Colorado: Final avg. unsubsidized 2023 #ACA rate changes: +10.4%; Colorado Option plans going live
The Reinsurance Program, Colorado Option and federal assistance will save people money on health care.
DENVER - The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies, has released the approved health insurance plans and premium information for 2023 for individual plans (for people who don’t get their insurance from an employer) and small group plans (for small employers with 2- 100 employees).
Because of the innovative programs the Polis-Primavera administration – in partnership with the legislature – has championed over the last three years, Coloradans can save $326 million statewide on individual health insurance plans for 2023. The Reinsurance Program, the Colorado Option and the DOI’s rate review process are driving substantial savings for the 2023 plan year.
The Reinsurance Program will save Coloradans $294 million on their 2023 individual plan premiums. As the Reinsurance Program enters its fourth year, it continues to save Coloradans money on health care throughout the State.
When Coloradans shop for health plans during open enrollment, which begins on November 1, they will have the opportunity to purchase a Colorado Option plan for the first time. That will create the opportunity for Coloradans to collectively save $14.7 million by shopping and choosing the lowest cost Colorado Option plan in their preferred metal tier (bronze, silver or gold). Coloradans in every county will be able to shop for Colorado Option plans that are better quality and better value.
On top of those savings, the work of the Division saved Coloradans $17.6 million for people buying individual plans for the coming year, through its rate review process (in addition to $23.5 million saved for businesses buying small group plans).
“Saving Coloradans money on health care has been a priority of the Polis-Primavera administration and I’m excited that we can make more savings a reality for our neighbors as we work to provide affordable, accessible, and equitable health care to all Coloradans,” said Lieutenant Governor Dianne Primavera and Director of the Office of Saving People Money on Healthcare. “The Colorado Option, which is being offered for the first time, allows participants to better understand what they are paying for and prioritizes mental and physical well being intended to better support total wellness.”
“I am incredibly thankful to our legislative champions, as well as Governor Polis and Lieutenant Governor Primavera, for our Reinsurance Program and the Colorado Option. It is because of legislators like Rep. Roberts, Rep. McCluskie, Rep. Jodeh, Rep. Rich, Senator Rankin and Senator Donovan, that we have these great tools to make health insurance more affordable for Coloradans,” said Colorado Insurance Commissioner Michael Conway. “But I also want to emphasize how much people can save by using the assistance continued under the federal Inflation Reduction Act. Continuing this help means more than 80% of Coloradans that shop for coverage on Connect for Health Colorado will be eligible for subsidies next year. I encourage everyone to visit Connect for Health Colorado to determine what financial help they could receive, and shop for the plans that fit their needs.”
The Importance of Shopping
Earlier this year, the increased assistance for health insurance originally put into place under the federal American Rescue Plan Act (ARPA) in 2021 was extended as part of the Inflation Reduction Act (IRA). For 2023, like 2022, more people across Colorado are eligible for more assistance.
By taking time to shop for plans and use the financial assistance available, many people will be able to get coverage for 2023 with premiums less than they are paying currently.
For example, people in Summit County (in the West area, or area 9, of the state) who are eligible for assistance, could see their premiums decrease up to 38%, by automatically renewing their current plan. However, they could see a decrease of up to 53% by taking the time to shop and look at lower cost plans.
Similarly, people in El Paso County (in the Colorado Springs area, or area 2) who are eligible for assistance would be looking at an average 17% decrease in premiums when they auto renew their 2022 plan. Yet they could realize even greater savings, up to a 33% decrease, when they consider the lower cost plans available in their area. In the Denver area (area 3 of the state), shopping can lead to up to a 12% decrease in premiums.
On top of these opportunities for savings, new for 2023, the Colorado Option plans will also be available. These plans cover all essential health benefits required by the Affordable Care Act (ACA), provide free ($0) primary care and mental health visits, and have the same benefits across all companies, allowing for easier shopping and comparisons.
Remember, financial assistance is only available when enrolling through Connect for Health Colorado, and with so many people eligible, Connect offers a Quick Cost & Plan Finder that can check eligibility for financial help while finding plans that fit consumers’ needs. In addition, Connect for Health has other tools to help with decision-making: their “We Can Help” site, a robust network of certified insurance brokers, and in-person enrollment assisters. People can also call 855-752-6749 to ask questions and get started.
Open enrollment for individual plans will start November 1 and run until January 15, 2023. It is an opportunity to find the plan that best fits a person’s health needs and budget.
For 2023, the State’s Reinsurance Program will keep saving Coloradans money on health care. On individual plans, across the state, consumers will save an average of 32.1% over what health insurance premiums would have been without the program. That translates to nearly $300 million ($294,000,000) in anticipated savings for Coloradans in the coming year.
The Colorado Option consists of health plans with standard benefits from all current individual and small group health insurance companies. These standard benefits are the same across all companies, allowing consumers and businesses to easily compare and choose plans that fit their needs. In addition to covering all essential health benefits required by the Affordable Care Act (ACA), the Colorado Option plans offer free primary care and free mental health health visits, and have been designed to improve access, affordability, and racial health equity.
For individual plans for 2023, almost all counties will have access to a Colorado Option plan at or below the average premium for that county in each metal level. Consumers could save $14.7 million in total if they enrolled in the lowest cost Colorado Option plan available to them in their county at their current metal level.
- Bronze Plans - 63 out 64 counties have access to a Colorado Option bronze plan at or below the average bronze premium in that county
- Silver Plans - ALL counties have access to a Colorado Option silver plan at or below the average silver premium in that county.
- Gold Plans - 63 out of 64 counties have access to a Colorado Option gold plan at or below the average gold premium in that county.
Individual Health Insurance Plans
The overall average consumer impact on premiums in the individual market will be a 10.4% increase over 2022 premiums. Know that this is an average for the entire state, across all companies, all plans, all areas and all ages. A person’s premium will depend on the plan they choose, their age and where they live.
Again, it is critical to note how consumers can reverse this increase by shopping and considering the other plans available in their area. Across Colorado, assistance-eligible people can see up to a 21% decrease in premiums by looking for cheaper options rather than automatically renewing their current plan. Even people who are not eligible for financial help could realize a decrease of up to 5% by shopping.
There will be 337 individual plans available across the state, including 72 Colorado Option plans, in the bronze, silver and gold metal levels. While those 337 plans are almost evenly divided between 166 on-exchange plans (meaning that they are available through Connect for Health Colorado, our state’s health exchange) and 171 off-exchange plans (meaning they are sold directly through the insurance company), it is critical to note that the assistance to make insurance more affordable is only available when enrolling through Connect for Health Colorado.
The six companies offering individual plans in 2023 will be Anthem (as HMO Colorado), Cigna, Denver Health, Friday Health, Kaiser Foundation Health Plan of Colorado and Rocky Mountain HMO. All counties but one - Jackson - have multiple companies offering on-exchange plans.
Small Group Health Insurance Plans
For 2023, the impact to small group plans (for small employers with less than 100 employees) will be a statewide average increase of 7.4%, across all companies and plans.
There will be 11 companies selling 497 plans, including 48 Colorado Option plans, for small employers in the coming year.
Where to Start
While premiums are critical when shopping for health insurance, it is important to consider other factors such as deductibles, co-payments, coinsurance costs, doctor preferences, health conditions and prescription coverage. All of these should play into a person’s decision.
Becoming familiar with one’s current health insurance is a good place to start the process. Consumers who have questions about their current plans should contact their insurance company, Connect for Health Colorado, their insurance broker, their employer or the Division of Insurance (303-894-7490 / DORA_Insurance@state.co.us).
I actually calculate lower weighted average rate increases for both the individual & small group markets, but the elimination of Bright (and Oscar, in the individual market) and other factors could account for the discrepancy: