Section 1311 of the Affordable Care Act outlines a set of participation standards for carriers contracting with, and doing business on, the Exchange. While these new requirements include many significant consumer protections, the Exchange has the statutory authority to add requirements above the ACA standards if it finds such additional measures prudent and in the interest of the State?s broader health reform efforts.
On November 29, 2012, the Exchange Board approved Connecticut's requirements for QHP certification. The Exchange will use those requirements as outlined in this Solicitation to evaluate Issuers' applications and certify QHPs.
The Exchange encourages interested Issuers to review this Solicitation and file the Notice of Intent by January 4, 2013.
Final Amendment to QHP Solicitation -- Revised April 6, 2013
Plan Design Updates -- August 30, 2013
Individuals and families with lower incomes may be eligible to enroll in one of three Silver Cost Sharing Reduction Plans available only through Access Health CT. Cost sharing subsidies decrease out-of-pocket costs for care. These subsidies are in addition to premium subsidies. Eligibility to enroll in a silver plan with cost sharing subsidies is determined by income level and family size. The following samples illustrate the requirements that apply for the 2014 plan year:
Silver Cost Sharing Reduction Plan- 73
$22,980-$28,725 for an individual
$47,100-$58,875 for a family of four
Silver Cost Sharing Reduction Plan- 87
$17,235-$22,979 for an individual
$35,325-$47,099 for a family of four
Silver Cost Sharing Reduction Plan- 94
Less than $17,234 for an individual
Less than $35,324 for a family of four
If your annual income is estimated to be higher than these levels for your family size, you are not eligible to enroll in any of these plans. You may still be eligible for premium subsidies.
QHP Solicitation Questions and Answers
April 19, 2013