by Jenn Fanning

High cost of health care. Rising insurance premiums. Families making difficult decisions about monthly costs like food and rent because of health insurance costs.

Do these topics sound familiar to you? One thing we all have in common, regardless of our opinion on the Affordable Care Act: health insurance costs are out of reach for many of us in our community. The reasons for this are many, including how we pay our providers, the fragmentation of our healthcare system, and much more.

But it is important for you to know CORRECT information about health insurance options available to you and how federal policies that impact you now. Then you can make an informed decision, rather than one based on misinformation or fear, for you and your family.


Here’s what you need to know:

  • First, open enrollment for 2018 is November 1st through January 12. That means you have a very limited window to enroll for individual and family health insurance through the marketplace or with insurance companies independently. You must apply by December 15 in order for coverage to begin January 1. Applications received from December 16 through January 12 will have a February 1 start date.

The health insurance marketplace in Colorado is called Connect for Health Colorado, The marketplace is the only place you will be able to receive tax credits either monthly or when you file your taxes. These credits are there to make insurance more affordable for most people.

Start the process early. It may take a few weeks to finalize everything. This year, the database seems to be working very well compared to glitches in years’ past, but it’s best to be prepared.

  • Second, you still have to be covered by health insurance or pay the penalty. Any policies passed at the federal level from this point forward will NOT impact the requirement in 2018 to still have health insurance. This means you will still be penalized if you do not have health insurance, unless you file an exemption. If you are not covered by insurance, you will be fined $695 per person or 2.5% of your household income, whichever is greater.

This is because of a very complicated process when health insurance companies have to submit plan coverage and cost to the state Department of Regulatory Agencies. These plans must be approved by early fall by the regulatory agency in order for the insurance companies to create and finalize contracts in time with hospitals and providers.

  • Third, you may have heard that health insurance premiums have gone up, but that tax credits may have also gone up making it so most families will actually pay less. Yes – premiums have increased in our region an average of more than 33%. BUT, in our experience so far during open enrollment, the tax credits have not increased dramatically. Therefore, our community is seeing higher costs of insurance regardless of tax credits.

This is primarily due to the fact that we have only one insurance carrier available to Grand County on the marketplace, Anthem. The tax credits are based off the second lowest priced Silver plan. Because we only have one carrier, we only have a few Silver plans available and therefore the price difference is not that great. This makes it so our tax credits are not drastically changed.

Therefore, people are choosing to have a comparable tax credit as last year. But they are often dropping plan coverage to a Bronze plan, meaning a much higher deductible and out-of-pocket expenses.

  • Fourth, the Children’s Health Insurance Program (CHP+) in Colorado is waiting for Congress to reauthorize the funding. This program covers children just above the Medicaid eligibility level, making their health insurance affordable for these families. If Congress does not authorize CHP+ before December 1, 2017, the State of Colorado estimates they have enough money through January 31, 2018. Therefore, children covered on CHP+ will need new coverage beginning February 1.
  • Fifth, make sure you know what you are getting before purchasing. A plan must cover the 10 Essential Benefits in order to be a qualified plan. That means you must purchase one of these plans in order to avoid the tax penalty. Many other plans are offered for much less monthly payments, but these often come with greater out-of-pocket expenses. These plans could be the right choice for you and your family. Just make sure you understand what it covers vs. what it doesn’t, and your monthly and total costs.

Sound complicated? Yes! It is SO complicated. We are fortunate to have several health insurance brokers in our county to help people understand this information and make informed decisions. We have 5 brokers that are certified in the marketplace and several others who work directly with insurance companies

Grand County also has FREE in-person help with your enrollment. Avoid the rush and schedule an appointment with Kim Long, Certified Health Coverage Guide today. Kim can help you understand your health insurance options and what that means for your individual situation.  He can meet you at any of the Grand County Library District libraries, and can help you apply for financial assistance and enroll in a plan.  

To make a free appointment, call Kim at 970-531-4769.