Health Insurance Assistance

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 2016 household income. When you file your 2016 taxes, the Internal Revenue Service (IRS) will determine the correct amount of tax credit for which you are eligible based on your actual 2016 gross household income. Use the Individual Tax Calculator to estimate your tax credit.

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Health Care Reform

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.

Key Changes Have Taken Place

Insurance Requirements

In January 2014, federal law mandated that all individuals are required to have health insurance. There are 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 plan. (Space) People who are not lawfully present in the United States and people who are incarcerated are also not subject to the mandate. The Internal Revenue Service (IRS) will be responsible for enforcing the requirement.

How More People are Accessing Affordable Insurance

Two changes that help more people meet the federal requirement to have health insurance:

These changes have helped reduce the number of uninsured residents in Boulder County to 5%.

Tax Resources

There are three forms for you and the IRS to use that indicate your insurance coverage history each year.

1095-A

Individuals who have obtained insurance through the Marketplace will receive this form showing their months of coverage and any applicable tax credits.

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. The employer is also expected to report this information to the IRS.

Form 8965

This form is used to show gaps in coverage and to apply for exemptions to the tax penalty for not having coverage.

Form 8962

This form is used to calculate your final tax credit amount based on your actual income earned. This information is then reconciled to the tax credits that were paid out on your behalf during the year based on the income estimate you used when you applied for assistance.

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If you had Marketplace coverage in 2015 you should have received your 1095-A form before the end of February 2016. You can access your 1095-A form through your Connect for Health account in the “My Documents” section.

If you had Medicaid or CHP+ coverage in 2015, you should have received your 1095-B form before the end of February. You can access your 1095-B form through your PEAK account in the “Communications” section.

Did you have a gap in coverage?

You may be exempt from the tax penalty for not being covered for a variety of reasons, such as if your gap was only one month or two months in a row. Also, if you were out of the country for most of the past year, you may also be exempt.

Tax Information Resources:

Publications

Medicaid Expansion

In January 2014, Medicaid eligibility requirements expanded to 133% of the Federal Poverty Level (FPL) for all individuals. Colorado Medicaid already covered children up to 133% FPL, so the expansion increased coverage for parents with Medicaid-eligible children and to adults without dependent children.

Increase in Eligibility

The expansion means that Coloradans earning an income up to 133% of the Federal Poverty Level (FPL) will be eligible for Medicaid. See the current income limits for Colorado Medicaid . Children and pregnant women who are over income for Medicaid may be eligible for CHP+ Find out if you are Medicaid eligible and apply for benefits online by accessing Colorado PEAK

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