Transcript Document
Marketplace Overview October 2013 What is Connect for Health Colorado? • Competitive marketplace for private health insurance • Exclusive way to get new financial help to reduce costs • Broad statewide Customer Support Network • Open for individuals, families and businesses with less than 50 employees 2 2 Essential Health Benefits • • • • • • • • • • Ambulatory patient services Emergency services Hospitalization Maternity and newborn care Mental health and substance use disorder services, including behavioral health treatment Prescription drugs Rehabilitative and habilitative services and devices Laboratory services Preventive and wellness services and chronic disease management Pediatric services, including oral and vision care 3 3 ConnectforHealthCO.com 4 4 Small Business Marketplace 2 5 5 92 Health Plans for Small Employers • • • • • • • Anthem Blue Cross and Blue Shield / HMO Colorado Colorado Choice Health Plans Colorado HealthOP Kaiser Permanente Rocky Mountain Health Plans SeeChange Health Dental plans available also 12 6 6 Individual/Family Marketplace 7 7 150 Health Plan Choices for Individuals/Families • Access Health Colorado • Anthem Blue Cross and Blue Shield / HMO Colorado • Colorado Choice Health Plans • Colorado HealthOP • Humana (Kit Carson County) • Kaiser Permanente (Lincoln County) • Rocky Mountain Health Plans • UnitedHealthcare 12 8 8 Dental Plans for individuals/families • • • • • • Anthem Blue Cross and Blue Shield / HMO Colorado BEST Life and Health Insurance Company Cigna Delta Dental of Colorado Dentegra Insurance Company Premier Access Dental and Vision 12 9 9 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 10 Health Plan Shopping 12 11 11 Compare Health Plans 12 12 Key Changes • Starting in 2014, you can not be denied health coverage based on a pre-existing condition or your health history • Your health history or medical needs will not affect your ability to apply for health insurance or the cost (except tobacco use) • 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 o You can sign up at other times with qualifying event 12 13 13 Affordability • New resources available based on income • Medicaid will be available to many more Coloradans • Individuals earning up to about $15,000 a year • New kind of tax credit available to Coloradans who earn too much for Medicaid and up to about $45,000 a year for individuals and $94,000 a year for family of 4 • Tax credit can be used up-front or taken off taxes • Health insurance plans with lower co-pays and deductibles also available to certain individuals and families who earn too much for Medicaid 12 14 14 Income eligibility New tax credit to reduce the cost of premiums • Individual earning about $15,000 to $45,500/year • Couple earning about $21,000 to $62,000/year • Family of four about $32,000 to $94,000/year o Applied by IRS o Amount tied to cost of benchmark plan Health plans with lower co-pays and deductibles • Individuals earning about $15,000 to $28,500/year • Family of 4 earning about $32,000 to $58,500/year o Three levels of reductions based on income 12 15 12 15 Financial assistance application process Shop and Compare Advance Premium Tax Credit Medicaid denial In October, finish enrollment through Customer Service Center 16 16 Key Takeaways • Now you have more options to find quality health coverage • Connect for Health Colorado offers a broad array of health plan choices in one place • Connect for Health Colorado is the only place to access cost savings • 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; Open enrollment continues until March 31, 2014 12 17 17 Partners in Covering Coloradans MEDICAID Who is eligible? • Beginning January 1, 2014, individuals earning up to 133%* of the Federal Poverty Level (FPL) (for 2013, this equates to about $15,000/year for an individual or $30,000/year for a family of four) may be eligible for Medicaid coverage. The Department estimates over 160,000 newly eligible Coloradans could enroll in Medicaid. * The federal government allows for up to 5% disregards, thus, persons with income up to 138% of FPL may be eligible When does coverage begin? • Coverage begins January 1, 2014 for newly enrolled individuals. 18 18 Partners in Covering Coloradans MEDICAID When can Coloradans apply? • Coloradans can apply beginning October 1, 2013, though coverage will not begin until January 1, 2014. • To access additional information visit or call: • www.Colorado.gov/PEAK • Toll free: 1‐800‐221‐3943 • TDD: 1‐800‐659‐2656 19 19 Contact • Website: www.ConnectforHealthCO.com • Email questions: [email protected] • Toll-free help by phone: 1-855-PLANS-4-YOU (855752-6749) 7 am to 8 pm Monday to Saturday 12 20 20 Local Contacts • Local Email questions: [email protected] • Local help by phone: –Kit Carson County Health and Human Services – 719-346-7158 –Prairie Family Center – 719-346-5398 –Cheyenne County Public Health – 719-767-5616 –Lincoln County Public Health – 719-743-2526 –Lincoln County Social Services – 719-743-2404 12 21 21