Most people who enroll in an exchange/Marketplace health plan are eligible for an advance premium tax credit (APTC). But it’s important to understand how this is reconciled with the IRS after the year is over.
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Screening Colonoscopy Incorrectly Billed as Diagnostic
As long as you use an in-network facility, all costs associated with a screening colonoscopy should be paid by the health plan, including the bowel preparation drink, the facility fee, the doctor’s fee, and the anesthesiologist’s fee.
What is an Expanded Bronze Plan?
there is also an option to offer “expanded” bronze plans that can have higher AV than regular bronze plans. In order to be considered expanded bronze, a plan must
What is Silver Loading in the Connect for Health Colorado ACA Exchange?
On exchange with Silver Loading (no Cost Sharing Reduction) vs Off Exchange
Fixing the ACA’s Medicare Glitch
This article was co-written with Andrew Sprung, who writes about health care reform and health policy at xpostfactoid. Andrew has closely followed all aspects of ACA implementation over the years, and his website provides a wealth of information about health care reform. His work has also been published at healthinsurance.org and Health Affairs. For most… Read more about Fixing the ACA’s Medicare Glitch
2022 HSA Contribution Limits Announced
The IRS has released 2022 limits for HSA Contributions and High Deductible Health Plans (HDHPs). 2022 HSA Contribution Limits: Self-Only: $3,650 (up from $3,600 in 2021) Family: $7,300 (up from $7,200 in 2021) 2022 HDHP Deductible Minimum: Self-Only: $1,400 ($1,400 in 2021) Family: $2,800 ($2,800 in 2021) 2022 HDHP Out-of-Pocket Expense Maximum: Self-Only: $7,000 ($7,050… Read more about 2022 HSA Contribution Limits Announced
The American Rescue Plan and your Colorado health insurance
You may have seen headlines recently about how the American Rescue Plan (HR1319) makes health insurance more affordable for people who buy their own coverage. As always, you can reach out to me if you have questions about your specific circumstances. But I wanted to summarize some general information: Section 9662 of the American Rescue… Read more about The American Rescue Plan and your Colorado health insurance
Special enrollment window through May 15, 2021
If you’re uninsured in Colorado, you have another opportunity to enroll in health coverage for 2021. Connect for Health Colorado has opened a special enrollment window that closely mirrors the enrollment window that the Biden administration announced for states that use HealthCare.gov (DC and 14 states, including Colorado, run their own exchanges; the rest of… Read more about Special enrollment window through May 15, 2021
What if Republicans had succeeded in repeal of the Affordable Care Act?
By Andrew Sprung, David Anderson and Louise Norris On November 10, the Trump administration will ask the Supreme Court in oral argument to declare the Affordable Care Act unconstitutional – and nullify the law in the midst of a pandemic, uninsuring an estimated 23 million people. As Republicans rushed to confirm the nomination of Amy Coney Barrett… Read more about What if Republicans had succeeded in repeal of the Affordable Care Act?
2021 HSA Limits
The IRS has released 2021 limits for High Deductible Health Plans (HDHPs) and Health Savings Accounts (HSAs). 2021 HSA Contribution Limits: Self-Only: $3,600 (up from $3,550 in 2020) Family: $7,200 (up from $7,100 in 2020) 2021 HDHP Deductible Minimum: Self-Only: $1,400 ($1,400 in 2020) Family: $2,800 ($2,800 in 2020) 2021 HDHP Out-of-Pocket Expense Maximum: Self-Only:… Read more about 2021 HSA Limits
States seeking to reduce their uninsured populations must beware a Catch-22
By David M. Anderson, Charles Gaba, Louise Norris and Andrew Sprung State policymakers have been prolific and creative in putting forward measures to strengthen their ACA marketplaces. Measures enacted since 2017 or in progress now include reinsurance programs, which reduced base premiums by an average of 20% in their first year in the first seven… Read more about States seeking to reduce their uninsured populations must beware a Catch-22
Claiming the ACA tax credit after paying full price for your health insurance
Most people know that there are premium tax credits (often referred to as premium subsidies) available for people who buy their health insurance through Connect for Health Colorado. But claiming the ACA tax credit as an advanced subsidy requires you to estimate your income for the coming year and supplying supporting documentation to verify that… Read more about Claiming the ACA tax credit after paying full price for your health insurance
Treating Employees Differently: Employer Contribution Requirements
Employers offering small business group health insurance benefits have flexibility treating employees differently as long as the contribution policy complies with the insurance company’s employer contribution requirements and basic non-discrimination laws (HIPAA and Section 125). Employers can contribute a flat dollar amount, or they can require employees to pay a set percentage or a set… Read more about Treating Employees Differently: Employer Contribution Requirements
IRS Announces 2020 HSA Limits
The IRS published Revenue Procedure 2019-25 last week, specifying the 2020 HSA contribution limits. 2020 HSA contribution limits If you have individual coverage under an HSA-qualified plan: $3,550 (up from $3,500 in 2019) If you have family coverage under an HSA-qualified plan: $7,100 (up from $7,000 in 2019) Minimum deductible for HSA-qualified plans Individual coverage: $1,400 (up from $1,350 in 2019) Family coverage:… Read more about IRS Announces 2020 HSA Limits
HSA Contribution Limits for 2019 Have Been Increased By the IRS
The IRS published Revenue Procedure 2018-30 last week, most importantly specifying the HSA contribution limits for 2019. In addition, the minimum deductibles for HDHP’s remained unchanged. However, the maximum out-of-pocket exposure on HSA-qualified plans increased. HSA contribution limits for 2019 For individual coverage under an HSA-qualified plan, the limit is $3,500, which is up from $3,450 in 2018. For family coverage… Read more about HSA Contribution Limits for 2019 Have Been Increased By the IRS
2018 Colorado Individual/Family Market Specialist Maps
Last week, I shared charts showing how many total providers are in each individual market insurer’s network, and compared that with total enrollment for each insurer. But the total number of providers doesn’t tell the whole story. Network adequacy issues still arise for specific consumers when an insurance plan might have many primary care providers, but… Read more about 2018 Colorado Individual/Family Market Specialist Maps
2018 Colorado Individual Market Enrollment and Total Medical Providers
2018 Connect for Health Colorado Individual Market Enrollment
2018 Essential Community Provider Maps
Network coverage is an important part of picking a health insurance policy. And while the insurers and the exchange have tools that will let you check to see if your doctor is in-network with the plan you’re considering, those tools aren’t as helpful if you don’t have a specific provider in mind and just want… Read more about 2018 Essential Community Provider Maps
Spring Is Here! Health Wonk Review
Welcome to the Spring edition of the Health Wonk Review. With condolences to our east-coast and Great Lakes friends who have been dealing with what probably seems like 47 straight months of winter. Maybe they can call it the “Spring is eventually coming” edition? We’ve got a great round-up of health care articles in this… Read more about Spring Is Here! Health Wonk Review
Yuma County Colorado Individual Market Network Size Rating Based on SERFF Data
Statewide Results, Scientific Methodology, and links to other Colorado Counties Yuma county contains the city of Wray. Totals By Carrier for Yuma County Anthem BCBS 2 Bright 2 Cigna 2 Colorado Choice 47 Denver Health 0 Kaiser 0 RMHP 84 Per Carrier Breakdown Anthem BCBS Anthem BCBS has 2 unique providers in Yuma County. Anthem… Read more about Yuma County Colorado Individual Market Network Size Rating Based on SERFF Data
Weld County Colorado Individual Market Network Size Rating Based on SERFF Data
Statewide Results, Scientific Methodology, and links to other Colorado Counties Greeley and parts of Thornton, Brighton, and Longmont are in Weld county. Colorado Choice will be called Friday Health in 2018. Totals By Carrier for Weld County Anthem BCBS 390 Bright 27 Cigna 36 Colorado Choice 326 Denver Health 1 Kaiser 617 RMHP 613 Per… Read more about Weld County Colorado Individual Market Network Size Rating Based on SERFF Data
Washington County Colorado Individual Market Network Size Rating Based on SERFF Data
Statewide Results, Scientific Methodology, and links to other Colorado Counties Anthem BCBS and Colorado Choice (Friday Health Plans) are the only insurance carriers offering individual/family plans in Washington county. Akron is the largest town in Washington county. Totals By Carrier for Washington County Anthem BCBS 2 Bright 0 Cigna 0 Colorado Choice 9 Denver Health… Read more about Washington County Colorado Individual Market Network Size Rating Based on SERFF Data
Teller County Colorado Individual Market Network Size Rating Based on SERFF Data
Statewide Results, Scientific Methodology, and links to other Colorado Counties Anthem BCBS and Kaiser are the only insurance carriers selling individual/family plans in Teller county. Totals By Carrier for Teller County Anthem BCBS 32 Bright 41 Cigna 4 Colorado Choice 18 Denver Health 0 Kaiser 70 RMHP 52 Per Carrier Breakdown Anthem BCBS Anthem BCBS… Read more about Teller County Colorado Individual Market Network Size Rating Based on SERFF Data
Summit County Colorado Individual Market Network Size Rating Based on SERFF Data
Statewide Results, Scientific Methodology, and links to other Colorado Counties The only carriers selling plans in Summit county are: Anthem BCBS, Bright Health, Cigna, and Kaiser. RMHP is only for sale in Mesa county. Totals By Carrier for Summit County Anthem BCBS 39 Bright 148 Cigna 7 Colorado Choice 21 Denver Health 0 Kaiser 92… Read more about Summit County Colorado Individual Market Network Size Rating Based on SERFF Data