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Open Enrollment and Colorado Carrier Changes

by Carmen Tawney on 09/27/16

Open Enrollment

Colorado Open enrollment for 2017 is right around the corner! Open enrollment begins November 1, 2017 and will end January 31, 2017. This will be the only time individuals will be allowed to make changes OR purchase a new health plan without experiencing a "Qualifying Event".
Effective Date                   Submission Deadline
January 1, 2017                November 1 through December 15
February 1, 2017              December 16 through January 15
March 1, 2017                  January 16 through January 31
2017 Carrier Changes

Colorado will have a new healthcare provider, Bright Health Insurance, coming to Colorado in 2017. Anthem and Rocky Mountain will be limiting plan offerings, while United Healthcare and Humana will no longer offer individual plans in the Colorado market. If you are currently enrolled with one of these carriers, you may need to choose another health carrier and/or plan during open enrollment. (Read more details below.)

Carrier Change Details for 2017

The Division of Insurance has confirmed four insurance companies either will not offer or will significantly cut back individual plans next year. However, a new carrier will be entering into Colorado and will be selling plans only in the individual market.
There are expected to be 10 carriers providing individual plans, 131 plans offered on the exchange and 144 offered off the exchange. We have provided a list of the most significant carrier changes below:

Bright Health

Bright Health is a new entrant to the Colorado Individual Health Market for 2017. The Division of Insurance states they will be focusing on quality care through a healthcare provider. Echoeing what Rocky mountain is doing through its Monument Health Program. (More information to come.)

Humana and UnitedHealthcare

Humana and UnitedHealthcare will be pulling out of the Colorado individual market altogether.  Golden Rule, which is a UnitedHealthcare subsidiary, will continue to offer individual plans, outside of the exchange only.

Rocky Mountain Health

Rocky Mountain Health Plans has determined it will reduce individual plan offerings for 2017, offering individual plans only in Mesa County, via its Monument Health affiliate.

Anthem Blue Cross Blue Shield

In addition, Anthem has decided it will not offer its PPO (Preferred Provider Organization) individual plans for 2017. Anthem will continue to offer HMO (Health Maintenance Organization) individual plans statewide, and these plans will be available to all consumers affected by the PPO decision.

*Special Note: If you have a small business with at least one employee on payroll, you may wish to look into a small group health plan as group health plan rates are showing very small increases and may even have a decrease for 2017.
Shop a New Carrier and/or Plan

If you would like to compare plans and pricing, please contact Health Shop at 303.425.4466 or send your request via email and one of our brokers can assist with any questions you may have.

Qualifying Events to Apply for Individual Coverage Outside Open Enrollment

by Carmen Tawney on 05/12/14

Rocky Mountain Health Plans makes it easy for individuals to identify qualifying events, timeline and effective dates for individuals to enroll outside of open enrollment period.

Qualifying Event

  • Involuntary loss of creditable coverage for any reason other than fraud, misrepresentation, or failure to pay premium
  • Individuals experiencing a plan renewal
  • Individual gains a dependent or becomes a dependent through;
    • Marriage / Civil Union
    • Birth
    • Adoption or placement in foster care
    • Court Order
    • Entering into a Designated Beneficiary agreement
  • Enrollment or disenrollment is unintentional, inadvertent, or erroneous and is the result of an error. The error must have been made by a Carrier, Producer, or Connect for Health
  • Loss of eligibility for Medicaid or CHP
  • Colorado.
  • Demonstrating to the Colorado Insurance Commissioner that the health plan violated part of its contract
  • Becoming eligible or ineligible for tax credits or cost share reduction-For members enrolled in Connect for Health Colorado
  • Gaining access to other creditable coverage as a result of a permanent change in residence
  • Gain citizenship or immigration status
  • American Indians / Native Americans may enroll in a new plan or change from one QHP to another once a month

Time Line

  • Within 60 days of the event or 30 days in advance with the exception of:
    • Plan Renewal - 30 day Special Enrollment Period prior to the plan renewal date
Effective Date
  • First of the month following receipt of application with the exception of:
    • Birth / Adoption / Foster Care - Effective date will be date of birth, adoption, placement of adoption or placement of foster care
What Documentation is Needed
  • The following documentation is required with your application
    • Adoption - Placement paperwork
    • Court Order - Court ordered paperwork
    • Designated Beneficiary - Designated Beneficiary Form
*More information may be required at request

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