2017 Rate Increases for Colorado Individual Health Insurance Market

EDIT, 9/25/2016: Rates were approved recently by the Colorado Division of Insurance. The following average rate changes (actual changes will vary by plan) will take effect January 1, 2017 for the seven carriers that will offer individual market coverage through the exchange. They will also apply off-exchange, as all of these carriers offer their plans both […]

Carrier Contact Information And Updates For People Who Need To Pay January’s Premium

Today, January 10th, is the payment deadline for most Connect for Health Colorado policies with January 1 effective dates.  A few carriers have pushed the deadline out a little bit: Updated  Anthem Blue Cross and Blue Shield is moving the payment deadline to 1/31 for 1/1 effective dates. Delta Dental:  January 15. Premier Access Dental […]

How Does Obama’s Policy Continuation Announcement Impact Colorado’s Individual Market?

By now you’ve probably heard about the Obama Administration’s compromise over the policy cancellation uproar.  The fix that Obama has offered is that health insurance companies can extend existing plans for one more year, allowing them to continue to exist in 2014.  This has been incorrectly reported in some media outlets as allowing carriers to continue […]

Fewer Plans Available In Exchanges In 2013, But Maybe That’s A Good Thing

At the end of September, just as the exchanges were about to open for business, HealthPocket created a comparison of the number of individual and family health insurance policies available in each state in 2013 and compared that with the number of policies that would be available in each state’s exchange in 2014.  It’s an […]

Renewal Options for Each Individual Health Insurance Carrier in Colorado

Last week I explained how early renewal at the end of 2013 might be a good option for some people who have individual health insurance.  If you’re happy with your coverage and aren’t going to qualify for a subsidy in the Colorado exchange, keeping your existing plan for most of 2014 might be a good way to save some money on premiums.  This is especially true for people who prefer very high deductibles, as those plans are generally not ACA compliant and thus will not be available for purchase after the end of 2013.  But if your carrier allows it, you can keep your current policy until it renews in 2014, and switch to an ACA compliant plan at that time.  For people with plans that renew late in the year, this could mean keeping a lower-cost, higher deductible policy for most of 2014.  If you’ll be eligible for a premium subsidy, it’s definitely worth your time to compare a subsidized exchange plan with what you have now.  But if you’re happy with your coverage and you’re going to be paying full price for an ACA compliant plan, check with your carrier to see about keeping your current plan in 2014.

Keep in mind that each Colorado health insurance carrier is doing things a little differently in terms of 2013 renewals heading into 2014.  It’s important to check with your carrier to make sure you’re aware of what steps you need to take – don’t assume that Renewal Options for Each Individual Health Insurance Carrier in Coloradoyour plan will automatically renew – or automatically not renew.  The Colorado Division of Insurance has left a lot of leeway for carriers to determine their own protocol for renewals going into 2014.  There is no state requirement that existing policies be cancelled as of the end of 2013, although some carriers have opted for that as a default.  All plans must be ACA-compliant by January 1, 2015.  So when your policy renews in 2014, you will have to transition to an ACA compliant plan.  But the date of that renewal can be anytime from January to December.

Here’s a brief summary of what we have heard so far from some of the main carriers in Colorado.  This is subject to change, so check with us or your carrier before you make a decision.

Anthem Blue Cross Blue Shield:  The default is for your plan to just keep its current renewal date and continue unchanged until that date in 2014.  But Anthem is also offering insureds an option […]

Early Renewal Provides A Good Alternative For 2014

Over the last few years, opponents of health care reform have often exaggerated – and sometime outright lied about – the potential negative aspects of the reform law.  This has resulted in a public that is often woefully misinformed about what the law does and does not do.  But the spin is not limited to just opponents of the law.  Sometimes ACA supporters spin things too.  This Huffington Post article from a few months ago is a good example.  The title, “Aetna seeks to avoid Obamacare rules next year” is designed to play on the general unpopularity (and over-estimation of perceived profits) of insurance companies.  When you read a little further, you find that Aetna is reaching out to brokers and insureds to let them know that Aetna will be allowing members to opt for an early renewal in December of this year – if they want to keep their current policy until December 2014.

Why is this being portrayed as a bad thing?

It is indisputable that people who are healthy, buy their own health insurance, won’t qualify for subsidies and prefer high deductible health plans are going to have higher premiums for ACA-compliant plans than they have now.  Some of these people don’t mind high deductibles.  They don’t consider their policy to be skimpy or junk insurance just because it isn’t ACA compliant.  You might have seen headlines about how only a tiny fraction of existing individual health plans meet the requirements that the ACA will impose next year, but that doesn’t mean that the existing Early renewal will provide many insureds with a good alternative to ACA compliant plans in 2014.plans are junk.  If you look closely, you’ll see that when it comes to basic medical benefits, a lot of individual plans offer coverage that is in line with ACA regulations.  But benefits like dental and vision coverage for children (required on ACA-compliant plans starting next year) are usually not part of individual coverage (Many plans allow applicants to select add-on dental and vision coverage, but a lot of people find that it’s more cost effective to pay for dental and vision out of pocket rather than paying for dental/vision insurance.  Remember, nothing is free.  And the more likely you are to use an aspect of your coverage, the higher your premiums will be in order to cover the cost.  So coverage for something like dental and vision checkups – which people plan to use – has to be priced accordingly).  In many states, maternity coverage is one of the most significant medical benefits missing from a lot of individual plans.  But in Colorado we’ve had maternity on all plans for more than two years now.

There are absolutely some bad health insurance plans on the market, with skimpy coverage, limited networks and lots of fine print.  But there are also lots of good quality health insurance plans and reputable carriers.  And there are plenty of people who are not going to qualify for subsidies next year (roughly half of the people who currently buy individual health insurance).  If those people currently have – and are happy with – a high deductible plan that is less expensive than what they would have to pay for an ACA-compliant plan, there’s no reason that they shouldn’t be able to keep their plan as long as possible in 2014.  The law requires coverage to be ACA-compliant when a policy renews in 2014.  Carriers that are offering early renewals in December are providing good customer service, especially for insureds who […]

Colorado Health Insurance Options On the Exchange in 2014

Although we’re still at least a week away from knowing the specific details on rates and plan designs for policies that will be sold in the Connect for Health Colorado exchange, the Division of Insurance has approved 242 plans that will be available in the exchange from 13 Colorado health insurance carriers.  In late May, the number of carriers stood at 11 and the number of plans was 250+.  But as we noted last week, there was still a lot going on behind the scenes over the summer, and some carriers had to resubmit plan information that was not accepted in the spring.  The final count is 150 plans that will be available to individuals and 92 for small groups (keep in mind that this is just for plans within the exchange.  There will be lots of other ACA-compliant plans available outside the exchange).

The plans for individuals will be available from ten different carriers (All Savers, Cigna, Colorado Choice, Colorado Health Insurance Cooperative, Colorado health insurance plans available in the exchange in 2014Denver Health Medical Plan, HMO Colorado (Anthem), Humana, Kaiser, New Health Ventures and Rocky Mountain HMO).  Although there are some new names in this list, there are also plenty of familiar ones (All Savers is a UnitedHealth company, which means that the main carriers that currently sell policies in the individual market in Colorado will all be represented in the exchange).  Although we haven’t yet seen the final premium and plan details, it appears that Colorado will continue to have a robust individual health insurance market in 2014, both in and out of the exchange.

For consumers who will qualify for a subsidy, the exchange is definitely the place to be – subsidies are only available in the exchange.  Consumers who do not qualify for a subsidy (either because their income is too high or because they have access to an employer group plan that is technically “affordable” but might actually be outside of their budget) can shop within the exchange (via an approved broker or directly through the exchange) or they can […]

Assurant and UnitedHealth Still Available In Colorado Individual Market

The Colorado Division of Insurance has announced that finalized health insurance rates won’t be available until the middle of August – about two weeks after the originally-scheduled August 1 release date.  The preliminary rates, carriers and plan designs were announced in June, and it’s likely that the final rates will be in the same basic range.  When we first saw the list of carriers that were going to be providing individual health insurance in Colorado starting in October (for 2014 effective dates), we were surprised to see that UnitedHealth Care was only listed as a carrier for small group Assurant and UnitedHealth Still Available In Colorado Individual Marketplans (they have had a strong presence in the individual health insurance market in Colorado for many years, both as Golden Rule and UnitedHealthOne).  And we also noticed that Assurant (Time) was not included at all in the list of carriers that had submitted rates and plans to the DOI earlier this year.

We’ve recently found out that Assurant will indeed continue to offer individual health insurance in 2014, outside of the exchange.  They submitted rates and plans in May but the submission was incomplete and had to be refiled, which is why they were missing from the data that was released in June.  The Assurant details should be included with the finalized rate information that will be released in mid-August.

In addition, UnitedHealth Care will be offering individual health insurance in the Connect for Health Colorado exchange, under the name All Savers Insurance Company.  This was included with the June data, but many people might have been unaware that All Savers Insurance is a UnitedHealth Care company.

We wanted to clarify this information in case you’re looking for an individual policy from either of these companies.  More info will be forthcoming once we have the finalized rate data, so stay tuned.

Do You Need Critical Illness Insurance?

When my father was 54, he was diagnosed with an auto immune disease that struck quickly and in a devastating fashion.  He lost his kidneys to the disease, and spent the next 11 years on dialysis until he received a kidney transplant last summer.  Thankfully, he had long-term disability insurance through his employer, along with […]

Networks And Carriers Are Part Of The Big Picture With Exchanges

[…] Aetna, United and Cigna are all absent from the CA exchange, and Dan looks into several reasons why some of the bigger carriers might have opted not to sell in the exchange on day one, and why some large provider networks are not going to be covered by plans sold in that state’s exchange.

Connect for Health Colorado Exchange Marketplace and networksHere in Colorado, Aetna stopped selling individual policies a couple years ago, so we weren’t expecting them to be in the state’s exchange, Connect for Health Colorado.  United Healthcare has been a mainstay in the Colorado individual market, and while they submitted numerous plans to the DOI for small group products, they are all to be sold outside of the exchange and there don’t appear to be any individual plans in their new lineup.  Cigna, however, will be selling individual plans both inside and outside of the exchange in Colorado.

We’ve heard from carrier representatives – who are familiar with multiple state exchanges – that Connect for Health Colorado has been particularly great to work with, and that is no doubt part of the reason Colorado will have a large number of carriers and policy options available within the exchange.  We’re happy to be in a state that has been actively working on healthcare reform for several years, and that moved quickly to begin building an exchange and implementing the ACA as soon as it was passed.

Comparing CEO Compensation in Various Healthcare Industries

Joe Paduda of Managed Care Matters did an excellent job with the most recent Health Wonk Review – be sure to stop by his blog and check it out.  I thought this article from Dr. Roy Poses was especially interesting.  Writing at Health Care Renewal, Dr. Poses shines the spotlight on UnitedHealth Group’s CEO Stephen Hemsley’s oversized compensation.  Roy notes that while the increase in CEO compensation does mirror the company’s overall financial success of late, it must also be considered in light of the fact that the company has made some missteps in terms of fulfilling its stated mission to provide health care “at an affordable price” and “expand access to quality health care.”  Roy’s article cites several examples of allegedly unethical behavior, and concludes by noting that “Real health care reform needs to make health care leaders accountable, and especially accountable for the bad behavior that helped make them rich.”

Comparing CEO Compensation in Healthcare - Health Insurance vs Pharmaceutical CompaniesI definitely do not disagree with Dr. Poses, and we’ve noted in the past that UnitedHealth Group has had issues with large executive compensation and backdating stock options (that was with a previous CEO, however).  But I do want to use this as an opportunity to remind our readers and clients that most health insurance companies have CEO compensation packages that are far lower.  Forbes compiled a list of the 498 highest-paid CEOs in 2012, and I scrolled through the first 150 on the list.  UnitedHealth Group is there on the first page, ranked number 8 (they’re also ranked number 31 in Fortune 500 total profits, so as Roy said, the CEO salary is at least in the same ballpark with the company’s financial performance).

But you have to click through several pages of the CEO compensation list to get to the next health insurance carrier.  Humana was the next one I found, ranked at […]

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.

Primary Care Practices In Colorado Chosen As Part Of CMS Pilot Program

The Centers for Medicare & Medicaid Services (CMS) announced this week the start of a pilot program to enhance primary care via collaboration among CMS, private health insurance carriers and 500 primary care practices in seven regions across the US. 73 of those practices are in Colorado, with 335 participating physicians, and several of the top health insurance carriers in Colorado are participating too: Anthem Blue Cross Blue Shield, Cigna, Humana, Rocky Mountain Health Plans, and United Healthcare, in addition to Colorado Medicaid, Colorado Choice Health Plans, and Colorado Access (a health plan specifically designed for underserved populations).

CMS will be paying participating providers a “care management fee” which is estimated to be about $20 per month per beneficiary, in addition to the usual fee-for-service reimbursements. The private health insurance carriers that are participating have worked out their own reimbursement schedules, but one would assume that the setup will be similar to the one that CMS has devised. […]

Aetna, Humana and UnitedHealth Vow To Maintain Some Aspects Of ACA, Regardless Of Court Decision

Much of the healthcare community is eager to hear what the Supreme Court has to say – likely next week – about the ACA. Given how polarized the topic of healthcare reform has been over the past few years, there’s no way that any decision is going to please more than about half of the country, although the court has the option of picking and choosing various parts of the law to uphold or overturn as it sees fit.

Some aspects of the ACA have already been implemented and have proven to be very popular. A few of the country’s biggest health insurance carriers have stated that they will keep some of the most popular ACA provisions – even if the law is overturned. Aetna, Humana, and UnitedHealth have said that they will continue to offer preventive care with no cost-sharing, allow young adults to remain on their parents’ health insurance policy through age 26, and maintain the third-party appeals process that insureds can use if a claim is denied. Humana and UnitedHealth have also said that they will continue to have no lifetime benefit maximums on their policies and ban rescission except in cases of fraud. […]

Best Health Insurance Companies In Colorado

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 […]

Colorado Child-Only Open Enrollment Details For January 2012

The next open enrollment for child-only policies is almost here, so I thought it might be helpful to provide some specific details in terms of what policies are available and what parents should expect when submitting child-only applications next month.

The first open enrollment window in 2012 will be the month of January. Applications for child-only policies have to be submitted between January 1 and January 31. Application not submitted by the end of January will have to wait and re-submit in July, which is the second open-enrollment period of the year. For most carriers, each child in a family will have to have a separate application.

All eligible child-only applications submitted during the open enrollment period are guaranteed issue, so the child cannot be refused coverage. However, the applications are still medically underwritten and the rate can be increased by up to 200% based on the child’s medical history (so if the standard price is $100, the policy could actually be assigned a rate of $300, which is equal to a 200% rate increase).

Colorado Senate Bill 128 requires all Colorado health insurance carriers that offer coverage for adults to also offer child-only plans during the two annual open enrollment windows. But the bill does not require carriers to provide guaranteed issue coverage for children who are eligible for health insurance from another source (other than a high risk pool like CoverColorado or GettingUSCovered – see the bottom of page 4).

Most Colorado carriers have selected one or two plan designs that will be available for child-only applications next month. To give you an idea of what is available in Colorado for child-only coverage, we’re providing information here regarding child-only options from six of the top individual health insurance carriers in the state. […]

Grand Rounds – Colorado Fall Colors Edition

Henry Stern of InsureBlog brings us an interview with the whistleblower who has brought a lawsuit against LabCorp for allegedly charging a lower price to United HealthCare than to Medicare. The post is particularly interesting because Hank adds his own thoughts after the interview, and he sees things a little differently than Andrew Baker (the whistleblower). Hank agrees that it does look like LabCorp lowered their fees for UHC […]

Decline And Rate Up Statistics – Interesting But Confusing

[…] Your policy will cost the same amount regardless of whether you use a broker, but an experienced broker will be able to help you make sense of the plan comparison information, including the underwriting statistics. A policy or carrier’s statistical likelihood of declining or rating up any one application isn’t really relevant to each specific client… what is relevant however, is each carrier’s underwriting guidelines for the particular pre-existing condition the applicant has. […]

United HealthOne Finally Changes Initial Charge Protocol

Good news for those applying to United HealthOne:
Beginning with applications received on March 24, 2011, the processing of credit card or EFT payment will not take place until the application is approved and issued.
It’s about time. It was tough to explain to clients “and yeah, they’re going to charge you before they’ve even made a decision.”

United HealthOne Plans Available in Colorado on January 13th

United Health has notified us that they’re ahead of schedule and will have rates, plan descriptions and applications ready by January 13th.  Quotes and applications for United Health medical can be done here.  Quotes and applications for dental and vision can be done here.

Consumer Reports Health Insurance Rankings

I recently picked up a copy of the November issue of Consumer Reports, which included a section about health insurance. The article featured an interview with President Obama, and a good overview of how the changes included in the PPACA will impact consumers. In addition, Consumer Reports published a ranking of 227 HMO and POS (point-of-service) plans (you have to subscribe to Consumer Reports Health in order to be able to see the details online), according to data compiled by the National Committee for Quality Assurance (NCQA). […]

Maternity Coverage In The Individual Health Insurance Market

The House Committee on Energy and Commerce released a memorandum this week detailing the practices of the four largest private health insurance carriers (Aetna, Humana, UnitedHealth Group and Wellpoint) regarding maternity coverage on individual policies. For anyone who is familiar with the individual health insurance market, the details of the memo will come as no surprise. But since the majority of Americans are covered by group health insurance plans that cover maternity just like any other claim, the details of how maternity coverage works in the individual market may be eye-opening for a lot of people. […]

Regulators And Insurers Still Working On Child-Only Coverage Issue

[…] So far, none of the carriers who had backed out of the child-only market have commented on whether the open enrollment periods might make them change their minds, but AHIP (America’s Health Insurance Plans) has said that they are continuing to work with regulators to try to find solutions that would make the child-only market feasible for insurers in the future.

Quoting Blackout On Most Plans and Effective Dates

Many plans with most carriers still haven’t gotten the rates approved past 9/23. These plans with carriers like Anthem BCBS can still be quoted with effective dates of 9/22 and before.
Carriers like Cigna only have 1st and 15th of the month effective date options. Therefore, rates and plans are not being quoted at all until the DOI approves their rates. Hopefully any moment.
Make sure to subscribe via email or follow us on Facebook for rate approval updates.

UnitedHealthOne Erroneous Email

Yesterday, September 13th, UnitedHealthOne (Golden Rule) sent out an erroneous email to individual/family clients:

“Thank you for choosing a UnitedHealthOne Insurance plan. Payment is currently past due and your plan may be at risk of lapsing. In order to make a payment over the phone, please contact Client Services at 1-800-657-8205 or your broker […]”

If you call the client services number given, an automated message will play before the list of options:

“Please note, if you received an email on Monday about your premium, please disregard this as it is an error and we apologize for any inconvenience.”