Providing Resources & Education for all your Health Related Questions

The State of Health Coverage in Grand County

by Jen Fanning, Executive Director, Grand County Rural Health Network

High costs of health insurance coverage. Rising insurance premiums. Families making difficult decisions about monthly costs like food and rent because of health coverage costs.

Do these topics sound familiar to you? One thing we all have in common, regardless of our opinion on the Affordable Care Act: health insurance costs are out of reach for many of us in Grand County. The reasons are many, and include how we pay our providers, the gaps in our healthcare system, and much more.

It is important to know CORRECT information about your health insurance options, and how federal policies may impact you now.  Then you can make an informed decision, rather than one based on misinformation or fear, for you and your family.

Five things you need to know:

1) 2018 open enrollment started November 1 and runs through January 12. You have a very limited window to enroll for individual and family health insurance through the marketplace or with insurance companies independently. You must enroll by December 15, 2017 for coverage to begin January 1, 2018.  Applications received December 16 through January 12 will have a February 1 start date.

The health insurance marketplace in Colorado is called Connect for Health Colorado, The marketplace is the only place you can receive tax credits. These credits are there to make health insurance more affordable for most people.

Start the process early

It may take a few weeks to finalize everything. This year, the database seems to be working very well compared to glitches in years’ past, but it is best to be prepared.

2) You still have to be covered by health insurance or pay the penalty. Any federal policies passed now will NOT impact the requirement in 2018 to still have health insurance.  Health insurance companies have to submit 2018 plan coverage and costs to the state Department of Regulatory Agencies early in 2017.  The Regulatory Agencies must approve those plans by early fall, so that insurance companies can create and finalize contracts in time with hospitals and providers.

So if you do not have health insurance coverage in 2018, you will still be penalized on your tax return, unless you file an exemption. If you do not have health insurance coverage in 2018, you will be fined $695 per person or 2.5% of your household income, whichever is greater.

Know your options

3) You may have heard that while health insurance premiums have gone up, tax credits have also gone up, so most families will actually pay less than last year. Yes – premiums have increased in our region an average of more than 33%. BUT, in our experience so far during open enrollment, the tax credits have not increased dramatically. So our community is still seeing higher costs of insurance coverage, regardless of tax credits.

This is largely due to the fact that we have only one insurance carrier available to Grand County on the marketplace: Anthem. Tax credits are based off the second lowest priced Silver plan. Because we only have one carrier, we only have a few Silver plans available.  The price differences between those silver plans are not that great, and so our tax credits have not changed by much.

Most people choose to have at least the same tax credit amount as last year. But to do that, they often have to drop their plan coverage to a Bronze plan.  This usually means a much higher deductible and out-of-pocket expenses.

4) Colorado’s Child Health Plan Plus (CHP+) insurance program needs Congress to renew federal funding. This program covers children just above the Medicaid eligibility level, making their health insurance affordable for these families. If Congress does not renew funding for CHP+ before December 1, 2017, the State of Colorado can only fund CHP+ through January 31, 2018. Any children covered on CHP+ will need new coverage beginning February 1

Do your research

5) Make sure you know what you are getting before purchasing.  To avoid a tax penalty, you must purchase a qualified plan that covers the 10 Essential Benefits. Plans with much lower monthly payments are available, but these often come with higher out-of-pocket expenses. These plans could still be the right choice for you and your family. Just make sure you understand what these plans cover, and double check your monthly and total costs.

Need more help?

Sounds complicated? Yes! It is SO complicated. Luckily, Grand County has several health insurance brokers to help people understand this information and make informed decisions. We have five brokers that are certified in the marketplace, and several others who work directly with insurance companies.

Grand County also has FREE in-person help with your enrollment. Avoid the rush and schedule an appointment with Kim Long, Certified Health Coverage Guide today. Kim can help you understand your health insurance options and what that means for your individual situation.  He can meet you at any of the Grand County Library District libraries, and can help you apply for financial assistance and enroll in a plan.

To make a free appointment, call Kim at 970-531-4769.