"Your Colorado Health Benefit Specialists"
Colorado Health Insurance Exchange
Health Shop ® 7823 W 38th Ave, Wheat Ridge, CO 80033 Phone (303) 425-4466 Fax (303) 420-8988
Copyright 2013: Health Shop | Insurance Agency Denver | All rights reserved.
Our Denver Insurance Brokers can assist with
Colorado's Health Reform Marketplace
Colorado Health Exchange & Plans
Connect for Health Colorado is a new place for consumers to compare, purchase qualified health plans and determine if an individual or small group employer qualifies for a subsidy / tax credit. Licensed and exchange certified brokers are qualified to assist consumers whether they choose to enroll on or off Colorado's exchange.
- Carriers offering a plan on the exchange will also offer the plan off the exchange, by law they must be the same price.
- Carriers will also be offering a portfolio of plans available as off the exchange plans only.
- If an individual or small group qualifies for a subsidy / tax credit, they must purchase a plan on the exchange in order to receive it.
Connect for Health Colorado Exchange Carrier Plans
Individuals will have from October 1, 2013 to December 15, 2013 to purchase a qualified health plan on Connect for Health Colorado for a January 1, 2014 effective date. For this year only, the open enrollment period will be extended to March 15th for an April 1st effective date and from March 16th to March 31st for a May 1st effective date. Generally individuals will only be able to purchase individual plans from October 1 to December 15 of each year unless one has a loss of coverage qualifying event, ie: loss of group coverage, divorce, cobra exhaust etc.
Plan Options on the Exchange
Exchanges will be offering 4 basic metal plans, Bronze, Silver, Gold and Platinum. The goal of the Exchange is to offer plans which are easily comparable and approximately equal in Actuarial Value.
Actuarial Value, developed by the ACA (Affordable Care Act) refers to the percentage to be paid by the insurance carrier through, coinsurance, claims and deductibles. For example: A plan with a 70% actuarial value means 70% of all charges in a given year are to be paid by the insurance company.
The ACA generally requires that individuals purchase plans with at least a 60% actuarial value whether through individual, small group, large group or self funded policies by January 2014 or are subject to a penalty/tax.
Employers will have the opportunity to enroll from October 1 to December 15, 2013 for a January 1, 2014 effective date. Employers with an existing health plan will have the option of choosing a new qualified health plan at their anniversary renewal period on or off the exchange.
Basic Responsibilities of an exchange:
- Plan Management- Certify insurers health plans as qualified health plans(QHP) and determine structure of choices.
- Assistance- Manage exchange website, establish and maintain call centers and navigator program.
- Eligibility- Collect applicant information and verify to determine eligibility for enrollment, tax credits, subsidies, hardship or exemption status.
- Enrollment- Facilitate enrollments and send information to health plans as well as information related to premium tax credits and cost sharing reductions information related to premium tax credits and cost sharing reductions.
- Finance Management- Manage financial functions such as handling fees and risk adjustment.
Bronze 60% Actuarial Value
Silver 70% Actuarial Value
Gold 80% Actuarial Value
Platinum 90% Actuarial Value
All plans offered on the exchange must include items and services from at least these 10 categories:
1. Ambulatory patient services
2. Emergency services
4. Maternity and newborn care
5. Mental health, behavioral and substance abuse disorder services
6. Prescription drugs
7. Laboratory services
8. Preventative services and chronic disease management
9. Rehabilitative and habilitative devices and services
10. Pediatric services with vision and oral care
Call our insurance agency in Denver for questions about the Colorado health insurance exchange, we will be able to shop plans available on the exchange and plans available off the exchange only.
The Public Exchange is simply another option for purchasing health coverage. Health Plan costs are required to
be the same whether purchased on the exchange, through a broker or direct from the carrier.
utilize the services of a broker and have a broker represent you?
Did you know Colorado insurance rates are fixed by law, so there is no additional cost to
Plan Requirements - Essential Health Benefits
The Colorado Health Exchange is a federally mandated marketplace where individuals and small business may purchase minimum required health insurance by January 1, 2014. The Colorado Health Benefit Exchange (COHBE) has developed "Connect for Health Colorado" for our states individual market currently open. The Small Business Health Options Program (SHOP) will be the Colorado exchange marketplace for small employers.
Tax Credit Qualifications
Coverage Level Lowest Highest
Catastrophic $135.57 $355.27
Bronze $176.89 $524.49
Silver $232.44 $667.10
Gold $273.44 $774.16
Platinum $311.40 $705.12
Small Group Plans
Coverage Level Lowest Highest
Bronze $224.04 $670.32
Silver $253.10 $1,003.69
Gold $324.36 $998.14
Platinum $376.65 $967.95
Division of Insurance Rate Filings