Health Insurance Assistance

The Affordable Care Act expanded access to affordable health coverage in 2010. Public health insurance programs – Medicaid and Child Health Plan Plus – which provide free or very low-cost coverage – were expanded. In Colorado, a private health insurance marketplace was created – Connect for Health Colorado – that offers financial assistance to reduce the cost of purchasing private health insurance through Premium Tax Credits or Cost-Sharing Reductions. See the chart for how these programs align to household incomes: dollar amounts are the maximum of each range.

• Medicaid and Child Health Plan Plus can be applied for and enrolled in at any time throughout the year.
• Private health coverage, on or off the Marketplace (Connect for Health Colorado), has an Open Enrollment period, November 1 – January 15, annually.
• Outside of Open Enrollment, you may still qualify to enroll during a 60-day Special Enrollment Period if you have a “Life Change Event” such as loss of health coverage, a change in marital status, a new household member or the loss of a household member, etc.

What to Expect

You will be contacted by one of our staff to schedule an appointment date and time and provided relevant information. Prior to your appointment you will receive an email with an Authorization Form that you need to review prior to your appointment.

A Health Coverage Guide will contact you at the scheduled time by phone and take it from there! The appointment may be entirely over the phone, or there may be an option to use online tools.

What to Prepare

To apply for health coverage you’ll need to provide some information about you and your household, including:

• Name, address, contact information
• Login information for Peak and/or Connect for Health Colorado accounts (if relevant)
• Social Security numbers
• Birth dates
• Employer information
• Income information (If self-employed please estimate your business expenses prior to the appointment)
• Information and policy numbers for health insurance plans
• Preferred health care providers
• Disability, asset and expense information (if applicable)

If you have access to insurance through your employer, and the insurance your employer offers is considered affordable, you may not qualify for help paying your premiums. We will need to know how much the premiums are and the amount your employer contributes to figure it out.

Provide Needed Verifications

Verifications are documents that may be requested to confirm information that you included in your application such as proof of citizenship, lawful presence, residence or a bank statement. If you need to verify information provided in your application, Connect for Health Colorado will send you a Mailed Notice.

Confirm Premium Payment

Your enrollment in your health insurance plan will be activated once you make your first premium payment. Call your health insurance company 7-10 days after paying your first month’s premium to confirm that payment was received and that your plan is activated.

Late Payments

There is a 30-day grace period for late payments for those with Marketplace plans and not receiving tax credits. Those receiving tax credits have a 90-day grace period for late premium payments. When repaying within that time limit, all overdue months need to be paid at one time.

Report Household Changes

If your income goes up or you lose a household member you may qualify for less tax credit than you’re receiving. If you don’t report the change, you could have to pay money back when you file your federal tax return.

If your income goes down or you gain a household member you could qualify for more tax credit than you’re receiving. This could lower what you pay in monthly premiums or you could qualify for free or low-cost coverage through Medicaid or the Children’s Health Plan Plus (CHP+).

If Eligibility Changes

If there is a change in APTC or CSR amounts, options include:

• Remain in current plan with revised APTC/CSR
• Purchase a new plan or make changes to current plan within a 60-day SEP

If Marketplace-eligible but no longer eligible for APTC/CSR, options include:

• Continue with or make changes to current plan without financial assistance, purchase a new plan without financial assistance, or cancel existing plan — within a 60-day SEP

If public health insurance-eligible, options include:

• Automatic enrollment in Health First Colorado (Medicaid) or CHP+ (which may require an enrollment fee)
• Continue with existing Marketplace plan without financial assistance, and Medicaid as a second payer

Renew Health Coverage Annually

• Colorado’s annual Open Enrollment is from November 1st – January 15th
• Those with existing health insurance and those purchasing new health insurance need to do so by December 15 in order to have coverage that begins January 1st
• Medicaid and Child Health Plan Plus do not have an open enrollment period, and my be applied for and enrolled if eligible, throughout the year

File Your Taxes

Tax Forms

• 1095-A: In late January, Connect for Health Colorado will mail the primary household member a copy of Tax Form 1095-A. Tax Form 1095-A is used to fill out Tax Credit Form 8962 – used to determine the final health insurance tax credit amount based on actual income and household size rather than the projected income used to apply.
• 1095-B: Individuals who have been covered by Medicaid or CHP+ will receive this form showing their months of coverage.
• 1095-C: Individuals who were offered coverage through their employer will receive this form indicating the months for which they were eligible for coverage. In some cases, the form also includes information on whether individuals and dependents were enrolled in health coverage offered by their employer.

Health Care Reform: The Affordable Care Act Remains the Law

The passage of the Patient Protection and Affordable Care Act in 2010 created a number of changes in the private and public health insurance system. The Affordable Care Act remains the law and the requirements, financial assistance, and protections put forth by the Act are still in place.

Key Changes Are Still in Place

Insurance Requirements

The 2014 federal law that mandated that all individuals are required to have health insurance remains in effect. The only change to the law is that the penalty for being uninsured will not be in effect in 2019. There continue to be exemptions to the requirement, including people who have certain religious beliefs, people who are members of a federally recognized tribe or who cannot find an affordable health plan. People who are not lawfully present in the United States and people who are incarcerated are also not subject to the mandate. Health insurance in universally considered a cornerstone to protecting your physical and financial health.

More People Are Accessing Affordable Insurance

In 2017 Boulder County saw a historically low rate of just 4% of residents remaining uninsured. Maintain your coverage with the financial benefits available.

Health Insurance Marketplace

Sometimes referred to as “the exchange”, Connect for Health Colorado is the state’s health insurance Marketplace. Individuals, families and small employers can shop for and buy health insurance through the Connect for Health Colorado website. Boulder County is a Certified Connect for Health Colorado Assistance Site and has trained Health Coverage Guides to help residents enroll in health insurance. Call 303-441-1000 or email healthcoverage@bouldercounty.org for more information or to make an appointment with a Health Coverage Guide.

Marketplace Helps People Who Are Not Eligible for Medicaid or Employer Based Coverage

With one application individuals and families can be evaluated for their eligibility for Medicaid/CHP+ and tax credits to help pay for private insurance in the Marketplace. The Marketplace is for U.S. citizens, legal permanent residents and all other lawfully present immigrants who currently buy insurance on their own, who are uninsured, or don’t have access to affordable coverage through their employer. Note: Deferred Action for Childhood Arrivals (DACA) permit holders are not eligible.

Tax Credit Lowers Your Monthly Premium

If you are eligible for tax credits they can be applied directly to your monthly premiums in order to reduce your monthly payment. Tax credits are calculated by the Marketplace using your estimated 2019 household income. Use Connect for Health’s Quick Cost and Plan Finder Tool to estimate your tax credit amount. To find out what counts as gross income, visit Health Reform: Beyond the Basics to see the formula for calculating Modified Adjusted Gross Income (MAGI).

Financial Assistance Reduces the Cost of Insurance

Financial assistance in the form of tax credits and cost share reductions is available for plans purchased through Connect for Health Colorado. Many households assume they earn too much to qualify. A household of four earning up to $100,400 may still qualify for financial assistance to reduce the costs of premiums. Not sure about your household’s eligibility? Meet with a Health Coverage Guide to see if your family qualifies for tax credits.

Learn More

Marketplace Client Information

• Steps to Have & Use Health Insurance
• Understand Your Health Insurance
• Confirm Your Enrollment
• Use Your Health Insurance
• Report Household Changes
• Provide Tax-filing Information
• Renew Health Insurance Annually

Health First Colorado Client Information

• Understand Health First Colorado (Medicaid)
• Understand Child Health Plan Plus

Tax Information Resources:

Publications