the new connecticut partnership plan

Saving your city or town money by joining with the state to purchase health benefits

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Why Join CT Partnership 2.0


Rate Stability: Claims from Partnership 2.0 are being pooled with all the state claims and will be factored into the yearly renewal rating thus reducing exposure to volatile claims.

Rich Plan Design: Same point-of-service (POS) plan design offered to state employees providing: in- and out-of-network coverage, 100% coverage for preventive care, an extensive local and national network through UnitedHealthcare, and low co-pays for maintenance drugs available at local pharmacies.

Health Enhancement Program (HEP): The Health Enhancement Program (HEP) is also included in the Partnership Plan 2.0. It is a program designed to promote preventive screenings, wellness visits and chronic disease education and counseling for employees and, as a result, saves money on health care in the long term by focusing health care dollars on prevention.

Dedicated Service Team: The Partnership Plan 2.0 has a dedicated team of individuals who are your point of contact throughout the process. You will not be lost in the shuffle with questions or concerns about enrollment, billing, or claims.

Ease of Applying: Simply fill out an application on the partnership website to start the process. Fixed (quarterly) rates are posted on the website so you know exactly what you are paying and can budget appropriately.


Per Employee, Per Month (PEPM) Rates by Quarter of Enrollment*:


Jul. 1 - Sept. 30 Single Employee +1 Family
Active $846.63 $1,815.43 $2,219.11
Pre-65 Retirees $1,082.75 $2,327.19 $2,845.71
Medicare Retirees
Per Individual Enrolled
Parts A & B: $225.37
Part B Only: $506.71
Post-65 Retirees
Not Eligible for Medicare
$1,934.71 $4,202.55 $5,147.53

Oct. 1 - Dec. 31 Single Employee +1 Family
Active $853.18 $1,829.86 $2,236.81
Pre-65 Retirees $1,091.23 $2,345.84 $2,868.60
Medicare Retirees
Per Individual Enrolled
Parts A & B: $225.37
Part B Only: $506.71
Post-65 Retirees
Not Eligible for Medicare
$1,950.16 $4,236.54 $5,189.24

Jan. 1 - Mar. 31 Single Employee +1 Family
Active $859.80 $1,844.41 $2,254.66
Pre-65 Retirees $1,099.78 $2,364.65 $2,891.68
Medicare Retirees
Per Individual Enrolled
Parts A & B: $222.12
Part B Only: $506.71
Post-65 Retirees
Not Eligible for Medicare
$1,965.73 $4,270.81 $5,231.30

Apr. 1 - Jun. 30 Single Employee +1 Family
Active $866.47 $1,859.07 $2,272.66
Pre-65 Retirees $1,108.40 $2,383.61 $2,914.94
Medicare Retirees
Per Individual Enrolled
Parts A & B: $222.12
Part B Only: $506.71
Post-65 Retirees
Not Eligible for Medicare
$1,981.43 $4,305.36 $5,273.70

Application      Partial Group Preapproval


* Rates are for Medical and Rx, and are paid monthly. Applicable rates are dependant on start date and are guaranteed through June 30, 2019


View Dental Rates       View Vision Rates

Medical Benefit Summary

IN NETWORK CT Partnership Plan 2.0
Medical Office Visit $15 co-pay | $0 for Tier 1
Specialist Office Visit $15 co-pay | $0 for Tier 1
Vision Exams (one per calendar year) $15 co-pay
Inpatient Hospital $0 co-pay
Outpatient Hospital $0 co-pay
Emergency Room $250 co-pay (waived if admitted)
Urgent Care $15 co-pay
Walk-In $15 co-pay
Lab/X-Ray
High Cost Radiological and Diagnostic Tests
$0 co-pay for Tier 1 | 80%/20% coinsurance for Tier 2
In-Network Deductible Individual: $350
Family: $350 each member ($1,400 maximum).
Waived for HEP-compliant members.
Coinsurance Not applicable
Max out of pocket $2,000 individual
$4,000 family
PREVENTIVE SERVICES CT Partnership Plan 2.0
with Health Enhancement Program (HEP)
Primary Care (Adult and Child Wellness Exams) $0 co-pay
Gynecologist Wellness $0 co-pay
Mammogram $0 co-pay
Lifetime Maximum Unlimited
OTHER SERVICES CT Partnership Plan
with Health Enhancement Program (HEP)
Deductible Not applicable
Acupuncture (20 visits/year) $15 co-pay
Chiropractic $0 co-pay
Nutritional Counseling (3 visits/year) $0 co-pay
Physical/Occupational Therapy $0 co-pay
Durable Medical Equipment $0 co-pay
Routine Hearing Screening (as part of an exam) $15 co-pay
OUT OF NETWORK CT Partnership Plan
with Health Enhancement Program (HEP)
Annual Deductible $300 individual / $900 family
Coinsurance 20% of allowable UCR charges
Max out of Pocket $2,300 individual / $4,900 family
Lifetime Maximum Unlimited

Dental Benefit Summary

Plan 1
In/Out Network
Plan 2
In/Out Network
Basic
In/Out Network
Enhanced
In/Out Network
Dental HMO
Network Any dentist Any dentist Any dentist State of CT DPPO State of CT DHMO
Out of Network Coverage Yes Yes Yes Yes, low reimbursement(MAC) No
Annual Deductible $25 indiv/$75 family None None $25 individual, $75 family None
Annual Maximum per person $1,000 $1,500 Unlimited $3,000 Unlimited
Periodontal Care Maximum per person Annual Max applies. No Annual max for periodontal cleanings, scaling & root planing. Annual Max applies. No Annual max for periodontal cleanings, scaling & root planing. $500 Annual Max except  periodontal cleanings, scaling & root planing. Annual max applies covered
Implant Maximum (per calendar year) Not covered Not covered Not covered $500 No dollar annual max, frequency max applies
Lifetime Maximum per person $1,500 $1,500 Not covered $1,500 None
DEDUCTIBLE WAIVED
Preventative Yes Yes Yes Yes Yes
Perio Cleaning Yes Yes Yes Yes Yes
Orthodontia Yes N/A No Yes Yes
PREVENTATIVE
X-Ray 100% 100% 100% 100% 100%
Cleanings 100% 100% 100% 100% 100%
Oral Exam 100% 100% 100% 100% 100%
Fluoride 80% 100% 80% 100% 100%
Sealants 100% 100% 80% 100% covered
BASIC
Fillings 80% 80% 80% 80% copay applies
Emergency Care 80% 80% 80% 80% covered
Endodontics 80% 80% 80% 80% copay applies
Periodontal Cleaning 80% 80% 100% 100% copay applies
Periodontal: All Other 50% 80% 50% 80% copay applies
Denture, Bridge, Crown Repair 80% 80% 80% 80% copay applies
Simple Extractions 80% 80% 80% 80% copay applies
General Anesthesia not covered 80% not covered 80% copay applies
MAJOR
Crown/Inlay/Onlay 50% 67% 67% 67% copay applies
Dentures 0% 67% not covered 50% copay applies
Bridges 0% 67% not covered 50% copay applies
Space Maintainers 50% 100% 67% 80% copay applies
Oral Surgery (non Simple Extractions) 50% 80% 67% 80% copay applies
Implants not covered not covered not covered 50% copay applies
ORTHODONTIA
Braces 50% 50% not covered 50% copay applies
Child and Adults Yes Child Only not covered Yes Yes

Pharmacy Benefit Summary

PRESCRIPTION COVERAGE Maintenance Drugs Non-Maintenance Drugs HEP Chronic Condition Drugs
Generic $5/$10 $5/$10 $0
Preferred/Listed Brand Name $25 $25 $5
Non-Preferred/Non-Listed Brand Name $40 $40 $12.50
Annual Maximum Unlimited
Max out of Pocket $4,600 Individual / $9,200 Family

Vision Rider

BENEFIT IN-NETWORK OUT-OF-NETWORK
Materials Co Pay $0 N/A
Single Vision Lenses Covered in Full $40 Allowance
Bifocal Lenses Covered in Full $65 Allowance
Trifocal Lenses Covered in Full $75 Allowance
Lenticular Lenses Covered in Full $100 Allowance
Contact Lenses (Retail Allowance)
Elective $360 Allowance $345 Allowance
Therapeutic Covered in Full $345 Allowance
Frame (Retail Allowance) $175 Allowance $126 Allowance

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