About Jay Norris

Jay operates a health insurance brokerage in Colorado, where he helps individuals and small groups obtain and maintain health insurance coverage.
Complimenting his work as a health insurance broker, Jay is also a data analyst working to create visualizations that are easily understood by consumers and other stakeholders in Colorado’s health insurance market.

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Recent posts by Jay Norris
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Connect for Health Colorado and the OIG Audit Report

On December 27, the U.S. Department of Health and Human Services’ Office of Inspector General (OIG) released an audit report (the full report is here) regarding Connect for Health Colorado’s use of federal start-up funding. This funding was provided for state-run exchanges to get their operations up and running in 2013 and 2014. To make a […]

PEAK Issues

As of now, it appears that PEAK has various errors. If you’ve had coverage through PEAK in the past, submitting a financial determination for 2017 also re-determines your 2016 financial eligibility. This can cause major problems with your 1095-A, your billing, and your insurance plan. **NO Confirmed Fix Yet** I will update this page when there […]

Short and Sweet Health Wonk Review

Jason Shafrin has the latest Health Wonk Review at Healthcare Economist. You’ll find some of the greatest writing by healthcare experts about health insurance, pharmaceuticals, the ACA, mental health, and physician pay.

If you’re facing the subsidy cliff, enroll through Connect for Health Colorado

The Canon City Daily Record published a story this week highlighting how expensive health insurance is in the Colorado mountains, and how few carriers offer coverage in the mountains. Despite the fact that the Division of Insurance combined some rating areas to alleviate the problem ahead of the 2015 open enrollment period, rates for 2016 […]

Connect for Health Colorado and non-resident brokers

At today’s Connect for Health Colorado board meeting, there was some discussion over the issue of whether or not Colorado’s exchange should work with out-of-state web brokers. Here’s the background on the issue, and I want to clarify my position in case there was any confusion. I’ve been a local broker in Colorado for 14 […]

Healthblawg has a great Health Wonk Review

Sit down with David Harlow for the Turkey Edition of the Health Wonk Review. It’s a full helping of educational and though provoking posts.

Assigning an agent/broker with Connect for Health Colorado

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The Coming Storm Over the 340B Rx Drug Discount Program

We’ve invited Healthcare Lighthouse CEO Billy Wynne to share his posts with us. Today’s piece addresses the forthcoming regulation that will likely make sweeping changes to the 340B program. Keep an eye out for additional pieces in the coming weeks and be sure to check the Lighthouse Blog for some of our posts. Beneath the glare […]

Infographic – Affordable Care Act and How Individual Health Insurance is Changing in 2014

A quick overview of how individual health insurance will change in 2014 due to the Affordable Care Act (ACA).

A Little Flurry of Snow in Northern Colorado Today!

Just enough snow came through the Fort Collins area for the kids to plow… and mow. We’re hoping the mountains get a lot for skiers and snowboarders. We put the kids to work in the yard. Plowing…

Good exercise plowing the snow

And mowing…

Mowing the snow

Here is a video of the front end loader in action plowing the snow off of the porch! It was a gift from a friend and is their favorite toy…

Rocky Mountain Health Plans 2013 Rate Increase Announced

Rocky Mountain Health Plans announces the 2013 new business rate increase for the “SOLO” individual/family health insurance plans in Colorado is 18%. As with all carriers, for existing clients on open plans, rate changes may be different due to age attainment and trend. Carriers may adjust rates differently for closed plans effective January 1, 2013.

RMHP posted the disclosure of the increase for new and renewing business on healthcare.gov.

For clients who pay monthly:

  • January renewals were mailed Friday, November 30, 2012.
  • February renewals will be mailed the end of December.
  • March renewals will be mailed the end of January.

No 2013 Rate Increases for Cigna or Anthem Blue Cross of Colorado

Both Cigna and Anthem Blue Cross of Colorado report no rate increases on new business in Colorado. However, for existing clients on open plans, rates may change due to age attainment and trend. Carriers may adjust rates for closed plans effective January 1, 2013.

Kaiser Permanente 2013 Rate Increase Announced

Kaiser Permanente announces the average 2013 rate increase for individual/family health insurance in Colorado was 11%.

I wish my health insurance _____________?

I understand the trade off we got when we switched to a really inexpensive high deductible plan when even our high deductible HSA qualified plan was too rich and expensive. So I wish my health insurance had a monthly credit card billing option. Our current health insurance company, Anthem Blue Cross of Colorado used to have it, like most health insurance companies did. But then, like most other companies also did, they stopped offering that as an option about a year ago.

What would you change about your health insurance company or plan? It could be the coverage, billing, customer service, anything…

2012 Obamacare Premium Rebates (Infographic)

Did you receive a health insurance premium rebate this year? If so, how much was it? We created a simple visualization of how the PPACA (Obamacare) health insurance premium rebates break down between the individual/family, small group and large group markets and how Colorado’s rebates compared to the national average.

2012 Obamacare Colorado Health Insurance Rebates

No 2013 CoverColorado Assessment

CoverColorado announced that there will be no assessment in 2013 on Colorado health insurance carriers. The 2012 assessment was roughly $3.79/month/contract for individual/family insureds.

Anthem Blue Cross of Colorado has also announced that their membership this year was higher than expected this year. They were making up for a shortfall by charging $4.36/month/contract in 2012. Due to the higher enrollment, Anthem BCBS has enough funding to satisfy December without billing subscribers a CoverColorado assessment.

Snow in Colorado Last Night, But Not Very Much

We just got a little bit of wet, sticky snow in Colorado last night; just enough for a little snowman in the morning. Matt made the snowman all by himself! Most of the snow in the yard has melted this evening, but not the snowman!

Snow in Colorado last night but not very much. Just enough for a small snowman

Colorado Selects Kaiser Permanente As Its Benchmark Health Insurance Plan

Last December, HHS made it clear that they were giving states a lot of flexibility in determining what plan would serve as the benchmark for the state’s “essential benefits” for individual and small group health insurance policies that would be sold starting in 2014.

After months of consideration, Colorado has selected Kaiser Permanente’s small group plan as a benchmark.  This is the largest small group plan in the state, with almost fourteen thousand members, and was selected by a group of officials from the Colorado Division of Insurance, the Governor’s office, and the health benefits exchange.  The Division of Insurance will be taking comments until next Monday before making a final announcement, and you can contact them by email (ehb@dora.state.co.us) if you’d like your comments to be considered.

The Kaiser plan covers services in the ten areas that are required by the PPACA (ambulatory patient services, emergency care, hospitalization, maternity and newborn care, mental health and substance abuse services, prescription medications, rehabilitative services, lab work, preventive care/disease management, and pediatric care), which means that it will serve as a benchmark for services in those areas without the DOI having to add additional coverage minimums.  In addition, the Kaiser plan was generally considered to be a good balance between comprehensive coverage and affordable coverage.  It’s not the most comprehensive policy out there (the much maligned “Cadillac plans” offer more benefits), but it provides […]

Low Deductible Still Required To Waive CSU Student Health Insurance

I’ve been getting a lot of questions from CSU graduate and international students. I just confirmed with the Colorado State University (CSU) Health Network that they’re not budging (much) on the requirement that graduate and international students have a $500 deductible if they want to waive the CSU Student Health Insurance. The person I talked to did mention they might allow a $1000 deductible if the student can prove sufficient financial resources to pay such a large bill.

Meanwhile, the CSU Student Health Insurance Plan has a policy year limit of $250,000 per accident/illness. It’s much better than a mini-med, but they still have a reputation for getting maxed out. I asked if they’ve ever had a student hit the limit (like has happened at other schools), and she said she could only think of one minor case when the student was able to wait until the next calendar year when the benefits started over.

The CSU Health Network is a really great organization though, if it weren’t for the low cap on benefits. They have top notch providers and are very friendly and helpful.  And on January 1, 2014, even university health insurance plans will be required to not have a cap on benefits because of the Affordable Care Act.

I Thought Insurance Companies Couldn’t Decline Due To Pre-Existing Health Conditions Anymore?

One of the most common questions lately: I was declined for health insurance due to a pre-existing health condition. I thought insurance companies couldn’t look at our pre-existing health conditions anymore because of [the PPACA] ObamaCare?”

I’ve written a quick (yet detailed) answer to the question: “I thought they couldn’t decline people because of pre-existing health conditions” here.

Colorado Health Insurance CO-OP Receives Loan From HHS

At the end of July, the first of Colorado’s health insurance CO-OP plans got a $69 million loan from HHS as part of a push by the ACA to develop consumer-owned-and-operated health insurance plans (“CO-OP” is short for Consumer Oriented and Operated Plans).   The CO-OP is sponsored by Rocky Mountain Farmers Union and the bulk of the loan from HHS will be put in reserve to fund claims expenses for initial enrollees. As premium dollars are collected, the loan will be paid back to HHS.

Colorado Senator Irene Aguilar introduced a bill last year to create a state-wide Colorado health insurance co-op, but the bill was tabled in May 2011 after passing its second reading in the Senate.

The new CO-OP being created with the loan money will be especially focused on rural areas of Colorado – which are generally underserved in terms of health insurance options.  In addition, residents in rural areas are often already familiar with the concept of co-ops for other services like utilities.  So a Colorado health insurance plan that is owned and operated by its members should be an especially good fit.

The CO-OP will begin marketing plans next fall with policy effective dates starting January 1, 2014, and is hoping to enroll 10,000 Colorado residents in its first year.  Unlike most commercial health insurance plans available in Colorado, the CO-OP will be able to direct profits back into the plan in the form of lower premiums and/or higher quality service rather than sending profits to shareholders.  And while most health insurance carriers that do business in Colorado are multi-state organizations, the CO-OP will be a local plan based here in Colorado (Rocky Mountain Health Plans is another example of a local, non-profit health insurance option for people in Colorado).

The CO-OP expects to be available both through the Colorado Health Benefits Exchange (aka “the exchange”) and also via independent health insurance brokers and agents.  An innovative new health insurance product – especially one that strives to serve populations that are underserved by our current health insurance industry – is good news for Colorado, as it should foster more competition among the existing health insurance carriers in the market.  Congratulations to Rocky Mountain Farmers Union for the approval from HHS for the loan to get the CO-OP going!

5280 Magazine Needs Denver Area Self-Employed for Health Insurance Article

Are you a Denver area resident who’s self-employed and had to navigate getting individual health insurance? Or do you fall somewhere in this description—“the self-employed, freelancers or ‘accidental entrepreneurs’ who started their own business or began doing freelance/contract work after being laid off from full-time positions during the economic turmoil of recent years”?

I’m writing a short article for 5280 magazine and would like to talk to about your experience. I would ask a few questions and potentially use a few short quotes. It should take about 10-15 minutes. I would be glad to speak at your convenience, but it will need to be during the week of July 30. You may contact me at jeremyvjones@comcast.net or 719-649-3634.

Walgreens, Anthem Blue Cross Express Scripts Agreement Reached

Express Scripts and Walgreens have come to a multi-year agreement for Walgreens to participate as an in-network retail pharmacy. Anthem Blue Cross Blue Shield of Colorado members will be able to use their prescription drug benefits at Walgreens locations beginning Sept. 15, 2012.

Walgreens was in a situation where it needed to get this deal figured out. They were losing millions, not just in prescription drug sales, but the people who weren’t in the store filling their prescriptions also weren’t in the store to buy juice, toilet paper, grills, etc…

ACO Downsides

Attorney Nina Kallen hosted this week’s Cavalcade of Risk, and it included a couple of interesting entries about the Facebook IPO. Given that we write about health insurance, I especially liked Dr. Jaan Sidorov’s article comparing Facebook and ACOs. His verdict? Well, you’ll have to read his article to get the details, but he’s not particularly impressed with either one. I tend to see ACOs in a relatively positive light, and I think they have a lot of potential for cost savings and creating more of a teamwork dynamic between providers and health insurance carriers. But Dr. Sidorov makes some good points about the potential downsides. As usual, good food for thought from the Disease Management Care Blog.

Anthem Introduces New Accident And Critical Illness Benefits In Colorado

[…] For individuals and families who are healthy and rarely need their health insurance benefits, an accident may be their primary concern. Obviously we’re all susceptible to illness aswell, but accidents have a more “out of the blue” quality to them, and can happen to even the healthiest of people. We’ve never needed our health insurance due to illness, but we’ve had a few injuries over the years that have been pretty costly. Stitches and x-rays on our son’s finger alone came to $1,400. The charges can add up quickly when you’re in an emergency room, and if you have a high deductible health insurance policy, you’d be responsible for the entire bill for an incident like that. An accident supplement that will cover all or a portion of the deductible can help people feel more at ease with a high deductible (ie, less expensive) health insurance policy.

The accident supplement portion of Balance will coordinate with your health insurance, so it will pay you either your out-of-pocket amount or the Balance benefit maximum, which ever is lower. For example, if your out-of-pocket expenses for an accident – after health insurance has paid its portion – come to $1750 and you have the $2500 benefit Balance plan, you’ll get $1750 in supplemental coverage. But if your out-of-pocket expenses come to $4500, you’ll get the full $2500. The critical illness benefit is a lump-sum payment, but the amount paid depends on the specific diagnosis.

With the introduction of Balance, Anthem Blue Cross Blue Shield has added another solid plan to the options available for individuals and families in Colorado who are looking for an accident and critical illness supplement to go along with their health insurance policy.