Connect for Health Colorado insurance exchange now open; tax credits and small groups could help lower individual rates
Special to the Daily
Bethe Wright, of The Wright Insurance Co. in Eagle, offered some examples of rates she’s seeing for 2018.
• 35-year-old male or female (same rate) making more than $48,240 will pay $398 per month for a Kaiser Bronze Plan, $523 for an Anthem Mountain Enhanced Network Plan or $628 with an Anthem Statewide Network Plan.
• If that same 35-year-old makes $35,000 a year, each premium would be $209 less per month with Obamacare’s Advanced Premium Tax Credit.
• A family of four (mom and dad 50 years old and two kids, 10 and 13) making more than $98,400 will pay $1,790 a month for a Kaiser plan, $ 2,350 for an Anthem Mountain Enhanced Network Plan or $2,580 with an Anthem Statewide Network Plan.
• If that family of four makes $80,000, each premium will be $1,525 per month less with the Obamacare tax credit.
• Group plans for people the same age and with similar coverage to the individual plans above will cost less. For example, Kaiser small-group for age 35 costs $328 and $1,370 for the family of four.
• Anthem Mountain Enhanced small group for age 35 is $405, and it’s $1,690 for a family of four.
• Anthem Statewide Network small-group plan for age 35 is $450 and $1,880 for a family of four.
Source: The Wright Insurance Co.
One of the biggest reasons health insurance rates on the individual markets have jumped so much the past several years on Colorado’s Western Slope is the severe lack of competition.
There are 14 counties in the state with a solitary insurance carrier for 2018, according to Connect for Health Colorado CEO Kevin Patterson, and the majority of those counties are in the Colorado Division of Insurance region known as Area 9, which happens to include Eagle County.
“There is concern that we still have there,” Patterson told reporters on a recent conference call, fielding the very first question on mountain county prices. “One of the things that we’re going to continue to work on with our Division of Insurance is really to begin to think about how do we try to increase competition in those areas where we don’t have more competitive markets.”
Eagle County actually has two carriers, Kaiser and Anthem, but rates for the 8 percent of people who are either self-employed or own a small business are still astronomically high, with monthly premiums for a family of four ranging between $1,800 and $2,500 if that family makes too much (more than $98,400) to qualify for tax credits under the Affordable Care Act, or Obamacare.
Still, while Patterson, the Division of Insurance and some concerned state lawmakers work on ways to bring down rates in mountain resort counties, the CEO of the state-run Obamacare exchange encourages anyone in need of an individual or small-group plan to “stop, shop and enroll,” adding people may be surprised at the deals they can find.
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Connect for Health Colorado kicked off its fifth open enrollment period on Wednesday, Nov. 1, and anyone in need of insurance starting Jan. 1 must sign up by Friday, Dec. 15. That, however, is not the final deadline for obtaining 2018 health insurance in Colorado.
While the federal exchanges shut down then, cut dramatically by the Trump administration, Colorado’s exchange will keep on enrolling until Friday, Jan. 12, although plans that are signed up for after Friday, Dec. 15, don’t kick in until Thursday, Feb. 1.
Connect for Health officials say confusion over the Trump administration move to cut cost-sharing reductions shouldn’t keep people from shopping around. Those subsidies for low-income people are still in place in Colorado, Patterson said, but how they’re being paid for has changed, and ultimately he acknowledged insurance companies will pass along those costs.
But in the meantime, he stressed that while rates on the individual market are going up on average nearly 27 percent across the state, Obamacare subsidies are also going up, and despite all the recent negative press in the wake of repeated failures by Congress to repeal and replace the law, the number of insurance plans on Connect for Health only dropped from 132 to 124 for 2018.
“We feel like we have a healthy and thriving amount of choice overall. That choice is limited, of course, in certain counties,” Patterson said. “With all of the market changes that we’ve heard, we still feel like we have a viable and thriving market to put out there for our consumers.”
Connect for Health spokesman Luke Clarke said he would be releasing enrollment updates starting Thursday, Nov. 16, showing whether sign-ups are lagging due to the national debate and federal uncertainty.
“I can tell you that we are pleased with the traffic on our enrollment site and with the call volume to date, which are good indicators for a good open enrollment season,” Clarke said.
Consider small group
Nationally, government statistics released late week show that despite cuts of as much as 90 percent in funding for Obamacare marketing, more than 600,000 people had enrolled for coverage on healthcare.gov — a faster rate than in years past.
In the mountain resort counties, the only certainty is that individual rates jumped dramatically from 2017 to 2018. Bethe Wright, of The Wright Insurance Co. in Eagle, said some clients who already locked in plans for 2018 can expect another increase of between 6 percent and 10 percent to reflect President Donald Trump’s executive order pulling back cost-sharing reduction payments.
“I have final rates, but not all clients have received the second increase letter yet,” Wright said, adding small-group rates could be the way to go for those who qualify (a company with at least one nonrelated employee). “I am seeing that the small-group rates in 2018 are about equal or a bit less than the 2017 individual rates, so approximately 35 (percent) to 40 percent lower than the individual rates in 2018.”
But Obamacare’s Advanced Premium Tax Credits don’t apply for small-group rates. Still, if your income is too high to qualify for individual rate tax credits, then small group may be the way to go.
The key, Wright said, is to shop and be creative. If it’s possible for an individual to keep his or her net income at certain levels, writing off expenses, then Obamacare’s tax credits can make health insurance very affordable, even in mountain counties.
Without the Affordable Care Act premium, Wright said those who are going without coverage and simply absorbing the Affordable Care Act individual mandate penalty — either $695 per adult or 2.5 percent of a person’s income — are taking a big financial risk in the event of a catastrophic injury or illness.