Colorado Health Insurance FAQs

There is no penalty in Colorado if you do not carry health insurance. 

ACA-qualified plans are those that meet the requirements of the 10 Essential Benefits and 100% coverage for preventive services. Also, you cannot be declined coverage for a pre-existing health issue.

You can sign up for a Bronze, Silver, Gold, or Platinum plan. Policies are offered by Anthem Blue Cross Blue Shield, Bright Health, Cigna, and several other companies. 

Or, you can elect not to purchase health insurance. In that case, you may want to consider joining one of the many health sharing organizations available in Colorado.

Subsidies are actually tax credits that pay portions of health care premiums for those who earn at least 100% of the federal poverty level (FPL), or 135% FPL if you live in a state without Medicaid expansion.

FPL is an amount determined every year by the Department of Health and Human Services. For the purpose of calculating subsidies used to purchase plans for 2024, the FPL ranges from $14,580 for individuals to up to $50,560 for a family of 8.

Your subsidy is delivered as either a reduction in monthly premiums or as a tax refund when you file. 

How are tax credits calculated?
As of 2021, there is no longer an income cap for subsidy eligibility. The amount of your subsidy is based on a sliding scale based on your income. The higher your income, the smaller your subsidy, and the more you will have to contribute towards your premium.

If you earn                      Your contribution towards your premium is:

Up to 150% of FPL           0% of your income (ie, the benchmark plan
will have no premium)

150%-200% of FPL             0%-2% of your income

200%-250% of FPL             2%-4% of your income

250%-300% of FPL             4%-6% of your income

300%-350% of FPL             6%-8.5% of your income

400% of FPL or higher      Capped at 8.5% of your income

Yes. You can apply your tax credit to a Platinum plan, though it will be based on that of a Silver plan level.

Since you won’t be getting a tax refund, your qualified subsidy will be applied to your premium costs. The IRS will pay your insurance carrier directly to pay for the approved portion of your premium.

Employees covered by their employer-based group plan routinely don’t qualify for a subsidized tax credit. If your employer fails to meet the adequate and affordable standards of ACA-qualified plans, (not offering the 10 essential benefits, and costing more than 9.61% of your income), you could be eligible for cost-sharing assistance.

The Affordable Care Act requires that all health care plans include 10 Essential Benefits. These benefits include a list of Preventive Services and guaranteed acceptance of pre-existing conditions that were often excluded in the past.

No. Exchanges are either state- or federally-operated, and are staffed by government employees to assist consumers in purchasing insurance only from those companies registered with the exchange, as well as activate your subsidy should you qualify. But there’s no requirement for you to purchase coverage on the exchange.

Keep in mind that there are many other coverage options not found on the exchanges, and an experienced Personal Benefits Manager on the Colohealth team can help you find the best option.

No, probably not. The increase of covered benefits and the number of insured individuals, many of whom have pre-existing conditions, will likely raise rates for everyone.

A potentially helpful strategy for many people is a health savings account (HSA) combined with a high-deductible health plan. An HSA can:

• Lower your taxable income
• Reduce your annual income tax bill
• Help you qualify for a health insurance tax credit
• Be prepared for future out-of-pocket medical bills

Another option is to join a health sharing plan, instead of getting health insurance. This could cut your monthly costs in half.

Talk to one of our Personal Benefits Managers, who can help you analyze your true net costs after tax credits, and help you find the best option for you.

Under the ACA no one can be denied coverage due to pre-existing health conditions.

Health sharing plans may put a waiting period before sharing for certain pre-existing health conditions. 

We think that is a great idea. You won’t get better advice than from an experienced, independent agent. However, not all insurance agents are certified to sell plans on the exchange. And not all agents have the years of experience to decipher insurance language and options. Colohealth brings over 30 years of insurance expertise to all of our clients. Plus, we don’t charge for our services.

There are several different options for small business owners. They can consider a small group plan; set up a health reimbursement arrangement (HRA) to reimburse employees for the cost of individual health insurance; or set up the group with a health sharing plan. Please contact us to discuss your situation

Prenatal and child wellness care are 100% covered part of the ACA’s essential benefits and preventive services within an ACA-qualified health plan. Even breast pumps are covered under Obamacare.

If you do not enroll in a plan during the OEP (November 1 through January 15) you generally cannot enroll until November of the following year. Keep in mind that, unless you are insured for 9 months out of the year, you’ll be required to pay a penalty.

If you are outside of this time period, you may qualify for a special enrollment period. 

If you experience any of the tactics described above, contact the Colorado Department of Insurance. Your agent should be licensed in the state of Colorado, and should never ask you for money to find you a policy.

ColoHealth never pressures our clients, and we never charge for our 30+ years of insurance expertise. Our only goal is to find you the best coverage, lowest taxable income, and legitimate tax-favored health savings accounts for your future medical expenses.

While a high-deductible health plan means you must pay a typically larger deductible, it does usually result in lower premiums. Your premium could be 40 percent lower than other plans.

Only high-deductible plans are eligible to be combined with a tax-favored health savings account (HSA). The least expensive of these is an HSA-qualified Bronze metal tier plan. When combined with an HSA, tax benefits and reduced taxable income can lower out-of-pocket costs. Sometimes by reducing taxable income by contributing to an HSA an individual may qualify for a premium subsidy.

There are also HSA-qualified plans that work with health sharing, which may dramatically cut your costs.

If you are in need of frequent medical attention, a high-deductible plan may not be the most advantageous plan for you. A metal tier platinum or gold plan may be better for you. Your licensed Colohealth Personal Benefits Manager can help you find the best solution for your unique health care needs.

Commonly called an HSA, a health savings account is a tax-free savings account that, when combined with an HSA-qualified health plan, can be used to pay for medical expenses not covered by your insurance.

HSA plans are very popular among our clients. The contributions you make to your HSA are tax-free. These contributions also act to lower your taxable income, thereby reducing your income taxes. An HSA can also put your income level to qualify you for a tax credit on your health premiums.

We encourage you to contribute the maximum allowable amount every year in order to accumulate the largest balance possible in your account by retirement.  Starting at age 55 you are allowed to contribute an extra $1,000 each year above the typical maximum amount.

If you don’t use the money in your HSA at the end of the year, you can roll it into the next year while earning tax-free interest and building your funds for retirement as well.

If you use any of your funds for qualified medical expenses, the withdrawals are tax-exempt.  However, withdrawals used for non-medical uses before the age of 65 are taxed at 20 percent. After the age of 65, you can use your savings for any purpose with no tax penalty.

If this is of interest, be sure to check out our HSA-qualified health sharing plan. 

Those under the age of 30 have the option of enrolling in a catastrophic plan that meets the requirements of the ACA while providing them with the essential benefits of preventive care.

Adults under 26 can stay on their parent’s health plan, even if they’re married. The coverage under their parents’ plan does not extend to the spouses of adult spouses or grandchildren; neither does it cover an adult child’s pregnancy.

Waiting periods common to group health plans are limited to 90 days. Individual health policies do not impose waiting periods. Healthshare plans may have waiting periods on certain pre-existing conditions.