Colorado Health Insurance Consumer Guide

In order to sign up for private health coverage through Connect for Health Colorado, you must:⁵

• Be a resident of Colorado
• Not be incarcerated
• Not be enrolled in Medicare
• Be lawfully present in the United States. (Colorado has created a separate platform that undocumented residents can use to enroll in state-subsidized health coverage.)⁶

So most Colorado residents are eligible to enroll in coverage through the exchange. But a bigger question for most people is financial assistance, and a few additional parameters must be met in order to qualify for subsidies through Connect for Health Colorado. 

To qualify for income-based Advance Premium Tax Credits (APTC), federal cost-sharing reductions (CSR), or Colorado’s state-funded cost-sharing subsidies,⁷  you must:

• Not have access to affordable employer-sponsored health coverage. If you have access to an employer’s plan and aren’t sure whether it’s considered affordable, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies via Connect for Health Colorado. 
• Not be eligible for Health First Colorado (Colorado Medicaid) or Child Health Plan Plus (CHP+).⁸

Beyond those basic parameters, qualifying for subsidies through Connect for Health Colorado depends on how much your household earns and how that compares with the cost of the second-lowest-cost Silver plan in your area – which will depend on your age and location.

Colorado’s open enrollment period begins November 1 and continues through January 15, giving Colorado residents an opportunity to select a health plan for the coming year. This enrollment window is applicable for plans obtained through the exchange, OmniSalud, and directly from insurers (No subsidies are available for plans obtained directly from insurers.) 

For coverage to take effect on January 1, your application needs to be completed by December 15. If you enroll between December 16 and January 15, your new coverage will take effect on February 1.⁹

Outside of the annual open enrollment period, you may be eligible to enroll or make a plan change if you experience a qualifying life event, such as giving birth or losing other health coverage. And some people can enroll year-round even without a specific qualifying life event.

Enrollment in Health First Colorado (Medicaid) and Child Health Plan Plus (CHP+) is available year-round.¹⁰

To enroll in an ACA Marketplace/exchange plan in Colorado, you can: 

• Visit Connect for Health Colorado, which is Colorado’s health insurance Marketplace. This online platform will allow you to compare available health plans, determine whether you’re eligible for financial assistance, and enroll in coverage, either during open enrollment or during a special enrollment period. 
• Enroll in a Connect for Health Colorado plan with the help of an insurance broker or certified enrollment assister. ¹¹
  

You can reach Connect for Health Colorado’s call center at 855-752-6749 (TTY line: 855-346-3432)

Under the Affordable Care Act (ACA), income-based subsidies (APTC) are available to lower the amount you pay for your health coverage each month. These subsidies are available to enrollees who meet the eligibility requirements and select a health plan through Connect for Health Colorado.

Nearly three-quarters of Connect for Health Colorado’s enrollees were receiving premium subsidies as of early 2023. These subsidies averaged $404/month, and reduced the average enrollee’s premium to about $143/month.¹²

If your household’s income doesn’t exceed 250% of the federal poverty level, you’ll also be eligible for federal cost-sharing reductions (CSR), which will reduce your deductible and other out-of-pocket expenses as long as you select a Silver-level plan through the exchange. In 2023, 27% of Connect for Health Colorado enrollees were receiving CSR benefits.¹ Centers for Medicare and Medicaid Services.[/efn_note]

Colorado also offers additional cost-sharing subsidies to some silver-plan enrollees and these are being further expanded in 2024.¹³

As a result, all Connect for Health Colorado enrollees with household income up to 250% of the poverty level will qualify for the most robust category of CSR benefit. Under federal rules, there are three levels of CSR, with the most robust benefits going to those with the lowest incomes. Colorado’s supplemental subsidies boost the lower two levels up to the benefits provided by the most robust level, resulting in much lower deductibles and other out-of-pocket costs.¹³

If you’re eligible for both APTC and CSR, you can use them both if you enroll in a Silver-level plan through Connect for Health Colorado. (APTC can be used with any metal-level plan, but CSR benefits, including Colorado’s additional state-funded cost-sharing subsidies, are only available if you enroll in a Silver plan.)

Depending on your income and circumstances, you may be able to enroll in free or low-cost health coverage through Health First Colorado (Medicaid) or CHP+. Learn more about whether you might be eligible for these programs in Colorado.

As of 2023, Colorado provides state-funded premium and cost-sharing assistance to undocumented immigrants who enroll through a new public benefit corporation (Colorado Connect/OmniSalud) that the state has created.¹⁴ This is separate from Colorado’s health insurance exchange, as undocumented immigrants are not eligible to use an ACA-created health insurance exchange.

Source: CMS.gov ¹⁵

Five insurers offer health plans through Connect for Health Colorado in 2023, and that will grow to six in 2024, with the addition of SelectHealth.¹⁶

There will be six insurers offering exchange plans in Colorado for 2024 – including one newcomer – with coverage areas that vary from one insurer to another:¹⁷

• Anthem
• Cigna
• Denver Health
• Kaiser
• Rocky Mountain Health Plans
• SelectHealth (new for 2024)

Friday Health Plans offered coverage in early 2023, but stopped accepting new enrollees in May and existing FHP policies will terminate on August 31, 2023.¹⁸

For 2024, SelectHealth plans to join the exchange in Colorado, with plans that will be available mostly along the Front Range.¹⁶ SelectHealth already offers plans in the exchange in Utah, Idaho, and Nevada. Their expansion into Colorado is due to a merger between Intermountain Health (SelectHealth is Intermountain’s insurance arm) and Colorado-based UCHealth.¹⁹

For 2024, Colorado’s individual/family insurers have proposed the following average rate changes, according to data published on SERFF²⁰ and by the Colorado Division of Insurance:²¹

These rate proposals are under review by the Colorado Division of Insurance, and rates will be finalized before open enrollment starts in the fall of 2023.

It’s important to keep in mind that average rate changes apply to full-price rates, and most enrollees do not pay full price: 75% of the people enrolled through Connect for Health Colorado were receiving premium subsidies in 2023, offsetting some or all of their monthly premium cost.¹ Centers for Medicare and Medicaid Services.[/efn_note] 

Subsidy amounts differ for each enrollee and change annually depending on the cost of the second-lowest-cost Silver plan relative to the enrollee’s household income. As a result of the American Rescue Plan and the Inflation Reduction Act, subsidies are larger than they used to be, and also more widely available; that will continue to be true at least through 2025.²²

If the cost of your plan is going up for the coming year, you may want to consider some of the other plans that are available through Connect for Health Colorado. You may find alternatives that offer similar benefits with a lower monthly cost.

During the open enrollment period for 2023 coverage, 201,758 people selected private plans through Connect for Health Colorado, according to Centers for Medicare & Medicaid Services (CMS) data.²²

Effectuated enrollment is always a bit lower than the number of people who select plans during open enrollment. According to CMS, 180,309 people had effectuated coverage through Connect for Health Colorado as of early 2023.¹

Source: 2014,²³ 2015, ²⁴ 2016,²⁵  2017,²⁶  2018,²⁷ 2019,²⁸ 2020,²⁹ 2021,³⁰ 2022,³¹ 2023,²² 2024³²

Connect for Health Colorado: This is the Marketplace/exchange in Colorado. Residents can use Connect for Health Colorado to enroll in individual/family health plans and receive income-based subsidies, and also to enroll in Health First Colorado. You can contact Connect for Health Colorado at 855-752-6749

Colorado Division of Insurance: Regulates the insurance industry in Colorado, and assists consumers and businesses with insurance-related questions and concerns.

Colorado Department of Health Policy and Financing (HCPF): Administers Medicaid (Health First Colorado), Child Health Plan Plus (CHP+) and other health care programs.

Colorado Senior Health Care and Medicare Assistance: A service for Colorado Medicare beneficiaries and their caregivers, providing information and assistance with questions related to Medicare eligibility, enrollment, and claims.