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Posted by on Aug 20, 2013 in Colorado | 0 comments

Colorado Health Insurance Marketplace

CONNECT for HEALTH COLORADO

Connect for Health Colorado or C4HCO is the state of Colorado’s new, online, health insurance marketplace.

Will there be many options for health insurance on the exchange?

On Friday August 16, 2013 the Colorado Department of Regulatory Agencies’ Division of Insurance released approved health insurance carriers, plans, and rates for 2014.

242 health insurance plans were approved for the state’s exchange; this does not mean that all of these plans will be offered on the exchange come October 1, 2013; insurance companies may choose not to participate in the state’s online health insurance marketplace.

CO_Exchange_Plans_2014

Will coverage and premiums be the same statewide?

While many carriers will be offering plans statewide, some insurance companies will only offer plans in specific areas of the state. Also, insurance premiums can vary across the state depending on where you live.

Colorado is broken up into groups of counties to create 11 different Geographic Rating Areas, which are used to determine health insurance premiums. The United States Office of Management and Budget (OMB) delineates these geographic areas or Metropolitan Statistical Areas (MSAs) –

“The general concept of a metropolitan … statistical area is that of a core area containing a substantial population nucleus, together with adjacent communities having a high degree of economic and social integration with that core.”

This means that the same person may have a different health insurance premium in Area 1 than they would have in Area 9. Here is a breakdown of the 11 rating areas in Colorado:

Area Area Name Counties
1 Boulder Boulder
2 Colorado Springs El Paso, Teller
3 Denver Adams, Arapahoe, Broomfield, Clear Creek, Denver, Douglas, Elbert, Gilpin, Jefferson, Park
4 Fort Collins Larimer
5 Grand Junction Mesa
6 Greeley Weld
7 Pueblo Pueblo
8 South East Baca, Bent, Cheyenne, Crowley, Custer, Fremont, Huefano, Kiowa, Kit Carson, Las Animas, Lincoln, Mineral, Otero, Prowers, Alamosa, Chaffee, Conejos, Costilla, Rio Grande, Saguache
9 North East Logan, Morgan, Phillips, Sedgwick, Washington, Yuma
10 West Archuleta, Delta, Dolores, Grand, Gunnison, Hinsdale, Jackson, La Plata, Lake, Moffat, Montezuma, Montrose, Ouray, Rio Blanco, Routt, San Juan, San Miguel
11 Resort Eagle, Garfield, Pitkin, Summit

Which insurance companies were approved to offer plans on the exchange?

All Savers Insurance Company, a UnitedHealthcare company, had 9 approved individual exchange only plans at the platinum, gold, silver, bronze, and catastrophic metal levels. These EPO plans will be offered in regions 3, 7, 8, 9, and 10 and use the Navigate network.

Cigna Health and Life Insurance Company was approved to offer 11 individual plans. These plans were approved for both on and off the exchange at the gold, silver, and bronze levels. Cigna only applied to offer plans in region 3, which is the Denver MSA. These PPO plans use theDenver LocalPlus network.

Colorado Choice Health Plans was approved to offer plans both on and off the exchange. 12 Individual plans were approved at the gold, silver, bronze, and catastrophic metal levels and 10 small group plans were approved at the gold, silver, and bronze levels. CCHP HMO plans will be available in rating areas 2, 3, 4, 6, 8, 9; using the CCHP Network.

Colorado HealthOP is the state’s new health insurance cooperative. The company was approved to offer 2 Individual exchange only plans and 6 individual plans for both on and off the exchange at the gold, silver, bronze, and catastrophic metal levels. 6 small group plans were also approved for both on and off the exchange at the gold, silver, and bronze metal levels. Individual plans with the company’s CoOpCentralMetro (EPO) network will be available in rating areas 1, 3, 6, 9, 10, and 11. PPO plans using the CoOpStateWideOne network and CoOpStateWideTwo network will be available statewide.

Denver Health Medical Plan was approved to offer 4 exchange only individual plans at the gold and silver metal levels. These HMO type plans will only be available in region 3. Consumers will have two network choices: the DHMP Close Network and the DHMP Expanded Network.

HMO Colorado (Anthem Blue Cross and Blue Shield) was approved to offer 14 Individual exchange only plans statewide. Plans using the Pathway x Enhanced network will be offered at the gold, silver, bronze, and catastrophic metal levels; while plans using the Pathway Enhanced network will be offered at only the gold and bronze metal levels. The company was also approved to offer 3 SHOP exchange only plans.

Humana was approved to offer 7 individual exchange only plans. The company is offering one of the few platinum plans in Colorado, as well as plans at the gold, silver, bronze, and catastrophic metal levels. Humana HMO plans will be available in regions 2 and 3 using the Colorado HMOx network.

Kaiser Foundation was approved to offer 27 individual exchange only plans at the gold, silver, bronze, and catastrophic metal levels and 24 small group exchange only plans at the gold, silver, and bronze metal levels. Plans will be available in many regions across the state including areas: 1, 2, 3, 4, 6, 7, 8, 9. Kaiser’s HMO plans will use the Kaiser Permanente Denver / Boulder, Kaiser Permanente Northern Colorado, and Kaiser Permanente Southern Colorado networks.

New Health Ventures was approved to offer 6 individual exchange only plans statewide at the gold, silver, and bronze metal levels. These PPO plans will use the Access Health Colorado network.

Rocky Mountain HMO was approved to offer 18 exchange only individual plans and 34 individual plans for both on and off the exchange at the gold, silver, bronze, and catastrophic metal levels. Rocky Mountain individual plans will be offered statewide, but the provider network depends on location, plans will use the Rocky Mountain HMO Colorado Springs Health Partners Provider Network (HMO), Rocky Mountain HMO Mesa County Provider Network (HMO), Rocky Mountain HMO New West Provider Network (HMO), and Rocky Mountain HMO Statewide Provider Network  (PPO). 30 small group plans were approved to be offered both on and off the exchange. These plans will also be offered statewide using the Rocky Mountain HMO Colorado Springs Health Partners Provider Network (HMO), Rocky Mountain HMO New West Provider Network (HMO), and Rocky Mountain HMO Statewide Provider Network (PPO).

Rocky Mountain HealthCare Options was approved to offer 14 SHOP plans both on and off the exchange at the gold, silver, and bronze metal levels. These PPO plans will be offered statewide using the Rocky Mountain Health Care Options Statewide Provider Network.

SeeChange was approved to offer 3 SHOP plans both on and off the exchange. These plans will use the Statewide Cigna PPO network and be available statewide at the gold, silver, and bronze metal levels.

Rocky Mountain Hospital & Medical Services, Inc. had two exchange only small group plans approved, however, it appears the company may have withdrawn the plans.

New information is being released every day. Follow this blog to receive updates as new information is released in Colorado.

Jillian Carlile
Research Analyst & Health Exchange know-it-all
Strenuus
jcarlile@strenuus.com

About Strenuus

Strenuus® is the industry leader in delivering network competitive intelligence services. We are the largest collector of managed care data in the country. With a singular focus on the managed care industry, we provide services to support payors, brokers, consultants and healthcare IT companies. Whether you represent employer-based coverage, Medicare, Medicaid, dental, work comp or specialty networks, we have the data and insights you need.

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