Active Employee Medical
TO GET ANSWERS TO YOUR BENEFIT QUESTIONS, FIND DOCTORS/PROVIDERS AND MORE, CONTACT US AND SPEAK WITH A PERSONAL CARE COORDINATOR AT 833-740-3258.
Healthy Living Programs
As of July 1, 2023, medications prescribed for weight loss or management will only be covered if the prescribing physician is part of FlyteHealth or CT Children’s Weight Management programs.
Virtual Weight Management
FlyteHealth is a virtual medical weight loss program for those 18 and older that combines medication with lifestyle behavior to help participants improve their health. Learn MoreChildren’s Weight Management
Connecticut Children’s offers a weight management program for eligible plan members under age 18. Learn MoreDiabetes Management & Diabetes Reversal
Get help managing your A1c level with a personal health coach and remote glucose monitoring or opt into the Diabetes Reversal program that includes a low-carb nutrition plan and on-gong medical monitoring. Learn MoreDiabetes Prevention Program
A free, 12-month program focused on improving lifestyle behaviors to reduce diabetes risk. The program brings powerful education and motivating support through to your computer, smartphone or tablet. Learn MoreVirtual service available seven days per week where licensed medical professionals via video chat or can be reached by phone in under 15 minutes for assistance with acute or chronic musculoskeletal pain or joint mobility and stability issues. Learn More
Get confidential emotional support virtually with a licensed therapist. You must be at least 18 years old, or if between age 10-17, be accompanied online with a parent. A $5 copay payment is required at the time of each appointment. Learn More
The state of Connecticut has identified providers in Connecticut that meet the highest patient care standards for specific procedures and conditions as “Providers of Distinction”. By completing your care with a provider that is tagged as a “Provider of Distinction” in the Find Provider tool, you will receive a cash incentive in the mail. Learn More
The Health Enhancement Program (HEP) encourages employees and their enrolled family members to take charge of their health and their health care by providing guidelines to follow for preventative and chronic care management. HEP is designed to positively impact the overall health of its participants. Learn More
Our Plans
Quality First Select Access
[Tiered POS]
State BlueCare Prime network
Employees and their covered dependents must reside in Connecticut to choose this plan. Most in-network provider practices are located in Connecticut, with some in bordering states. This is the most affordable plan because it has the smallest network of providers. On October 1, 2024, Hartford Healthcare providers and facilities were added to this plan’s network. Referrals to specialists are not required.
Primary care Select Access
[POE PLUS]
State BlueCare network
In this plan, you save on premiums by working directly with your Primary Care Provider (PCP) to coordinate your care. Your PCP will be required to refer you to specialists in the network.
Standard access
[POE]
State BlueCare Network
This plan covers all your care within the network and does not require referrals from your PCP. Out-of-network care is only covered for emergencies.
Expanded access
[POS]
State BlueCare Network
The most expensive plan is also the most comprehensive. You can see any in-network provider with no referrals, and have up to 80% of costs covered outside the network.
Out of Area [OOA]
Available if you (the employee) move out of Connecticut or live outside of Connecticut upon hire. When you (the employee) notifies your agency about your move mid-year, your agency will send them a Core-generated form to enroll in the OOA plan if you elect to change plans.
State preferred
The State Preferred plan is closed to new enrollment.
Plan Information
Eligible dependents generally include:
- Your legally married spouse or civil union partner.
- Your children: Medical and dental coverage through the end of the year they turn age 26.
- Children residing with you for whom you are legal guardian (to age 18) unless proof of continued dependency is provided. Disabled children may be covered beyond age 26 for medical and dental, with proper documentation from the medical insurance carrier.
You can make changes to your medical and/or dental plans, add or drop coverage for your eligible family members or enroll if you previously waived coverage during the following times:
- Qualifying Life Event
- If you have a Qualifying Life event, changes can be made on Core-CT and the required documentation must be provided within 31 days of the qualifying event.
- Open Enrollment
- This is your annual chance to adjust your health care benefit choices. It’s a good time to take a fresh look at the plans, consider how your and your family’s needs may have changed, and choose the best plan option for you. Open Enrollment usually takes place in May.
There are several plan options for you to choose from. Each of the plans offered cover the same medical benefits-the same services and supplies. The amount you pay out of pocket at the time you receive services is very similar to.
HOW TO PICK A PLAN
The main items to consider are:- The premium (what your payroll deduction will be).
- Network size: This is a good time to look up your providers and hospital preference in each plan to be sure you are covered by in-network co-pays).
See medical and dental rates. If you opt out of the Health Enhancement Program (HEP), or are deemed non-compliant with the annual HEP requirements, you’ll pay an additional $46.15 per paycheck for coverage. (Employees on semimonthly pay schedules will have slightly higher premiums.)
Benefits Enrollment