Blog

Earlier this year Congress passed a bill ending the Medicaid “Continuous Coverage Requirement” provision that was part of the Public Health Emergency put in place January 2020. As a result, beginning May 2023, Health First Colorado, our state Medicaid program, will resume the normal eligibility renewal processes. Renewals / redeterminations of everyone currently enrolled in Health First Colorado will be completed over the next 12 months. If you are currently a Health First Colorado member there a recommended actions for you to take, as this may impact your health insurance coverage. Per the Department of Healthcare Policy and Financing, Members should

• • Update their contact information so we can reach them.
  • Respond to and sign renewal paperwork to make sure they keep their Health First Colorado and CHP+ coverage if they are still eligible.

• Members can find out their renewal dates and access more information at hfcgo.com/renewals

For more information, and details of the steps you should take, please visit, https://hcpf.colorado.gov/covid-19-phe-planning

Should you receive a notice that you, or your family will be losing your Health First Colorado coverage, we can help! We are licensed, independent health insurance agents, Certified with Connect for Health Colorado. Our agency, Integra Insurance Group, is also a Connect for Health Colorado Enrollment Center. This means that we can help you navigate, and understand your health insurance options, determine if you qualify for financial assistance to help lower your health insurance premiums, and find the best plan to meet your needs, lifestyle and budget.

As independent agents we are appointed with every major health insurance carrier in the state. We understand each carrier’s network of doctors and hospitals, and we can help you enroll in a plan that allows you continued access to doctors who are important to you, so that the care you receive is not negatively impacted. Best of all, we are no cost to you, and the premiums you pay are not impacted by our assistance. In fact, you could actually pay less for your health insurance if you use a licensed agent with the Integra Insurance Group, as our expert guidance can help you understand and determine any financial assistance you might be eligible for! Additionally, you will have a direct contact for your health insurance questions and needs beyond enrollment in your plan.

Contact us today to speak with one of our licensed, expert health insurance advisors! We look forward to assisting you!

The American Rescue Plan Act (ARPA) was signed into law on March 11, 2021, and it includes significant expansions of the Affordable Care Act (ACA) that will dramatically improve marketplace access and affordability over the next two years by:

• Extending ACA subsidies to higher-income individuals / families who do not currently qualify;
• Increasing ACA subsidies for lower-income individuals / families who already qualify;
• Providing maximal ACA subsidies for individuals / families that receive unemployment benefits in 2021; and
• Preventing taxpayers who misestimated their income in 2020 from having to repay excess premium tax credits at tax time (unless the income earned exceeded the 400% of the Federal Poverty Level threshold).

These changes are currently temporary, and will apply to 2021, and 2022 coverage years.

One of the most significant changes is the elimination of the “subsidy cliff” of 400% of the Federal Poverty Level (FPL). Previously, if your household Modified Adjusted Gross Income is greater than 400% of the FPL, you were ineligible for subsidy to lower the cost of your health insurance premiums. Now, subsidy eligibility will be determined based off of the premium of the second lowest cost Silver level plan available to you. If that benchmark plan is greater than 8.5% of your household Modified Adjusted Gross Income, then you will now be eligible for a subsidy to lower your monthly premiums. This will significantly increase the number of individuals / families who are eligible for a subsidy, specifically for those who are older (50+), families, and those who live in our mountain and rural communities where premiums are significantly higher than in our metro area communities.

For example, previously, a 55 year old individual (non-smoker) earning $53,000 / year, in Adams County, has not been eligible for a subsidy. However, now, that same individual will be eligible for an estimated subsidy of $207 / month. Connect for Health Colorado has partially updated the Quick Cost and Plan Finder Tool (QCPF) to support the changes in the American Rescue Plan (ARP), if you would like to know how this might impact you specifically.

Another significant provision of the act will provide maximum subsidy to those who receive unemployment benefits for at least one week in 2021. Meaning, your subsidy will be calculated as if your income is 138% of the Federal Poverty Level, the lowest income amount to be subsidy eligible in the state of Colorado, which will give you maximum subsidy toward your health insurance premium.

A final significant provision of ARPA has to do with COBRA. For anyone who has involuntarily lost health insurance coverage due to a termination of employment, or reduction in hours, COBRA will be fully subsidized for 6 months (beginning April 1, 2021 – September 30, 2021). This does not apply to individuals who have voluntarily left, or will voluntarily leave employment. There is a lot to this one, so if you believe it may affect you, please give us a call, or read more from the following link – https://www.healthaffairs.org/do/10.1377/hblog20210311.725837/full/.

So what does this mean for you, and when can you take advantage of these changes?

If you are currently enrolled in Affordable Care Act qualified health insurance coverage, off or on the marketplace (Connect for Health Colorado), a new Open Enrollment Period will open on May 15^th, 2021, and is currently set to extend through August 15^th, 2021. Yes, this is being described as a new Open Enrollment Period, different from the current Special Enrollment Period, which means you will have the option to shop, and change your current health insurance plan without a separate Qualified Life Event.

If you are currently enrolled in your health insurance plan through Connect for Health Colorado, and you are receiving a subsidy, you can expect your subsidy to increase, however that increase will not be automatic. You will have three options:

• Keep everything as-is. You can keep your current health insurance plan, and continue to pay what you are paying for that plan, and when you file your 2021 taxes you will be refunded in one-lump-sum all additional tax credit / subsidy you were eligible for.
• Update your subsidy amount, and remain on your current plan. After May 15^th, 2021, log into your Connect for Health Colorado account, click the Make Changes button, scroll through and review your eligibility application (make changes if necessary), and resubmit that application. This action will then update your APTC for the remainder of 2021. DO NOT TAKE THIS ACTION UNTIL MAY 15^th, 2021. Chances are the update APTC, and your updated monthly premium will not accurately reflect on your health insurance bill until the July cycle. If you pay your current premium for the month of June, any excess will be credited to your July bill.
• Update your subsidy amount, and shop for, and enroll in a different health insurance plan. After May 15^th, 2021, log into your Connect for Health Colorado account, click the Make Changes button, scroll through and review your eligibility application (make changes if necessary), and resubmit that application. This action will then update your APTC for the remainder of 2021, and you will be allowed to shop for, and enroll in a different health insurance plan, effective 06/01/2021. If you change your plan, but remain with your current health insurance carrier we are currently being told that any deductible and annual max out of pocket accumulation will be carried over to your new plan. However, if you switch to a different health insurance carrier then your deductible and max out of pocket will start over with your new coverage / effective date, and you will lose any accumulation toward your previous deductible and annual max out of pocket. AGAIN, DO NOT TAKE THIS ACTION UNTIL MAY 15^th, 2021.

If you are currently enrolled in a health insurance plan direct with a health insurance carrier (not through Connect for Health Colorado), we recommend you check if you might now be eligible for a subsidy. Connect for Health Colorado has partially updated the Quick Cost and Plan Finder Tool (QCPF) to support the changes in the American Rescue Plan (ARP). Connect for Health Colorado has removed the 400% federal poverty level (FPL) cap, which was the previous cutoff amount to receive APTC. Simply enter some basic information for you, and/or your household, including estimated 2021 income, and click the Get Your Estimated Savings button. This will let you know if you will now be eligible for subsidy.

• If you determine that you will now be eligible for a subsidy please schedule an appointment with me (after May 15^th) to discuss this in more detail. To receive the subsidy you will need to create an account on Connect for Health Colorado, and complete and submit an eligibility application. You will then be allowed to shop for, and enroll in a subsidized health insurance plan for the remainder of 2021. If you change your plan, but remain with your current health insurance carrier we are currently being told that any deductible and annual max out of pocket accumulation will be carried over to your new plan. However, if you switch to a different health insurance carrier then your deductible and max out of pocket will start over with your new coverage / effective date, and you will lose any accumulation toward your previous deductible and annual max out of pocket.
• If you determine that you are still not eligible for a subsidy then you have two options:
  • Remain on your current health insurance plan, direct with your current carrier, and continue to pay your current monthly premium.
  • After May 15^th, 2021, and through August 15^th, 2021 you will be able to shop, and change your health insurance plan if you would like. Again, if you change your plan, but remain with your current health insurance carrier we are currently being told that any deductible and annual max out of pocket accumulation will be carried over to your new plan. However, if you switch to a different health insurance carrier then your deductible and max out of pocket will start over with your new coverage / effective date, and you will lose any accumulation toward your previous deductible and annual max out of pocket.

If you receive unemployment benefits for at least 1 week in 2021 then it is highly recommended you resubmit your eligibility application in Connect for Health Colorado after May 15^th, 2021, as you will receive maximum subsidy for the remainder of 2021.

If you currently do not have health insurance coverage, or are a member of a Health Share program, or non-ACA qualified health insurance plan, you will be able to shop and enroll in an Affordable Care Act qualified plan after May 15^th, 2021. Again, this is a new, one-time, Open Enrollment Period that is currently set to last through August 15^th, 2021. Please use Connect for Health Colorado’s Quick Cost and Plan Finder Tool to find out if you will now be eligible for a subsidy – Quick Cost and Plan Finder Tool.

I understand this is a lot of information. This is all still fairly new, and there are some things we are still learning, and awaiting guidance / clarification with regard to. If you are enrolled in a plan through Connect for Health Colorado you will receive notifications and information from Connect for Health Colorado in the coming weeks, so please pay attention to those. If you are enrolled direct with a carrier you should also be receiving notifications and information about your options.

Of course, if you have questions, or would like to schedule an appointment with your licensed health insurance agent at the Integra Insurance Group, please reach out to us – 303.466.5500.

Colorado is joining the federal mandate to open back up the health insurance marketplaces to individuals and families who do not currently have Affordable Care Act qualified health insurance coverage. This Special Enrollment Period (SEP) will begin on Monday, February 8th, and will end on Saturday, May 15th. The purpose of this SEP is for individuals and families who are currently uninsured to enroll in coverage, and is not for those who are currently insured to change their plan, or carrier. Coverage will begin the first of the month following submission of an application / enrollment, with the soonest effective date being March 1st, and latest being June 1st. For more information about the SEP, below is the press release from the Colorado Division of Insurance.

https://doi.colorado.gov/news-releases-consumer-advisories/colorado-to-re-open-enrollment-for-individual-health-insurance

Of course, if you experience a Qualified Life Event at any point during the year (https://connectforhealthco.com/get-started/when-can-i-buy-insurance/), you will be granted your own Special Enrollment Period (60 day window) to enroll in new coverage.

All of Your Healthcare Questions Answered When you Need it Most

There is a new start-up, Orderly, right out of Denver, CO, and it looks to be a game-changer in the individual and business healthcare world. Their mission? To change how you understand and utilize your healthcare by providing immediate answers to your most important questions. That’s right, with Orderly, answers to many of your important healthcare questions are always just a text message away. They use multiple data sources to provide you with answers to questions regarding shoppable medical services, medication pricing and discounts, even answers to questions about your current health insurance plan’s benefits and coverage! Think of Orderly as your personal healthcare concierge.

Ever wonder how much a service or procedure should cost? With Orderly you can get that information before you even make an appointment with your provider. What are fair costs for your prescriptions? Orderly can tell you, and even locate coupons to help lower those costs. Orderly will help you compare and find the lowest price options for your care, even prescriptions, so that you can make more informed, smarter healthcare decisions. Again, all of this information is available via text message, just like you are texting a friend.

In other good news, Orderly is HIPAA compliant so your personal health information is safe and secure.

To learn more about Orderly, and how you can take advantage of this service visit their site – https://www.orderlyhealth.com/, and click the Try Demo button.

The Integra Insurance Group is not partnered, or affiliated with Orderly in any way. Orderly was highly recommended by a friend who has benefited by using Orderly’s service. This technology simply looks and sounds like something that could be extremely beneficial to our clients. We welcome your feedback and comments if you use Orderly.

It is that time of year again… Spring, yes of course, but that also means that it is 9Health Fair season! Here, in the great state of Colorado, we are blessed to have the largest volunteer-driven, non-profit health and education program in the nation. The 9Health Fair gives you the tools you need to take responsibility for your own heath. They are committed to providing life-saving early detection and prevention to help you and your family stay healthy.

At a 9Health Fair (sponsored by 9News) you can receive free and low-cost healthcare services/screenings at over 130 locations across Colorado. Many of these services are provided by medical professionals who volunteer their time year after year.

I make it a priority every year to take advantage of the low-cost comprehensive blood screening, skin screening, blood pressure, oral health, and vision and eye screenings. This year, for the first time, some sites will be offering testosterone screening for both men and women. I am surprised by how many clients I speak with every year who are unaware of this wonderful and affordable opportunity to invest in their personal healthcare and well-being. Even more importantly, lives are literally saved by these screenings every year!

Why attend a 9Health Fair? When you attend a 9Health Fair, you’re taking responsibility for your health. You’ll have access to an array of free and low-cost comprehensive health screenings and interactive educational centers to empower you to make healthy decisions for your life and future. Here are the top 9 reasons to find and attend a Fair near you! – http://www.9healthfair.org/my-health-101/health-topic-of-the-month/.

What can you expect at a 9Health Fair? We want to make sure your visit to 9Health Fair is pleasant, useful and efficient. That’s why we engage medical professionals as volunteers and use the same lab – Quest Diagnostics – as most medical offices. You have the option to choose what which health screenings you want – with no fasting required – and your results will be available in as little as two weeks!

To find a 9 News Health Fair near you please visit, https://www.9healthfair.org/health-fairs/find-a-fair.

For a complete of screenings offered at many of this year’s locations please visit, https://www.9healthfair.org/attend/available-screenings/.

The Integra Insurance Group is not partnered or affiliated with 9News, or 9Health Fairs in any way. We personally take advantage of the healthcare services offered at these fairs, and simply believe this to be something that can be extremely beneficial to our clients.

By now most of us know about the penalty for not having Affordable Care Act qualified health insurance for a portion, or all of the year. But what exactly is that penalty, and what will it be in 2017?

In 2016 that maximum penalty is 2.5% of household income  per individual (max of the national average annual cost of a Bronze level plan), OR $695 per adult and $347.50 per child (max of $2,085 per family), whichever is greater. The penalty is calculated against the amount of income, either individual or household, that is above and beyond the tax filing threshold. The tax filing threshold for an individual is approximately $10k, and the tax filing threshold for a family is approximately $20k. So, the max penalty for an individual whose Modified Adjusted Gross Income (MAGI) is $50k will be 2.5% of $40k, that individual’s amount of income above and beyond the individual tax filing threshold of $10k. A family whose household income is $5ok will face a max penalty of 2.5% of $30k (per individual in the family), that family’s amount of income above and beyond the family tax filing threshold of $20k.

In 2017, and going forward, the Percentage of Income penalty remains the same, 2.5%. However, the per person penalty of $695 per adult and $347.50 per child will increase every year with inflation. In 2017 that increase will only be 1.1%.

Open Enrollment for 2017 Affordable Care Act qualified health insurance coverage is right around the corner! Below are some important dates to help you plan accordingly, and be more prepared:

NOVEMBER 1, 2016 – First date to apply for a plan beginning January 1, 2017

DECEMBER 15, 2016 – Deadline to apply for a plan beginning January 1, 2017

JANUARY 15, 2017 – Deadline to apply for a plan beginning February 1, 2017

JANUARY 31, 2017 – Last day to apply for 2017 health insurance coverage without a Life Change Event

Does it still make sense to have a broker help you choose a health or life insurance policy? Absolutely! The Internet may have made shopping for insurance easier, however I think we can agree that the Affordable Care Act has made the process considerably more complicated. Brokers are insurance experts. It is our job to help you shop plans from leading carriers so you can be confident you’ve found the best rates and benefits for you. Also, a broker who is Certified with Connect for Health Colorado understands the processes and nuances of which path you should take before you enroll in a plan. Do you qualify for a subsidy (tax credit) that will help lower the cost of your monthly health insurance premiums? What steps are necessary to receive that credit? A broker can assist you not only with answering those questions correctly, but also with the process from start to finish. And most importantly, it does not cost you a penny more!

4 Reasons to Work with a Licensed Insurance Broker

1. Brokers guide you through the process – Let’s face it, buying an insurance policy can be extremely complicated. A licensed broker will walk you through each step of the process and help you make sense of it all.

2. Brokers offer you choice – Your broker has a portfolio of plans to choose from, from every carrier in the state. The hundreds of choices available can be very confusing, and it is our job to know which policies may best fit your needs, lifestyle and budget. It is also our job to understand the landscape of this constantly changing market, so that you can make informed decisions that give you peace of mind.

3. Brokers troubleshoot mistakes – A mistake on your application, especially if you are looking to receive tax credits to subsidize your monthly premium costs, could lead to months of headache and frustration. Every broker in our office completes a Certification process with Connect for Health Colorado so that we can help you through that application process. Some households are still very complex, so we have built a partnership with Eligibility Specialists who assist us to help ensure a correct eligibility determination. Also, being Certified with Connect for Health Colorado means that we can take any enrollment issues directly to a broker support team. This saves you time, headache, and more often than not is a path to quicker resolution.

4. It is FREE – This is the best part about getting insurance through a broker. Brokers receive payment from the insurance companies they represent. And because we represent every carrier in the state, the advice you receive from us will be totally unbiased.