Non-Medicare Retirees

What’s New?

Dental Plan Expansion
Last year, we expanded our dental plan options to include a new Total Care DHMO plan. The Total Care DHMO covers exams and routine care, bridges, dentures, orthodontia, implants, periodontics, simple restoration (fillings), oral surgery and more! Plus, there’s no annual deductible or calendar-year benefit maximum! See more information about this plan.

Updated Medical Plan Options
You have a new medical plan option, the Quality First Select Access plan. This plan is the least expensive because it features the smallest networks. However, all providers in this plan’s network meet strict care experience and quality measures. This plan replaces the State BlueCare Prime Plus POS plan. Learn more about the Quality First plan.

Orthopedic Resources
Do you have pain keeping you up at night? Is a nagging injury slowing you down? There are several orthopedic resources available to help you with any orthopedic injury, from evaluation through surgery. Learn more.

Your Care Coordinator
Need help? Call 833-740-3258 to connect directly with a Care Coordinator. Your Care Coordinator can help you navigate your state health plan benefits. Care Coordinators can assist with finding Providers of Distinction locations, answering questions about benefits, and troubleshooting problems. The support you’ll receive will be highly coordinated with the member services teams at Anthem, Cigna, CVS Caremark and Care Management Solutions to make it easier for you to navigate your benefits and access the right care for you.

Providers of Distinction
The State of Connecticut has identified some of the highest-quality doctors, hospitals and medical groups in the state for many common procedures. Doctors and care locations that have a proven track record for delivering high-quality, cost-effective care are designated Providers of Distinction under your health plan. Learn more.

Enrolling in Retiree Health Benefits

Current Retirees
If you are a retiree, you and your dependents who are Medicare-eligible are enrolled automatically in the UnitedHealthcare Group Medicare Advantage (PPO) plan. You or your dependents do not need to complete an enrollment form unless changing dental coverage or changing your covered dependents.

If you want to make changes to your or your dependents’ dental coverage or non-Medicare-eligible medical coverage (if applicable), follow the Open Enrollment Checklist on page 1 of the health options planner. Fill out the Retiree Health Enrollment/Change Form (CO-744-OE) and return it to the Retiree Health Insurance Unit.

New Retirees
Your health coverage as an active employee does NOT automatically transfer to your coverage as a retiree. You must enroll if you want retiree health coverage for yourself and any eligible dependents. To enroll for the first time, follow these steps:

• Review the Retiree Planner and choose the medical and dental options that best meet your needs. Note: If you are Medicare-eligible, there is only one medical plan option.
• Complete the Retiree Health Enrollment/Change Form (CO-744), included in your retirement packet. Note: This is different from the form included in the back of this Planner.
• Return the completed form and any necessary supporting documentation to the Office of the State Comptroller at the address shown on the form.

You must complete your enrollment in retiree health coverage within 30 calendar days after your retirement date. If you do not enroll within 30 days, you must wait until the next Open Enrollment to enroll in retiree coverage.If you enroll as a new retiree, your coverage begins the first day of the second month of your retirement. For example, if your retirement date is October 1, your coverage begins November 1.

Important! If you are Medicare-eligible, you must be enrolled in Medicare to enroll in the State of Connecticut Retiree Health Plan. If you are age 65 or older, contact Social Security at least three months before your retirement date to learn about enrolling in Medicare.

Waiving Coverage

If you have other medical coverage and want to waive State of Connecticut coverage when you’re initially eligible, and you later lose your other coverage, you can enroll within 30 days of losing your other coverage, or during any Open Enrollment period. Retirees who do not want coverage must complete the Retiree Health Enrollment/Change Form (CO-744-OE), check “Waive Medical Coverage,” and return it to the Retiree Health Insurance Unit. Important! If you waive non-Medicare-eligible or Medicare-eligible retiree coverage, you cannot cover any dependents under the State of Connecticut Retiree Health Plan. You must be enrolled in order to cover
your eligible dependents.

Coverage

Non-Medicare-eligible coverage is only for non-Medicare-eligible retirees and non-Medicare-eligible dependents (of either non-Medicare-eligible or Medicare-eligible retirees). If you are eligible for Medicare, please visit the Medicare Advantage site.

In general, the plans and coverage available to non-Medicare-eligible retirees and dependents are the same. However, certain copays and prescription drug programs vary based on your retirement date. Be sure to review the coverage for your retirement group.

Making Your Decision

When it comes to choosing a medical plan, there are six main areas to consider:

• What is covered: The services and supplies that are considered covered expenses under the plan. This comparison is easy to make at the State of Connecticut because all of the plans cover the same services and supplies.
• Cost: What you pay when you receive medical care and what is deducted from your pension check for the cost of having coverage. What you pay at the time you receive services is similar across the plans. However, your premium share (that is, the amount you pay to have coverage) varies substantially, depending on the plan selected.
• Networks: Whether your doctor or hospital has contracted with Anthem to be a “network provider.” If your plan offers in- and out-of-network coverage, you’ll pay less for most services when you receive them in-network. That’s because in-network providers discount their fees, based on contractual arrangements they have with Anthem. If your plan does not offer in- and out-of-network coverage, you will not receive any benefits for services received outside the network (except in cases of emergency).
• Quality doctors: The state has identified which doctors provide the highest-quality care and outcomes in the state. While all plans provide access to these quality doctors, only one is devoted strictly to quality: the State BlueCare Prime Plus POS plan. This plan ensures that the only doctors included in its network are those that meet the highest quality standards. By agreeing to only go to the highest-quality doctors, you pay the lowest premiums of any plan option.
• Plan features: How you access care. Under some plans, you must use network providers (except in certain emergencies); others give you access to out-of-network providers. Plus, certain plans require you to have a primary care physician and receive referrals for in-network specialists.
• Health promotion: All of the plans offer health information online; some offer additional services, such as 24-hour nurse advice lines and health risk assessment tools.

Plans Details

1 You pay coinsurance plus 100% of any amount your provider bills over the allowable charge.
2 Waived for HEP-compliant members.
3 Health Enhancement Program participants have $50 copay waived once every two years.

* You may be eligible for a $0 copay by using a Tier 1 PCP or specialist.

** Waived for HEP-compliant members.

‡ You pay 20% of the allowable charge after the annual deductible, plus 100% of any amount your provider bills over the allowable charge (balance billing).

◊ Emergency room copay waived if admitted; waiver form available for certain circumstances.

§ Prior authorization may be required.

¶ Subject to medical necessity review.

Rates

2023-2024 Rates for Non-Medicare Retirees