Colorado Health Insurance FAQs
What You Need to Know About Health Insurance in Colorado
Colohealth has 30 years of health insurance experience, so we have the expertise to answer any question you have about individual and family coverage here in Colorado.
If you don’t see your specific question below, don’t hesitate to contact us.
1. When do I have to enroll in an ACA-qualified health insurance plan?
Health insurance open enrollment in Colorado lasts from November 1 to January 15 every year. This is the only time you can purchase health insurance, unless you qualify for a special enrollment period at another time of the year.
Those who do not have ACA-compliant health insurance coverage for at least 9 months of the year will face penalties when they file their federal income taxes. This penalty, known as the “individual shared responsibility payment”, or sometimes simply “the mandate” is calculated using one of two methods. You’ll pay the higher of the two calculations, either:
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- 2.5% of your household income, not to exceed the total yearly average premium for a bronze plan, or
- $695 per adult and $347.50 per child in your household, not to exceed $2,085.
You will not be required to pay a penalty if you fall into one of the following categories:
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- Income below the tax-filing threshold
- Religious objection to having health insurance
- Approval of hardship waiver
- Lack of a plan on the exchange with a rate under 8% of your Adjusted Gross Income
2. Is there a penalty for not carrying health insurance?
There is no penalty in Colorado if you do not carry health insurance.
3. What are my health insurance options?
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.
4. Is a subsidy a tax credit? What does it pay for? Do I qualify?
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 2025, the FPL ranges from $15,650 for individuals to up to $54,150 for a family of 8.
5. How do I get this tax credit?
Your subsidy is delivered as either a reduction in monthly premiums or as a tax refund when you file.
6. How are tax credits calculated?
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
7. Will my Silver tier tax credit apply to a Platinum level plan?
Yes. You can apply your tax credit to a Platinum plan, though it will be based on that of a Silver plan level.
8. I am unemployed. How do I get tax credits on my health insurance premiums when I don’t owe income taxes?
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.
9. How are premiums and tax credits affected by group plans?
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.
10. What benefits must an ACA-qualified plan include?
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.
11. Do I have to get my insurance from the health exchange?
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.
12. Do qualified health plans mean lower premiums?
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.
13. I have a health problem. Will I be denied coverage?
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.
14. What if I want to get help from an insurance agent to search the exchange?
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.
15. What about the small business owner? Can I use the exchange?
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
16. What about women’s health coverage?
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.
17. What if I want to wait to enroll in a health insurance plan?
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.
18. How do I report an insurance scam?
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.
19. Why should I consider a high-deductible plan?
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.
20. Are high-deductible plans a good idea if I need frequent medical care?
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.
21. Why should I enroll in a Health Savings Account?
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.
22. What are options for young adults?
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.
23. What about coverage waiting periods?
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.
More questions? We have answers!
With over 30 years of expertise behind our team of licensed Personal Benefits Managers, we simplify your health care options to find the absolute best coverage that saves you the most money. Colohealth can help you understand your options and feel confident in the decisions you make about your health care and your financial future.
We’re always available and we never charge for our services! Call your Colohealth Personal Benefits Manager at (800) 913-6381, or email us at [email protected] today!
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Health Insurance Instant Quote
HEALTH INSURANCE INFORMATION
- Plans approved and authorized under the Affordable Care Act
- Covers Pre-Existing conditions
- Low cost subsidized plans available to those earning
< 400% of the federal poverty level - Unlimited lifetime benefits
- Available during open enrollment (November 1 – January 15), or if you qualify for a Special Enrollment Period
How to Choose an HSA-Qualified Health Plan
HSA plans are simple and easy to understand. If you need some basic information on how Health Savings Accounts (HSAs) work, visit our HSA page.
A relatively small percentage of health insurance plans are HSA-eligibile. If you are looking at health insurance quotes through our quote engine, HSA plans will be noted.
While HSAs are typically associated with insurance plans, ColoHealth also offers a partially self-directed HSA combined with a healthshare program through MPowering Benefits. Health care sharing programs are not insurance; instead, they pay formedical expenses in a different way. Members pay monthly contributions, and that money is pooled together to pay for its members’ qualifying medical expenses.
Health share programs offer significant savings, one of their biggest appeals and one of the reasons why there are now more than a million people who have joined a health share program. However, they aren’t for everyone. If you have a pre-existing condition or are currently going to the doctor often, medicare cost sharing programs might not be the right fit for you.
When you are ready to choose a plan, follow the directions below. It usually takes no more than 10 minutes or so to choose the best plan for your needs.
1. Get an Instant Quote.
Our instant quote engine can rapidly show you the available plans in your area, so that you can get an overall feel of what premiums will be for the different HSA plans.
To see just the HSA health insurance plans, change the “Plan Type” on the Customize Search tab at the top of the page to “HSA”. Note that not all insurance companies and plans are available in all areas.
The healthshare program that works with an HSA is very attractively-priced, particularly if you do not qualify for a health insurance subsidy.
Get an Instant HSA Health Insurance Quote
Get an Instant HSA Healthshare Quote
2. Compare premiums/monthly contribution amounts.
This will quickly give you a feel for which companies are most competitive in your area.
3. You may want to consider adding an $100 deductible accident policy. Stand-alone accident plans can be viewed on our Accident Plans page. Because these accident plans are very inexpensive, you may be able to keep your premiums lower while greatly reducing your exposure for the type of claim you’re most likely to need your health insurance for – an accident.
4. With both health insurance and most health sharing plans you may want to check the insurance company’s PPO or HMO network to see which doctors and hospitals are considered in-network providers. The link to each plan’s PPO or HMO network can be found on that company’s page on our site.
Note that some healthshare programs do not use a network, and allow you to see any doctor of your choice.
How to Apply for Coverage
Applying for HSA health insurance and establishing an HSA is quick and easy. Most companies allow you to apply online. Or you may simply print out an application and fax it to us at 866-284-0082, or mail in your application to the address below.
Apply Online
The easiest and most efficient way to apply for an HSA plan is online through a secure online application. This will enable you to avoid the hassles of filling out a paper application and will speed up the process by instantly transmitting your information directly to the insurance company. The application usually takes about 10 minutes to complete.
You may apply online by running instant quotes, and apply online for most plans we offer right from the quoting system's results page. Or simply select the apply online link below for the plan you are interested in.
If you are interested in a healthshare plan, you can get a quote on the MPowering Benefits HSA-qualified health share plan, and apply online.
Mail or Fax an Application
You can download an application for the plan you are interested in, print it out, fill in all the required information, and then either fax it to us toll-free at (866) 284-0082 or mail it to us at the address below.
What Happens After You Apply
When you apply for a health insurance plan through Colohealth, we immediately submit the information. We monitor your application during the whole process, and keep you informed. We use our experience and connections to make sure your policy gets issued as quickly as possible. If any additional information is needed, we’ll let you know. We will inform you as soon as you’ve been approved, and make sure you’re happy with your coverage.
We're Here to Help
As you've probably noticed, our website is comprehensive and should answer most of your questions. However, if you need personal assistance, we are happy to help. Simply pick up the phone and call us, or if you are already in communication with one of our Personal Benefit Managers, you can contact them directly.
If you’re unsure, you may want to schedule a telephone consultation before you sign up for a plan. We will help you fully analyze all your options, let you know the pros and cons of the various plans you are considering, and give you our professional opinion about which plans will best meet your needs. We’ll then help you get enrolled with the plan you choose.
How to Establish Your Health Savings Account
Once you have applied, you'll want to go ahead and set up your Health Savings Account. You are not required to establish an HSA, but by funding the account as soon as possible you'll be able to take advantage of the tax deductions and tax-deferred growth HSAs offer.
To establish your HSA, follow the steps below:
- Choose the bank or trustee you would like to administer your HSA.
- Fund your account no later than April 15th for the previous year.
- Decide how you want that money invested.
- Decide on a strategy for when you’re going to make withdrawals (see the How to Maximize Your Tax Benefits section below).
How to Maximize Your Tax Benefits
An HSA plan is really a pretty simple concept. You have a high-deductible health insurance plan you hope to never use, but if something big does happen, it will protect your assets and cover your medical expenses. There are a few things that can make a big difference in how much money you spend and how much money you accumulate in your account.
There are basically three different strategies on how to fund your HSA.
- Put no money in the account, except when you incur a medical expense. This strategy allows you to legally "launder" any money used to pay medical expenses. In other words, by depositing money into your HSA, then immediately withdrawing it to reimburse yourself for medical expenses, you are making your medical expenses all tax-deductible. You may want to use this strategy if you are on a tight budget and want to keep your cash outlay as low as possible.
- Fully fund the account, or at least put in as much as possible based on your budget. Take money out of the account any time medical expenses are incurred, and let the rest grow tax-deferred. This strategy will maximize your tax deduction, while making your HSA funds available to pay any non-covered medical expenses before your deductible is met.
- Fully fund the account, but pay all medical expenses from a non-HSA account. Reimburse yourself for medical expenses at a later date. This strategy will allow you to maximize your tax deduction and the tax-deferred growth of your HSA. You can then reimburse yourself, tax-free, at any time in the future for medical expenses incurred over the ensuing years.
To maximize the potential growth of your funds, you may want to make your HSA deposits as early in the year as possible. Any growth in your account is tax-deferred, like an IRA.
Take Full Advantage of Your HSA
Don't forget that every time you fund your account you get an instant tax deduction. When you offset the tax savings against your premiums, your net cost for an HSA plan can be very low.
The maximum allowable contribution goes up every year with the Consumer Price Index. If you are contributing to your account for 2024, the individual contribution limit is $4,150, and the family limit is $8,300. In 2025, that limit is $4,300 for individuals and $8,550 for families.
Review your options.
Rate increases for plans happen only in January, so make sure to review your options every year during open enrollment to make sure they’re still the best choice for you. Even if you switch to a plan without an HSA, the account and money are still yours to use; however, you simply can’t contribute to it anymore until you’re under another HSA-qualified plan
Often, people keep their plan much longer than they should, and end up paying much more than they should. If your rates go up, you can compare a wide variety of plans on our Instant Quote System. If you have your coverage through ColoHealth, we automatically do this analysis of available plans for you any time we are notified of rate increases.
Whether you pick an HSA with an insurance plan or a health share plan, HSAs plans are a great way to protect yourself while saving tax-deferred money. If you have any questions or would like to review your options, reach out to your Personal Benefits Manager or give us a call. We’d love to chat and help you through the process.
Healthshare Instant Quote
HEALTH COST-SHARING INFORMATION
- Not health insurance, but a way for like-minded individuals to share medical expenses
- Waiting periods on pre-existing conditions
- May exclude sharing for certain conditions or activities
- Enroll any time
- Much lower monthly cost than unsubsidized health insurance