Important notice regarding Charter Oak premium rate for members whose enrollment takes effect on or after June 1, 2010.
Click here to view the notice [PDF]  (PDF, 522 KB)

There has been an important change to the cost of the Charter Oak Health Plan.
Click here to view the changes [PDF]  (PDF, 68 KB)

If you are cared for by a doctor, hospital or other health care provider not participating with Community Health Network of Ct, Inc. (CHNCT), you may be responsible for paying the entire fee if the provider chooses not to agree to a payment arrangement with CHNCT. The provider or hospital may also choose to accept a fee from CHNCT and then “balance bill” you for the remainder of charges for the services provided. Unless the care you need is an emergency, before you receive care, please call CHNCT if you are unsure whether a doctor, hospital or other health care provider is enrolled as a participating provider with CHNCT. The membership services phone number is: 1-800-859-9889 and will help you understand payment issues and refer you to an enrolled provider participating in its network, if necessary.

How to read your Charter Oak Explanation of Benefits [PDF]  (51 KB)

Benefits Package Includes: Español

Medical Benefit Features	Coverage
Premium	$307
Deductible	Varies*
Primary Care Office Visit	$25 co-pay
Specialist Office Visit	$35 co-pay
Preventative Care Office Visits	100% coverage, no co-pay
Emergency Room Visit	$100 (waived if emergency)
Prescription Medication	Three-tiered co-pay as low as $10, $7,500 annual benefit limit
Durable Medical Equipment	$4,000, no co-pay
Behavioral Health Services	$35/$25 co-pay (Please see the Charter Oak Behavioral Health website for details on co-pays)
Outpatient Rehabilitation	$35 co-pay, 30 visits a year
Maternity Pre–and Post–Natal Care	100% covered
Inpatient Rehabilitation/Skilled Nursing	14 days per year, 80% covered after deductible met
Inpatient Hospital Visits	90% covered after deductible met
Outpatient Surgical	80% covered after deductible met
Lifetime Benefit Maximum	$1 million
Annual Benefit Maximum	$100,000
Lab	100% covered if obtained at Quest lab
Hospital Outpatient Lab	Benefit: 80% coverage after deductible/co-insurance met for services performed at an in network hospital

*Based on income

Monthly Premiums:

Due to recent legislation, monthly premiums are changing in the Charter Oak Health Plan.

• All new enrollees will have a monthly premium of $307. This is regardless of income level. This will begin on June 1, 2010. Follow this link for a chart and more details.
• For members already enrolled in Charter Oak, monthly premiums will be changed. It will affect most income levels. This will begin on June 1, 2010. Follow this link for a chart and more details.

Below are more details about these changes:

I. Details for New Charter Oak Members

A new member is a Charter Oak member who enrolled on or after June 1, 2010.

Public Act 10-3 (budget deficit mitigation legislation) ends subsidized health coverage for new enrollees in the Charter Oak Health Plan. As a result, new enrollees will now be charged full unsubsidized premiums. This will no longer be based on income. This single-level, unsubsidized rate will be $307 per month. Even though new enrollees will pay one premium amount regardless of income, you will still need to report your income. This will help the state decide whether you are eligible for other state health care programs. It will also help the state determine Charter Oak deductibles and co-insurance amounts.

I. Details for Current Charter Oak Members

A current member is a Charter Oak member who enrolled before June 1, 2010.

Earlier this year, the state had to consider extra member costs to conform to the statutorily-mandated state premium subsidy levels and to help cover these expenses. The first phase of increases began on Feb. 1, 2010. As a result of Public Act 10-3, the second and final round began on June 1, 2010 for current enrollees. So while Public Act 10-3 did not stop all state subsidy for current enrollees, it decided that premium increases, which reflect higher cost-sharing for current enrollees would begin on June 1, 2010.

Starting June 1, 2010 and after, current Charter Oak members will have to pay individual premiums by income level. Details are as follows:

Premium Band	Income % of Federal Poverty Level	Premium Effective 2/1/10	Premium Effective if Enrolled Prior to 6/1/10	State Subsidy	Premium if Enrolled After 5/31/10 No State Subsidy
Band 1	<150%	$93	$129	$175	$307
Band 2	>150%-185%	$124	$172	$150	$307
Band 3	>185%-235%	$184	$202	$75	$307
Band 4	>235%-300%	$213	$239	$50	$307
Band 5	>300%	$296	$296	$0	$307

6/1/10 premium changes apply only to members who enrolled after 5/31/10, with no state subsidy. Members enrolled prior to 6/1/10 are ?grandfathered? and receive state subsidy at redetermination. State subsidies established in statute?Section 11 of Public Act 10-3