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Connecticut Insurance Department Commissioner Andrew N. Mais reminds insureds that there should be no out-of-pocket costs for COVID-19 vaccines for all Affordable Care Act (ACA) compliant fully insured plans and all self-funded plans according to Federal Law.*

“Along with all fully insured plans, employer-based plan sponsors must remove all cost sharing for COVID-19 vaccines for their workers and their families, and anyone without insurance is also eligible for no-cost COVID-19 vaccines,” said Commissioner Mais. “I urge all grandfathered and non-ACA compliant health insurance plans to follow suit and remove financial barriers to COVID-19 vaccines for individuals, workers, and their families.”

The Connecticut Insurance Department regulates all fully insured health insurance plans, including high-deductible health plans, issued in the State of Connecticut only.

Governor Lamont released Executive Order No. 9Q Protection of Public Health and Safety During Covid-19 Pandemic – Vaccine Administration, Reporting, and Out-Of-Network Charges (Dec. 7).

The Department issued a notice to all health carriers; Covid-19 Immunization at “No-Cost” and Out-of-Network Reimbursement (Dec. 8).

Consumers should know that there are some differences among plans and policyholders should contact their insurer or employer to get additional information on important details.

Some employers, especially large ones, sponsor self-funded health plans that are regulated by the U.S. Department of Labor. Those plans are also required to cover COVID-19 vaccines with no out-of-pocket costs under the Federal CARES Act.

The Federal CARES Act (Enacted March 27, 2020)

Section 3203 of the CARES Act requires non-grandfathered ACA-compliant group health plans and health insurance issuers offering non-grandfathered group or individual health insurance coverage to provide no cost sharing for qualifying COVD-19 preventive services, which includes COVID-19 immunizations.

*No-cost coverage for vaccines is for all health plans including fully insured, and self-funded, individual and group health plan under this Act. It also includes private employment-based group health plans (U.S. DOL ERISA plans), non-federal governmental plans (such as plans sponsored by states and local governments), and church plans. It does not include grandfathered, non-ACA compliant plans. Consumers and policyholders should contact their insurer or employer for information on the out-of-pocket costs for COVID-19 treatment, if any.

Consumers, insurers and brokers with questions can contact the department directly by email at insurance@ct.gov, online, or by calling the Department at 800-203-3447 or 860-297-3900

For the most up-to-date information from the State of Connecticut on COVID-19, including guidance and other resources, visit ct.gov/coronavirus. Regular email news updates are available from the Governor’s Office by subscribing online here.

About the Connecticut Insurance Department: The mission of the Connecticut Insurance Department is to protect consumers through regulation of the industry, outreach, education and advocacy.

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