Colorado’s health insurance marketplace is “very competitive” and offers relatively low premiums, especially in its urban markets, according to a recent analysis by a health policy research group.
The Urban Institute, a nonpartisan, nonprofit center has been tracking the effects of the Affordable Care Act with funding from the Robert Wood Johnson Foundation.
In the Denver area, eight carriers offer coverage in the individual marketplace. The lowest-cost “silver” plan through the state exchange, called Connect for Health Colorado, costs $201 a month for a 27-year-old and $343 for a 50-year-old. Both were offered by Kaiser Permanente.
Plans can vary in benefits offered and patient co-pays, but the lowest monthly premiums in the Denver market were offered by Kaiser Permanente and Humana. Rocky Mountain Health Plans offered rates about 25 percent higher than Kaiser’s. Cigna and Access Health Colorado were even higher, the analysis found.
Four carriers offer plans in the Grand Junction area. The lowest-priced ilver-plan premium costs $234 for a 27-year-old and $399 for a 50-year-old — offered by Rocky Mountain Health Plans. That carrier is extremely competitive in the Grand Junction area but less so throughout the state, the report said.
Six carriers are active in a region that includes 18 rural counties in southeastern Colorado.
Colorado Choice, a health-maintenance organization centered in the San Luis Valley, has relatively low premiums in that market, according to the analysis.
Colorado Health OP, the state’s consumer co-op, is fairly competitive in Denver but less so in Grand Junction, the Urban Institute said. The co-op has the lowest-cost silver plan in the rural rating area examined in the study, but rates in the San Luis Valley are still high — as they are in all small towns and rural areas with limited medical providers.
Insurance carriers set rates based on what they assume about the population being covered, study authors John Holahan and Linda Blumber wrote. However, insurers offering their first exchange plans for 2014 didn’t know the health status or claims history of enrollees. And, under the Affordable Care Act, every applicant must be charged the same as everyone else in their age group.
Minimum benefits, too, are mandated.
So how much carriers charge is based on assumptions about how much the population will use insurance. And rates also are based on how carriers perceive ACA’s regulations will effectively spread risk among plans, the report noted.
Another factor in setting rates is how much leverage carriers have over physicians and hospitals in setting prices.
Electa Draper: 303-954-1276, edraper@denverpost.com or twitter.com/electadraper
