continuation Coverage

Groups of more than 20 insured employees must follow federal COBRA guidelines which allow any employee to remain on the group health plan for 18 months or 36 months after leaving employment with the company, regardless of the reason they are leaving. In some special cases, a widows, dependent children etc. may be eligible to remain on COBRA for 36 months. This includes person that meet disability guidelines. The premium amount, plus a 2% administration fee will be charged directly to the insured. You have 60 days from the date of the notice or the day your previous coverage ended, whichever is later, to decide if you want to sign up for COBRA.
Groups of 2-19 insured persons are subject to Connecticut mini-COBRA laws. Under state law, small groups must follow the same federal guidelines imposed on larger group health plans. The only exception is that small groups are only required to permit disabled persons to remain on COBRA for 29 months. Public Act 97-268 gives persons that become disabled in the first 60 days of COBRA coverage are entitled to an extension for 29 months. If a Connecticut employee between the ages of 62 and 65 loses his job and the employee is eligible for COBRA, then state mandates the employer to extend COBRA coverage until the person reaches age 65, regardless of the number of months involved.
Once a person has exhausted their COBRA coverage, they may be eligible to be guaranteed coverage under the Connecticut Health Reinsurance Association, which is the state's risk pool program.