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.
Individual/Family Health
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
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
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
State Approaches to Handling CSR Uncertainty for 2018 Premium
Joint post by: David Anderson, Charles Gaba, Louise Norris, Andrew Sprung Note: this post is a joint effort with colleagues who have closely tracked the CSR chaos induced by Trump and Republicans in Congress. Dave Anderson is a former health insurance analyst, now a health care scholar at Duke, and a blogger at Balloon Juice; Charles Gaba is… Read more about State Approaches to Handling CSR Uncertainty for 2018 Premium
Weekend reading recommendation: The Summer Lull edition of the HWR
Peggy Salvatore has done an excellent job with this week’s edition of the Health Wonk Review, hosted at her Health System Ed blog. There’s something for everyone, and it makes for some great weekend reading. Two of my favorites in this edition are Harold Pollack’s explanation of why red states that voted for Trump would… Read more about Weekend reading recommendation: The Summer Lull edition of the HWR
2017: Made for health wonks
Joe Paduda hosted the Health Wonk Review on Friday, and it’s a must-read edition. It coincided perfectly with the release of the long-awaited, top-secret Senate GOP health care reform bill, and Joe’s edition includes an everything-you-need-to-know summary of the Senate bill, written by the inimitable Tim Jost and Sara Rosenbaum. In related news, Joe is… Read more about 2017: Made for health wonks
Groundhog Zombie Goes Back to the Future: AHCA Vote Day Health Wonk Review
Yesterday was a bit of a banner day in health care reform circles, with the passage of the AHCA in the House of Representatives. The vote came less than 24 hours after the final amendment was added to the bill, and before the CBO had scored the last three amendments that were added. It’s now… Read more about Groundhog Zombie Goes Back to the Future: AHCA Vote Day Health Wonk Review
Health care reform: What’s next in Colorado?
2017 has been a whirlwind year for health care reform. As rate filing season draws near, there is still considerable uncertainty surrounding the future of the ACA and what lies ahead for health care reform. Here’s a summary of where things stand in Colorado: Failed: Bill to extend premium help to people above 400 percent… Read more about Health care reform: What’s next in Colorado?
Pre-Passover edition of the HWR at InsureBlog
Hank Stern has done an outstanding job with the Health Wonk Review this week; don’t miss his pre-Passover edition. Hank has factoids about Passover interspersed with ten excellent articles from some of our favorite health wonks. Thanks for hosting, Hank, and Happy Passover!
What do the proposed HHS regulations mean for Colorado’s individual market?
HHS Secretary Tom Price was confirmed by the Senate last week, and the agency wasted no time in drafting new proposed regulations under his leadership. The new regulations are intended to stabilize the individual and small group health insurance markets. The comment period is only three weeks (it closes on March 7, 2017), which is… Read more about What do the proposed HHS regulations mean for Colorado’s individual market?
Health Wonks Wonder… Will ACA Repeal Really Happen?
Steve Anderson hosted this week’s “#Alternative_Facts” edition of the Health Wonk Review, at medicareresources.org. It’s an excellent edition, and each entry in framed in terms of an #alternative_fact… of course, the alternative-ness depends a bit on your perspective. My favorite? Joe Paduda’s assessment that ACA repeal isn’t actually going to happen soon, and might not… Read more about Health Wonks Wonder… Will ACA Repeal Really Happen?
Joe Paduda has an excellent Health Wonk Review
It’s a crazy time in healthcare and even the biggest health wonks are struggling to keep up. Get up to speed with the concisely written Health Wonk Review from our friend Joe Paduda. Hot off the press.