Prescription Drug Lists (PDLs) for Fully Insured Commercial Plans (non-exchange)
The PDL includes brand and generic medications separated into cost levels called tiers. When selecting a medication, review the PDL to see if there is a Tier 1 option (lowest cost) to treat your condition. If your medication is in Tier 2, 3 or 4 (highest cost), you may pay more. In addition we are providing a sample of a plan design offered in your market. This includes high level detail of all benefits provided, including prescription drugs.
Small Group Plans
Fully Insured Health plans that have 2-50 employees
Large Group Plans
Fully Insured Health plans that have 51 or more employees
2024
2023
For additional information and definitions, refer to the Advantage Tier 4 Prescription Drug list found within the Connecticut drawer on the Prescription Drug Lists page.
2024
For additional information and definitions, including other PDLs offered, refer to the Connecticut drawer on the Prescription Drug Lists page.
2023
For additional information and definitions, including other PDLs offered, refer to the Connecticut drawer on the Prescription Drug Lists page.
2023
2022
Summary of Benefits Coverage
2021
Summary of Benefits Coverage
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