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Broker forms and documents

    

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Large group

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Small group

ConnectiCare plans for small group customers are sold through our partners. Forms can be found on their websites.

Exchange

  • 2020 Access Health CT product brochure

  • ACA drug list

    Drugs covered without a cost share under the Affordable Care Act.

  • Benefits of a health savings account (HSA)

Other forms

  • Medicare Advantage

    Forms for members of Medicare Advantage plans.

  • Medicare Supplement

    Forms for Medicare Supplement subscribers.

  • Members under 65

    Find forms members may need.
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Any information provided on this Website is for informational purposes only. It is not medical advice and should not be substituted for regular consultation with your health care provider. If you have any concerns about your health, please contact your health care provider's office.

Also, this information is not intended to imply that services or treatments described in the information are covered benefits under your plan. Please refer to your Membership Agreement, Certificate of Coverage, Benefit Summary,or other plan documents for specific information about your benefits coverage.