DENVER - The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA), has released the approved individual and small group health insurance plans and premiums for 2019 - these are the Affordable Care Act (ACA) plans. Overall, premiums for individual health insurance plans are increasing by an average of 5.6 percent — a significant improvement over last year’s 32 percent average increase.

This is an average for all individual plans, from all insurance companies, in all areas of the state, for all ages. The specific plan purchased, along with a person’s age and residential location, will impact their specific premium, making it higher or lower than the average. Part of this average includes the DOI’s approval of one company’s request, Anthem, for an average decrease in their premiums.

In the small group market (health plans for small employers with two to 100 employees), the average increase will be 7.28 percent.

Tables and charts breaking down the 2019 information are available on the DOI website (www.colorado.gov) for approved health plan information.

With individual plans, the 5.6 percent increase does not take into account premium tax credits (also called Advance Premium Tax Credits, or APTC). For people who are eligible for these credits, premiums will change on average -24 percent when enrolling in the same plan for 2019 that they have this year. For those who do some comparison shopping and choose a different plan, it’s possible to bring this decrease down even further, as much as 30 to 50 percent less than what they paid in 2018.

Even for folks who are ineligible for premium tax credits (a household income over four-times the federal poverty level), they can lessen the impact of premium increases by considering different plans for next year. In some cases, they may be able to actually see a decrease over their 2018 premiums.

“The 2019 premiums are the lowest we’ve approved in years, with minimal increases and, in some cases, decreases,” said Interim Insurance Commissioner Michael Conway. “This year we worked to keep premium increases modest. With this foundation, my goal for the coming year is to attack out-of-control healthcare costs — the costs that drive insurance premiums up. That’s where we can really start to make a difference.

“For this year’s open enrollment, it’s critical that people take some time to shop and compare the plans to see what can best fit their health and financial needs. There really are savings to be had for many if they take the time to look,” said Commissioner Conway.

The premium tax credits that can help with the cost of insurance are available only for plans purchased through Colorado’s health insurance marketplace, Connect for Health Colorado. Eligibility for the credits depends on a consumer’s household income in relation to the federal poverty level. The credit is calculated based on income, age and the cost of insurance in a community. For more information about the credits contact Connect for Health Colorado at connectforhealthco.com or 855-752-6749. 

The same seven health insurance companies that sold individual plans in 2018 are returning for 2019:  Anthem (as HMO Colorado), Bright Health, Cigna Health and Life, Denver Health Medical Plans, Friday Health Plans, Kaiser Foundation Health Plan of Colorado and Rocky Mountain HMO.

The one company that left, Rocky Mountain Health Care Options, isn’t really going away as its efforts are being folded into Rocky Mountain HMO.

The number of plans across the state, and within each geographic region and county, will remain similar to the numbers from 2018. The mix of plans across all metal tiers remains similar as well.

In total, 16 insurance companies will offer individual and small group plans across Colorado in 2019.

Silver Plans in 2019?

Plan levels are categorized into gold, silver and bronze depending on how much the plan covers in healthcare costs. The average premium change for gold plans is a 3.81 percent increase, while the average premium increase for bronze plans is only 0.94 percent.  Yet the average premium increase for silver plans is a significant 11.86 percent.

Individual silver-level plans are going up more on average compared to bronze and gold plans because of how Colorado has chosen to manage the cost-sharing reduction (CSRs) payments that President Trump ended for 2018.

CSRs are subsidies that help people reduce their out-of-pocket costs (co-payments, coinsurance and deductibles) when they get healthcare. CSRs are available to people with annual incomes below 2.5 times the federal poverty level and who purchase an on-exchange, silver-level individual plan.

When the President took away the funding for CSRs they became extra costs for the insurance companies. Because CSRs are only available with on-exchange, silver-level individual plans, for 2019, the DOI instructed the health insurance companies to place the extra costs (also called “load”) onto the on-exchange silver plans -- this is called “silver loading.”

Substantially Similar Silver Plans ?

Although premiums for on-exchange silver plans are going up more than other levels, people who qualify for the premium tax credits are shielded from much of this increase. This is because as premiums go up, the tax credits go up. However, people who do not qualify for the tax credits could feel the full effect of the higher increases. This means these consumers should actively avoid the on-exchange silver plans and instead look for on-exchange gold or bronze plans, which are seeing significantly smaller increases, or shop off-exchange for a substantially similar silver plan.

Substantially similar silver plans are off-exchange plans that are almost identical to their on-exchange silver counterparts, but do not have the silver load added to the premiums. Consumers would purchase these plans either through a licensed insurance broker/agent or directly from the insurance company.

Find a comparison of the on-exchange silver plans to the off-exchange, substantially similar silver plans on the DOI website.

Comparing Plans in Open Enrollment, Nov. 1, 2018 through Jan. 15, 2019?

While Colorado consumers may be able to bring down the cost of insurance for 2019 through shopping and comparing available options, it is important for people to consider factors beyond premiums. Consumers should think about deductibles, co-payments and co-insurance costs, along with their doctors, their health conditions and any prescriptions they take. These are all factors that can impact the usefulness of a plan and its overall cost.

Consumers who have questions about their current plans should contact their insurance carrier, Connect for Health Colorado, their insurance broker, or their employer.

About the Division of Insurance:

The Colorado Division of Insurance (DOI), part of the Department of Regulatory Agencies (DORA) regulates the insurance industry and assists consumers and other stakeholders with insurance issues. Visit dora.colorado.gov/insurance for more information or call 303-894-7499 / toll free 800-930-3745.

About DORA:

DORA is dedicated to preserving the integrity of the marketplace and is committed to promoting a fair and competitive business environment in Colorado. Visit dora.colorado.gov for more information or call 303-894-7855 / toll free 1-800-886-7675.