State marketplace for health insurance to open
The first step toward the requirement that all individuals have health insurance takes place on Tuesday, when open enrollment begins across the nation.
Coloradans who don’t have insurance through their employers — and it’s estimated there are 760,000 of them, 23,000 in Mesa County, according to the American Community Survey — can take the first steps toward getting insurance by flying solo on the web, with a broker or with the aid of a “guide,” whose job it will be to help consumers navigate the various choices they’ll confront at http://www.ConnectforHealthColorado.com, the state insurance marketplace, or exchange.
“We’re ready to go Oct. 1,” said Patty Fontneau, president and CEO of Connect for Health Colorado. “We’ll be opening the doors just after 8 a.m. Everything you want to do, you can do.”
With ConnectforHealthColorado.com, or Connectforhealthco.com, the Colorado experience with the introduction of the Affordable Care Act will be unique.
The Centennial State is one of a minority of states that opted to build its own marketplace.
“Colorado built the most market-based market in the country,” said Steve ErkenBrack, a member of the board of the marketplace that will feature participation by more companies than any other marketplace, including the federal one.
Colorado also is unique in that “we’re the only exchange to put an insurer on the board to help build the thing.” ErkenBrack said. He also is the president and CEO of Grand Junction-based Rocky Mountain Health Plans.
While much attention will be focused on Day One of the enrollment period, consumers should expect that the marketplace will adapt to changing conditions, ErkenBrack said.
“I don’t look at it as 30 or 60 or even 90 days,” ErkenBrack said. “I look at it as a one- to three-year rollout.”
That’s plenty of time for consumers of all varieties to become familiar with the marketplace, where people will be able to choose among bronze, silver, gold and platinum plans and can learn there whether they will qualify for what is known as an advance premium tax credit. That’s nothing more than a tax credit that can be spent to purchase health insurance before a consumer actually files a tax return.
Those premium subsidies will be available only by using ConnectforHealthColorado.com. Consumers can choose to navigate the site alone, but they also can consult with licensed brokers, who can make recommendations, or with “guides,” available at several locations around the state.
Consumers, however, don’t need help to simply skim the site and study options without committing themselves.
“The advance premium tax credits are a big deal,” said Randy Pifer of Active Insurance Solutions, 940 Colorado Ave., urging consumers, even those who already have coverage via their employers, to cruise through the site.
Consumers can navigate the site by providing partial data about themselves, enough to make a judgment about where they might fit into the premium scheme.
Still, said another broker, Jim Sjerven of Mountain West Insurance, 480 W. Park Drive, suite 100, consumers would do well to deal with certified brokers who are familiar with the offerings.
“This is so complex that people do need help,” Sjerven said, noting that using a broker adds nothing to the cost of the policy.
Once in the site, consumers can test the limits of the policies, checking, for instance, whether their physicians are part of the networks associated with the policies they are researching.
Consumers can make an “apples to apples to apples comparison,” ErkenBrack said.
Choices will be abundant even within the offerings of certain insurers.
Rocky Mountain Health Plans, for instance, will have three silver-level offerings that consumers can peruse, prompting Sjerven to quip that they’ll have “a Red Delicious to Gala to Fuji apple comparison.”
“I think that at the end of the day, the game plan is to have expanded choice for consumers,” ErkenBrack said.
Hilltop Community Resources will be fully staffed in Delta, Mesa, Gunnison and Hinsdale counties for the first day of open enrollment, said Jackie Sievers, director of community programs for Hilltop.
Guides will be unable to offer advice as a broker does, but they have passed background checks and were screened for the ability to understand and communicate complex ideas, Sievers said. Some have insurance backgrounds, as well.
Questions that were coming up last week showed that many consumers have a lot of catching up to do, Sievers said.
“That’s our biggest challenge,” she said. “People are asking, ‘Oh that passed? Do we get that?’”
In Mesa County, guides will meet with consumers at 602 Bookcliff Ave. and appointments can be made by calling 244-0850.
In Delta County, the guides will be located at 1025 Main St., and appointments can be made by calling 901-6841.
Though Tuesday is the first day of open enrollment, consumers can take their time making choices, the brokers and Sievers said.
The one deadline they must meet falls on Dec. 15. That’s when the premium must be paid in order for policies to be effective on Jan. 1.
The federal health insurance exchange for small businesses won’t be open in time for the first day of open enrollment, officials said last week, but the small business portal at ConnectforHealthColorado.com will be fully operational, Fontneau said.
Not only will small-business owners be able to use the site, but their employees will be able to sign up for any of the policies their employer offers, Fontneau said.
While the Patient Protection and Affordable Care Act includes the individual mandate to own health insurance, it will make only a dent in the number of uninsured people, according to the Kaiser Family Foundation, which estimates that the number of uninsured Coloradans, 853,000, or 19.9 percent of the population, will fall to 464,000, or 9.6 percent, as a result of the law.
It still will leave 389,000 Coloradans without coverage, the foundation said on its website, kff.org.
The new law remains at the center of a political storm that also includes the federal budget and demands that the individual mandate be delayed a year.
Politics aside, said Sjerven, consumers who aren’t covered by their employers, Medicare or Medicaid should investigate the site for themselves.
“Don’t let the media decide for you,” he said, referring to commentary on both sides of the aisle, “because they don’t know what they’re talking about.”
Pifer, who in 2009 questioned President Barack Obama’s health care plans during an appearance by Obama at Central High School, urged individuals to learn about the marketplace.
“You owe it to yourself to check it out, without a doubt,” Pifer said.