| Group |
Income Eligibility |
| Children |
300% FPL |
| Pregnant Women |
185% FPL |
| Parents |
150% FPL |
| SSI Disabled (non-elderly) |
69% FPL |
Reinsurance
The state of Connecticut operates a non-subsidized reinsurance pool for the small group market (groups of 1 to 50). Any insurer may purchase reinsurance from the pool, with a $5,000 deductible per covered life, for individuals, dependents, or small groups. The choice to reinsure is determined by individual carriers.
The pool is funded by reinsurance premiums paid by carriers that cede risk into the pool, and is augmented with an annual assessment paid by carriers based on their small group market share. The Connecticut reinsurance pool (legislation: Sec. 38a-569) is credited by state officials with keeping the small group market competitive.
High-Risk Pool
The Connecticut Health Reinsurance Association has been in operation since 1976 and is financed through premiums and assessments on insurers. The premium cap is 125 percent of market rate for comparable coverage at initial enrollment and 150 percent at maximum. Connecticut charges a lower premium for recipients who have income less than 200 percent FPL. As the end of 2005, more than 2,400 persons were enrolled in the program.
Other
SCHIP - Connecticut 's SCHIP program, called HUSKY B, allows uninsured children in families above 300 percent FPL the opportunity to buy-in to HUSKY B. The cost of the Husky B buy-in is not subsidized by the state; the family buys into the plan at a negotiated group rate. Enrollment in the unsubsidized (>300 % FPL) portion of Husky B was just over 800 in the fall of 2006. Benefits under the HUSKY B program are similar to those available to state employees. The Husky Plus program provides supplemental coverage for children in families with incomes below 300 percent FPL enrolled in Husky B with intensive physical or behavioral needs.
State-Administered General Assistance (SAGA) - SAGA provides medical assistance for adults who do not qualify for Medicaid (HUSKY) or who are awaiting eligibility determination. Unlike Medicaid, there are no categorical program requirements; eligibility is based on income and assets only. Approximately 31,800 individuals were receiving medical assistance via the SAGA program as of June 2006.
Connecticut Business and Industry Association's (CBIA) Health Connections - CBIA - a statewide, private, business organization - launched its purchasing cooperative, Health Connections, in 1995. Health Connections, designed for companies with 3 to 100 employees, allows small firms to take advantage of competitive premium rates, and allows employees a choice of health insurance. As of October 2006, Health Connections provides coverage to over 4,500 firms and covers more than 65,000 lives.
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