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Individual/Family Health

Connect for Health Colorado getting more user-friendly

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Connect for Health Colorado has been one of the most successful exchanges in the country during the first year of operation.  The exchange had enrolled nearly 146,000 people in private plans as of the end of August, and Colorado’s uninsured rate dropped by six percentage points from the end of 2013 to mid-2014. But despite… Read more about Connect for Health Colorado getting more user-friendly

Weekend reading from some great health wonks

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Have you scrolled through the latest Health Wonk Review yet?  Billy Wynne hosted this week over at Healthcare Lighthouse, and his “Thank God It’s Recess” edition is excellent. A few articles were particularly interesting to me.  At the National Center for Policy Analysis, John R. Graham wrote about how the second open enrollment is going… Read more about Weekend reading from some great health wonks

Average rates only increasing 0.71% in the Colorado individual market for 2015

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The Colorado Division of Insurance released 2015 health insurance rates this morning, and things are looking pretty good.  The average increase across all carriers in the individual market is less than one percent:  0.71% to be exact.  We’ve been in the health insurance industry since 2002, and we’ve certainly never seen an average even close… Read more about Average rates only increasing 0.71% in the Colorado individual market for 2015

Summer Reading Program – learn something new about ACA implementation and gear up for open enrollment!

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Brad Wright hosted this week’s Health Wonk Review over at Health Policy Analysis – be sure to check it out.  Two of my favorites this time around are from Health Affairs and Healthcare Lighthouse. At Health Affairs, John Kingsdale and Julie Lerche have an outstanding piece on some upheaval that could cause headaches for consumers… Read more about Summer Reading Program – learn something new about ACA implementation and gear up for open enrollment!

Fixed Indemnity Plans – buyer beware; regulations begin soon

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In early 2013, we worked with a client shortly after he had received a sales pitch for what sounded like a very sketchy health insurance product.  We followed up on the issue, talking with an agent for the carrier in question, as well as the Colorado Division of Insurance.  At that time, full ACA implementation was still… Read more about Fixed Indemnity Plans – buyer beware; regulations begin soon

Bundled payments and other risky endeavors

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Jaan Sidorov of the Disease Management Care Blog did an excellent job with the latest edition of the Cavalcade of Risk.  There’s plenty of good reading there, so don’t miss it.  I thought one of the most interesting posts was from Dr. Sidorov himself, writing about bundled payments.  He makes some really going points, explaining… Read more about Bundled payments and other risky endeavors

Lost your job? Apply for Medicaid ASAP to have a qualifying event when you get another job

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Job loss and short periods of unemployment are a relatively common part of life.  But with the new open enrollment rules in the individual health insurance market, it’s important that people understand exactly how the system works in order to avoid finding themselves stuck without health insurance.  Recently we’ve had several clients in this position,… Read more about Lost your job? Apply for Medicaid ASAP to have a qualifying event when you get another job

Combining rating areas in Colorado to bring down mountain premiums

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Even before the ACA, individual health insurance in Colorado’s mountain towns was more expensive than in most of the rest of the state.  The ACA makes health insurance much more affordable for most people earning up to 400% of poverty level (especially in states like Colorado, where Medicaid has been expanded… we have no coverage gap).  And… Read more about Combining rating areas in Colorado to bring down mountain premiums

Short term health insurance is your best option if you missed open enrollment

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Short term health insurance plans don’t have an open enrollment period Short term health insurance plans may be the best option if you missed open enrollment and you don’t have a qualifying event. Get short term health insurance quotes Qualifying events include marriage, divorce, birth, adoption, moving to a new area where different plans are… Read more about Short term health insurance is your best option if you missed open enrollment

Colorado making great progress covering the uninsured and underinsured

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Last November, the 2013 Colorado Health Access Survey was released with a variety of updated data, including the number of Colorado residents who were uninsured in 2013:  about 741,000.  That was down from 829,000 two years earlier, but is still 14% of our state population.  And it doesn’t include the people who are considered underinsured… Read more about Colorado making great progress covering the uninsured and underinsured

Connect for Health Colorado Updates On The End Of Open Enrollment for Health Insurance in 2014

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Back in October, six months probably seemed like plenty of time to have open enrollment for health insurance in 2014.  And for all the procrastinators out there – you know who you are! – there was always tomorrow.  But we’re now down to just one week remaining in open enrollment.  The good news is that… Read more about Connect for Health Colorado Updates On The End Of Open Enrollment for Health Insurance in 2014

Wouldn’t it be more efficient to spread ACA open enrollment across the whole year?

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As we head into the final few weeks of open enrollment, there’s likely to be a surge of applications both on an off the exchange.  And that means an uptick in phone calls to carriers and brokers, ID cards and policies being mailed out, premium payments being processed… all of the things that go along… Read more about Wouldn’t it be more efficient to spread ACA open enrollment across the whole year?

Connect for Health Colorado Exceeding Enrollment Targets

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By February 17, Connect for Health Colorado had enrolled 79,779 people in private health insurance plans, and another 128,219 in Medicaid.  Prior to the start of open enrollment, CMS published monthly enrollment targets for each state – based on those numbers, Colorado’s target for the end of February was 73,600 people enrolled in private plans…. Read more about Connect for Health Colorado Exceeding Enrollment Targets

If You Read One Thing Today, Pick an Article That Debunks An ACA “Horror Story”. Here Are Two…

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David Harlow’s “In like a lion” edition of the Health Wonk Review is full of great articles – be sure to head over and check it out.  My favorites in this edition include posts from Joe Paduda, Wendell Potter and Maggie Mahar. Joe gives us a great summary update of what’s going on with Obamacare…. Read more about If You Read One Thing Today, Pick an Article That Debunks An ACA “Horror Story”. Here Are Two…

Understanding Drug Formularies On New Individual Health Insurance Plans In Colorado

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Colorado residents only: Compare how each health insurance company covers your medication with our exclusive Colorado prescription drug formulary transparency tool. Opponents of the ACA have raised the issue of drug formularies as a negative aspect of the new ACA-compliant plans, complaining that the new plans won’t cover all of the medications people need.  Just like many of their… Read more about Understanding Drug Formularies On New Individual Health Insurance Plans In Colorado

It’s Not Just About Supply And Demand For Labor – The ACA Makes Life Better, Increases Choices

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Last week, the CBO released a report that sent the internet into paroxysms of spin.  Initially – and much to the delight of ACA opponents – numerous media outlets reported that the CBO was predicting a loss of more than 2 million jobs over the next decade as a result of the ACA.  Then they… Read more about It’s Not Just About Supply And Demand For Labor – The ACA Makes Life Better, Increases Choices

Future Healthcare Expenses Will Not Necessarily Mirror Past Expenses

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I recently wrote an article responding to the Americans for Prosperity video about Emilie Lamb that has been making its way around the internet.  I spoke with Emilie and took a good look at the plan she used to have, comparing it with her new Platinum plan.  To sum it up, her old plan was… Read more about Future Healthcare Expenses Will Not Necessarily Mirror Past Expenses

What to look for when comparing Connect for Health Colorado plans

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Many of the health insurance regulations in the ACA have made it easier to compare apples to apples in the individual health insurance market. There are no more “junk” plans with low benefit maximums or major holes in the coverage. All policies cover maternity (although that has been the case in Colorado since 2011). Preventive care is covered before the deductible with no copays or coinsurance. All policies must cover the essential health benefits with no annual or lifetime maximums (there can still be limits on the number of visits for some treatments). And all policies must have out-of-pocket maximums of no more than $6350 ($12,700 family) in 2014.

Other than Catastrophic plans, which are available for people under 30 and those who have a hardship exemption from the exchange, which includes people who had a 2013 policy that was terminated in December, all policies available in Connect for Health Colorado (and off-exchange too) fall into one of four categories: bronze, silver, gold or platinum (virtually all of them are bronze, silver or gold though). Also, Catastrophic plans aren’t significantly less expensive in Colorado. The designation is based on the actuarial value of each policy. Bronze plans cover roughly 60% of costs; silver, 70%; gold, 80%; and platinum, 90%. After the maximum out-of-pocket is met, all policies cover 100% of covered costs (with some rare exceptions, such as policies that put an annual limit on the number of covered visits for services like home healthcare and skilled nursing).

But comparing apples to apples still takes quite a bit of reading. Within each metal level, there’s a wide variety of different plans available from the many different carriers offering policies in the exchange (Anthem Blue Cross Blue Shield, Cigna, Colorado HealthOP, Elevate by Denver Health, Humana, Kaiser Permanente, Rocky Mountain Health Plans, United Health). Networks vary considerably, but so do the plan designs comparing apples to apples with a wide variety of plans from the many carriers offering policies in the exchange (Anthem Blue Cross Blue Shield, Cigna, Colorado HealthOP, Elevate by Denver Health, Humana, Kaiser Permanente, Rocky Mountain Health Plans, United Health). Differing deductibles and out-of-pocket maximums

Our Glass Is Half Full And We Like It That Way

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David Williams hosted a great Health Wonk Review this week, and it was interesting to see how he divided the articles into optimistic and pessimistic viewpoints, with one section for “glass half full” articles, and another for the “glass half empty” ones.  It’s a reminder that there are always different ways of looking at the… Read more about Our Glass Is Half Full And We Like It That Way

Carrier Contact Information And Updates For People Who Need To Pay January’s Premium

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Today, January 10th, is the payment deadline for most Connect for Health Colorado policies with January 1 effective dates.  A few carriers have pushed the deadline out a little bit: Updated  Anthem Blue Cross and Blue Shield is moving the payment deadline to 1/31 for 1/1 effective dates. Delta Dental:  January 15. Premier Access Dental… Read more about Carrier Contact Information And Updates For People Who Need To Pay January’s Premium

Do Not Assume Your Provider Network Will Be The Same As It Was Last Year

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A description of PPO, HMO, EPO and a search tools for all carriers is available here. EDIT 2/18/14:  Connect for Health Colorado updates the provider directory once per month.  It is possible therefore that the list may not be up-to-date at all times.  If you have questions, you can call your carrier directly, or contact… Read more about Do Not Assume Your Provider Network Will Be The Same As It Was Last Year