Health Insurance Exchanges

Governor Hickenlooper signs Boyd bill to create the Colorado Health Benefit ExchangeThe basic idea is that Colorado’s Health Insurance Exchange will be website where people can see if they qualify for Federal government subsidized insurance plan or a government run program like Medicaid. If the person does qualify they’ll then be able to compare plans and apply online.

The goal for Colorado’s new health insurance exchange is to create a marketplace that makes it easier for consumers and businesses reviewing and purchasing health care coverage. Currently, Americans who work for small employers or who purchase health insurance on their own do not have access to the same negotiated economies of scale of administration, marketing and risk pooling that are available to employees working in large firms.

It is estimated that Colorado’s Health Insurance Exchange will provide insurance to at least 300,000 uninsured individuals.

Under the Affordable Care Act, states can create two types of health insurance exchanges; they will organize the health insurance marketplace so individuals and businesses have clear and understandable choices.  Sliding scale federal subsidies will help make health insurance more affordable for eligible individuals.

The Affordable Care Act (ACA) creates state-based health insurance exchanges. Individuals and families and businesses with fewer than 100 employees can buy insurance through the state based exchanges. Beginning in 2017, states may allow businesses with more than 100 employees to get insurance through exchanges.

Colorado’s Health Insurance Exchange’s five basic functions:

  1. Certification of health plans to ensure they meet minimum benefits standards.
  2. Customer Service via a toll-free phone line and a website with standardized information on plans, and help for individuals and employers to purchase and enroll in certified plans.
  3. Quality assurance using a standardized rating system.
  4. Assistance for eligible individuals and small businesses in accessing premium and cost sharing subsidies.
  5. Streamlining access to subsidized health insurance programs including Medicaid, Medicare, and Child Health Plan Plus.

There will be four categories of plans plus a separate catastrophic plan offered through the exchanges. Plans will cover 60 to 90 percent of medical expenses, depending on which plan an enrollee selects. Plan benefits, premiums, and out-of-pocket expenses will vary depending on the plan chosen.

The products will be named based on their levels of coverage. “Bronze” is the minimum coverage package, followed by “Silver,” “Gold,” and “Platinum,” which will offer the highest level of coverage. The Bronze package will cover roughly 60 percent of the costs of services it covers. Silver will cover roughly 70 percent, Gold will cover roughly 80 percent of costs and Platinum will cover roughly 90 percent of the costs of the benefits provided. The fifth product offered in the exchange is a “Catastrophic Plan” which is primarily intended for people 30 years and younger or those who 35 would otherwise be exempt from the requirement to purchase coverage because the premium exceeds eight percent of their income. Catastrophic Plans must provide first-dollar coverage (no cost-sharing) for at least three primary care visits.

62 thoughts on “Health Insurance Exchanges

  1. Colorado is normally one of the healthiest states in the US, yet health insurance rates are always VERY high, sometimes even higher than California. Why is this the case. USA today and many publications always rate CO as super healthy?

    • Great question! Colorado is one of the leanest and healthiest states in the country, but that doesn’t mean our healthcare system is any leaner than the rest of the country’s. Colorado is one of the countries leaders in knee replacements and other claims that have to do with winter sports and our active lifestyles. Escalating health insurance rates are a symptom of the underlying increasing costs for doctors, hospitals and prescription medications. As those costs increase, insurance premiums go up along with them.

      • I have to call bogus on that. The health insurance companys are the ones responsible for people having to pay 500 dollars for aspirin in the hospital and driving up the costs to doctors who in turn pass along the cost of havjng needless medical billing to the rest of us. We should be paying less than half of what we do but the doctors have to make a living as well. The student loan repayments come in as well. I dont know the solution but obama care is not it!!

        • Actually, in that example it would be the hospitals that are billing the insurance companies $500 for aspirin.

          • Actually,the insurance industry benefits from paying out more money. Insurance companies base their rates on the amount that the pay out. They charge a percentage more than the amount which they pay. If a hospital charges 50 cents for an aspirin then they would only require 80 cents in premiums to cover their risk. If a hospital charges 500 dollars then they can justify 800 dollars to cover their risk. If insurance companies did not benefit from higher medical costs then they would challenge those costs.

  2. I have been in contact with several authorities within the Governor’s office and have still not gotten an answer. The question is:
    How will the exchanges benefit the general population differently than brokers do now. We currently search the available market and assist clients with understanding the plans available and help them decide what options best meet their needs. If the state wishes to mandate plans (Bronze, Silver, Gold, Platinum), go ahead and we will get this to the general population. The claim that there is “x” number of individuals “uninsured” is false. I can make insurance available to ANY person who wishes to have coverage. If they do not qualify for private carriers, there is still Cover Colorado as an option. Most people choose not t have coverage. If you look at the Unisured population, you would find them in the 19 to 27 age catagory and these folks again, choose not to have them. They feel they do not need it. I think we would serve our country better to inform and educate rather than mandate. I have not seen any request from the state to get information from those of us in the trenches who see the health care problem from both sides. Just a thought.

    • I set up this blog to help educate the public about what’s going on with Health Insurance Exchanges. That being said, please keep in mind the Health Insurance Exchanges are a work in progress, so it’s important to check back frequently as policies are formalized and things come into focus.

      Brokers will continue to provide the widest breath of plan offerings to the public, including a multitude of products not available through the Exchange. For now it appears that Brokers will be able to assist clients purchase insurance plans through the exchanges and brokers will hopefully be compensated at market rate.

      In my opinion, the metal plans (Bronze, Silver, Gold, and Platinum) offered through the exchange hope to capture and focus enough market share to keep the price comparable to what a large group might pay for insurance. People eligible for federal government subsidies (below 4 times the federal poverty level) must buy insurance through the exchange in order to get the subsidies. But, there will still be products sold outside the exchange that may be more attractive to the majority of people who will not qualify for the federal subsidies.

      I hear what you’re saying about that quasi-universal health insurance already exists to some degree in Colorado, but that is not the case in some other states. Perhaps, it’s better to see the exchange as yet another tool for Brokers to use to help clients. If Brokers are, in fact, compensated for sales through the exchange, then it could end up being a good thing for Brokers, as well as clients. It is my hope that Colorado’s exchange will be consumer friendly, market friendly and broker friendly. If it does that then it will be an asset for Coloradans.

    • I would beg to differ with the statement that the uninsured population is in the 19-27 age range or that they’ve chosen to remain uninsured.

      I’m 46 and I haven’t had medical insurance for more than a decade, and not by choice. My income is just ever so slightly above the cutoff for state or federal assistance with medical care and yet nowhere near enough to cover the cost of self-insuring. And I know many, many others from 23-60 who desperately need and want decent (not catastrophic) coverage and cannot afford it.

      That we have so many uninsured in this country is absolutely an issue of affordability.

      • Thank you for your feedback and I wholeheartedly agree that it’s an over-generalization to say that the uninsured population is in the 19-27 age range or that they’re uninsured by choice. Affordability is a huge factor and I agree that many of the uninsured would very much like to be insured, but just don’t have the funds. The ACA’s subsidies will help many people with insurance affordability, while increasing insurance premium costs for others who have higher incomes.

          • Wealth redistribution has being going on for decades. Look it up, the wealthiest have been enjoying skyrocketing shares of the nation’s wealth, while the producers have seen their share hardly keep up with inflation. It’s only called class warfare when the rabble starts to fight back.

    • CGI won the contract for technology services and customer service. Link to article in WSJ that you may find of interest.

  3. I’m 27 years old and a full-time college student with no job. Is medicaid going to cover me so I am not penalized? If Medicaid covers me, I’m still going to act like I don’t have health insurance because I already feel bad enough taking out student loans on the federal dime. How much will it cost the tax payer if I have medicaid to avoid the penalty but don’t use it?

    • That’s a very good question. Since this forum is about Colorado Health Insurance Exchange, my answer will address that aspect of it. Generally speaking college students will benefit from the Affordable Care Act in 3 ways: enhanced student health plans, expanded Medicaid eligibility, and the chance to stay on their parent’s insurance if they are under 26 years old.
      In your case, you will absolutely want to get your health insurance through Colorado’s health insurance exchange when it opens in October for a January 1st, 2014 effective date. You should be eligible for Medicaid since you have no income and most people making less than $15,000/year will be eligible for Medicaid.
      Don’t feel guilty as clearly the government wants you to have health insurance, since it is mandated that everyone must have it starting in 2014. Some will not agree with this philosophically or politically, but it’s the law of the land. In fact, one of the reasons for the health insurance mandate is that when people are unable to pay large medical bills that cost is ultimately passed onto others, so the public is paying either way.
      You’re already going to have student loan debt that you’ll be paying back, with interest, so don’t take the risk of having an unforeseen illness or injury add thousands of dollars of additional debt. I know for some young healthy people it can seem tempting, but life can change in a split second and going without health insurance is simply not a risk worth taking, if at all possible.
      I know you don’t have a job and money’s tight, but you should still consider a low cost catastrophic health insurance plan to cover you in the interim. First check with your college to see if there are any inexpensive decent quality student plans you can get onto. If that’s not the case, then if your health is good you should be able to get a lower cost catastrophic plan for under $130/month in the individual health insurance market. Use a reputable broker to help you shop for the best plan. Then you can cancel that plan at the end of 2013 and enroll through the exchange in October for a January 1st, 2014 effective date for the new plan. Food for thought.

  4. What are the plans for building subsidy calculator for Colorado state. Will this be an in-built feature within the online state exchange or will it be routed to Federal exchange to determine the subsidy eligibility?
    Do you have information about others states like California, Nevada etc.

  5. Urgent!!! What are the plans for building subsidy calculator for Colorado state. Will this be an in-built feature within the online state exchange or will it be routed to Federal exchange to determine the subsidy eligibility?
    Do you have information about others states like California, Nevada etc.

    • All the states’ exchanges are expected to have premium subsidy calculators of some fashion. It seems logical that the applications with the actual subsidy calculations may have hooks into federal websites, but I don’t know that for certain.
      This website pertains to Colorado’s health insurance exchange. It’s said to be modeled after California’s to some extent, but we wont’ know to what extent until it’s rolled out in October.

  6. What would a person need to do to become a “consultant” to help people sign up for a policy on the exchange? Are there legalities such as affiliation with a provider or any certification necessary?

    • Great question! The Affordable Care Act requires the Exchange to train and certify staff and volunteers of certain organizations to serve as application counselors. The Exchange is in the process of developing the Application Counselor approach and will release further details soon. For more information about the Connect for Health Assistance Network, please send your request to assistancenetwork@connectforhealthco.com.

  7. If we currently have coverage through my wife’s employer, but are paying more than 9.5% of our monthly gross income for premiums, can we switch to a Colorado plan and qualify for a subsidy? We are a family of 5. Her premiums are paid pre-tax; does this affect the 9.5%?

    • While larger employers may be subject to penalities if their coverage isn’t considered affordable, that doesn’t, in itself, trigger employee eligiblity for a subsidy. “Affordable” means the employee’s portion of the premium on the employer’s lowest-cost employeeonly plan is less than 9.5% of the employee’s W-2 income.

      To see if you may be eligible for a subsidy please use the subsidy calculator at:
      http://kff.org/interactive/subsidy-calculator/

      Most of those who will be able to claim the subsidies are in working families with annual earnings between $47,100 and $94,200 and more than a third of those eligible will be young adults between ages 18 and 34.

  8. Thanks for the reply. I wish to clarify. For example, if our Gross Income in 2013 will be $98,000 for a family of five and her annual, employee-portion premiums are $11,280 we are paying over 11%. Does that seem correct? If so, can we then switch to a Colorado plan and then pay no more than 9.5% of our income based on five people?

    • Yes, your premium exceeds 9.5%, so based on the numbers you provided and assuming you and your wife have 3 children are under age 20 and that your premium exceeds 9.5% of your household income for your own coverage through the insurance offered by your employer, the calculator gives these results:

      ResultsThe information below is about subsidized exchange coverage. Note that subsidies are only available for people purchasing coverage on their own in the exchange (not through an employer).
      Household income in 2014: 351% of poverty level
      Unsubsidized Health Insurance Premium in 2014: $11,786
      Maximum % of income you have to pay for the non-tobacco premium, if eligible for a subsidy:9.5%
      Amount you pay for the premium:$9,310
      (which equals 9.5% of your household income and covers 79% of the overall premium) You could receive a government tax credit subsidy of up to: $2,476 (which covers 21% of the overall premium) .

      Bronze PlanThe premium and subsidy amounts above are based on a Silver plan. You have the option to apply the subsidy toward the purchase of other levels of coverage, such as a Gold plan (which would be more comprehensive) or a Bronze plan (which would be less comprehensive).

      For example, you could enroll in a Bronze plan for about $7,293 per year (which is 7.44% of your household income, after taking into account $2,476 in subsidies). For most people, the Bronze plan represents the minimum level of coverage required under health reform. Although you would pay less in premiums by enrolling in a Bronze plan, you will face higher out-of-pocket costs than if you enrolled in a Silver plan.

      Out of Pocket Costs
      Your out-of-pocket maximum for a Silver plan (not including the premium) can be no more than $12,500. Whether you reach this maximum level will depend on the amount of health care services you use. Currently, about one in four people use no health care services in any given year.

      You are guaranteed access to a Silver plan with an actuarial value of 70%. This means that for all enrollees in a typical population, the plan will pay for 70% of expenses in total for covered benefits, with enrollees responsible for the rest. If you choose to enroll in a Bronze plan, the actuarial value will be 60%, meaning your out-of-pocket costs when you use services will likely be higher. Regardless of which level of coverage you choose, deductibles and copayments will vary from plan to plan, and out-of-pocket costs will depend on your health care expenses. Preventive services will be covered with no cost sharing required.

      Other Coverage Options
      Children and young adults under age 30 are eligible to purchase catastrophic coverage. Catastrophic coverage does not provide coverage for essential health benefits until you reach the annual limit on cost sharing ($12,500 in 2014).

      Children under the age of 19 may also be eligible for coverage under Medicaid or the Children’s Health Insurance Program (CHIP), depending on your state’s eligibility requirements.

  9. My wife and I currently have a high deductible($10000) HSA policy, that recently increased in cost by $120/mo, is there a downside ( other than not having coverage), in relation to getting coverage through the exchange when it happens, to dropping our coverage now and signing up in October for a January effective date? Also wondering, as mentioned in an earlier post- why is it that catastrophic coverage is only available for those under 30? That is basicly what we have now. And one more question, will there be anything like an HSA under the new rules?
    Thank you

    • While there are deductible and out of pocket maximums for employer sponsored group plans, higher deductible options should continue to exist in the individual marketplace. HSA qualifed plans will exist in both the employer sponsored and group markets.

      It’s not 100% clear yet if there no longer be a waiting period for coverage for pre-existing conditions for individual policies when people have a lapse in coverage before getting a new policy in 2014. Even if you are healthy, the risk of an injury should be enough to cause most risk averse people to maintain health insurance coverage when possible.

  10. I just graduated and have a family of five people. The IRS estimated the worst plan of health insurance will cost me $20,000. With a really high deductable. I will be making over the 400% poverty level and will not receive any subsidies. I can pay the $20,000, but will not afford to use the plan because of the high deductable. Before the affordable care act I would have bought catastrophic insurance with a $15,000 out of pocket first. Paid cash for my day to day health costs. I am over 30 now and can not do this. What are my options to afford health care for my family? I will be self employed with no group employer option.

    • Hi Ryan,
      If you’ll make too much to qualify for subsidies through the exchange then you’ll want to look at the private market plans as well. A goood broker will be able to quote private market plans for you with higher deductibles that should be more affordable for your situation. Many carriers are offering plans sold in 2013 that you’ll be able to keep through December of 2014, before having to change to the newer ACA plans.

  11. My wife and I have two infants. I have my own business and carry an individual plan and my wife is no longer employed but staying home to take care of the babies (child care for two was almost twice as much as she made). Household income is around $50K and, according to the calculator, we are at 212% of poverty level and should qualify for a subsidy in the exchange. However, I haven’t found any information on when the Colorado exchange will be up and running for us to obtain. When will we be able to apply for coverage under the exchange? Thanks.

    • The Exchange will be operational on October 1st, 2013 for plans that will go into effect on January 1st, 2014. After October 1st you’ll be able to see what subsidies you qualify for, the net cost of the different plan options and you’ll be able to enroll for the coverage that starts on 1/1/14. Take care!

  12. news over the weekend says nobody has to prove income to qualify for subsidized care. when can we begin to sign up for that part? also, can you send out an additional check just for the fun of it. this seems like it will go really well. free healthcare and extra money. who wouldn’t vote for democrats in the midterms? can we smoke weed, too? oh…yeah…we got that already.

    • To receive tax subsidies to help buy insurance, enrollees still must have incomes ranging from 100 percent to 400 percent of the federal poverty line and not have access to affordable insurance through an employer.

      The ruling states that, “For income verification, for the first year of operations, we are providing (state and federal) exchanges with temporarily expanded discretion to accept an attestation of projected annual household income without further verification.”

      It’s not yet clear how Colorado will support this new flexibility or what penalties will come into play for people who falsify their income attestations. Defrauding the government is a bad idea, as they will be able to audit this and the penalties would be large, I would think.

      • the govt defrauding us should be your concern, not the other way around. this is another vote-buying boondoggle. the system will break from the weight. there aren’t enough payers to support the non-payers. there is no sense in those with the ability to pay to continue to pay. the fraud will be monumental, but can just be added to the global warming and banking boondoggles. we’ll all just follow the libs. they will be the first ones to the trough.

  13. I am a 30 year old college student and in excellent health. I make around $24K per year with my post 9/11 GI-Bill, and I do not work during the fall or spring semesters while a full time student. Certainly I cannot afford to pay $350/month for health insurance as I am a homeowner and have to budget my finances carefully, therefore I plan to simply pay the penalty for not having health insurance. Does anyone know what the cost of the penalty will be? Is the penalty a yearly cost or will it be charged monthly? Also, if I were to set up a personal health savings account would this be adequate keep me from having to pay the penalty?……If yes, then how much money would I need to put into a personal HSA?

    • Good questions. I suggest seeing if there are lower cost options available once the exchange opens in October.

      If those are too expensive then I suggest working with a good health insurance broker in Colorado to help you find a lower cost plan. They’ll have lower cost pre-ACA plans that you can keep through Dec of 2014, if you sign up before the end of 2013. This will help delay the impact of the ACA for nearly a full year.

      In order to open a Health Savings Account you must first have an HSA qualifed high deductible health plan. The health insurance broker can help you price those out. It’s too early now, but you’ll want to shop between mid-October through November to have the most options.

      Here’s some info that may be helpful.

      “Beginning in 2014, lower cost catastrophic health plans will be available to young Americans up to age 30 and to individuals who are exempt from the individual mandate because no affordable coverage is available or they have a hardship exemption.

      Beginning January 1, 2014, all U.S. residents are required to maintain minimum essential coverage unless the individual falls into one of the following exceptions:
       individuals with a religious conscience exemption (applies only to certain faiths);
       incarcerated individuals;
       undocumented aliens;
       individuals who cannot afford coverage (i.e. required contribution exceeds 8% of household income);
       individuals with a coverage gap of less than 3 months;
       individuals in a hardship situation (as defined by the Secretary of Dept. of Health &
      Human Services (HHS));
       individuals with income below the tax filing threshold; and
       members of Indian tribes.”

      For the penalties, they start out small and increase significantly. “The flat dollar amount per individual is $95 in 2014; $325 in 2015 and $695 in 2016. After 2016, the flat dollar amount is indexed to inflation. The flat dollar penalty is capped at 300% of the flat dollar amount.”

      Hope that’s helpful!

      • Hmmm, sounds like another tax to me in disguise. Can I turn in my citizenship and become an “undocumented illegal alien”? It sounds like that’s the best way to avoid the penalty or tax. Look the problem is these lousy politicians that people keep electing into office, they’ve made America a 24/7 superstore just selling crap made in China! Really, healthcare cost are not going down, not now, not ever, most hospitals are a monopoly owned by insurance companies so when they charge us or themselves $100 for an aspirin as you stated earlier, they’re just taking the money from one pocket and putting it in their other pocket. The Dems shoved this plan down the American publics throats and it’ll destroy our healthcare system as we know it today! If this plan is soooo great, then all the politicians should be on this coverage as well. No more cadillac plans or special coverage for them! If it’s good enough for us, then it’s good enough for them!

  14. Thanks for the great answers to all these questions.
    Currently, we pay $1300 per month for health insurance for my husband, myself and my son with a $5500 annual in network deductible. It is crazy that I got a letter from my insurance company that says the Colorado option may cost me more. My husband had cancer 5 years ago and now, thankfully, has had a clean bill of health since. Also, I do not believe we will qualify for any subsidies. Is the best way to estimate cost to call the exchange number now? Or call in October? I’d it likely I will stay with a private individual plan? I really want to be part of the State plan.

    • I’m so glad to,hear your husband is cancer free now! Your best bet will be to get a full insurance review from a health insurance broker and make sure they review plans both inside and outside the exchange. There will be dozens of guarantee issue plans outside the exchange that may be very attractive to those who earn too much to qualify for subsidies. You’ll have to wait until the exchange opens in October and the brokers have all the off-exchange rates, in order for them to do a thorough job evaluating all the carriers’ plans. Hope that’s helpful!

    • Good question. I have no idea how one would document that, but it sounds like it could be a red flag to trigger an audit to me. I wouldn’t touch it with a ten foot pole unless I truly belonged to a church where that was a well known restriction.

  15. When Obamacare was being pushed through Congress, one of the major points presented by proponents was that if I liked my insurance I could keep it. Well, I just received my cancellation notice from Anthem stating that my policy would no longer be offered due to the Obamacare law.

    Now my premiums per month are looking like they are going to double for the same level of coverage. Also, I do not quailify (barely) for a subsidy. Where is the benefit to me for this law. Looks like wealth redistribution to me.

    • You should get an option in the mail to keep your Anthem plan through Nov 20, 2014. Those notices are being mailed out next week according to Anthem.

  16. I really wish we had a single payor system. If I had my way, I would like to see the for-profit health insurance industry abolished in this country as I feel they are the culprits in the high costs of healthcare. But since that isn’t going to happen, what are my choices in choosing a non-profit health plan?

    • There are several non-profit insurance companies with the biggest being Kaiser and Rocky Mountain Health Plans.

  17. I am struggling to understand why I should be required to participate in coverage if I do not need it. I am a stay at home mom and my husband is self employed. We have plenty of money tucked away for a rainy day because we don’t spend if we don’t have to. Last year as a whole my family spent $382 on healthcare for well baby check ups and one ear infection. Now I will be required to spend at least that every month on a plan I will rarely use. For this to work I will have to get a part time job, which means putting my daughter in a daycare full of germs where she will get sick more often. Then I will have to get a second job to pay for the daycare so I can work the first job. This is not fair to families in Colorado and this is not the American Dream.

  18. I would like to know how these new plans will affect my ability to keep seeing my current doctors. I don’t want to be forced to see a lesser doctor because the new H.C system is more concerned with costs and some unconcerned committee makes the decisions.

  19. I am 28 and have not had health insurance for years. My employer does not and will not be providing me health insurance for 2014. Is it true that if I do not have health insurance in 2014 I will be fined? Secondly, where can I purchase my health insurance to avoid the fine (I thought this would be the website to purchase it but I do not see those options)? Lastly, my annual income for the past many years has been below the cutoff for Medicare however I do have some money saved, if my annual income is lower than the required amount but I have money in savings does that affect my status? Please and thank you.

  20. I have heard that only 200 people have purchased insurance over on the Connect for Health Colorado. Can you verify or correct this number?

    • According to an article in the Denver Post, “Officials with Connect For Health Colorado said 226 people have signed up for insurance using the exchange, for a total of 305 people getting coverage. That’s the tally from the exchange’s first week, Oct 1-7. ”

      A spokesman for the exchange, Ben Davis, said “Colorado is on pace to meet its target of having 136,000 people get health insurance through the exchange by the end of 2014. More than 18,000 people have created online accounts to start shopping and nearly 10,000 people had called for help navigating the system.”

      “This is a much more complicated purchase than buying a T-shirt at gap.com,” Davis said. “We expect people to take their time and really weigh their options, and that’s what they’re doing.”

  21. I thought I heard the same article quoted as a source on CPR on the 28th of Oct. claiming 3,200 Coloradans had purchased Health insurance since the law took effect.
    I saw this when looking for the article you mentioned.

    http://www.healthpolicysolutions.org/2013/10/30/exchange-snafus-linked-to-only-3164-purchases-so-far/
    “Posted on 30 October 2013.
    Exchange snafus linked to only 3,164 purchases so far

    By Katie Kerwin McCrimmon

    Just over 3,100 people purchased health insurance through Colorado’s new health exchange from Oct. 1 through Oct. 26, according to new data released Monday.”

  22. Why must I pay more for a plan that covers less than what I need (many of services I use are not covered on the EHB Benchmark plan) and makes me pay for things I don’t need. My understanding of the theory behind insurance sickens me at this point. If I, a very healthy individual, thought I was paying for everybody else then, I really am now. I am going through menopause and currently cannot become pregnant, but I am now forced to pay more for a plan that MUST include maternity and pediatric services because I have to pay for everybody else who OPTS for these things. I don’t mind paying for the sick, but why should I have to pay for everybody else’s OPTIONS? Or… maybe I’m missing something. I can’t tell because I can’t get any plan information.

    By the way, has Mr. Obama signed up for an ACA plan?

    Also, can somebody explain to me why I can’t get plan information and costs without giving my tax info and SS #? What does that information have to do with plans and cost? And… why is it so secretive? Since when in this country do we have to give out personal information just to get information on a potential purchase? It appears that ACA has more to do with exercising power over us than giving us healthcare.

    It’s like living in a communist country. No individualism – no choice.

    • You can go to this page and then select browse plans. You do not have to provide a SSN to see the plan premiums. Select the option to skip seeing if you qualify for financial assistance. Hope that helps!

      • Thank you Mr. Moderator. It so happens that I was able to contact a rep from the website and she was able to walk me through it. Somehow, I was hoping that everything people were saying was wrong but, no, they were right.

        I don’t understand. All the info I was reading said that a gold PPO would have 20% coinsurance. Wrong. It is 35% coinsurance; that is, of course, unless you increase your premium $200. There are only two gold PPOs available in my area, and the only one that is somewhat near what I’m paying now is very benefit deficient compared to my current plan. Oh… and not to mention the deductible, out-of-pocket and coinsurance are extremely high compared to my no-deductible-20% plan.

        Additionally, I’m a little disappointed in my government’s intellect that would have them concerned about all the men and 80-year old women running around getting pregnant. ALL ACA plans must carry maternity, an option in life – forget the fact there isn’t a snowball’s chance in hell of ever using it for many.

        Fortunately, my insurance company informs me they have no plans to cancel me. My current plan is grandfathered in… at least until Dec 2014. My only hope after that is that something happens to end this whole mess.

        Thank you for your help.

  23. Heartening is that lots of people will qualify for either Medicaid or a govt. subsidy. VERY disheartening to me is that Coloradoans buying through the exchange of choice of – count them – only 2 companies to choose from – Anthem and Cigna. AND, when I compared the prices to the quote I got from Anthem months ago, the new price, under Obamacare, is $400/month HIGHER.
    So, there are people who will get help through Medicaid or govt. subsidies, and the rest of us are screwed.
    Of course, what did we expect – When insurance companies are forced to issue guarantee issue, to everyone, no matter what their health condition is, and to remover ALL coverage caps (that’s right – if treatment costs $20M, insurance has to pay), prices could go nowhere but sky high.
    In Colo., we have had CICP that pays almost all costs for uninsured’s. I say that option is a lot better than the crap that this new law results in.

  24. The cost of these insurance plans, I will not be able to afford. It would be living in a house or paying for insurance rates. I’ll take my chances with no insurance or see if I can find affordable outside the state plans.

  25. I’m having a hard time with the fact that since Kaiser has become a big insurance name, I cannot even get on their panel as a provider, even thou I have tried for the last 3 years. Patients have even called and written to them asking for them to add my practice to their panel but the response always given is “there are to many providers in the area. Now I find that they are one of three insurance providers I can choose from, and needless to say I will not be opting for Kaiser, and neither will any of my patients who call asking if I am on their panel. What happened to “affordable” and “choice”.

    • A few of the plans include very limited pediatric dental, but for people over the age of 18 dental will have to be purchased separately. The Delta Dental Mesa Family plan is a good one for adults and it’s also available through the Connect for Health Colorado Exchange. Anthem BC/BS also has a pretty good one. With the dental plans just keep in mind that they provide good coverage for preventative care but there are waiting periods (generally 6 months) before cavities are covered. Major dental care is often just discounted. They’re inexpensive enough to still be a good deal, but it’s important to understand the limitations of the dental insurance policies.

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