ColoHealth's Consumer Guide to Colorado Health Insurance
Now more than ever, choosing the right health coverage for you and your family can seem complicated. The Affordable Care Act (ACA) has changed the way we buy health insurance.
ColoHealth is certified by the Connect for Health Colorado insurance marketplace. When you authorize us as your agent on the exchange, you’ll have a licensed, independent ColoHealth Personal Benefits Consultant to help you with every step of your enrollment, including premium tax credit applications.
Table of Contents
- Colorado Health Care Reform
- ACA-Qualified Health Plans
- ACA-qualified Metal Plans
- HSA-Qualified High-Deductible Health Plans
- Catastrophic Plans
- Alternative Coverage Options
- PPO Networks
- Insurance Company Ratings
- Choosing an Insurance Professional
- Colorado Health Insurance Made Easy Special Report
- About ColoHealth
- Wiley Long’s Personal “No-Risk, Totally Thrilled, Money-Back Guarantee”
Unless you qualify for an exemption, you are required to carry health insurance that is approved under the Affordable Care Act (ACA) – or face a tax penalty. ACA-qualified plans must include 10 Essential Benefits and 100% coverage for a long list of preventive care services.
ACA plans provide guaranteed acceptance of pre-existing conditions for coverage. No one can be denied coverage, regardless of health status or pre-existing conditions. However, if you decide to purchase a non-ACA policy (catastrophic or short-term coverage), you are not guaranteed coverage for pre-existing conditions. You also will not be 100 percent covered for preventive care and will not receive the 10 Essential Benefits provided by Obamacare plans.
Premium Tax Credits
If your household income is below 400 percent of the federal poverty level, you can qualify for a premium tax credit (subsidy) to reduce the amount you pay for ACA-approved plans purchased on the Colorado health insurance exchange.
Household incomes below 400 percent of the federal poverty level (FPL) qualify for assistance in paying for health care premiums. Additional tax credits called cost-sharing subsidies are also available for those households with income levels below 250 percent of the FPL.
Advance premium tax credits can be submitted on the Connect for Health Colorado marketplace exchange at the time of health plan enrollment, or as a reimbursement at the end of the tax year with your tax return. Your Personal Benefits Consultant can help you correctly estimate your income to avoid having to repay any excess subsidy you may receive as an advance premium tax credit.
Catastrophic, short-term and other alternative coverage plans do not qualify for tax credit subsidies.
Colorado’s Connect for Health Colorado marketplace is state-operated, so some deadlines and regulations may differ slightly from federally-facilitated exchanges.
Visit the ColoHealth Health Care Reform page for complete information you need to know about the Affordable Care Act.
ACA-qualified health plans are sold both on and off the Connect for Health Colorado exchange. ColoHealth is certified by the Colorado exchange to assist you in the process. We can also help you consider plans not on the exchange, or coverage outside open enrollment period.
Based on premiums and deductibles, ACA-qualified health plans are categorized by four “Metal” tiers: Platinum, Gold, Silver and Bronze. The higher premiums with lower deductibles of the Platinum plans are a popular choice for individuals who frequently seek medical care, while the Silver and Bronze plans fall into a lower premium range with higher deductibles for those who need fewer routine medical services.
High-deductible ACA plans can be combined with a health savings account to provide for the out-of-pocket costs of copays and deductibles and many other HSA-qualified expenses.
Catastrophic plans are also available to satisfy ACA requirements for those who have hardship exemptions after a non-ACA plan cancellation, and for young adults under the age of 30.
ACA health plans are categorized into four categories (or metal tiers) based on the actuarial value (percentage of coverage). Typically, the actuarial value is the percentage paid by a carrier for ACA-approved health services.
Silver - 70% Actuarial Value|
Gold - 80% Actuarial Value
Platinum - 90% Actuarial Value
Bronze Plans – offer the lowest premiums, in general, but have the highest deductibles, copays, and coinsurance, as a result. Bronze plans also typically result in higher limits on out-of-pocket costs. Bronze plans are popular for those who are generally healthy and rarely need medical care, can afford to pay reasonable out-of-pocket costs, and are mostly concerned about the financial impact of an unexpected, major medical event.
Platinum Plans – have the highest premiums, but have lower deductibles, smaller copays, and coinsurance. Platinum plans typically have the lowest out-of-pocket limits. Platinum plans are popular for those who seek frequent medical attention.
Silver and Gold Plans – offer a middle ground of coverage costs when compared to Bronze and Platinum plans.
A health savings account (HSA) is a tax-favored savings account into which you can fund tax-free contributions for use in paying for medical-related costs. When combined with a qualifying high-deductible health insurance plan, an HSA can provide lower-cost major medical protection, significant premium savings, immediate tax-savings, and a long-term investment vehicle.
HSA plans, which were first introduced a decade ago, have become the most popular plans we offer due to how much money they can save most people. They continue to be available under health care reform—that is, many Metal plans are also HSA plans. For more information, please see our Health Savings Accounts page.
Catastrophic plans under health care reform were previously only available to people under 30 or people with certain hardship exemptions. After millions of so-called “grandfathered” plans were abruptly canceled in 2013, the Obama administration lifted the age restriction on these plans.
These plans have very low premiums but also require you to pay most costs, other than preventive care, out-of-pocket. Their benefits only begin paying at the point where your care has become extremely costly.
However, because government subsidies and other help are available to people whose incomes are below 400 percent of the federal poverty level, some people with financial hardships may find that buying a Bronze plan with a premium tax credit is a more economical option.
If you are without health insurance between ACA open enrollment periods, and you will not qualify for a special enrollment period, you have options. Short-term plans, low-cost supplemental accident plans and critical illness plans are solid options to protect yourself and your family for both routine and unexpected medical care.
Short-Term Medical Coverage
If you have a lapse in health coverage for any reason (employment, graduation, cancelled plan, waiting for ACA open enrollment), a short-term plan can get you covered immediately at affordable rates for up to six months in Colorado. This is a popular option for many during their transition into an ACA plan.
Suffering an accident of any kind can cost you thousands of dollars before your major medical deductible is met. We encourage you to review our affordable accident plans that can cover you while only costing you $100 out-of-pocket if you are treated for an accident. The monthly premium is minimal, but the protection is very high in value.
Critical Illness Coverage
Each year, thousands of Americans are diagnosed with serious illnesses such as cancer, heart disease and stroke. When not prepared, patients suffering these critical illnesses are left to pay for financially-devastating medical costs, as well as loss of income and inability to pay for living expenses. A critical illness plan can pay a lump sum to be used for illness-related expenses, including alternative treatment options, travel for treatment and family expenses.
Visit our Alternative Coverage Options page for many more details about coverage to protect your health and finances.
Many plans, including HSA plans, are associated with a PPO network that offers discounted pricing. Even if you have not met your deductible, the savings from a PPO can be significant. You can view the doctors and hospitals in all the PPO networks. These networks have been affected by Obamacare, so check with your Personal Benefits Consultant at ColoHealth for details.
It’s important to select health insurance coverage from a carrier with a high performance and financial stability rating by one of these industry organizations: (A.M. Best, Standard & Poor’s, Moody's). These organizations independently rate insurance companies based on their financial strength, thus giving you some assurance that your insurance company will be there when the claim needs to be paid.
As an independent broker, ColoHealth promotes companies that are rated ‘A-’ or higher, though we will offer you options for significantly lower rates if you choose to review a company with less than an ‘A’ rating.
"I would definitely recommend you to others because you have made it very easy."
"You were able to give me a recommendation of plans that would best suit me in one quick phone call. Once I read a little further and understood what I needed from the info you have available online, I was able to ask you some final educated questions to make my decision. I was surprised with how quickly you were able to get back to me. I called late in the afternoon on a Tuesday and was able to set up a phone appointment with you the next morning. After you answered my questions, I was able to apply on line that same day. I was surprised to find out that I was approved in just 1 week. It really was very easy.
I would definitely recommend you to others because you have made it very easy.”
"I truly appreciate that you are accessible and return calls promptly."
"I just wanted to thank you for all of your efforts to successfully resolve the administrative problem I was having with Anthem. You had helped me switch from a PPO plan to an HSA plan, when the billing got mixed up. It was no simple matter and you managed to get through all of the red tape. You have been a terrific agent, always able to answer my questions and having thorough knowledge of your products. And I truly appreciate that you are accessible and return calls promptly.
Thank you again for all of your hard work and diligence and, not to mention, your personable demeanor.”
- Alaine Ginocchio
When purchasing a health insurance plan, both on and off the health insurance exchange, it is vital that you work with a licensed, independent agent who will be with you from beginning to end — and through the life of your coverage.
Unfortunately, many insurance agents work on commission and are nowhere to be found once your policy is sold. The government’s navigators cannot provide you with the scope of expertise to show you exactly what your options are. By working with an objective broker who will continue to service the changing needs of your coverage and alert you to better options and ways to save money, you’ll be in a better position to confidently make decisions each year.
Get more information to make better decisions about choosing a health insurance broker. Make sure your Personal Benefits Consultant meets the criteria for your best interests.
"Personalized emails that were applicable to ME and being able to reach someone by phone without having to go through 15 minutes of "press 1 for..." has been amazing!"
"I chose to go through your agency because I was recommended to try it by a good friend! My friend told me that he found it easy to find a good policy and that the process was made clear and easy to understand. When I visited the website, I found it to be so.
The best part about my experience has been the personal attention that I received. Personalized emails that were applicable to ME and being able to reach someone by phone without having to go through 15 minutes of "press 1 for..." has been amazing!
The personal approach has been key. By phone or email, I was dealt with in a friendly and helpful manner. I also found the website and paperwork to be straightforward and easy to understand.
I am getting my masters in Community Counseling through the University of Northern Colorado, and I have recommended this service to some of my classmates in my masters program who are looking for insurance.
Thanks so much for the great service!”
Colorado Springs, CO
Our Special Report, “Colorado Health Insurance Made Easy” is free to you! It’s a great resource you can refer to often to answer almost any question you have about health care in Colorado. Order your copy today!
ColoHealth was founded by Wiley Long fourteen years ago with a focus on the unique needs of the Colorado health insurance consumer – not the insurance companies. Wiley brings more than 25 years of insurance expertise to offer Coloradans only the top-rated health plans and additional benefits, striving to bring more savings strategies than any other independent broker in the state.
ColoHealth doesn’t work for any one insurance carrier. We work to find our clients the right fit for them—at no charge. Choose how you browse plans:
- Get an Instant Quote for all available plans.
- Apply Online for fast and easy coverage.
- Schedule a Free Personal Telephone Consultation.
"You were the most helpful in guiding me through the process of selecting what was right for me."
"You were very responsive when I first called, followed up well, and were patient and helpful despite me taking so long to make my decision. You were the most helpful in guiding me through the process of selecting what was right for me. In today's world of web-based and long-distance business, your personal touch was and continues to be important for me.
I appreciate your willingness to work with the customers, providing information online for the customers to peruse before they buy, providing choices to the customers, and assisting the customers in selecting from them.
Thanks for continuing to follow up, you have been very helpful. I would most definitely recommend you to others.”
As president of ColoHealth, I want to earn your complete confidence in our service. My team is backed by 25 years of insurance know-how with a single objective -- serving you, not the insurance companies.
If you purchase a health insurance plan from ColoHealth and are not totally blown away by the service you receive from us – from the start of your application to 10 days after you receive your policy – we’ll take your cancellation and give you a 100 percent refund with no questions asked.
We are so confident that you’ll be completely happy with the time and money you save with us, that we offer this unequaled guarantee:
If you are unhappy with our service at any time in the future, we will personally assist you in finding coverage through a different insurance agency, at absolutely no cost to you.
If you decide you are not completely satisfied with our service, we’ll make it right – without sales pitches, questions, forms or flaming hoops to jump through – NO EXPLANATIONS REQUIRED!
If our health insurance service is not saving you money and making your life easier, then we don’t deserve your business!
To your health and wealth,