New Health Insurance Marketplace Launch

October 1, 2013 marks the beginning of a new annual open enrollment period for people purchasing individual or family coverage for 2014.  In other words, people who do not have insurance will be able to enroll in an insurance plan, without the requirement of a “qualifying event”.

 

It also is the date Connect for Health Colorado (“C4HCO”), Colorado’s new health insurance Marketplace, is expected to launch. These events may be considered the start of our “count down” to January 1, 2014, the key date for the health care reform law.

 

January 1, 2014 will bring about a monumental shift if health care in the United States, including:

• No one applying for health insurance can be denied coverage because of a pre- existing medical condition.
• No one applying for health insurance can be charged a higher premium due to a health condition.
• U.S. citizens and legal residents will be required to have basic health coverage (“minimum essential coverage”) or pay a penalty. This is often referred to as the “individual mandate.”
• Connect for Health Colorado will provide Coloradans an additional way to purchase coverage.  Individuals, families and small employer groups can compare plans from private insurance companies and enroll via the C4HCO website or with personalized assistance.
• Financial assistance, in the form of premium tax credits that lower the consumer’s out-of-pocket cost for a policy will be available to many qualified individuals and families when they purchase coverage through C4HCO.
• All new plans must cover a minimum set of benefits called essential health benefits. This means all plans will cover the same basic services, including coverage for hospitalization, office visits, preventive services, prescription drugs and more.
• All plans in C4HCO will be labeled Bronze, Silver, Gold, or Platinum to help consumers compare plans. These labels represent different levels of member cost-sharing, including deductibles and coinsurance.  Individuals under 30 and others who meet certain criteria will also have the opportunity to purchase a “Catastrophic” plan, which offers essential health benefits with higher deductible and lower premium.

 

When you purchase in the Marketplace, you will be able to:

• Compare plans from multiple insurance companies (Colorado has more insurance carriers participating than any other state).
• Compare the price of each plan. RMHP will offer 52 new plans on C4HCO, more than any other carrier in Colorado.
• Calculate whether you are eligible for an Advanced Premium Tax Credit, to lower the cost of your insurance.
• Make sure that your doctor is in the network of the plan you are considering purchasing.
• Compare the Quality Rating of all carriers.  (Rocky is one of the only insurance carriers with a 5 star quality rating.)

 

This innovation will likely not be seamless.  There will be glitches, and some things will simply be out of our control. Launching the new Marketplace and enrolling thousands of previously uninsured Coloradans is a monumental task.  It will take patience, time, and teamwork.

 

Rocky Mountain Health Plans will help our members and providers navigate these new waters.  I expect this process to take several months to “shake out” and several years to re-adjust, as we learn from the market.  We are here for the long haul, and here to help our fellow Coloradans through a confusing time, and our perspective should reflect that.

 

Let’s also remember that providing access to care is just the first step towards the larger goals.  We still have much to do in the years ahead to improve quality of care and continue to address the rising costs of care.

 

Over the next several weeks, as Connect for Health Colorado moves to open enrollment, Steve ErkenBrack, CEO of RMHP and the only insurance carrier on the Board of Directors of Connect for Health Colorado will address four other topics on the Exchange:  How does it work?  Where did it come from?  Common misperceptions.   What is the future?