Colorado Health Insurance Consumer Guide

To sign up for private health insurance through Connect for Health Colorado, you must:⁶

• Be a resident of Colorado
• Not be incarcerated
• Not be enrolled in Medicare
• Be lawfully present in the United States. (Colorado has created a separate platform that undocumented residents can use to enroll in state-subsidized health coverage.)⁷

So most Colorado residents are eligible to enroll in coverage through the exchange. But a bigger question for most people is financial assistance, and a few additional parameters must be met to qualify for subsidies through Connect for Health Colorado. 

To qualify for income-based Advance Premium Tax Credits (APTC), federal cost-sharing reductions (CSR), or Colorado’s state-funded cost-sharing subsidies,⁸  you must:

• Not have access to affordable employer-sponsored health coverage. If you have access to an employer’s plan and aren’t sure whether it’s considered affordable, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies via Connect for Health Colorado. 
• Not be eligible for Health First Colorado (Colorado Medicaid) or Child Health Plan Plus (CHP+), or premium-free Medicare Part A.⁹
• File a joint tax return if you’re married.¹⁰
• Not be able to be claimed by someone else as a tax dependent.¹⁰

Beyond those basic parameters, qualifying for subsidies through Connect for Health Colorado depends on how much your household earns and how that compares with the cost of the second-lowest-cost Silver plan in your area – which will depend on your age and location.

Colorado’s open enrollment period begins November 1 and continues through January 15, giving Colorado residents an opportunity to select a health plan for the coming year. This enrollment window is applicable for plans obtained through the exchange, OmniSalud, and directly from insurers (No subsidies are available for plans obtained directly from insurers.) 

For coverage to take effect on January 1, your application needs to be completed by December 15. If you enroll between December 16 and January 15, your new coverage will take effect on February 1.¹¹

For OmniSalud (Colorado’s health coverage program for undocumented immigrants), the enrollment process is different for 2025. Instead of a first-come-first-serve approach, OmniSalud coverage renewal will be open to existing enrollees from Nov. 1 to Nov. 22, 2024.¹² After that, new applicants can enroll, with financial assistance if any remaining spots are left (in the fall of 2023, all of the available financial assistance had been claimed within the first two days of open enrollment beginning¹³). Enrollment in OmniSalud will end January 15, 2025, just like all other individual market plans in Colorado.

Outside of the annual open enrollment period, you may be eligible to enroll or make a plan change if you experience a qualifying life event, such as giving birth or losing other health coverage.

As of 2024, Colorado joined several other states that consider pregnancy to be a qualifying event.¹⁴ This allows uninsured pregnant women the opportunity to enroll in health coverage without having to wait until the baby is born.

Some people can enroll year-round even without a specific qualifying life event.

Enrollment in Health First Colorado (Medicaid) and Child Health Plan Plus (CHP+) is available year-round.¹⁵

To enroll in an ACA Marketplace/exchange plan in Colorado, you can: 

• Visit Connect for Health Colorado, which is Colorado’s health insurance Marketplace. This online platform will allow you to compare available health plans, determine whether you’re eligible for financial assistance, and enroll in coverage, either during open enrollment or during a special enrollment period. 
• Enroll in a Connect for Health Colorado plan with the help of an insurance broker or certified enrollment assister.¹⁶
  

You can reach Connect for Health Colorado’s call center at 855-752-6749 (TTY line: 855-346-3432)

Under the Affordable Care Act (ACA), income-based subsidies (APTC) are available to lower the amount you pay for your health coverage each month. These subsidies are available to enrollees who meet the eligibility requirements and select a health plan through Connect for Health Colorado.

More than three-quarters of Connect for Health Colorado’s enrollees were receiving premium subsidies as of early 2024. These subsidies averaged $461/month, and reduced the average enrollee’s premium to about $199/month.¹⁷

If your household’s income doesn’t exceed 250% of the federal poverty level, you’ll also be eligible for federal cost-sharing reductions (CSR), which will reduce your deductible and other out-of-pocket expenses as long as you select a Silver-level plan through the exchange. In 2024, 27% of Connect for Health Colorado enrollees were receiving CSR benefits.¹⁷

Colorado also offers additional cost-sharing subsidies to some silver-plan enrollees and these benefits were expanded starting in 2024.¹⁸

(The subsidy expansion will retract after the end of 2024; state-funded subsidies will still be available in Colorado in 2025, but with a lower income limit.)¹⁹

As a result of the state-funded subsidies, all 2024 Connect for Health Colorado enrollees with household income up to 250% of the poverty level qualify for the most robust category of CSR benefit, as long as they select a Silver-level health insurance plan (as noted above, this will no longer be the case as of 2025). Under federal rules, there are three levels of CSR, with the most robust benefits going to those with the lowest incomes. Colorado’s supplemental subsidies boost the lower two levels up to the benefits provided by the most robust level, resulting in much lower deductibles and other out-of-pocket costs.¹⁸

If you’re eligible for both APTC and CSR, you can use them both if you enroll in a Silver-level plan through Connect for Health Colorado. (APTC can be used with any metal-level plan, but CSR benefits, including Colorado’s additional state-funded cost-sharing subsidies, are only available if you enroll in a Silver plan.)

Depending on your income and circumstances, you may be able to enroll in free or low-cost health coverage through Health First Colorado (Medicaid) or CHP+. Learn more about whether you might be eligible for these programs in Colorado.

As of 2023, Colorado provides state-funded premium and cost-sharing assistance to undocumented immigrants who enroll through a new public benefit corporation (Colorado Connect/OmniSalud) that the state has created.²⁰ This is separate from Colorado’s health insurance exchange, as undocumented immigrants are not eligible to use an ACA-created health insurance exchange.

In 2023, OmniSalud provided coverage to 10,000 enrollees, and the state announced that the program would be available to 11,000 people for 2024.²¹

But that 11,000 cap was reached in just the first two days of open enrollment for 2024 coverage.³ Now that the cap has been reached, additional OmniSalud enrollments for 2024 are at full price.

There was no automatic re-enrollment, so people with coverage through OmniSalud in 2023 had to re-enroll during the open enrollment period for 2024 coverage. For 2025, however, Colorado officials have indicated that people with existing OmniSalud coverage will have their spaces saved for 2025, giving them time to renew their coverage before new applicants are given access (if available) to the program.²²

Source: CMS.gov ²³

A note about Marketplace health benefits: Colorado updated its Essential Health Benefits Benchmark health plan as of 2023 (benchmark plans dictate what must be covered under essential health benefit rules on individual and small group health plans).

Colorado’s changes to the benchmark plan for 2023 include additional mental health coverage, expanded access to drugs that can be prescribed as alternatives to opioids, and up to six acupuncture treatments per year. In addition, Colorado is the first state to explicitly include gender-affirming care in its benchmark plan.²⁴

Six insurers will offer 2025 coverage in Colorado’s health insurance Marketplace, with coverage areas that vary by insurer.²⁵

They are the same six insurers that offered coverage for 2024.²⁶ For 2024, SelectHealth joined the health insurance exchange in Colorado, with plans available mostly along the Front Range.²⁷ SelectHealth already offered plans in the exchange in Utah, Idaho, and Nevada. Their expansion into Colorado was due to a merger between Intermountain Health (SelectHealth is Intermountain’s insurance arm) and Colorado-based UCHealth.²⁸

Friday Health Plans offered coverage in early 2023, but stopped accepting new enrollees in May and all FHP policies in Colorado terminated on August 31, 2023.²⁹

For 2025, the following average rate changes have been approved for Colorado’s individual/family insurance carriers, according to data published on SERFF³⁰ and by the Colorado Division of Insurance:²⁵

Overall the average approved premium increase is 5.6% for 2025.²⁵ This is slightly higher than the average increase of 5.53% that the state’s insurers had initially proposed for 2025.³¹ Most of the carriers’ approved rates were the same as or very similar to the rates they initially proposed, but the approved average rate increase for Anthem/HMO Colorado was lower than proposed (0.15%³² versus 1.1%³¹), while the approved average increase for Denver Health Medical Plan was significantly higher than proposed (15.79%³² versus 8.6%³¹).

It’s important to keep in mind that average rate changes apply to full-price rates, and most enrollees do not pay full price: 78% of the people enrolled through Connect for Health Colorado were receiving premium subsidies in 2024, offsetting some or all of their monthly premium cost.¹⁷

Subsidy amounts differ for each enrollee and change annually depending on the cost of the second-lowest-cost Silver plan relative to the enrollee’s household income. As a result of the American Rescue Plan and the Inflation Reduction Act, subsidies are larger than they used to be, and also more widely available; that will continue to be true at least through 2025.³³

If the cost of your plan is going up for the coming year, you may want to consider some of the other plans that are available through Connect for Health Colorado. You may find alternatives that offer similar benefits with a lower monthly cost.

Here’s a summary of how Colorado health insurance plans’ average full-price premiums have changed over the years in the individual/family market:

• 2015: Average increase of 0.71%³⁴
• 2016: Average increase of 9.84%³⁵
• 2017: Average increase of 20.4%³⁶
• 2018: Average increase of 34.3%³⁷ (including loss of federal CSR funding)
• 2019: Average increase of 5.6%³⁸
• 2020: Average decrease of 20%³⁹ (reinsurance program took effect)
• 2021: Average decrease of 1.4%⁴⁰
• 2022: Average increase of 1.1%⁴¹
• 2023: Average increase of 10.4%⁴²
• 2024: Average increase of 9.7%⁴³

More than 237,000 people enrolled in private plans through Connect for Health Colorado during the open enrollment period for 2024 coverage.²

This was a significant record high (see below for a chart detailing enrollment in prior years). The increase in enrollment in recent years is due to the enhancements of federal subsidies under the American Rescue Plan and Inflation Reduction Act, as well as Colorado’s investment in additional state-funded subsidies.

In addition, enrollment growth in 2024 is partly due to the “unwinding” of the pandemic-era continuous coverage rule for Medicaid. People were not disenrolled from Medicaid for three years, but disenrollments resumed in mid-2023. CMS reported that 18,921 Colorado residents had transitioned from Medicaid to a Connect for Health Colorado plan by March 2024.⁴⁴

Source: 2014,⁴⁵ 2015,⁴⁶ 2016,⁴⁷  2017,⁴⁸  2018,⁴⁹ 2019,⁵⁰ 2020,⁵¹ 2021,⁵² 2022,⁵³ 2023,³³ 2024⁵⁴

Connect for Health Colorado: This is the Marketplace/exchange in Colorado. Residents can use Connect for Health Colorado to enroll in individual/family health plans and receive income-based subsidies, and also to enroll in Health First Colorado. You can contact Connect for Health Colorado at 855-752-6749

OmniSalud/Colorado Connect: This state-run platform allows undocumented immigrants to sign up for health coverage. Depending on an applicant’s income and the number of people who have already enrolled, state-funded premium and cost-sharing subsidies may be available.

Colorado Division of Insurance: Regulates the insurance industry in Colorado, and assists consumers and businesses with insurance-related questions and concerns.

Colorado Department of Health Policy and Financing (HCPF): Administers Medicaid (Health First Colorado), Child Health Plan Plus (CHP+) and other health care programs.

Colorado Senior Health Care and Medicare Assistance: A service for Colorado Medicare beneficiaries and their caregivers, providing information and assistance with questions related to Medicare eligibility, enrollment, and claims.