Many could see premiums go down as stability takes hold.
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% — a significant improvement over last year’s 32% 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%.
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.
In the small group market, we see the same stability as 12 of the 13 companies from last year are
selling policies for 2019. 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% increase, while the average
premium increase for bronze plans is only 0.94%. Yet the average premium increase for silver plans is a
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.” (See a detailed explanation on the DOI
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.