Colorado Option health premiums are 30% lower than non-Option plans. - Insurance News | InsuranceNewsNet

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July 20, 2023 Health/Employee Benefits News
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Colorado Option health premiums are 30% lower than non-Option plans.

By Press Release

DENVER - Today, Governor Polis and the Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA), released preliminary information about the 2024 health insurance plans and premiums that insurance companies filed for the individual market (for people who do not get insurance from an employer) and for the small group market (for small businesses with less than 100 employees). 

Preliminary analysis shows that the bipartisan Reinsurance Program continues to save people money on their health insurance by reducing premiums. Governor Polis signed this innovative cost-cutting initiative into law initiative in 2019, sponsored by Representatives Julie McCluskie and Janice Rich, Senators Kerry Donovan and Bob Rankin. Based on the premiums requested by the insurance companies, without the Program, premiums would be 21% higher this year. That means that the reinsurance program is estimated to save $357.8 million dollars for consumers next year, taking the total estimated savings from the program to $1.5 billion dollars since 2020.

“Saving people money on health care has been our top priority since day one, and we are starting to see these money-saving measures, from the Colorado Option to the Reinsurance program, putting money back into the pockets of hardworking Coloradans. This is an important step in our work to make sure every person can access and afford high-quality health care in Colorado,” said Governor Jared Polis. 

In 2021, Governor Polis signed landmark legislation into law to create the Colorado Option and establish a standardized plan that ensures quality coverage and lower premiums. This legislation was sponsored by Representatives Dylan Roberts and Iman Jodeh, Senator Kerry Donovan. 

This year, the requested increase for Colorado Option plans is 7.7%, which is 30.6% lower than the requested increase of 11.1% for non-Colorado Option plans.  

The coming year will also see a new insurance company, Select Health, enter the Colorado market, while the Peak Health Alliance will return to the individual market, working with Denver Health to offer plans again.

“I am pleased to see our signature programs around health insurance - the Colorado Option and the Reinsurance program - delivering for Coloradans, making health insurance more affordable and accessible,” said Colorado Insurance Commissioner Michael Conway. “The Reinsurance Program continues to keep significant dollars in the pockets of people. And the Colorado Option, with its new hearing process, was able to achieve something that has rarely been done in the U.S. -- bring hospitals and insurance companies together to lower the costs of care. Now the DOI will dig into everything the companies have submitted for 2024 to find even more savings.” 

Colorado Option for 2024

The Colorado Option is a program designed to improve access, affordability and racial health equity. As part of the Colorado Option, the DOI designed a standard plan for health insurance companies to offer, allowing consumers and businesses to easily compare plans. In addition to covering all essential health benefits required by the ACA, Colorado Option plans have free primary care and free mental health health visits. Find more information at the Division’s Colorado Option website. 

For Colorado Option plans for 2024, the DOI implemented a public hearing process for the first time. Public hearings are a new regulatory tool to keep insurance companies, hospitals, and other health care providers accountable for lowering premiums for consumers. The process brought insurance companies and hospitals together to negotiate - those negotiations allowed companies and hospitals to reduce reimbursement rates to the maximum allowed under the statute (either to the Colorado Option’s statutory floor, or 20% lower than what was paid in 2023). 

This represents a significant success for the Colorado Option program. Over the next few months, the DOI will review the impact of these negotiated lower provider reimbursement rates to ensure that the savings are passed on to consumers in the form of lower premiums. When we announce the final, approved plans and premiums in October, the Division will also include an analysis of the Colorado Option plans that were able to achieve the premium rate reduction, to gauge the full impact of the Colorado Option process.

Individual Market Plans for 2024

The coming year will see over 300 individual health plans made available across Colorado - 78 Colorado Option plans and 225 non-Colorado Option plans - from six insurance companies.

  • Anthem (as HMO Colorado)
  • Cigna
  • Denver Health
  • Kaiser
  • Rocky Mountain HMO
  • Select Health

Keep in mind that this analysis is based only on what the insurance companies have requested for 2024, not what has been approved. As the DOI conducts a deep analysis of the filings from the insurance companies, it is very likely that these average premium increases could go down, while the Reinsurance Program savings could go up. 

New and Returning Players in the Individual Market

A new insurance company, Select Health, will enter the Colorado individual market for next year, selling plans in eight of the nine health insurance rating areas of the state (all except rating area 8). Select Health is an established company in the Mountain West region, currently providing plans to members in Utah, Idaho and Nevada.

And next year will also see the return of the Peak Health Alliance, as the Alliance partners with Denver Health to offer individual plans in eight counties in rating area 9 (Archuleta, Dolores, Grand, La Plata, Lake, Montezuma, San Juan, and Summit). The Peak Health Alliance brings together the individual, small group and large group health insurance markets to negotiate directly with hospitals and doctors. 

Small Group Plans for 2024

For 2024, six insurance companies have proposed to offer 371 plans across Colorado, consisting of 30 Colorado Option plans and 341 non-Colorado Option plans.

  • Anthem (as HMO Colorado)
  • Anthem (Rocky Mountain Hospital & Medical Service, Inc.)
  • Kaiser Foundation Health Plan of Colorado
  • Kaiser Permanente Insurance Company
  • United Healthcare Insurance Company
  • United Healthcare of Colorado, Inc.

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