Advocates are calling on Connecticut’s Insurance Department to reconsider its decision to approve the Aetna-Humana merger.

Connecticut is one of 15 states to approve the merger, but it is not the lead regulator so its role in the merger was limited to approving a market analysis. Connecticut is the lead regulator for the Anthem-Cigna merger, which means there will be public hearings regarding that merger.

On January 22, the Insurance Department made the determination that the proposed Aetna-Humana merger “would not substantially lessen competition or create a monopoly in Connecticut as Humana has a small market footprint in this state.”

The department hired an economist to provide an independent evaluation before reaching its conclusion, according to Insurance Department spokeswoman Donna Tommelleo.

Because the Connecticut does not have a domestic Humana Insurer, a Form A, change of control application, was not required to be filed and therefore a public hearing was not required.

Aetna’s $37 billion acquisition of Humana still needs to be approved by five more states and the U.S. Department of Justice. On Tuesday, Missouri’s Insurance Department objected to the deal calling it “anti-competitive.”

Humana only sells Medicare supplemental plans in Connecticut, which aren’t regulated by the Insurance Department, which is why Connecticut’s role in the process is so limited.

Regardless, advocates are calling on Insurance Commissioner Katharine Wade to reconsider the approval. A coalition calling itself Connecticut Campaign for Consumer Choice criticized the department for approving the merger without a public process or an analysis of how it will impact patient care, jobs, and costs.

Last week Aetna CEO Mark Bertolini announced to shareholders that Hartford-based Aetna was not committed to keeping its headquarters in Connecticut after merging with the Kentucky-based Humana.

“We had to make that commitment in order to get the merger done,” Bertolini told shareholders at the company’s annual meeting.

That doesn’t matter to Connecticut consumer advocates.

“Aetna has already eliminated over 10 percent of their job force in Connecticut, is telegraphing additional cuts and borrowing $16 billion on the promise of further cost savings,” Tom Swan, executive director of the Connecticut Citizen Action Group, said. “The Commissioner of Insurance has failed to live up to her fiduciary duty to protect consumers, employees, the community and shareholders in rubber stamping this deal in the dark of the night. She had tools to make this more public and to protect jobs in Connecticut – she has failed to use them and this is unconscionable.”

Frances Padilla, president of the Universal Health Care Foundation of Connecticut, said it’s “shameful that the people of Connecticut had no chance to have their voice heard.”

A public hearing is expected to be scheduled in the future on the Anthem-Cigna merger.