Connect for Health Colorado is the state’s health insurance marketplace — an insurance program created by the Affordable Care Act and organized by the state. The marketplace, also called the exchange, is a one-stop shopping resource for affordable, comprehensive health insurance for individuals, families and small business owners. Health plans are made more reasonable in cost by financial assistance awarded to a large population of Coloradans: those who earn between 133 and 400% of the poverty line. Additionally, the health plans available through Connect for Health Colorado are not operated by the government, they are sold by the trusted insurance companies already serving the state for many years. What’s different about coverage on the exchange? No matter what plan you choose, you have access to a wide range of covered health care services and the ability to pay less for coverage with tax credits.
Whether you shop on the exchange website or with a licensed agent who’s certified to sell marketplace coverage, you can compare plan details, pricing and benefits to find the best fit for your needs. You can also find out if you qualify for a subsidy and how much yours will cover. Lower income individuals and families earning between 133 and 250 percent FPL may be eligible for financial assistance to reduce both premiums and cost sharing (deductibles, coinsurance and copays), while those who earn up to four times the poverty threshold may qualify for a premium tax credit.
For assistance with enrolling in and exploring the options of Connect for Health Colorado, call us at 888 803 5917 and ask about marketplace plans.
While health insurance purchased off the exchange in Colorado offers its own perks, you cannot get your premium reduced with anything but an exchange plan. As so many residents are eligible for tax credits, it’s worth investigating Connect for Health Colorado’s policies to save money. The requirements for enrollment include not having access to other forms of creditable coverage, whether Medicaid, Medicare, military benefits, or employer-sponsored insurance, unless the employer plan has a lesser actuarial value than the exchange plans. If you’re a resident of Colorado and legally present in the United States along with having no access to coverage, you may be able to enroll.
In order to qualify for cost reductions on your coverage, it’s necessary to earn above the threshold for Colorado Medicaid at 133% FPL, but not earn more than 400% FPL. If you make less than 133% of poverty, you can apply for Medicaid, and if you earn more, you have the option of buying coverage off the exchange for the same price (with access to larger networks).
To make the process of shopping for coverage easier for Americans, the ACA developed a system of categorizing coverage levels by the names of precious metals. This helps guide consumers to the least and most costly coverage in terms of monthly premiums and cost sharing. Bronze plans are the cheapest from month to month, but they also have the highest cost sharing, which can be more expensive if you use a lot of health care. Conversely, platinum plans offer a higher price for the lowest share of medical expenses at 10 percent.
Each tier has several deductibles offered, which also adjusts the premium higher or lower. A lower deductible is easier to meet and therefore costs more each month, while high deductibles make for a more affordable premium. Below are the four tiers of comprehensive coverage, but the exchange also offers an alternative, low-cost plan for younger Coloradans up to age 30: the catastrophic plan.
Premium Tax Credit
Connect for Health Colorado offers financial assistance through subsidies to those who earn between 138 and 400 percent of federal poverty. Lower income individuals receive the greatest assistance for premiums and cost sharing. Marketplace plan members earning between 138 and 250 percent of poverty may qualify for a cost sharing subsidy contributing to copays, deductibles and coinsurance. Certain enrollees may be eligible for a no premium plan if their income is low enough and they pair bronze level coverage with their subsidy.
Tax credits are calculated by income and household size, and the second-least expensive silver plan in your area as a percentage of annual income. According to your income level, you’re only allowed to pay a certain percentage of the mid-level plan’s premium. The table below illustrates how much your premium share will be as a percentage of income. The subsidy pays the rest. Scroll down to use a localized Colorado marketplace subsidy calculator applied to available plans.
The Colorado marketplace features large and small insurers throughout the state to provide each region with a selection of plans. Be aware that the provider networks on Connect for Health Colorado plans are smaller than those usually found on the individual market. Reducing the network size helps insurers promote affordability in these plans, but as a consumer you should always check to make sure a particular doctor is in-network if needed. A broad selection of of covered services is still available through these plans, and for the price, it may be worth using a more limited network.
- Access Health Colorado
- All Savers Insurance Company
- Cigna Health and Life Insurance Company
- Colorado Choice Health Plans
- Colorado Health OP
- Denver Health Medical Plan
- HMO Colorado
- Humana Health Plan
- Kaiser Foundation Health Plan of Colorado
- Rocky Mountain Health Plans HMO
The process of finding a robust health plan is made simple by the marketplace. All plans cover a set of essential health benefits, which includes ten groups of services deemed necessary by the federal government. Certain types of care, including preventive screenings, are free under your health plan, while doctor’s office visits, emergency care, and medications are subject to coinsurance, deductibles, or copayments.
Essential Health Benefits covered by all exchange plans
- Prescription drugs
- Preventive, wellness, and chronic disease management services
- Maternity and newborn care
- Office visits
- Pediatric care, including dental and vision
- Mental health and substance abuse services, including behavioral health care
- Emergency care
- Laboratory tests
- Rehabilitative and habilitative services and devices
Small Business Health Options Program
In addition to individual and family plans, the Small Business Health Options Program (SHOP) is a helpful resource for Coloradans who own small, local businesses. If you want to cover yourself and a small group of full-time employees, this program makes small employer coverage more affordable. Those who qualify for a Small Business Health Care Tax Credit can lower the cost of coverage by receiving assistance with your premium contribution. Companies must have up to 49 workers to qualify for a SHOP plan, and up to 25 employees to be eligible for the tax credit. Subsidies are offered to businesses with 25 or fewer full-time equivalent workers (30 hours per week or more on average) with income up to $50,000 per year per person. The largest tax credit an employer can receive covers half of their premium contribution, which is given to companies with 10 or fewer workers with annual income up to $25,000 each.
How to Apply
You can apply for Connect for Health Colorado plans on the marketplace website at ConnectForHealthCO.com, in person with a navigator or application assistant at facilities throughout the state, or with a licensed insurance agent who can help you choose a plan at 888.803.5917. East Coast Health Insurance is licensed and certified to sell individual health plans inside and outside of the marketplace in Colorado, allowing you the best choice of policies and market knowledge. No matter which method of enrollment you choose, make sure you educate yourself on the policy and insurer you select so you can receive the coverage you need.
Compare Connect for Health Colorado Plans
Below is a cost comparison tool providing a picture of pricing, plans and subsidies on your side of the Rockies. These rates are estimates based on the averages released by insurers participating in Connect for Health Colorado. This tool does not provide an option to purchase plans. For a more accurate idea of coverage costs and subsidy eligibility, or to sign up for a plan in your area, call a licensed agent at 888 803 5917.
*The above disclaimer pertains to the creator of this comparison tool, not East Coast Health Insurance, a licensed broker of insurance products.