DEPARTMENT OF DEVELOPMENTAL SERVICES
Step 1: Call Access Health at 1-855-805-4325 or go to www.accesshealthct.com
The application you submit for health insurance here will assess your eligibility for
Medicaid (HUSKY), Covered CT, or a plan on the Health Insurance Exchange.
* When applying be sure to check the box or indicate that you would like to apply for
financial assistance, this will ensure you are reviewed for all of the available health
insurance groups mentioned above.
Checklist of information you will need to apply:
• Date of Birth and social security number for all family members that need
coverage.
• Projected Annual income (include upcoming bonuses or raises and income from
all sources not just your PCA work).
Step 2: If you are eligible for Medicaid (HUSKY) or Covered CT, you are not eligible for the
Premium Assistance Contribution benefit.
If you are NOT eligible for Medicaid or Covered CT, save the denial letter.
• You will use the denial letter as part of your application for the Premium Assistance
Contribution Benefit when the application is available.
Step 3: Submit the enclosed/attached application to the Fiscal Intermediary (Allied or Sunset
Shores). In order to receive the first payment, you must submit your applications with
attached denial letters no later than February 24
th
, 2023 in order to receive the funds
by March 13
th
, 2023. This benefit payment will be included as part of your paycheck.
Step 4: Return to the Health Insurance Exchange by Calling Access Health at
1-855-805-4325 or going to www.accesshealthct.com to purchase the plan that is right
for you. Once you pay the first month’s premium, your health insurance will go into
effect in accordance with the timeline shared by the insurance company.
***Access Health CT is exploring the option of a Special Enrollment Period for eligible PCAs to use
the new premium stipend after the January 15, 2023 deadline to purchase affordable healthcare on
the exchange. When details become available, they will be communicated with the union prior to
the end of regular enrollment.
Personal Care Attendants (PCAs) and Direct Support Professionals (DSPs)
If you do not have health insurance and would like access to the premium assistance contribution
you must provide a HUSKY and Covered CT denial letter.
If you need a denial letter to qualify for premium assistance contribution, follow these steps:
DEPARTMENT OF DEVELOPMENTAL SERVICES
IMPORTANT MESSAGE REGARDING ELIGIBILITY FOR
Health Insurance Premium Assistance for PCA’s and DSPs
Personal Care Attendants and Direct Support Professionals (PCA/DSP) may be eligible for additional
funds which can be used to help purchase health insurance, to defray the cost of health-related
expenses such as: co-pays, prescriptions, deductibles, or to offset other expenses. Article 13A of
the Collective Bargaining Agreement (CBA), titled Premium Assistance Contributions received
approval by the federal Center for Medicaid and Medicare Services (CMS) on 12/16/22. PCAs and
DSPs should prepare to meet the eligibility requirements to qualify for the benefit. The eligibility
requirements are included below.
(1) A PCA/DSP must be actively employed by and worked for a minimum of 6 months under
each individual consumer employer that benefits are being applied for.
(2) proof that the PCA/DSP does not have medical coverage
a. For example, through another job or through a spouse
(3) And proof that the PCA/DSP has applied for and been denied coverage through both
Medicaid (HUSKY) & Covered CT.
The Premium Assistance Contribution will provide up to an annual maximum of $5000 and is
calculated at 6% of the PCA/DSPs total wages earned over the previous 6 months of active
employment per each individual consumer-employer.
• If a PCA/DSP has not worked a full 6 months, then a PCA will not be eligible until a full
six (6) months has been worked.
• If the PCA/DSP is active or eligible for Medicaid (HUSKY) or Covered CT they are not
eligible for the benefit.
The Fiscal Intermediaries will be administering this benefit on behalf of the Department of Social
Services and Department of Developmental Services. See attached application (Sunset) or refer to
the online fillable form (Allied) for submission process. Employers of Record are encouraged to
share information about this benefit with their PCA/DSPs. The Medicaid (HUSKY) and Covered CT
denial letters must be submitted to the Fiscal Intermediary (FI) as part of the PCA/DSP’s application
package.
Similar to the CT Paid leave benefits, the PCA Workforce Council is not the administrator for
Medicaid or Covered CT, and PCA/DSPs should direct their eligibility questions regarding Covered
CT to Access Health CT, the State’s Health Insurance Exchange, by calling 1-855-805-4325, or
through e-mail or live chat by going to https://www.accesshealthct.com/get-help/. Medicaid
information can be found at https://www.connect.ct.gov/access/jsp/access/Home.jsp.
