Overview 1. What is the Colorado Health Benefit Exchange? An open, competitive marketplace soon to be called Connect for Health Colorado for individuals.

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Presentation transcript:

Overview 1

What is the Colorado Health Benefit Exchange? An open, competitive marketplace soon to be called Connect for Health Colorado for individuals and small employers to: Compare information regarding cost and quality Shop health plan features containing the same base benefits Determine eligibility for and access new federal financial assistance, based on income Support the health coverage decision-making process Call, text or sit down with trained representative for help Enroll in a health plan 2

Features of the COHBE Marketplace An open, competitive marketplace soon to be called Connect for Health Colorado Serving individuals, families and small employers with 2-50 employees A new way to shop for health insurance The sole access to new federal financial assistance, based on income A separate non-profit, committed to Colorado mission 3

What we will not be Not a replacement for the current market or brokers Not engaged with negotiating rates between carriers and providers Not part of Medicaid Not a new government health care system Not a State agency or regulatory body Does not pull funding from Colorado General Fund 4

Individuals and Families Marketplace is for Coloradans who currently buy insurance on their own, who are uninsured, or don’t have access to affordable coverage through large employer Online shopping, with assistance by phone and in-person Insurers compete for your business Health plans will provide more comprehensive coverage Customers can access new federal financial assistance to lower premiums, co-pays and deductibles Several ways to shop: browse health plans, estimate savings, or apply online for federal financial assistance 5 5

Small Employers Marketplace will provide small group plan options to Colorado employers with 2-50 employees Employers with up to 100 employees can be served in 2016 Employers can set benefit budget Employers can provide greater choice to workers Employees can use benefit allowance to shop for health plans Small business tax credits will be available (up to 50% of premium) for employers with 2-25 employees, earning on average $50,000 or less Other value-added services will be provided, like payment aggregation, management tools and ability to use brokers 6 6

Cost Reductions for Individuals and Families Financial help to reduce the cost of premiums – Individual earning between $15,282 to $45,960/year – Couple earning between $20,628 to $62,040/year – Family of 4 earning $31,322 to $94,200/year Tax credit applied up-front by IRS Tax credit is higher for Coloradans ages Financial help to reduce out of pocket costs (co-pays and deductibles) Individuals earning $15,282 to $28,725/year Family of 4 earning $31,322 to $58,875/year 7

Example Bill is a 40 year old male making $30,000 per year Bill enters the marketplace through the website and applies for assistance paying for his coverage. Bill qualifies for $166 per month in premium reduction (tax credit). Bill shops for and compares health plans with the same base benefits. Bill finds a plan that costs $375 per month. The tax credit brings his total cost to $209 per month. 8 8

Comprehensive Coverage Federal law requires health plans sold to individuals and small businesses inside and outside of COHBE to provide, at a minimum, the following categories of services (essential health benefits): Ambulatory patient services Emergency Services Hospitalization Maternity/newborn care Mental health/substance abuse Prescription drugs Rehab/habilitative services and devices Laboratory services Preventive and wellness care/chronic disease management Pediatric services, including oral and vision care Please visit for more specific details about services providedwww.getcoveredco.org 9

Benefits for You Makes comparing and purchasing health coverage more convenient, competitive and easier Increase your choices Helps you make an informed decision by creating transparency about your options Only place to check eligibility and register for tax credits and other benefits Offers a statewide network of trained professionals to assist consumers 10

Contact Speaker Requests: Soon to be called Connect for Health Colorado Sign up for updates at (bottom of home page). Submit a question at Follow us on Facebook and 11