State of Connecticut
Benefits Information

Personalized Benefits | HEP Status | Provider Search

Active Employee Medical

Find provider
Check your HEP status
Contact a Care Coordinator

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.

Medical Plan Features

30-minute health seminars led by Wellspark health professionals for anyone on the State of Connecticut health plan.

If you are in the HEP Chronic Condition program, you can meet your education requirement by attending the corresponding “Basics” seminar.

You can also participate in general well-being seminars for tips and information to support your health.

See the Schedule

Diabetes 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 More
Diabetes 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 More

Virtual 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

It’s important to care for your mental and emotional health and your plan makes it easy to find providers and resources. Your benefits include coverage for behavioral health, substance use treatment, and addiction recovery. 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

This is a covered benefit, eligible every two years, for enrolled state plan members employed as a firefighter. The State Comptroller’s office has also negotiated a discounted rate for state of CT firefighters not enrolled in the state health plan. These screenings are typically done onsite and scheduled by your fire department. To schedule an event at your fire station, contact United Diagnostics Services, at (646) 553-5803. For more information, view this flyer

Specialized programs and facilities to support children and adolescents’ mental health and weight management.
Mental and Behavioral Health Programs
Your child or teenager can also get mental health and behavioral health care covered by your health plan. Below is a list of programs listed by specialty. For more information on a specialty, visit carecompass.ct.gov/mental-health and select “A child under 18 years old”.
Autism Spectrum Disorder Therapy
This is a customized program for children under 21 years of age. Anthem’s case manager will identify available services, secure access to care that may be missing, and focus on the entire family, guiding through treatment and keeping your child’s care providers connected. Call Quantum Health 833-740-3258 to get started..
Weight Management Program
Connecticut Children’s offers a weight management program for eligible plan members under age 18. There are four locations where you can see one of their medical weight loss providers. Monthly education sessions are also available for children, teens, and their families to help build physical activity and healthy eating in your child’s care.

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.

Benefits Guides

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 calendar 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.
    Documentation of an eligible relationship is required when you enroll a family member. It is your responsibility to notify your agency Payroll/Human Resources office when any dependent is no longer eligible for coverage.

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.
Visit the Benefits Enrollment page for all the resources to make your changes.

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.)

  1. Login at: www.anthem.com/login/
  2. Scroll down to the My Health & Care section and select the Care Team button
  3. Click Search for a New PCP
  4. Search for a PCP
  5. Click on the provider’s name for more details
  6. When you click on the provider’s name, a window pops out
  7. Click the Assign as PCP button

Plan Documents

Summary of Benefits and Coverage