Division of Insurance approves 2016 health insurance plans
Twenty carriers to offer 1,073 plans
DENVER (Oct. 23, 2015) – The Colorado Division of Insurance (DOI), a division of the Department of Regulatory Agencies (DORA), has approved 1,073 health insurance plans from 20 carriers to offer health coverage to consumers and small businesses for 2016. As in past years, consumers have many plans to choose from, with a number of plan types and premiums available.
“Consumers should take the time to shop to find a plan that fits their needs,” said Commissioner of Insurance Marguerite Salazar.
Three carriers from the current year will not be offering plans in 2016, and three new carriers have entered the market for 2016.
Carriers not offering plans for 2016
Consumers who currently have plans with the following carriers must find new coverage in 2016 with different carriers in order to have health insurance:
- The Colorado HealthOP (112,000 members, both on and off of the exchange), as detailed in the DOI's October 15 release regarding its closure, will not be available as a choice this coming year.
- New Health Ventures (450 members) is also absent from the 2016 list, as the company voluntarily chose to pull its offerings due to heavy financial losses.
- Time Insurance Company (11,800 members), a carrier who had only offered individual plans off of the exchange, did not submit plans to DOI for 2016, as part of a nationwide strategy of reducing its health insurance business.
New carriers offering plans
Golden Rule Insurance Company, Aetna Health Inc. and Aetna Life Insurance Company are three new carriers for 2016. In addition, UnitedHealthcare of Colorado is entering the individual market for the first time, adding to its existing business in the small group market.
“Even as three carriers leave the Colorado market, three others jump in, so Coloradans continue to have many choices for health insurance, both on and off the exchange,” said Commissioner Salazar. “Because we have so many choices, I encourage consumers to look beyond monthly premiums to consider deductibles and other benefits. A plan has to fit both the health and financial needs of a consumer.”
2016 premiums will increase
Across the state, premiums will increase over 2015 premiums on average 7.04 percent, with individual policies rising an average of 9.84 percent, and 3.17 percent for small group plans (plans that are purchased by small employers, with 2 - 99 employees). However, premiums vary by carrier, age, geographic area and the tier, or type, of plan: bronze, silver, gold or platinum.
Why the increase?
“Rates reflect the cost of healthcare, and the DOI has verified that information,” said Commissioner Salazar in reference to the increases for 2016. “This is only the third open enrollment under the ACA, and these rates represent the first time carriers had a full-year of data to inform their rates. They are still trying to figure out what consumers want in terms of plans, deductible levels, and services, at a price that attracts enrollment, but allows the carrier to keep the lights on and pay their bills.”
Premiums also reflect the cost of healthcare in Colorado and in each of the state’s nine geographic rating areas. “The Division doesn’t regulate the cost of healthcare, but everyone involved in healthcare in Colorado needs to work on bringing these costs down,” said Commissioner Salazar.
Shopping for a plan
Because of the variation, consumers are encouraged to look beyond renewing their current plan and research the details for all plans available in their area to determine the best option for themselves and their families.
Shopping for the appropriate plan will be important for consumers. As an example, consumers who purchased through Connect for Health Colorado in 2015 who are not eligible for tax credits, will see an average increase of 12 percent when they simply renew their current plan for 2016.
However, if they take the time to shop and consider other plans, they would see an average increase of only 4 percent if they choose the lowest cost plan available in the same metal tier (bronze, silver, gold, platinum). Those who are eligible for tax credits will realize even greater savings, lowering their premiums by 46 percent, on average, if they were to select the lowest cost plan in the same metal tier.
Financial assistance options
The premiums released today do not take into account the federal tax credits, known as Advance Premium Tax Credits (APTC), which help to make premiums more affordable. APTC and other federal financial assistance are only available for coverage purchased through the state’s health insurance exchange, Connect for Health Colorado. Eligibility for the APTC depends on a consumer’s household income in relation to the federal poverty level. The tax credit itself is calculated based on income, age and the cost of insurance in a community. For more information about APTC, contact Connect for Health Colorado, www.connectforhealthco.com or call 855-752-6749.
Tips when shopping for health insurance
Colorado is fortunate to have many health insurance options, but with all of those choices, it is important for consumers to comparison shop and look at more than just the premiums before making their decision. Here are some other considerations in looking for health insurance.
- Is your doctor or hospital of choice included in the plan’s provider network? Seeing an out-of-network doctor typically is more expensive.
- Lower premiums often mean higher out-of-pocket costs when receiving care. Find out if there is a deductible and how much it is, as well as the out-of-pocket maximum. Determine what you would have to pay for a doctor’s visit and other co-pay or coinsurance amounts.
- Find out about prescription coverage, especially if you need specific medications.
- Does the plan cover procedures you might be looking for in the near future, such as back surgery, ambulance service, MRI scans or knee replacement?
Consumers who have questions about their current plans should contact their insurance carrier, Connect for Health Colorado, their insurance broker, or their employer.
The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA) regulates the insurance industry and assists consumers and other stakeholders with insurance issues. Visit dora.colorado.gov/insurance for more information or call 303-894-7499 / toll free 800-930-3745. DORA is dedicated to preserving the integrity of the marketplace and is committed to promoting a fair and competitive business environment in Colorado. Consumer protection is our mission. Visit dora.colorado.gov for more information or call 303-894-7855 / toll free 1-800-886-7675.