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Colorado Individual Health Insurance Cheat Sheet

Get The 2016 Individual/Family Coverage Open Enrollment “Cheat Sheet” FREE!

Save yourself hours of research and hours of aggravation with the insurance company cues:

  • Which insurance company allows you and your family to go to a specialist without a referral?
  • Are your doctors and hospitals on their list?
  • Who covers your specialty medications?
  • How plans differ in prescription drug coverage and how one company terminated Walgreens.
  • Who has telemedicine/tele-doc type services for when you can’t get into see your primary care physician?
  • Which companies cover your child in college in another state?
  • How can you get covered for procedures out of state and which companies are a definite “no” for out of state?
  • Are you covered for emergencies countrywide?
  • Which plan covers foreign nationals residing in the US with a green card?
  • What is the difference in plans on exchange and off exchange?  Which plans are only on exchange or off exchange/
  • Where to get your subsidy and find out if you qualify?
  • When you should enroll with us on exchange and why you don’t want to be on the exchange unless you qualify for a subsidy.
  • New Plans in Metro Denver, Boulder, Summit and Eagle Counties
  • Obtain brochures and Summary Benefits Coverage (SBC)
  • How to cover the high deductible with gap coverage if you are hurt in a skiing, dirt biking or other sports accident

As a service to our current and new clients we have put together valuable information below to save you time and avoid the aggravation of multiple calls and cues.   You won’t see this amount of detail from another Colorado broker!

OPEN ENROLLMENT starts November 1, 2015-December 15, 2015 for a January 1, 2016 effective date.  Do NOT get caught in a technical glitch waiting to the last day.  Target your enrollment by 1st week of December so you can get your ID cards by the holidays!

 

Solo-preneur?  Not covered at work? Need a quote for individual/family coverage?

PREVIEW premiums available now (for browsing ONLY) with open enrollment November 1, 2015      

ClickHere Individual Health Insurance Quote Engine

Link to Full Quote Engine with comparisons and side by side quotes for Cigna, Anthem, RMHP, Humana and Kaiser….UHC will be loaded soon.  Must create a login for access!  Enrollment through this link!

Online analysis saves time and answers many questions before you contact Us!

Direct Insurance Company Coded Links:  All links are encoded to our back office dashboard and case advocates hired to help.  Links activated on 11/1/15 for Open Enrollment! Why wait in a cue when we can check the status for you and handle any problems?  This is FREE to consumers.  Enroll Now:

CIGNA  HMO and EPO plans

UNITED HEALTHCARE ONE  HMO

RMHP  HMO Denver Metro, PPO Summit   All RMHP HMO Plans are filed as an HMO but operate like an EPO (select any PCP or specialist-all in state)

HUMANA  HMO plans (exchange only)

ANTHEM  All in network, some HMO plans require a PCP to refer to specialist.  Pathway HMO works like EPO!

KAISER All in network requires referral to specialist  (MOUNTAIN locations currently do not have hospital contracts and only ONE PCP, no specialist.  Please wait a year to enroll Summit/Eagle

Do you own a business with 2 or more employees?  Please get the Last Minute Guide To Small Group Coverage  LAST CHANCE FOR 2015 RATES:  Why pay 2016 rates?  If you have 2 or more employees contact usimmediately about small group coverage and save 8-12% for some plans for groups enrolling for a 12/1/15 effective date with rates locked in for the next year.  Enrollment with paperwork completed and sent to the insurance company by November 5-10 for 12/1/15 effective date.   Please note that GROUP coverage is in most cases BETTER than individual for the same type plan with a company mapped deductible.  See the comparison on the cheat sheet. 

For those of you who work for a small business and the employer can’t contribute we have one insurance company will enroll without contribution and we can set up PRE-TAX for your employees (average premium savings is 25%

290,000 individuals and many businesses must enroll in new coverage immediately for 1/1/16.  This is a huge undertaking and there is not enough time to field all the calls and take care of business groups.  This sheet will help you with selecting a new plan.  DO NOT WAIT UNTIL DEC 10-15, 2015 to enroll for January 1 2016 effective date!  Your target completion date for enrollment should be no later than December 5, 2015 for timely access to your new ID, billing, etc.  Expect delays from all insurance companies who will be inundated with applications to enroll in new coverage and all the people who want to change.Why do you want to work with us?  The homework has been completed for you.  It is an exhaustive summary of the marketplace going forward.    A lot of your questions will be answered as you read through this document.  For those of you who have a subsidy Connect For Health Colorado is still a clunky system that only provides so much information.  When you have completed your application, you do NOT want to be in a cue for an hour with an 800# that hangs up on you.  All the links on this document are encoded to the broker back office.  It’s simple, email me and I can check status or have one of our case advocates check on status for you.

BEFORE YOU ENROLL: Do not decide based on premiums alone.  Make sure your MD and Specialist is in network.  If you are unsure, call the MD’s office.  Make sure your Rx are covered and you understand the copays for generic (Tier 1), Brand Name (Tier 2 and 3), Specialty/Step Therapies (Tier 4 and 5).  Make sure you understand the difference between an HMO, EPO, PPO and how some HMO’s are filed as an HMO but open the entire network to you and operate like an EPO

Should you enroll on Connect For Health Colorado? Our opinion: If you do not qualify for a subsidy there is little reason to enroll through a second entity.  We have enough issues with data breaches that you do not want your information with a public entity unless you have a substantive subsidy of $100 or more per month. Second we are hearing that the IRS has access to the data and if data does not match you may be more likely to be flagged for an audit. Subsidies:  Please update with PEAK Colorado by October 31 all financial info including 2014 tax returns if you want to qualify for a subsidy.  It’s up to you to get this accomplished and have any technical issues resolved with Connect For Health Colorado and your subsidy before we enroll you in health insurance.

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Call 303-653-985 after you have reviewed the cheat sheet! contact