Frequently Asked Questions – FAQ

Q: Can I save money by going directly through the insurance company?

A: No. Rates for insurance are filed through the Colorado Division of Insurance. The rates filed with the division of insurance are the only rates that can be charged – whether you buy your policy from the insurance company or a broker.

Q: But, I’ve talked to somebody at the insurance company and the quotes they gave were different than the quotes I received on your quote engine?

A: The quote engines aren’t always 100% accurate, they may be slightly higher or lower than the actual price you’ll end up paying. To get the actual price, contact us to go over your options. We use the same software each of the health insurance companies use in order to verify your quotes – all with one call.

Frequently Asked Questions answered in detail.Q: What are the benefits of using a broker?

A: Working with large health insurance companies can be difficult, but a knowledgeable broker can make the experience of getting your own health insurance policy much more tolerable. Insurance Shoppers helps you choose the right plan to fit your tolerance for risk and budget by working with you to compare all of the available options. We understand the application and underwriting process of each company in Colorado, and we know how to streamline the underwriting process for quicker decisions. Finally, we’re able to act as your advocate for any customer service, billing, or claims issues that may arise. Since the price is the same whether you go directly through the company or through a broker, you’re paying for a broker whether you have one or not. You might as well have someone on your side if you ever have the need.

Q: What if I have a pre-existing condition?

A:  Probaly one of the most frequently asked questions now… Starting in 2014, there isn’t anymore underwriting.  Before then… all health insurance companies in Colorado had different underwriting standards and each health condition is unique in it’s own way. So although you may have heard that your condition may prevent you from getting coverage or if you’ve been declined before, you can get coverage now and your pre-existing conditions don’t matter.

Q: How does Insurance Shoppers get paid?

A: Like any agent or broker, we’re paid a commission by the insurance company each month you have coverage, so we have a vested interest in keeping you as a happy client as long as possible. All you end up paying is the same premium you’d have to pay even if you went directly through the health insurance company. And we end up getting paid a commission if you decide to purchase a policy we recommend to you. The insurance company benefits a lot from this because they don’t have to dedicate resources to have somebody at their company do all of the things we do for you (like explain your options and how the plans work, figure out your best underwriting options, help you through the application and underwriting, and being your advocate if you have any problems with billing or claims after you have the policy)

Q: How long of a contract am I going to be stuck in?

A: All of the health insurance policies are month to month. Even if you have quarterly or annual billing, you are able to cancel and receive a refund of any months you’ve paid for but won’t use.

Q: What is an HSA?

A: Health Savings Accounts combine a high deductible health plan with a tax deferred savings account. The idea is to self insure the smaller things and have them count toward your deductible. This will give you a large premium savings which you can put into your own health savings account. This money can grow tax deferred until you retire, or you can use it to pay for the smaller healthcare expenses you incur before your deductible. You can learn more from our HSA page and also by reading the HSA FAQ’s.

Q: I can’t understand all of the insurance terms used when I get instant quotes!

A: Most people we talk to everyday get confused with all of the insurance terms like copay, coinsurance, PPO, and out-of-pocket maximum. That’s why we’ve created this easy to understand glossary of health insurance terms.

Q: Both my husband & I are self-employeed. As owners, we have both have opted-out of the workers compensation program. That said, if either of us is injured while at working, will the individual health insurance plan I choose take care of our medical needs?

A: Any individual/family health insurance plan will cover you 24/7 – on or off the job.

Q: On the application for individual health insurance, it says “We will not pay for services related to a pre-existing condition for 12 consecutive months after the member’s original membership effective date.” But they put an “exclusion” on my asthma, and said they won’t ever pay for any expenses related to asthma. Is that legal?

A: Individual health insurance companies in Colorado will give credit for prior credible coverage that was in effect within 90 days of the effective date of the new policy. This credit waives the pre-existing coverage period, up to 12 months. This means that if there was prior coverage, no claims will be denied as a pre-existing condition, as long as it is not one that the insurance company has applied a benefit exclusion to. If there is no prior credible coverage, in addition to any conditions that were imposed a benefit exclusion, coverage will not be provided for up to one year for certain conditions that were treated within the 12 months prior to the effective date of the new health insurance policy.

A benefit exclusion from 3 years to lifetime can be put on the policy for any condition that the member has received treatment for in the period of time the health insurance company asks about on the application (usually 10 years). The length of the benefit exclusion is at the discretion of the health insurance company. These are conditions that may reoccur and/or have the possibility of the need for further treatment or follow up. When this/these conditions are listed in the health statement portion of the application, they may be imposed the benefit exclusion. If there was prior coverage, those conditions that have the benefit exclusion are the only ones that would be denied for claims payment. If there is not prior coverage, then the health insurance company can review to see if the condition is a new onset, or one that the member had been treated for in the previous 12 months. If there was treatment for a condition, the health insurance company may deny those claims, for up to 1 year, in addition to any benefit exclusions. After the one year period, then claims for the pre-existing conditions will be paid, while those that have a benefit exclusion will not.

Q: It’s been about 8 months since I signed up for the short term insurance and I may need to sign up again. I used 4 months of short term insurance so does that mean I would be able to use up to 8 months?

A: Colorado law says that you can have a policy for up to 6 months and renew it once for up to 6 months. Then, you must wait at least 6 consecutive months before you can get another short term policy (for up to 6 months – followed by another 6 month policy if you like).
So in your case, you would be able to get another 6 months of short term coverage right now. But once that expires, you’ll have to wait 6 months to get another short term policy of any kind with any carrier for any length of time.
The reason is because you need to have that full 6 month consecutive gap between back-to-back policies. If you were to wait another 2 months from now, you could have up to 12 months of short term coverage. But if you sign up now, you’ll have to complete your 6 month lay-off after this 6 month policy runs out.
Get short term health insurance quotes

Q: We have contacted several health providers in the Vail valley, and they all tell us the same thing. They do not accept Aetna directly, but they bill “Cofinity”; could you clarify this for us.

A: Confity is owned by Aetna. Its the old Sloans Lake provider that merged together with Aetna network. – so it is the same thing.

Most Frequently Asked Questions about networks, PPO, HMO, etc can be found here.

Q: I received my insurance cards but did not receive my wife’s or daughters. Do they get cards also?

A: Because you are the primary insured on the policy, the cards will typically only have your name on all of the cards for the family. Providers will still see which spouse and dependents are covered on the policy.

Q: What is your favorite ice cream flavor?

A: Hmmm…. good question – that’s a tough one. I’ll probably be changing this answer or adding to it every so often. But I tend to like ice cream with cookie dough in it – or chunks of reeses peanut butter cups. I also like coffee flavored ice cream…

Have questions about HSAs?

See the HSA Frequently Asked Questions (HSA faq) page.