Why Your Health Insurance Still Shows a One Dollar Charge, Even When Your Subsidy Covers Everything
If you enroll in health insurance through Connect for Health Colorado, you might notice something strange this year. Even if your subsidy covers the entire premium, the plan still shows a price of one dollar per person per month. It feels confusing at first, like there must be a glitch or a hidden fee.
The real answer comes down to how federal and state laws fit together, and it is much more about legal requirements than anything your insurance company is doing.
Why the one dollar exists in the first place
Federal law does not allow federal subsidies to pay for most abortion services. Because of that rule, every plan on the marketplace that covers abortion has to set aside a small separate amount to pay for that coverage. The federal government requires carriers to collect at least one dollar per person per month into a separate account that federal money cannot touch.
That one dollar must be shown on every marketplace plan that includes abortion coverage. Even if the rest of your premium is fully covered by financial help, that line item still appears.
What Colorado does to help
In Colorado, SB23-189 requires health insurance companies to provide certain reproductive health benefits and services. However, federal law and regulations do not allow the Advance Premium Tax Credit (APTC) to cover certain services. As a result, Connect for Health Colorado charges all marketplace customers a monthly premium of at least $1 per household member per month (PMPM), even if they otherwise would have enough financial help to bring their premium to $0.
In Colorado, the Health Insurance Affordability Enterprise (HIAE) has elected to cover the cost of this coverage, and the Colorado Division of Insurance (DOI) issued Bulletin-4.148 which establishes the regulatory and funding framework underlying the $1 PMPM process. This bulletin has recently been revised for plan years 2025 and 2026 and directs that the Health Insurance Affordability Enterprise (HIAE) payments of the $1 PMPM will be made for coverage that starts on or after January 1, 2025. The payment of the $1 PMPM for the first month of a subsidized enrollee’s coverage may be considered a binder payment that effectuates enrollee coverage.
Colorado decided that people should not lose coverage or get stuck with confusing partial bills because of this federal requirement. So the state created a process through the Health Insurance Affordability Enterprise that pays the one dollar on behalf of anyone receiving a subsidy.
The updated guidance for 2025 and 2026 makes this even clearer. The state will continue covering the one dollar for subsidized enrollees, and that payment can even count as a binder payment. The binder payment is the first payment that activates your coverage, so having the state handle it helps avoid delays.
Why you still see the dollar on your bill
Even though the state is paying it, the system still has to show the dollar. Federal rules require it to appear, and Connect for Health Colorado must display at least a one dollar premium per person per month. You may be asked to pay it during enrollment. If you do, your carrier will sort out any credits or adjustments afterward.
Think of it like a price tag that legally has to stay on the box, even if someone else is covering the cost for you behind the scenes.
Although the Health Insurance Affordability Enterprise will be supporting payment for the $1 PMPM requirement, customers will still see a premium of at least $1 when they enroll through Connect for Health Colorado. We encourage customers to pay the premiums shown as they enroll in the plan to prevent any delays in effectuating their coverage. If there are overpayments, insurance companies will work directly with customers to address applicable credits.
This does not apply to Colorado Connect or those customers.
Colorado Connect customers who receive Silver Enhanced Savings will continue to have zero-dollar premiums for Plan Year 2026.
A quick note on Colorado’s approach
Colorado has taken strong steps to protect reproductive healthcare. State law requires insurers to cover the full cost of reproductive health benefits and services, and voters have now placed reproductive health benefits and services rights in the state constitution. Handling this one dollar requirement on behalf of residents fits into that broader commitment to keep care accessible and uncomplicated.
If the billing still feels confusing
You are not alone. This is one of those tiny policy details that makes a big visual impact on your premium. If you ever want help checking your plan or making sure everything is correct, reach out.
