Transcript Document

Marketplace
Overview
What is Connect for Health Colorado?
An open, competitive marketplace for individuals and small
employers to:
• Compare health insurance costs and features side by side
• Shop plans containing the same base benefits
• Determine eligibility for and access new federal financial
assistance, based on income
• Call, chat or sit down with trained representatives for help
• Enroll in a health plan
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Connect for Health Colorado is NOT
• A replacement for the current market or brokers
• Engaged with negotiating rates between carriers and
providers
• Part of Medicaid
• Offering Medicare or supplemental health plans
• A new government health care system
• A State agency or regulatory body
• An organization that receives funding from Colorado
General Fund
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Who can shop?
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Coloradans who currently buy insurance on their own
Coloradans who are uninsured
Coloradans who are self-employed
Coloradans who don’t have access to affordable coverage
through their employer
• Coloradans with legal immigration status
• Small employers with up to 50 full-time employees
• Not for individuals eligible for Medicare or seeking
supplemental plans
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Individual Marketplace Open Enrollment
Open
Enrollment
Begins
Oct. 1
Deadline
for
enrollment
to have
coverage
Jan. 1,
2014
Dec. 15
Coverage
begins
Jan. 1, 2014
Individual Open
Enrollment
Ends
March 31, 2014
Shopping starts October 1, 2013
Coverage Begins January 1, 2014
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What can individuals/families shop for?
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150 new health plans that include a comprehensive set of medical
services and benefits, free preventive services
10 Carriers:
o Access Health Colorado, Anthem Blue Cross and Blue Shield,
Cigna, Colorado Choice, Colorado HealthOP, Denver Health,
Humana, Kaiser Permanente, Rocky Mountain Health Plans,
UnitedHealthcare
PPO, HMO, HSA, CYA (high deductible plans for young adults)
Health plans with dental coverage and without
Separate dental plans
Find out eligibility for Medicaid and CHP+ and enroll
A link to vision plans
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Who can help you use the Marketplace?
• Online chat and decision-support tools
• Help over the phone by Customer Service Center
Representatives through toll-free number
• Impartial help in-person by certified Health Coverage Guides
located at over 50 community-based Assistance Sites
statewide
• Advice in person and by phone by licensed and certified
health insurance agents and brokers located statewide
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Key changes
• Starting in 2014, you can not be denied health coverage
based on a pre-existing condition or your health history
• You will not be asked about your health history or medical
needs when you apply for health insurance (other than
pregnancy, tobacco use and disability status)
• Starting in 2014, about 160,000 Coloradans will be newly
eligible for Medicaid because of a state law passed this
year; adults earning up to about $15,000 a year, couples
earning up to about $21,000 and families of four earning up
to about $32,000 will be eligible for Medicaid and the
Marketplace will help you access Medicaid and CHP+
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Other facts to know
• There will be set open enrollment periods for commercial
health plans that will provide coverage for the calendar year
o Oct. 1 2013 to March 31 2014
o Oct. 15, 2014 to Dec. 7, 2014 for future years
• Customers who sign up by the 15th of the month will have
coverage begin on the first of the next month; if you sign up
after the 15th, you will wait until the following month
• There will be ways to sign up for coverage outside of open
enrollment periods (loss of job, marriage or divorce, move
into the state, birth of child, change in income, etc)
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How much will I pay?
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Prices depend on age, the region of the state in which you live,
how many people are on plan, and if you use tobacco products
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Colorado Division of Insurance (DOI) approved rates in August
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Prices will not be affected by your health needs or history
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Preliminary filings show a wide range of prices for individuals:
o Rates for a 21-year-old living in Denver range from $153 to
$299 a month for bronze plans and from $201 to $377 for silver
plans, before cost-reductions based on income.
o Rates for a 40-year-old living in Denver range from $186 to
$364 for bronze plans and from $245 to $460 for silver plans
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How can I organize my options?
• Health plans will be organized by coverage levels based on
how much of the services, on average, are paid for by the
carrier and how much are paid for by the customer
o Bronze (60% paid by carrier/ 40% paid by customer)
o Silver (70/30)
o Gold (80/20)
o Platinum (90/10)
• You can look for health plans by
• medical provider and facility
• Carrier
• Coverage level
• Premium
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Cost reductions for Individuals & Families
New financial help to reduce the cost of premiums
• Individual earning between $15,856 to $45,960/year
• Couple earning between $21,404 to $62,040/year
• Family of four earning $32,499 to $94,200/year
o Tax credit applied up-front by IRS
o Tax credit is higher for older Coloradans, especially for those ages 55-64
New financial help to reduce out of pocket costs (co-pays and
deductibles)
• Individuals earning $15,856 to $28,725/year
• Family of 4 earning $32,499 to $58,875/year
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Small Employer Health Care Tax Credit
Who qualifies?
• Employers with fewer than 25 employees for the tax-year
o Full-time employees
o Add part-time hours and divide by 2080 to obtain full-time equivalent
• Average employee income of less than $50,000
o (not counting owners or family members)
• Employer must pay premiums under a “qualifying
arrangement” with nondiscriminatory contributions of not
less than 50% of employee cost
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Small Group Choices
• 92 Health Plans
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Anthem Blue Cross and Blue Shield
Colorado Choice
Colorado HealthOP
Kaiser Permanente
Rocky Mountain Health Plans
See Change Health
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Protecting Your Privacy
• The Marketplace will comply with state and federal laws to
protect your information
o We won’t use or share your financial information after
determination of eligibility for financial assistance is made
o We won’t ask you for medical information (except for tobacco use,
pregnancy and disability)
• There will be strict security to protect access to files
• The website and backup systems will have strong
protections against outside attacks
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Key Takeaways
• You have a broad array of health plan choices in one place
• Connect for Health Colorado is the only place to access cost
savings that you can use right away to reduce your costs
• You can get help over the phone and in-person from a
statewide network of trained professionals
• Sign up by Dec. 15 to have your coverage start Jan. 1
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Resources
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Website: www.ConnectforHealthCO.com
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Email questions: [email protected]
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Toll-free help by phone: 1-855-PLANS-4-YOU (855-752-6749)
8 am to 6 pm Monday to Friday, 8 am to 5 pm Saturdays
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County Snapshots: http://www.connectforhealthco.com/how-itworks/county-snapshots/
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