Colorado insurance law and regulation
News that affects your health insurance and planning
December 22, 2019 – Colorado became the first state in the country this year to cap insulin costs at $100 a month for insured patients, regardless of how much insulin they require per month. While the cost of insulin production has not changed in the past decade, the cost of insulin itself has continued to rise at alarming rates. According to a study by the American Diabetes Association, the average price of insulin in the United States has nearly tripled between 2002 and 2013. Most diabetics need several vials per month, raising the cost of surviving for millions of Americans by thousands of dollars each year. The most popular forms of insulin can sometimes cost over $400 per vial without cost controls.
May 26, 2019 – Status of alternative non-ACA health plans: Colorado does not require individuals to maintain adequate health coverage. The state provides no premium or cost-sharing subsidies for individual market coverage, does not permit insurers to sell non-compliant transitional policies in the individual market and limits the sale of short-term coverage more strictly than the federal government by limiting the initial contract duration of underwritten short-term coverage to 6 months.
April 16, 2019 – The state legislature is considering House Bill 1168 to fund a state-run fund to help insurance companies cover their sickest patients and thereby reduce the premiums for everyone else. The Division of Insurance estimates that this plan will reduce premiums by an average of 23%. This is a different version of the high risk pools that existed prior to 2010 health care reform.
March 19, 2019 – A survey of 970 Colorado adults reported on the most significant problems and barriers they face within the current healthcare system. Overall, the survey results show that Coloradans across the state are concerned with health care costs. Results support the need for cost lowering initiatives. A surprising 58 percent of respondents experienced health care affordability burdens in the past year.
The history of health care planning in Colorado (Information is outdated and links may be expired)
10/24/2015 Colorado residents will have a choice of 20 individual health insurance carriers are offering a total of 1,073 health plans for 2016 including three new carriers: Golden Rule Insurance Company, Aetna Health Inc. and Aetna Life Insurance Company. Rates will be 10% higher than in 2015 but some insurance plans will increase by 26%. Personal professional help is available to help with the the options. COlorado Health Institute spokesman is concerned that the high rate increase may trigger some policyholders to drop coverage.
10/20/2015 Colorado HealthOP will not offer coverage for 2016. Some of its 83,000 members are reportedly scrambling for alternate commercial insurance coverage while other reuse to accept the higher cost of the other available option. The coop ran substantial operating losses of $72 million in federal loans used to start and support the co-op. About 3,000 of its members were offered coverage through a small-business group policy and the rest bought individual converge. Employers should be careful of the tax impact that cancelling group health insurance may have on other health benefits. See https://novaktony.wordpress.com/2015/10/22/10-tax-traps-for-small-business-health-plans/.
2/11/2014 Professional support for any health care reform issue is available free of charge through an arrangement with OnlineNavigator. All online inquiries are handled personally by Tony Novak, CPA. Online support is available through a number of popular social media channels including Facebook and Google+ as well as e-mail. Telephone support for insurance enrollment is available through Members Insurance Exchange at (800) 609-0683.
7/26/2013 Affordable Smart Term Life Insurance is now available to most Colorado residents from age 20 through 60 directly online with no physical exam, agent appointment or telephone verification. Most policies are issued on the same day with coverage amounts of $25,000 up to $350,000. The level premium life insurance is available for terms of 10, 15, 20 and 30 years. Sample rates for $150,000 coverage for a preferred risk male age 30, non-tobacco $30.85 per month; tobacco user $49.55 per month. A preferred risk female age 30 non-tobacco user would be $26.49 per month and a tobacco user would be $40.96 per month. Rates are higher for older applicants and lower health risks as described online. Pricing is based on input you provide about your medical history but, unlike most other life insurers, does not consider family medical history. Coverage is issued by innovative National Life Group, rated “A” by A.M. Best Company for 2013.
5/13/2013 Short term medical insurance underwritten by Markel Insurance Company has a 10% rate decrease for all new Colorado members enrolling on or after May 13, 2013.
2/22/2013 This page was updated to include a link to the insurance plan that will be used to determine specific “essential health benefits” for insurance that qualified for 2014 federal tax purposes. Also, a link to additional covered benefits required by state law. Non-qualified insurance is likely to continue to be available at a lower cost that does not include these benefits nor qualify for federal tax purposes.
2/19/2013 Celtic Insurance Company is not issuing individual insurance quotes for now due to required updates in the rating system and related regulatory approvals. No official date of return has been announced but we suspect it might be around May. For now, we suggest using one of the short term insurance plans listed above.
12/14/2012 Colorado is one of a minority of states that will run a health insurance exchange for individuals and small businesses that is not managed by the federal government. Consumer advocates who once viewed a state-run exchange as a positive are growing concerned that the state may not be fully committed to implementing all of the funding and features expected to be part of the federal health insurance exchanges that are expected to open in the fall of 2013.
2/1/2012 The Center for Consumer Information and Insurance Oversight, a division of the Center for Medicare and Medicaid Services (CMS)reported that as of June 30, 2011 United Healthcare Insurance Company, Kaiser Foundation Health Plan of Colorado and Rocky Mountain Hospital and Medical Service are the state’s largest health insurance providers and as such, earn the right to set the benchmark for the development of the state’s essential benefit plans to debut in 2014 under health reform law.
10/17/2011 State law S 128 Enacted as Chapter 133 on 5/3/2011 requires that insurance carriers that participates in the individual health insurance market issue child-only plans on a guaranteed-issue basis. Yet many the lowest cost policies are not affected by the law so child only coverage can be difficult to find. Benefits were expanded for fetal alcohol syndrome as long as such costs are not the financial burden of state government.
7/27/2011 Parents are reminded that the children’s’ health insurance open enrollment period ends on Sunday July 31 so applications should be submitted online before that date. See www.uhcenrollment.com for details on the UnitedHealthOne insurance products.
5/6/2011 Today Colorado’s interim insurance commissioner John J. Postolowski announced the results of a survey that showed that the number of small businesses in the state providing health insurance to workers dropped sharply from 2009 to 2010. About 20,000 fewer people were covered by health insurance in 2010 and the number has fallen by about 50% over the past decade. The commissioner fell short of blaming the state’s restrictive insurance laws that make coverage more expensive and has triggered the nation’s most innovative insurance companies to withdraw from the state. Recently Celtic Insurance Company, for example, known for its innovative cost-cutting coverage nationwide, re-entered the Colorado Insurance market after being temporarily blocked from offering coverage under new state laws. The 2010 Colorado Small Group Market Activity and Rating Flexibility Report shows that 6 of the original 16 small business insurance carriers have withdrawn from the state over the past year.
3/1/2011 The 2010 Colorado Annual Health Cost Report is available online. The report provides insight into a number of health care finance issues, particularly emphasizing the financial differences between individual health insurance and group health insurance.
1/19/2011 Child-only health insurance for children with significant medical problems will be available through an open enrollment period mandated by federal state law during the months of January and July. All children, regardless of medical condition, continue to be eligible for insurance when applying as a dependent on a parent’s policy and healthy children are eligible for child-only insurance at any time. When applying for child-only insurance for more than one child, make a separate application for each child.
12/16/2010 Officials from the Executive Office of the State of Colorado met representatives of 44 other states and numerous employees of the federal Health and Human Services Department in Washington DC this week for a two-day working meeting to discuss the next steps in establish a government-run health insurance exchange under the American Health Benefit Exchange Model Act. Their attendance at this meeting was paid for by a $1 million federal grant awarded by HHS in September to the state for research how to set up an insurance exchange. Two states (Alaska and Minnesota) declined to participate, saying that it was a waste of taxpayer money. Four other states (not identified in press reports) that received federal grants did not send representatives to the meeting. Attendees included representatives of 16 states that are suing the federal government in an attempt to overturn the federal health reform law; specifically the requirement that forces individuals to buy health insurance on the insurance exchange or pay a hefty tax fine.
In its initial federal grant request for the insurance exchange project, Colorado said that it would: 1) Create an interagency Exchange board, 2) Perform an insurance market and information technology assessment, develop an economic analysis of different options available for the Exchange, and design web services, 3) Convene community forums focusing on the development of a health insurance Exchange, and 4) Establish parameters for and the governance structure of a State Exchange.
The meeting reportedly did not address the role of the commercial health insurance exchanges on the implementation of new competing government systems. The model act does not address inter-state insurance exchange proposals nor insurance sales across state lines. Federal officials admitted that they may not be able to provide further guidance until 2012. Meanwhile, most states are motivated to continue to meet requirements to obtain additional funding promised by the federal government for the establishment of insurance exchange by 2014. Freedom Benefits has previously voiced the opinion that the huge amount of money being spent to set up alternate insurance sales system technologies could be better used providing health benefits to the public. We proposed on the Universal Health Insurance blog that adequate commercial insurance sales systems are already in place that could be modified in a public/private partnership to make health insurance more affordable.
7/15/2010 The new Colorado High Risk Insurance Pool called “GettingUSCovered” is now open through Rocky Mountain Health Plan and CoverColorado. This new open enrollment insurance is expected to provide coverage for about 4,000 previously uninsured Colorado residents at subsidized rate of $115 to $601 per month, depending on age for a $2,500 deductible single person coverage policy. A $90 million federal grant will subsidize the cost of the program until 2014.
5/14/2010 Diabetes Coverage: A new resource to help find health insurance for diabetics in Colorado is now available at Freedom Benefits.
3/23/2010 A proposed constitutional amendment that prevents citizens from being forced to purchase health care insurance has been proposed and the state attorney general says that the state will not enforce federal health care reform law. Colorado is considering joining a multi-state lawsuit to oppose federal health care reform.
3/13/2010 The bill intended to expand maternity and contraceptive coverage in individual policies and eliminating pregnancy as a pre-existing conclusion has been defeated. Maternity coverage will be available as an optional coverage.