colorado guide to health insurance

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Colorado health insurance exchange / marketplace

More than 142K enrolled on CO exchange

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The 2015 open enrollment period for private insurance has ended on Connect for Health Colorado. Colorado is one of the few states that is NOT offering a tax-related special enrollment period.

Until the next open enrollment period begins in November, opportunities to get health insurance are limited. You can purchase insurance if you have a qualifying event during the year, and Native Americans can enroll at any time. Enrollment for Medicaid and Child Health Plan Plus (CHP+) are open all year.

2015 enrollment

As of March 9, Connect for Health Colorado reported that 141,639 people signed up for qualified health plans (QHPs). More than 94,000 were returning customers, and about 47,000 were new to the marketplace in 2015. See detailed enrollment metrics such as enrollment by age group, average premiums with and without tax credits, and much more.

2015 premiums

Regions of Colorado had some of the nation’s highest premiums through the marketplace in 2014, so it’s very welcome news that the average increase for individual plans is just .71 percent for 2015. The state Department of Insurance created larger and fewer geographic regions in establishing rates. This action helped moderate — and even decrease — rates in some regions.

Connect for Health features 15 insurers offering 176 individual/family options. Two of the insurers are offering multi-state plans.

2015 budget

The Connect for Health board approved a $66.4 million budget for the fiscal year running from July 1, 2014, to June 30, 2015. The budget includes a $1.25 per-member-per-month assessment on insurance carriers, which officials say will allow the marketplace to maintain an operating reserve of $13 million. The assessment applies to all policies, not just those sold through the marketplace. According to Health News Colorado, the 2015 budget includes:

  •  $29.5 million for technology
  •  $13.6 million for the customer service center
  •  $7 million for salaries, legal and accounting fees, and travel
  •  $6 million for the assistance network
  •  $4.8 million for marketing, communication and outreach
  •  $2.3 million for consulting and operations

However, the exchange has gone back to the board repeatedly for more money.

In September 2014, the board approved $3.5 million for additional technology licensing fees.

In November 2014, Connect for Health sought a $4 million increase for the service center, explaining that the money was needed to handle higher than anticipated call volume due to a big change in subsidy amounts between 2014 and 2015. The board did not immediately approve the requested increase. Rather, it approved $875,000 at the time and an additional $300,000 in December.

In January 2015, the Connect for Health board of directors approved $322,000 in emergency spending to address enrollment system problems. The emergency spending was needed to fund workarounds to help people complete the enrollment process, but did not address the underlying problem.

In early February, Connect for Health requested $2.8 million  again for the service center. The board deferred making a decision.

Connect for Health Colorado enrollment in 2014

Connect for Health Colorado, the state-run health insurance exchange, far exceeded the qualified health plan (QHP) enrollment target of 92,000 set by the Centers for Medicare and Medicaid Services (CMS). Connect for Health Colorado announced more than 129,000 people had signed up for QHPs as of April 23. Through special enrollment periods, QHP enrollment grew to 137,000 as of mid-2014. In addition, nearly 182,000 people qualified for the state’s expanded Medicaid program.

Only 60 percent of those Coloradans who purchased private insurance qualified for assistance to offset the cost. Nationally, 85 percent qualified for financial assistance. Colorado’s relatively low rate of financial assistance and the high premiums in some areas of the state explain why 40 percent of 2014 plans sold in Colorado were bronze plans compared to 20 percent nationally.

Background on Colorado’s exchange

Gov. John Hickenlooper informed the federal government in October 2012 that Colorado intended to run its own health insurance marketplace, and the state received federal approval of its plan in December 2012.

Unlike politicians in most other states, Colorado legislators voted on a bipartisan basis to move ahead with a state-run exchange. Legislation to establish the state marketplace passed in May 2011 and was signed by Hickenlooper in June 2011. In early 2013, marketplace was given the brand name “Connect for Health Colorado.”

Colorado’s marketplace is governed by a 12-member board and led by interim CEO Gary Drews. Drews stepped in for Patty Fontneau, who took a position with CIGNA. Connect for Health expects to announce a permanent replacement by March 2015.

A limited performance audit conducted by the Colorado Office of the State Auditor in 2014 found problems with how Connect for Health Colorado handled its finances. The audit found that Connect for Health Colorado lacked adequate financial controls, such as not properly tracking payments and not following federal requirements for administering contracts. Auditors made four recommendations for improvements. Connect for Health officials accepted the recommendations and said they will implement them.

Citing the 2014 audit findings, the Colorado Senate in early 2015 passed two bills for increased oversight of the exchange. SB 19 authorized an in-depth performance audit, while SB 52 authorized committee review of any proposed bonuses for Connect for Health staff members. SB 19 passed the House 64-1 on March 16, but a House committee rejected SB 52 in late February.

HB 1066 did not make it out of the House Health, Insurance and Environment Committee. That bill sought to end operation of Connect for Health Colorado.

The Colorado Division of Insurance announced that transitional or “grandmothered” health plans must be discontinued at the end of 2015. Beginning in 2016, individuals must enroll in either ACA-compliant plans or in grandfathered plans (i.e., plans that don’t cover the ACA’s essential health benefits, but were in effect prior to prior to March 23, 2010).

Colorado health insurance exchange links

Connect for Health Colorado
855-PLANS-4-YOU (855-752-6749)

State Exchange Profile: Colorado
The Henry J. Kaiser Family Foundation overview of Colorado’s progress toward creating a state health insurance exchange.