We recently got a call from a client who mentioned that he had done a Google search for the “best health insurance companies in Colorado” and his concern was that Anthem Blue Cross Blue Shield was not on the top ten list that he said came up as the first search result. We were a… Read more about Best Health Insurance Companies In Colorado
Colorado Division Of Insurance
Last week, we got a call from a lady who had several questions about maternity and newborn coverage. She lives here in Colorado and has her health insurance with one of the state’s large, reputable carriers. She had called her health insurance carrier to see how maternity coverage works (it’s a group policy) and the person she spoke with told her that her policy wouldn’t cover the baby after it’s born, since the baby isn’t named on the policy as a member.
Colorado law requires health insurance carriers to add newborns to a parent’s policy as of the date of birth, with no medical underwriting. This automatic coverage is good for the first 31 days after the baby is born. In order to continue the baby’s coverage after the first month, the carrier has to be notified of the new addition to the policy within the first 31 days after the baby is born. No underwriting is allowed as long as the carrier is notified of the baby’s birth within that time frame. […]
We’ve written several articles over the years about the importance of skepticism when an insurance product just seems too good to be true (ie, no medical underwriting and premiums that are a fraction of the cost of most policies on the market). Often, those policies are actually discount plans or mini-med coverage that won’t provide much of anything in terms of coverage when it’s actually needed.
The Colorado Division of Insurance has a good page with warnings and advice to consumers who are considering medical discount plans. These plans are generally legal, but buyers definitely need to understand what they’re getting into before they sign up – especially if they’re dropping a standard health insurance policy to switch to a discount or mini-med plan.
With shady medical benefits companies, the focus tends to be on consumers getting ripped off. In an interesting twist, the Colorado Attorney General has filed suit against a Highlands Ranch, Colorado LLC, Consolidated Medical Services, but the lawsuit isn’t regarding their product. It pertains to the way in which they recruit – and allegedly scam – their affiliate marketers. […]
[…] Starting in 2014, health insurance will be guaranteed issue and all of us will be required to have coverage. But until then, individual health insurance is priced based on medical underwriting and (in most cases) slightly less comprehensive benefits than group policies. That’s why it’s less expensive to have an individual policy than a group policy or a guaranteed issue policy like CoverColorado. If health insurance carriers (both individual and group) don’t go over their claims closely and utilize preauthorizations, they run the risk of being defrauded – which will only drive premiums higher than they already are. If they don’t use the specific legal-eze required by state regulations, they will run afoul of the Division of Insurance.
There are plenty of examples of health insurance carriers using unfair or deceptive practices. We’re lucky in Colorado to have a strong Division of Insurance that works hard to protect consumers. Regulations that protect patients and insureds from unfair business practices are largely beneficial (and tend to weed out the shady insurance carriers). But Jaan’s article highlights the fact that health insurance carriers also have to protect themselves. If they don’t, they will end up with premiums that are far higher than the rest of their competition – and that isn’t sustainable.
A few months ago, I wrote about the new website that the Colorado Division of Insurance has created to improve transparency in the health insurance market. I particularly liked the features of the site that allow consumers to see how the rate filing process works and track a health insurance carrier’s rate increase history. Colorado used money from a $1 million grant from HHS last year (a provision of the PPACA) to create the website, and it’s obvious that the Division of Insurance is taking the goal of transparency seriously.
I’m a bit late to this party, but I just read a news release from the Division of Insurance from back in September noting that the HHS Regional Director, Marguerite Salazar, commended the Colorado Division of Insurance for the website, calling it a “shining example of consumer-friendly and transparent information…” […]
[…] As the cost of healthcare continues to rise, CoverColorado – just like every other insurer – needs more and more money to cover the cost of claims. Their website shows the fees that have been assessed over the past few years, and the increased fee that will go into effect next month for 2012.
Because the CoverColorado assessment is collected by health insurance carriers and passed on to CoverColorado, the fee is added to each policy’s premium every month. The end result is that we all pay a few dollars more per month than the actual cost of our policy. This can be confusing, especially if people are new to individual health insurance and haven’t had experience with paying their own health insurance premiums in the past. The amount that is going to be drafted from your bank account or billed to you will be a few dollars higher than your stated premiums because it includes the CoverColorado assessment. […]
[…] I’m sure there will still be people who falsely claim that Colorado’s maternity mandate and federal reform are the reason for any increase. But when we place the 2012 increase in context with the increases we’ve seen over the past decade, it becomes harder to blame recent reform laws for the 2012 premium increases. I’m glad to see that after a year of having guaranteed issue coverage for children, no lifetime maximums, more comprehensive preventive care, and maternity benefits on all new and renewed individual policies, we are seeing the lowest average rate increase in over a decade.
[…] I know that the law was written with good intentions, but we’re noticing that it’s the employees – the applicants who are trying to get individual health insurance policies – who get the short end of the stick. It’s the employees who end up getting their health insurance application declined. It’s the employees who end up having to pay for their own premiums in order to obtain coverage, even if they thought that they were going to be able to rely on some level of reimbursement from their employer.
[…] One of the comments on the post was from Dede de Percin, the Executive Director of the Colorado Consumer Health Initiative (CCHI). […] Dede’s comment on my article referenced the point I made about consumers not having to pay additional fees to have a broker. Basically, health insurance is priced the same whether you go directly through a health insurance carrier (calling Anthem Blue Cross Blue Shield directly, for example) or through a broker (who will compare options from multiple carriers for you). Dede made this point:
“While a consumer or business doesn’t not pay a health insurance broker directly, broker fees and commissions are paid by the insurance companies – and rolled into […]”
[…] These numbers are much more in line with the rise in health insurance premiums that we’ve seen over the past few years. I have no explanation for why the data from the two sources is so dramatically different in terms of medical trend in 2010, but if the trend was really closer to 7.5% rather than 1.7%, the health insurance premium increases would be a lot easier to understand. […] In addition to the MLR rules, some states (including Colorado) have implemented strict review processes for rate hikes. The ACA now calls for insurers who propose a rate hike of 10% or more […]
[…] So he applied for an individual policy with Anthem Blue Cross for his family, and was approved. But then when he tried to cancel his mini-med plan, his employer told him that he couldn’t cancel it until the open enrollment period next April. It would seem that trapping enrollees into a year-long contract with a mini-med plan is not in line with the spirit of the HHS guidelines that call for full disclosure regarding the waivers and directives to steer enrollees towards healthcare dot gov if they are interested in getting a policy that does comply with the ACA rules regarding annual policy limits. […]
[…] This should help boost public participation in the rate review discussion, and add to the general understanding of how the rate review process works. The DOI is obviously working hard to create as much transparency as possible with regards to rate increases. Rates will continue to increase as long as the cost of health care continues to climb (and as long as we continue to increase our utilization of health care) but at least the logic behind the rate increases will be more clear.
The Colorado Health Plan Description Form isn’t exactly the same as the forms that HHS will require carriers to make available next year, but it’s similar in many ways, and carriers in Colorado have been issuing these standardized plan summaries for nearly 14 years. As well as outlining the coverage provided, the new forms will include “coverage examples” that will show potential customers how the plan would cover three common medical scenarios: breast cancer, maternity care, and diabetes. […]
For parents looking for child-only policies in Colorado, we are in the middle of the 2011 open enrollment period, which will end August 31st. All carriers that offer individual health insurance policies for adults must also offer (during open enrollment periods only) at least one plan option for a child applying without an adult on the policy. This is pursuant to Colorado Senate Bill 128, which was signed into law earlier this year. Following the passage of SB128, the Colorado Division of Insurance stepped in to clarify the issue with emergency regulation E-11-03, which has specific details about the implementation of the law. […]
[…] Senate Bill 200 (the Colorado Health Benefit Exchange Act), co-sponsored by Senator Betty Boyd (D – Lakewood) gets the ball rolling on the health insurance exchange that the state will have to have in place by 2014. Specifically, the bill would create a “nonprofit unincorporated public entity known as the Health Benefit Exchange”. It includes guidelines for the appointment of a 12-member board of directors (9 of whom will be voting members) who will oversee the exchange, and lays out their responsibilities. […]
[…] The language in the Division of Insurance FAQ page does seem to create some confusion on the issue. Stating that “A person who is already pregnant may obtain insurance at this time” could be interpreted in various ways… some might see it as saying that the person may obtain insurance if the carrier allows it (which none of them currently do), while others might see it as stating that the DOI interpretation of the law requires carriers to treat a current pregnancy as a specific exclusion rather than cause for an outright decline. […]