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
2023
2022
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.
2023
2022
Summary of Benefits Coverage
2021
Summary of Benefits Coverage
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