Colorado

Colorado

Overview of Colorado’s Health Insurance Exchange

In 2010, the federal healthcare law—the Affordable Care Act--was passed, giving states the opportunity to build health insurance marketplaces called exchanges. Colorado’s marketplace is called Connect for Health Colorado, and it offers plans for individuals, families, and small employers across Colorado.

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The Connect for Health Colorado site allows state residents to discover whether they are eligible for financial assistance for healthcare from the federal government, and allows them to promptly make use of those benefits. Assistance will be available from licensed brokers, service representatives, and health coverage guides. Open enrollment lasts until March 1, 2014, and coverage begins January 1, 2014.

Connect for Health Colorado is offering 150 health plans for individuals and families, as well as 92 health plans for small businesses.

Individual and family plans are available from the following providers:

  • Access Health Colorado
  • Anthem Blue Cross and Blue Shield / HMO Colorado
  • Cigna
  • Colorado Choice Health Plans
  • Colorado HealthOP
  • Denver Health Medical Plan
  • Humana
  • Kaiser Permanente
  • Rocky Mountain Health Plans
  • UnitedHealthcare

Dental providers for individuals and families include Anthem Blue Cross and Blue Shield / HMO Colorado, Delta Dental of Colorado, Dentegra Insurance Company, BEST Life and Health Insurance Company, Cigna, and Premier Access Dental and Vision.

Small-business plans are available from the following providers:

  • Anthem Blue Cross and Blue Shield / HMO Colorado
  • Colorado Choice Health Plans
  • Colorado HealthOP
  • Kaiser Permanente
  • Rocky Mountain Health Plans
  • SeeChange Health

Dental providers for small business include Anthem Blue Cross and Blue Shield / HMO Colorado, BEST Life and Health Insurance Company, Delta Dental of Colorado, Dentegra Insurance Company, Guardian, MetLife, and Premier Access Dental and Vision.

Per the Affordable Care Act, all plans must offer the following essential services:

  • Ambulatory patient services (doctor visits)
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance use disorder services, including behavioral health treatment
  • Prescription drugs
  • Rehabilitative and habilitative services and devices (Habilitative services are for people with disabilities who need speech, occupational, or physical therapy.)
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including oral and vision care

Colorado’s exchange will also be offering standalone dental and vision coverage. Here is a helpful FAQ that may answer many of your questions.

Costs

There are four basic plans available with varying levels of coverage: Bronze (60 percent), Silver (70 percent), Gold (80 percent), and Platinum (90 percent). Lower plans have lower premiums, but higher out-of-pocket costs. There is also a catastrophic plan with a high deductible available for adults between the ages of 18 and 29.

Adults living at or below 133 percent of the federal poverty level (also known as FPL, which is $11,490 a year in wages for one person and $23,550 a year in wages for a family of four), or pregnant women living at or below 195 percent of the FPL, can qualify for Medicaid in Colorado, based on eligibility requirements that take effect January 1, 2014.

Tax credits are based on the Silver Plan, so individuals can easily determine what their additional out-of-pocket costs will be if they elect a higher or lower plan compared to Silver. The architects of the Affordable Care Act (ACA) wanted to make sure that people who must buy their own insurance could afford that benchmark Silver Plan, even in regions where healthcare is extremely expensive.

The Silver Plan rates for Colorado in the individual marketplace vary significantly from county to county—the rate for a benchmark plan for a 40-year-old individual non-smoker ranges from $233 to $667 a month.

Individuals and families with incomes between 133 percent and 400 percent of the federal poverty level and who are covered by an exchange plan are eligible for tax credits against the cost of their healthcare coverage. The payment of credits will begin in 2014. An interactive calculator on the Connect for Health Colorado site estimates the amount of tax credits that individuals and families might receive based on household size, income, and location within Colorado.

Many people want to know how much of a subsidy they qualify for, but the real question is how much will you pay? Once you figure out what the maximum health-care percentage is for your income, you then know that’s the most you’ll have to pay for a Silver Plan (you may pay less). For example, if your income is $32,500 a year (283 percent of the poverty level), the most you’ll have to pay for health insurance is nine percent of your wages, which amounts to $2,926 annually, or $244 monthly. The challenge is to look at the costs of Bronze, Silver, Gold, and Platinum, and decide which plan offers the best value for you. Here is a calculator offered by the Kaiser Family Foundation that provides an estimate of your subsidy eligibility and how much you should expect to spend on health insurance.

Starting in 2015, there will be additional federal financial protection that includes a maximum out-of-pocket cost of $6,350 for individuals and $12,700 for families. This financial protection will dramatically reduce the chance of bankruptcy due to medical bills not covered by insurance.

For more information about tax credits and subsidies visit this page on the Connect for Health Colorado site.

To learn more about Colorado’s Connect for Health, please visit http://www.connectforhealthco.com or call (855) PLANS-4-YOU. To start your application for individual or family coverage, click here.

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