Colorado Division of Insurance releases preliminary 2023 medical insurance information – State of Reform

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Reinsurance continues to avoid wasting Coloradans money on health care, while the Colorado Option Plan is included for the primary time.

DENVER – The Colorado Division of Insurance (DOI), a part of the Department of Regulatory Agencies (DORA), has released preliminary information concerning the medical insurance plans and premiums for 2023 — for the person market (meaning medical insurance plans for individuals who don’t get their insurance from an employer) and the small group market (for small businesses with 2-100 employees).

 

 

The initial review by the DOI of the insurance firms’ filings for 2023, indicate that the general average consumer impact on premiums in the person market might be an 11.3% increase over 2022 premiums. These are the medical insurance plans available to individuals on Connect for Health Colorado, the state’s health exchange made possible by the Reasonably priced Care Act (ACA).

Reinsurance Program

This June, the Centers for Medicare and Medicaid Services (CMS) authorized the continuation of the Reinsurance Program through 2027 for individual medical insurance plans. Initial evaluation by the DOI shows that without the Reinsurance Program, consumers could be an approximate 34% increase in premiums for 2023. Meaning without the Reinsurance Program, the rise would have been roughly 23% higher, showing that the Reinsurance Program continues to avoid wasting people money on health care.

“I’m really happy with all of the work that the Polis-Primavera administration has been capable of accomplish to make sure access to high-quality and inexpensive health take care of all Coloradans, including the Reinsurance Program and Colorado Option,” said Dianne Primavera, Lieutenant Governor and Director of the Office of Saving People Money On Health Care. “We’re setting a national precedent by offering cheaper coverage for our neighbors across the state and including primary care and mental health visits at no additional cost under the Colorado Option.”

 

“The Reinsurance Program continues to deliver savings for Coloradans in 2023. That makes it much more critical that the federal government authorized the extension of this worthwhile program through 2027 as a part of the approval of the amendment to our waiver for our first-in-the-nation Colorado Option Program,” said Colorado Insurance Commissioner Michael Conway. “The Colorado Option will bring strong competition to our individual and small group markets. The Colorado Option will increase the variety of plans available to people throughout the state, and in nearly every county, the Colorado Option plans may have premiums which can be cheaper than the typical non-Colorado-Option plan.”

The Colorado Option

The Colorado Option was enacted through HB21-1232, which was signed into law by Governor Polis in June 2021. The law was sponsored by  Rep. Dylan Roberts, Rep. Iman Jodeh and Senator Kerry Donovan. As a part of the Colorado Option, the DOI has created a Standard Plan which can allow consumers and businesses to simply compare plans and select the plan that is true for them. Along with covering all essential health advantages required by the ACA, the Colorado Option may have free primary care and free mental health health visits, and has been designed to cut back racial health disparities and improve health equity.

Starting in 2023, the Colorado Option might be available to all Coloradans who buy their medical insurance on the person market (i.e. not from an employer) and small employers with 2 – 100 employees. It’s going to also include latest support for Coloradans which were omitted of the financial help provided under the ACA, while expanding subsidies for some consumers enrolled through Connect for Health Colorado. Per the law, plans within the Colorado Option must lower medical insurance premiums for people, families, and small businesses by 5% in 2023 (in comparison with 2021 plans), by 10% in 2024, and by 15% in 2025. Find more details concerning the processes and methods for the Colorado Option on the Colorado Option website.

For 2023, the Colorado Option is succeeding in increasing the extent of competition for medical insurance in Colorado. It’s bringing 42 latest individual health plans with increased advantages into the market, and 48 latest small group plans. These plans might be sold by the insurance firms in each county they sell other individual and small group plans. In just about all counties within the state, across all metal levels (bronze, silver and gold), the bottom cost individual market Colorado Option Plan within the county is cheaper than the typical premium for non-Colorado-Option plans. And within the small group market, that is true for each county, for each metal level.

Initial reviews of the plans insurance firms submitted for 2023 show that ALL counties in Colorado may have access to bronze, silver and gold level individual Colorado Option plans. For current individual market enrollees, 87% may have access to either a bronze, silver or gold Colorado Option plan that’s at or below the 5% premium reduction goal. As that figure is predicated on the initial evaluation, over the subsequent few months the Division’s rate review process will dig deeper into these filings to find out exactly how most of the plans will hit that reduction goal. And for 2024, the law requires the DOI to carry hearings when plans don’t meet the goal.

Individual Plans

The Division is currently reviewing all the knowledge the businesses have filed to be certain that changes in premiums are justified and that the plans comply with State and federal regulations. The ultimate, approved plans and premiums might be made available in mid-October.

In the person market, seven corporations are returning to supply plans for 2023 – Anthem, Brilliant Health, Cigna Health, Denver Health, Friday Health, Kaiser and Rocky Mountain Health Plans. Of the 64 Colorado counties, 63 have on-exchange plans from not less than two insurance firms. Jackson County is the remaining county with on-exchange plans from a single company.

Oscar Health is not going to offer plans in Colorado going forward (in addition to Arkansas). Since entering the Colorado market in 2020, Oscar has struggled to compete with the opposite insurers in the person market. In 2022, Oscar’s enrollment was only 3,800 members.

Oscar plan members may have to decide on latest coverage for 2023 in the course of the fall open enrollment period that may start Nov. 1, 2022. Per Colorado insurance regulations, Oscar must provide notice to its members 180 days before its plans terminate, and the corporate mailed those notices in late June.

A complete of seven insurance firms have proposed to supply 399 individual plans in Colorado.

Small Group Plans

For the Small Group Market (for employers with 2-100 employees) for 2023, the general average change in premiums anticipated might be a rise of 9.2% over 2022 premiums. That is preliminary information based on what the businesses submitted to the DOI.

A complete of 11 insurance firms plan to supply 497 small group plans in 2023 in Colorado.

For the small group market, Brilliant Health has decided to not offer plans in Colorado for 2023, adding to their decision to stop offering individual plans in Illinois, Latest Mexico, Oklahoma, South Carolina, Utah and Virginia for the approaching 12 months (Brilliant will proceed to supply individual plans in Colorado in 2023). Considering t the DOI’s $1M nice of Brilliant regarding the corporate’s operational issues, pulling back from the small group market should provide the corporate with additional capability to deal with those issues. Like Oscar in the person market, Brilliant struggled to be competitive within the small group market since starting in 2021. This 12 months, Brilliant’s enrollment within the small group market was only 951 enrollees.

View Plans  / Submit Comments

The plans and requested premiums from the insurance firms, also called filings, are accessible from the Division’s “Insurance Plan Filings & Approved Plans” website. Note that these are very technical documents, so be prepared to spend a while on this process. There may be a step-by-step video guide (also available as a downloadable print guide) to show you how to navigate to the filings that interest you, to exhibit find particular information in those filings, and to point out you the way you may submit comments. The tables with preliminary information linked above are also available on this site.

Comments have to be received by Aug. 1, to be addressed and incorporated into the DOI’s review of the businesses’ filings.

This press release was provided by the Colorado Division of Insurance. 

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