By Serene Karplus
Connect for Health Colorado Marketplace
Connect for Health Colorado is the new health insurance marketplace that opened on October 1, 2013. The marketplace is a new way for Coloradans to get health insurance. It is for residents who currently buy insurance on their own, who are uninsured, or don’t have access to affordable coverage through their employer. This program is not for individuals who are eligible for Medicaid or Medicare or have affordable coverage through an employer. Eligible individuals must be a citizen or lawfully present, not incarcerated and be a Colorado resident.
Through Connect for Health Colorado, individuals and families will be able to purchase private health insurance through Access Health Colorado, Anthem Blue Cross and Blue Shield / HMO Colorado, Colorado HealthOP, Kaiser Permanente, and Rocky Mountain Health Plans. With one application, consumers can compare plans based on price, benefits, and quality. Health insurance prices depend on where we live, our age, how many people are covered by our plan, and whether we use tobacco products.
Some Coloradans will be eligible for zero premium health plans. With the expansion of Medicaid and Child Health Plan Plus more can access free or low cost coverage. Middle-income earners can access plans with lower deductibles, co-payments or co-insurance. Individuals earning approximately $15k – $33k per year, couples earning approximately $21k – $38k, and a family of four earning approximately $34k – $71k may be eligible.
Every plan has a network of doctors, hospitals, laboratories, imaging centers, and pharmacies that provide services at a contracted price, so it is wise to ensure that preferences are met before signing up for a plan. Costs vary, with a higher deductible keeping premiums low for those who rarely use their insurance or a higher premium being helpful for those with more costly conditions requiring frequent treatment.
Plans will all provide comprehensive coverage, including emergency services, hospitalization, outpatient services, laboratory tests, maternity/newborn care, management of chronic diseases such as diabetes, prescriptions, mental health and substance-abuse treatments, pediatric services including dental and vision care, rehabilitation services, and preventive services such as immunizations, mammograms, and colonoscopies.
The Federal Health Premium Tax Credit (also known as an Advanced Premium Tax Credit, or APTC) is a new kind of tax credit that lowers monthly health insurance premiums. It is “up-front financial help.” The new tax credit will only be available for insurance purchased through the Connect for Health Colorado marketplace and for income levels between 133% and 400% of the Federal Poverty Level (FPL). Individuals earning between $15,856 and $45,960 per year, couples earning between $21,404 and $62,040 per year, and families of four earning between $32,499 and $94,200 per year may be eligible. The amount of assistance will be determined on a sliding scale, so the amount of the tax credit lessens as income increases. Individuals or families earning more than 400% FPL can still purchase health insurance through Connect for Health Colorado, but will pay the full cost of coverage.
The tax credit can be applied upfront by the IRS. Tax credits are higher for older Coloradans, especially for those ages 55-64. It is also available for small employers, again only for those purchasing through the Connect for Health Colorado marketplace. For those with fewer than 25 employees who pay average annual wages under $50k, providing health insurance may qualify the business for a small business tax credit of up to 50 percent (35 percent for nonprofits) to offset the cost of premiums for employees. See the Small Employer Tax Credit Calculator on the website shown below.
Fines for failure to carry health insurance may seem affordable in 2014, the first year, at only $95 per adult or $285 per family the first year, but it escalates to $695 per adult and $2,085 per family already in 2016. Sign up by December 15 for coverage effective January 1, 2014.
- Connect for Health Colorado: www.ConnectforHealthCO.com
- Connect for Health Colorado: 1-855-752-6749 (1-855-PLANS-4-YOU)
- Boulder County Health Coverage Guide: 303-441-1000
- Boulder County Housing and Human Services: 303-441-1000
- Boulder County Healthy Kids: 303-441-1589
Join Nederland Area Seniors on Monday, October 7, for a Nutrition Talk during lunch by Boulder County Area Agency on Aging Nutritionist Candace Johnson. All who serve or handle food for us (volunteers included) are urged to stay for one hour after lunch for our Food Handling Safety Training program. Call by Friday 4pm (303-258-0799) to reserve a lunch at Noon or join us for the program only at 12:40pm.
On Wednesday, October 9, Colonel Crystal Epperson regales us with tales of her thirty year career as a nurse in the military. Call by Monday to reserve your place at lunch to hear her humorous and harrowing accounts.
Everyone is invited to the Nederland Area Seniors luncheon at the Nederland Community Center at noon. A donation of $4 is requested from those over 60 years of age and $8.25 all others, but no seniors are turned away due to inability to pay. Please make reservations by 4pm Friday for Monday lunch and 4pm Monday for Wednesday lunch at 303-258-0799.
Monday, October 7: Herbed Pork Loin w/Gravy, Oven Potatoes/Roll, Tossed Salad, Oranges
Wednesday, October 9: Oven Fried Fish, Green Beans, Brown Rice/Roll, Applesauce