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Colorado HealthOP 2013 Clipbook

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An all-in-one document showcasing the top media placements and PR efforts for the year.

An all-in-one document showcasing the top media placements and PR efforts for the year.

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Colorado HealthOP 2013 Clipbook Colorado HealthOP 2013 Clipbook Document Transcript

  • Media Presence | 2013
  • Table of Contents April...................................................................................................... May....................................................................................................... June...................................................................................................... July....................................................................................................... August.................................................................................................. September............................................................................................ October.................................................................................................. November............................................................................................. December.............................................................................................. page 4 page 6 to 16 page 18 to 25 page 27 to 34 page 36 to 44 page 46 to 68 page 70 to 96 page 98 to 105 page 107 to 115
  • April 2013
  • page 4 April 29, 2013 Colorado HealthOP receives license from state of Colorado | Howard Pankratz Colorado HealthOp, Colorado’s first statewide nonprofit health-insurance cooperative, said Monday it has received a certificate of authority from the Colorado Division of Insurance to provide health insurance. The organization said the licensing establishes Colorado HealthOp as an official health-insurance plan and authorizes Colorado HealthOp to provide “affordable, quality coverage to individuals and employers.” To earn a license in Colorado, an insurance provider must undergo a review process to determine its potential for longevity. The Colorado Division of Insurance evaluates the organization’s business plan and financial solvency, as well as the background of its executive team and board members. The Co-op, which was sponsored by the Rocky Mountain Farmers Union Educational and Charitable Foundation, will provide a variety of health-insurance options for individuals and employers in urban and rural communities across Colorado. In its first year of operation, Colorado HealthOp will offer a statewide provider network. Enrollment will begin Oct. 1, to coincide with the availability of Connect for Health Colorado, the state’s online health-insurance marketplace. Coverage will begin Jan. 1. Plans will be available on the marketplace through a network of brokers and agents and on Colorado HealthOp’s website at www.cohealthop.org.
  • May 2013
  • page 6 May 10, 2013 State gets different brand of insurance | Amy Gillentine
  • page 7
  • page 8 May 10, 2013 State’s first nonprofit health insurance co-op set to enroll | Sharon Dunn Come next fall, residents can start tapping into a new health insurance option, which is set to be one of likely many for residents to comply with before the January 2014 requirement for mandatory insurance under the Affordable Care Act. Colorado HealthOP, the state’s first nonprofit health insurance cooperative, will begin enrolling residents in October, to help people meet that federal deadline. It is a nonprofit health insurance cooperative, which touts itself as an affordable option for individuals, families and small employers and groups. “Health insurance has gotten less affordable for people over time, so a lot of what we’re doing is working to bend the trend and put health care decision-making back in hands of health care providers,” Julia Hutchins, CEO of Colorado HealthOP, said. “We hope it will allow people of all incomes to afford insurance and to be able to have insurance that’s a partner with them and improving health in their community.” According to the U.S. Centers for Medicare and Medicaid Services, there are approximately 37,842 uninsured people in Weld County. Across the state, it’s estimated that 829,000 residents are uninsured. The Affordable Care Act, among several health care reforms, requires most residents to buy health insurance, beginning in January. Those who have a religious objection, are undocumented immigrants, are incarcerated, are members of a American Indian tribe, or make less than the threshold to file federal taxes, or who would pay more than 8 percent of their income for health insurance, are exempted. Those who don’t meet those exceptions will be required to find insurance or face a penalty that rises ever year. The penalty starts at $95 per adult and $47.50 per child next year, and rises to $325 per adult and $162.50 per child in 2015. The penalty in 2016 and beyond rises to $695 per adult and $347.50 per child. People can look at the Health Insurance Marketplace for insurance options that best suit their pocketbooks. The Colorado HealthOP was one of 24 cooperatives across the country that received start-up funding under the ACA to get started. Hutchins said the Colorado HealthOP will offer insurance with several products to match their budgets and focus on keeping them healthy. Actual costs of the program are still being reviewed and will be announced later this month. “The benefit structure is unique in that it rewards for prevention and primary care,” Hutchins said. “We’ll have ways for people to go in and get screenings and to be financially rewarded for doing that.” Hutchins said the Colorado HealthOP program can help small businesses finally offer insurance to their employees. She said that 63 percent of small businesses in Colorado don’t offer insurance.
  • page 9 “We’ll stand out because we’re new, and we are a nonprofit, we’re local, and our benefit designs will be uniquely focused on helping members stay sustainable and healthy,” Hutchins said Hutchins said benefits under the insurance program will be tailored to the individual and work with primary health care providers to provide more management and coordination of the many complexities patients with multiple conditions have. “A lot of the care coordination work we offer will help people avoid unnecessary visits to the ER, which is part of a bigger recipe to reduce health care costs,” Hutchins said. While consumers will have to comply with the mandatory insurance requirement, hospitals are gearing up for the myriad changes they will see. Starting in 2015, hospitals’ Medicare and Medicaid reimbursement funding will be based on keeping people from repeat visits to the ERs, and even patient satisfaction surveys. Hospitals across the country are now revamping their entire systems. North Colorado Medical Center, as an example, is working to cut $30 million in costs in the next two years to comply with the coming provisions, as well as prepare for reduced reimbursements from the Medicaid and Medicare systems, which essentially make up about half of their budget. Consumers who opt into the cooperative also will have a voice in their coverage. Hutchins said consumers also will be rewarded under the Colorado HealthOP plan for certain preventative health steps. “Most of the plans also have a health incentive account attached, so when someone goes in for a health checkup, they could get some additional money on a health credit card to help pay other health costs.” The cooperative is structured so that if revenues exceed costs, the surplus will be given back to members through lower premiums, expanded benefits and quality improvements. “We’re really excited,” Hutchins said. “There’s a lot of interest in thinking of new ways for insurance to function as a vehicle to support health as opposed to something that’s there only when you’re sick.”
  • page 10 May 15, 2013 Member-owned health cooperative formed | Loretta Sword Colorado HealthOP, a new member-owned health insurance cooperative, will be among the choices Coloradans will have when choosing coverage this fall under the state’s new insurance exchange, called Connect for Health Colorado. Colorado HealthOP is a consumer-governed and operated health insurance plan that allows each member a vote in the cooperative’s operations. Members also will sit on the board of directors. In addition, if the COOP’s revenues exceed its costs, the surplus will be reinvested to directly benefit members through lower premiums, quality improvements and expanded benefits, according to a news release. The document said the company is “designed to make members sustainably healthy” through incentives for preventive care, including free wellness exams and other savings options. The cooperative will operate under a “no surprises” philosophy that includes a “pay first” rather than “deny first” policy regarding claims. In other words, “the CO-OP is committed to paying for (its) members’ health care, not denying claims and hoping their members won’t fight it,” said spokeswoman Shannon Fern. “It may seem lofty, but ultimately, Colorado HealthOP’s goal is to change the way health insurance is delivered in Colorado and to advance health care in the state. We’re really excited that we’re at a historic time in Colorado when not only will uninsured Coloradans be able to get insurance for the first time, but they’ll also have access to a new model that hasn’t previously existed in the state,” Fern said.
  • page 11 May 22, 2013 Technical problems slow launch of Colorado health insurance website | Michael Booth State insurance officials wanted to offer the public an easy way to check new health policy prices in preparation for “Obamacare,” but their site wasn’t working most of Wednesday. The state site — dora.colorado.gov/healthinsurance — and the first look at “base rates” were touted as an important step on the way to launching the health benefits exchange, a separate entity, on Oct. 1 for policies taking effect Jan. 1. The exchange, called Connect for Health Colorado, emphasized Wednesday that its connection to a national health insurance database on rates has tested properly. Despite the state hiccup, consumer advocates said Colorado attracted a “robust” group of insurers to craft policies. Nineteen health insurers filed proposed rates for hundreds of policy options, more than the state insurance commissioner expected. Wide competition should produce livable rates for buyers, said Dede de Percin, director of the Colorado Consumer Health Initiative, a coalition covering hundreds of thousands of members. One insurance plan that hopes to be approved for the exchange gave examples of the rates it filed to the state. The Colorado HealthOP, a nonprofit, consumer-governed plan, said one plan will offer catastrophic coverage to a non-smoking, 21-year-old Denver resident for about $155 a month. A 40-year-old Denver nonsmoker will get comprehensive “silver,” or mid-level coverage, for about $265 a month, the co-op said. The base rates will rise or fall for customers when adjusted for allowed variables, including age, geography and providers. Some of the retail cost may be paid by the U.S. government according to income. When the state site did begin working, it included a “bronze” plan from Humana Connect, for a family of six, at $740 a month. The deductible was high, at $6,300. A plan from Anthem’s HMO Colorado, at the “silver” level, for a family of five, listed at $1,305 a month; the deductible was unclear. Regulators will review the proposed rates. The state has already warned that some won’t meet benefit or pricing rules. If approved, the proposals will be listed on Connect for Health Colorado, the only place consumers can qualify for federal subsidies to afford insurance.
  • page 12 May 22, 2013 Big differences in costs for Colorado small-group coverage under health reform | Ed Sealover Monthly premiums vary wildly for individual and small-group health plans that are proposed to be sold in Colorado in 2014 -- the first full year of implementation of the federal health care reform bill -- according to officials at the Colorado Division of Insurance and a Denver Business Journal review of insurance filings released Wednesday. For example, a typical 40-year-old non-smoking Denver-area resident wanting a “silver band” plan -- those for which 70 percent of the costs are covered by the plan -- might pay anywhere from $265 to $405 a month for an individual plan. And an employer providing insurance to that same 40-year-old as part of small-group plan might have to pay $459 a month for that plan, according to a number of filings. The full scope of filings for the 17 companies that have submitted rate cases needed to sell individual and small-group insurance in Colorado next year was not available, as computer problems kept the Division of Insurance from being able to release all of the filings to the public Wednesday. The number of 17 companies also was two lower than Insurance Commissioner Jim Riesberg said last week that he expected to offer plans under the new, more heavily regulated market, as there was a mixup with two companies that appeared to be four separate companies originally, division officials said. But the initial reaction of health care activists watching the filings was a positive one. Dede de Percin, executive director of the Colorado Consumer Health Initiative, said the 17 carriers submitting a cumulative 813 plans for the individual and small-group markets ensures that prices will be kept at a reasonable rate because of competition, both in the general market and in the soon-to-launch Colorado health benefit exchange. “It’s good news. Some other states don’t have robust competition,” de Percin said. “And we have more carriers than we thought and more choices than we thought. And that will drive competition in the exchange.” According to a database released by the Division of Insurance, at least 11 of those 17 carriers will offer policies in the exchange -- known as Connect for Health Colorado, which is essentially an Internet marketplace for health insurance that will be available to consumers and small businesses on Oct. 1. Most of the state’s largest carriers -- including Kaiser Permanente Colorado, Humana, Rocky Mountain Health Plans and Anthem Blue Cross and Blue Shield of Colorado -- will sell multiple plans through the exchange. By comparison, similarly sized Washington state had just nine insurers submit plans for its exchange, according to Kaiser Health News. And Montana had just three, Colorado Insurance Commissioner Jim Riesberg said.
  • page 13 “It’s a new world for health insurance,” Riesberg said. “These will be new plans, with new premiums and new benefit packages, developed to meet new requirements.” Those new requirements under the federal Patient Protection and Affordable Care Act, termed by some as Obamacare -- including 10 essential health benefits, ranging from emergency care to mental-health treatment, that must be included in each policy -- have led insurers to speculate for months that premiums that already have been on a consistent upward trend will go through the roof in 2014. An immediate comparison to current prices is hard to make, as these new rates are being filed under first-time conditions, essentially creating new plans. Plus, with individuals having to pay different rates based on their ages, their geographic locations, their smoking statuses and the level of plan they choose -- not to mention their ability to get tax subsidies based on their incomes -- exact prices are hard to pinpoint right away. But the company that appeared to have the most affordable rates, at least initially, is a new one -- Colorado HealthOP, the health care cooperative launched to help slow the rise of premiums for rural residents and small rural businesses. The co-op’s average health premium for a 40-year-old Denverite will be $265 a month, and the per-person cost of a small-group policy will be slightly higher than that, CEO Julia Hutchins said. Colorado HealthOP can keep its premiums down, Hutchins said in an interview last week, because it offers a unique benefit structure that lowers costs for people who make efforts to stay healthy and funnels all of its revenues back into improving the insurance plan. Co-op members will elect the leaders of the company, and 50 percent of the board will be made up of customers who decide how the new company can improve benefits or lower premiums, she explained. “This really is about turning health care on its head,” Hutchins said. “And while we have some connection to the Affordable Care Act, we’re more of a vehicle for some of the goals of the Affordable Care Act.” Rate filings will continue to be made available in the coming days on the Division of Insurance website, and Riesberg and his staff will examine each of the filings between now and July 31 to ensure that they meet the new requirements of the federal law and that proposed rates are not excessive. But with other states reporting far less participation in the exchange, observers remain excited. “We have a pretty diverse market,” de Percin said. “Obviously the insurers are seeing this as a great place to do business.”
  • page 14 May 31, 2013 Rates ‘decent’ for Colorado health exchange | Katie Kerwin McCrimmon Rate shock. What rate shock? That seems to be the initial reaction both in Colorado and in states like California as rates for new plans proposed under Obamacare begin to emerge. Here in Colorado, while regular folks enjoyed Memorial Day, health policy geeks and insurance actuaries were mining a state website trying to find out how hundreds of proposed rates in Colorado look. The news about Colorado rates has been very slow to emerge because Colorado’s Division of Insurance (DOI) had a computer snafu that prevented industry insiders and members of the public from easily analyzing the new rates. Officials at both the DOI and Colorado’s new health exchange say that the computer problems that DOI has dealt with have nothing to do with how easily customers will be able to view plans and shop for health insurance once the exchange, known as Connect for Health, opens on Oct. 1. (To search for rates, click here. For FAQs on rates, click here.) Vince Plymell, spokesman for the DOI, says 13 carriers are offering about 242 plans to be sold on the exchange. About 150 of those plans will cater to individuals. While DOI officials still are working to improve their search engine and are hoping to release a definitive spreadsheet of proposed rates by next week, others are simply doing analyses of their own. And, to Dede de Percin, executive director for the Colorado Consumer Health Initiative, the early findings look good for consumers. “So far, we’re seeing some great rates, particularly from the co-op (Colorado’s new customer-owned nonprofit health insurance company cooperative called Colorado HealthOP),” de Percin said. “They look really competitive. We’re also seeing some decent rates from other insurers.” For instance, a 21-year-old in Denver could buy a health plan for about $150 a month from Colorado HealthOP. A 40-year-old living in Denver would pay about $270 per month for a mid-level “silver” plan. Out-of-pocket costs for most people will be much less than that since many consumers will qualify for tax subsidies to defray the costs of health coverage. Julia Hutchins, CEO of Colorado HealthOP, thinks the proposed rates in Colorado are an early sign that Obamacare will work. “It’s great for consumers. They will have a lot of choice. Prices look good overall.
  • page 15 People who have insurance now should consider other options,” Hutchins said. “There is not rate shock. Kaiser (Permanente) looks good. We look good. Overall, for consumers and small businesses, 2014 will be a good time to shop for health insurance.” The new health co-op will be selling insurance statewide and as the new kid on the block, has rather modest plans to have about 25,000 customers in its first three years. In particular they’ll target 20-somethings such as graduate students. “We believe everyone should have the option of choosing a co-op,” Hutchins said. She said the co-op’s low overhead allows it to offer less expensive plans. In addition, customers will own the health insurance company so they’ll get to decide what to do with any profits: return them to customers or invest in better quality. “The only way we’re really going to address costs in the long run is by recognizing that it’s our money too,” Hutchins said. “It’s a powerful model for health insurance.” Hutchins said Colorado HealthOP is partnering with local providers who will focus on keeping people healthy, not on providing “sick care.” There will be incentives for both patients and providers to commit to improving quality while reducing costs. “This is a long-term investment that will pay off over time,” Hutchins said. Created in concert with the Rocky Mountain Farmers Union, the co-op aims to serve people who haven’t gotten good health coverage in the past. “Our ideal customer is someone who really share’s the co-op’s philosophy and really believes in improving their own health or the health of the community,” Hutchins said. “The biggest opportunity is for folks who haven’t had reliable health insurance in the past.” Representatives for other health insurance providers did not respond to requests for comment on their rates or those of competitors. But a statement on the Colorado Association of Health Plans’ website http:// www.colohealthplans.org/ said that the industry is pleased that “every member of our health insurance plan association…will be offering a product on the Connect for Health Colorado exchange. “The number of insurers that have filed plans to be sold on the new exchange shows our industry’s commitment to quality, affordable health care for all,” the association’s executive director, Ben Price, said in the statement. While objecting to new taxes under the Affordable Care Act that the industry is fighting to repeal, Price said consumers should be able to access new high quality health plans. All plans are required to cover “essential benefits.” These include outpatient, emergency and hospital services; maternity and newborn care; mental health and substance use treatment; prescription drug coverage; rehabilitation; labs; preventive and wellness care; chronic disease management; and pediatric dental and vision care. For de Percin of the Colorado Consumer Health Initiative, it’s important to note that many people will qualify for subsidies, that the plans they’ll get are entirely new and that even if some rates seem high,
  • page 16 the existence of some lower bids will foster greater competition. “You only need some of the insurers to have good rates because that’s going to drive people to them. As long as we have some competitive rates, then we have a competitive market,” she said. “We’re still digging through all of it,” de Percin said. “We’re seeing some rates all over the place, but there is not rate shock. “I really want to make the point that these are new rates for new products with new coverage.” Caroline Pearson, an analyst who studies health exchanges as a vice president for the national consulting firm, Avalere Health, said the relatively high number of plans in Colorado is noteworthy. “You had a lot of participation. What was most striking about Colorado is the remarkable multitude of plans that will be there,” she said. While Colorado should have healthy competition, Pearson said having scores of choices could actually be confusing for consumers. “Is it too much? Does it become an overwhelming shopping experience?” While Colorado has a significant number of carriers choosing to participate in its exchange, it’s not the highest in the country. Oregon, for instance, will have 16 carriers selling plans in both its individual and group market, according to Pearson. And so far, rates are being unveiled in about eight states. Some health advocates in Colorado have theorized that carriers want to do business in Colorado because the population is relatively healthy. But Pearson said the reasons companies have chosen particular markets are more complicated than that. “It’s been a little hard to parse. We’re seeing more participation in larger states with larger populations. Bigger markets are drawing more (carriers),” Pearson said. But that’s not true across the board. For instance, in the northeast, regional health insurance companies dominate and states there will not have a high number of carriers offering multiple plans. Other states should have a lot of competition, but don’t. For instance, Pearson said Illinois has just six carriers. Meanwhile, the District of Columbia has four carriers, but they’re offering a lot of choice: 259 plans. Pearson said the jury is still out on rates. In California, she said a high degree of competition drove down rates. In Oregon, some carriers asked for “do-overs,” wanting to reduce their rates after they saw what other companies proposed. That could happen in Colorado as well. DOI analysts are now reviewing each of the proposed plans. They will determine if each plan offers all the components that it must and if the proposed rates are reasonable. They will ensure that rates are “actuarily sound” and that they are neither too low nor too high. Final rates will be approved by July 31. Until then, Pearson said rates could change slightly. “There are so many new moving parts. You could see a little flux,” she said. “I wouldn’t be surprised if states revise their numbers.”
  • June 2013
  • page 18 June 5, 2013 Colorado HealthOP Appoints Dr. Jack Westfall as Chief Medical Officer Dr. Westfall Will Develop New Health Promotion Model Focused on Collaboration Among Healthcare Providers and CO-OP Members In an effort to build a health insurance model that helps its members be sustainably healthy, Colorado HealthOP, Colorado’s first statewide nonprofit health insu... (CO-OP), has engaged a leading expert in family medicine and rural health as its new chief medical officer. Jack Westfall, MD, MPH, will lead Colorado HealthOP’s efforts to support member health needs by building a robust statewide network of care, developing Colorado HealthOP’s integrated care model and population health programs, and optimizing the CO-OP’s clinical effectiveness. “The aspiration to partner with patients and providers around improving health is a key concept of the CO- OP,” said Julia Hutchins, CEO of Colorado HealthOP. “Dr. Westfall’s expertise in family medicine, preventive care and rural health coupled with his experience in community health promotion will allow us to make this idea a reality for our members.” Colorado HealthOP offers quality, affordable Colorado insurance plans to residents of the state, with a special focus on rural areas. As the CO-OP’s chief medical officer, Dr. Westfall will lead the development of a new model for promoting health. While insurance companies have historically provided support for when people are ill, Colorado HealthOP, led by Dr. Westfall, will build an environment that not only provides “sick care,” but also supports healthy living. In an effort to optimize Colorado HealthOP’s potential to be an enabler of health rather than a barrier to care, Dr. Westfall will work with healthcare providers to maximize quality of care and minimize bureaucracy associated with claims. He will additionally lend his expertise to the CO-OP’s benefit design to ensure that the benefit structure supports prevention and health maintenance. “Colorado HealthOP is building a collaboration among the group that pays, the group that provides and the patient who needs healthcare; these three groups that have historically worked separately and at odds with one another now work together in our model,” said Dr. Westfall. “In Colorado HealthOP’s model, we will take existing concepts and constructs that have been shown to support health, pull them together into one organization and implement them in Colorado.“ Dr. Westfall serves as clinical professor of family medicine for the University of Colorado School of Medicine, an institution where he has held multiple teaching appointments since 1995, served as associate dean for rural health from 2004 to 2013, and was the Patrick and Kathleen Thompson endowed chair in rural health from 2008 to 2013. Board certified in family practice, Dr. Westfall has served as a family physician at the Yuma Clinic in Yuma, Colo., at Plains Medical Center in Limon, Colo. and for Rose Family Medicine in Denver. He is the founder and director of the High Plains Research Network, a practice and community based network that **digital outreach**
  • page 19 aims to improve health in eastern Colorado. He has also served as director of community engagement for the Colorado Clinical Translational Science Institute, a collaboration among the University of Colorado Denver, University of Colorado Boulder, and multiple healthcare and community organizations with a goal to accelerate the application of research into improved patient care and public health. Dr. Westfall is a member of the American Academy of Family Physicians, the Colorado Academy of Family Physicians, the American Public Health Association, the Colorado Public Health Association, the Society of Teachers of Family Medicine, the Colorado Rural Health Center and the National Rural Health Association. Among other awards, Dr. Westfall has received the Chancellor’s Diversity Award from the University of Colorado Denver and the North American Primary Care Research Group President’s Award. Dr. Westfall received his doctorate and a master’s degree in public health from the University of Kansas. He completed his internship in internal medicine and pediatrics at the Wichita Center for Graduate Medical Education and completed his residency at the University of Colorado, Department of Family Medicine, where he also served as chief resident.
  • page 20 A leading Colorado consumer advocacy group has completed a detailed study of new rates to be offered on the state health insurance exchange and found the price ranges to be Goldilocks — “just right.” The range of rates for sample mid-level insurance plans should deflate worries that expanded benefits and new mandates to cover consumers who are already sick will wildly inflate prices for the public, according to the Colorado Consumer Health Initiative. Comparing a “silver” level plan from 10 different carriers to go on sale starting in October found acceptable prices and robust competition between the insurance companies, said CCHI director Dede de Percin. “Colorado consumers will be pleased they will have enough health insurance plans from among which to choose without being overwhelmed by too many choices,” de Percin said. “It looks like Goldilocks, just right. “Despite doomsday predictions, the state is not seeing ‘rate shock’, so many of the choices will be affordable.” The prices will be lowered further for consumers by the federal subsidies that many exchange users will qualify for. A family of four can make up to $94,000 a year and still qualify for some federal tax credit help, which is one of the main features of the 2010 “Obamacare” law that is meant to expand health insurance to tens of millions of Americans who can’t afford it. When consumers sit down with “navigators” after Oct. 1 to sign up for coverage, they will choose from bronze, silver and platinum plans from various carriers, and then also learn what their take-home price will be after income-based subsidies are applied. The CCHI analysis found the pre-subsidy prices for a silver plan for a 27-year-old Denver individual will be $207 to $373 a month; for a 40-year-old in Denver, $253 to $454 a month. Outstate prices can range somewhat higher, with a Durango 27-year-old paying $207 to $504 for the same plans, and a 40-year-old paying $253 to $615. For families, the range in Denver is $756 to $1,360 a month; in Fort Collins, $718 to $1,481 a month. Once the subsidies are factored in, CCHI said, that 40-year-old offered a policy in the middle range of $350 a month, if they earned $23,000 a year, would only contribute $196 a month of their own money to a health plan. June 5, 2013 Colorado consumer group reviews new health insurance rates and calls them “just right” | Michael Booth
  • page 21 The state Division of Insurance is still completing its own analysis of the rate proposals. They still must be reviewed and approved by the state for factors including their adherence to the minimum benefit levels set by federal and state officials. The state’s computer system, which is separate from the systems that will be used by the insurance exchange, were clogged in May when they first tried to release data on the proposed rates. At that time, one of the few groups publicizing its own rates was the Colorado HealthOP, a nonprofit, consumer-governed plan. Officials from the cooperative said it will offer catastrophic coverage to a non- smoking, 21-year-old Denver resident for about $155 a month. A 40-year-old Denver nonsmoker will get comprehensive “silver,” or mid-level coverage, for about $265 a month, the co-op said.
  • page 22 June 14, 2013 Newsmakers
  • page 23 June 16, 2013 Health Care Options Health insurers are applying to offer individual coverage on the new Affordable Care Act exchanges for Oct. 1.
  • page 24 June 28, 2013 Colorado HealthOP now using social media to help consumers understand insurance options To break through the confusion about the changes in healthcare and help Coloradans make smarter decisions about how they choose and use health insurance, Colorado HealthOP, Colorado’s first statewide nonprofit health insurance cooperative (CO-OP), has taken to social media. The CO-OP’s new social media profiles, on Facebook, Twitter, YouTube, LinkedIn and SlideShare, are designed to offer tips and resources to help Coloradans better understand how health insurance can benefit their health and their pocketbooks. “Colorado HealthOP looks forward to helping Coloradans, particularly the more than 829,000 who are uninsured and the 466,000 who qualify for healthcare subsidies, take advantage of this unprecedented access to health insurance in Colorado,” said Fedelina Madrid, vice president of consumer and community engagement for Colorado HealthOP. “It is imperative that we engage and educate Coloradans where they are—whether on the ground or online. The launch of these profiles supports our efforts to make quality health insurance and health information more accessible.” Colorado HealthOP’s social media profiles will not only offer information about changes in Colorado healthcare, but will also give Coloradans simple steps they can take to improve their health and decrease their healthcare spending. The profiles will also help consumers keep track of important information about Connect for Health Colorado, the Colorado health benefit exchange, as well as enrollment dates and details about subsidies. Via Colorado HealthOP’s website and social networks, Coloradans can opt-in for more information about the CO-OP and ongoing updates about important changes in Colorado healthcare. “As a cooperative, Colorado HealthOP will demonstrate how being a more educated consumer of healthcare and making healthy decisions can make access to healthcare a more rewarding experience,” continued Madrid. “It is Colorado HealthOP’s priority to provide that education, and we are committed to helping our fans, followers and subscribers be better prepared to make smarter decisions.” In the coming months, Colorado HealthOP will launch a comprehensive website experience with a robust resource area, advance its social media communications and deploy a mobile application in its efforts to develop a new model for promoting health. To opt-in for more information about Colorado HealthOP and health insurance in Colorado, and to learn about how the CO-OP is turning health insurance on its head, visit www.COHealthOP.org. **digital outreach**
  • page 25 In order the help make decisions on their health care, Colorado HealthOP has joined the Social Media scene with Facebook, Twitter, YouTube, LinkedIn and SlideShare. With the social media sites they can give Coloradoans tips and other resources to help them make important decisions about their health care coverage. This also makes Colorado HealthOP the first non-profit insurance co-op to go social. The social media world is going to provide an on-line information system to where consumers can get up-to- date information on new ideas to improve their healthcare spending by sharing new information from Connect for Health Colorado, which is the benefit exchange. They will post enrollment dates and details about subsides as they change or become available. All you have to do is opt-in. This is only the beginning of the internet resources they will be providing as they have launched a website which will be continuously updated with all of the information you will need to help make those health care decisions and are following-up with a mobile application enabling you to make them anywhere. Fedelina Madrid, Vice President of Consumer and Community Engagement for Colorado HealthOP made the following comments about the new changes and how they are reaching out to the community making their services accessible in all fashions for Coloradoans; “Colorado HealthOP looks forward to helping Coloradans, particularly the more than 829,000 who are uninsured and the 466,000 who qualify for healthcare subsidies, take advantage of this unprecedented access to health insurance in Colorado,” “It is imperative that we engage and educate Coloradans where they are—whether on the ground or online. The launch of these profiles supports our efforts to make quality health insurance and health information more accessible.” Madrid also commented on the fact that they are going to demonstrate how the communities of Colorado can make better choices with their healthcare by visiting the sites, which will be very informative, making their visits rewarding, enabling them to not only make responsible decisions but to provide the education needed to remain healthy. To opt-in for more information about Colorado HealthOP, health insurance in Colorado and to learn about how the CO-OP is turning health insurance on its head click here or visit: www.COHealthOP.org. For more information on Connect for Health Colorado click here or visit: www.connectforhealthco.com. June 29, 2013 Colorado HealthOP has gone social | Charles Callahan
  • July 2013
  • page 27 July 1, 2013 CO-OPs Report Competitive Premiums, but Face Challenges | Neal Learner
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  • page 29 July 6, 2013 Business briefs Children’s Hospital Colorado recently named Greg Raymond as regional vice president for Southern Colorado and Alexis Rodmon, previously a community outreach coordinator at Parkview Medical Center, as physicians relations representative for Southern Colorado and South Metro Denver. The hospital’s main campus is in Aurora. ••• NPR teams with state’s public radio DENVER — Colorado Public Radio News is one of 15 public radio organizations that began contributing to NPR’s Here & Now program starting this month. Here & Now replaced the discontinued Talk of the Nation program in CPR’s noon to 2 p.m. time slot Monday through Thursday. RMVI expands Hispanic outreach Pueblo-based Rocky Mountain Vein Institute recently partnered with CyraCom to provide telephone and on- site interpretation and translation services as part of its customer service program for Spanish-speaking and other Limited English Proficiency clients. Health care websites launch Colorado HealthOP, the first statewide nonprofit health insurance cooperative to launch under the Affordable Care Act, recently began a social media informational campaign on Facebook, YouTube, LinkedIn, Twitter and SlideShare. “It is imperative that we engage and educate Coloradans where they are — whether on the ground or online. The launch of these profiles supports our efforts to make quality health insurance and health information more accessible,” Colorado HealthOP Vice President Fedelina Madrid said. Noodles donates Noodles & Co. will donate $1 from every entree purchased between last Monday and last Wednesday (up to $10,000) to Care and Share Food Bank for Southern Colorado in support of the victims of the Southern Colorado’s recent wildfires.
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  • page 31 July 15, 2013 Middle of the Pack | Rich Daly
  • page 32 July 18, 2013 Employers Could Make a Costly Mistake With Early Health Insurance Renewal Many Colorado employers are considering renewing their health insurance early. For business owners, this deliberation is being driven by confusion about changes in healthcare, and for larger businesses, specifically by their struggles to understand how the Affordable Care Act employer mandate delay announced this month will affect health insurance decisions for them and their workforce. According to Colorado HealthOP, Colorado’s first statewide nonprofit health insurance cooperative (CO-OP), the decision to renew early could be a costly mistake. “Business owners are feeling a lot of pressure to quickly lock in their 2014 health insurance rates. They are confused about the insurance landscape, and many insurance carriers are encouraging or providing incentives for early renewal,” said Julia Hutchins, chief executive officer of Colorado HealthOP. “Unfortunately, those that do not consider their options in 2014 prior to renewing may be missing out on opportunities to make smarter choices for their employees’ health and their bottom line.” For many employers, waiting and exploring new options available in 2014 may be a better alternative. Colorado HealthOP shares these four reasons why waiting to renew health insurance may be the best choice for many business owners: 1. Small employers will have more health insurance options. The number of carriers actively selling products in the small group market in 2014 has increased. New companies like Colorado HealthOP are offering innovative products that may be a better fit for employers committed to the health and wellness of their workforce. 2. Employees of small businesses get more choices. Small businesses that purchase insurance through Connect for Health Colorado’s small group exchange have the opportunity to offer their employees a choice of multiple health plans from multiple carriers, rather than contracting with one overarching health plan. For employers that have historically not been able to give their employees a lot of choice, this is a major benefit of waiting to renew. 3. Businesses of all sizes have the option of considering whether the individual market may actually be best for employees. For some employers, directing employees to Connect for Health Colorado to purchase a health plan may actually allow their employees to access richer benefits at a lower cost. This is especially true for businesses with a large percentage of employees who qualify for income-based subsidies. 4. Employers and individuals may be able to access health plan prices that are comparable to current renewal prices. When preliminary insurance rates were released in early June, small businesses and individuals alike were pleasantly surprised to see reasonable prices comparable to 2013. When Connect for Health Colorado launches in October, employers and individuals may find that there is financial benefit in waiting to renew their health insurance in Colorado. **digital outreach**
  • page 33 “As a responsible manager of their employees’ benefit plan, business owners need to research their options and do their financial due diligence, particularly around early renewal,” said Hutchins. “This is particularly important to ensure that early renewal does not put the business at risk for future financial or legal problems.” To help reduce the confusion, Colorado HealthOP is offering a free health insurance analysis to help employers determine if renewal of their current plan, purchasing a plan on the health insurance marketplace or directing employees to the individual market is likely to be the best choice for them. The analysis considers the size and composition of a company’s workforce and determines the optimal path for employers.
  • page 34 July 31, 2013 New co-op gearing up | Chris Woodka A statewide nonprofit health insurance cooperative is hoping to attract members who are looking for options under the Affordable Care Act. “In October, we will fundamentally change the way we offer insurance,” said Julia Hutchins, CEO of Colorado HealthOP. “We plan to turn health care on its head to make it more affordable.” Earlier focus groups showed Pueblo consumers favored the approach of having a member-elected board with insurance options that are tailored for individuals and small business. The cooperative was formed in 2012 with a $69.4 million loan from the U.S. Department of Health and Human Services. The co-op arose from the passage of the Affordable Care Act in 2010 and an effort to explore a Colorado health cooperative by the Rocky Mountain Farmers Union and Union Education and Charitable Foundation in 2011. The co-op is targeting the estimated 829,000 uninsured Coloradans, as well as those who are underinsured. Business owners looking for more flexible options are invited to participate. “One change is that small businesses, or any business, can allow employees to choose different plans,” Hutchins said. “We want to provide options for employees that are more affordable than in the past.” Open enrollment for the new plan will begin in October, and will be available through Connect for Health Colorado, which is the state’s online insurance marketplace.
  • August 2013
  • page 36 August 16, 2013 Interview with Julia Hutchins A story on healthcare reform and the launch of the Exchange was complemented with an interview with Julia Hutchins. The piece ran in the 5 and 6 p.m. newscasts on August 16. Full video available upon request.
  • page 37 August 16, 2013 Whether to buy or not to buy health insurance | Ed Sealover
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  • page 39 August 19, 2013 Colorado Exchange Releases Health Insurance Rates | Eric Whitney Colorado released its Obamacare insurance rates on Friday, joining 13 states and the District of Columbia in making rates public. The state earlier made the call to be a clearinghouse exchange, rather than an active purchaser, and so, it has approved all 242 health plans submitted for sale on its marketplace, Connect for Health Colorado. Thirteen carriers will offer 150 plans in the individual marketplace, and 92 for small businesses. The plans go on sale Oct. 1 for coverage that starts Jan. 1. Colorado also approved 299 plans for sale outside its exchange and prices for them. “We’re very pleased with the number of carriers and plans,” Deputy Insurance Commissioner Peg Brown told the Connect for Health board Monday. “It represents a wide variety of choice … and healthy competition in the Colorado insurance marketplace overall,” Brown said. Members of the exchange board greeted Brown’s announcement with applause but did not comment further. The rates came out more than two weeks later than the state’s Division of Insurance had initially promised. So where do the Colorado rates fall in the ongoing debate about whether prices on the exchanges are reasonable? It might be the rare “just right” state. Prices range from $135 a month on the low end to almost $1,000 a month for the most comprehensive coverage with some variation depending on a person’s age, where they live and whether they use tobacco. The average price of an individual policy in Colorado now is about $200 a month, and there are a variety of plans near that average in the rates released Friday. See all insurance marketplace rates that have been released to date But Brown cautioned against comparing plans approved for next year to those currently available. “It’s important to note that these are new plans, and developed for new requirements in 2014. Consequently, any comparison to past or current plans would not be an apples-to-apples comparison,” Brown said.
  • page 40 Prices will also be lower than listed for many people earning less than $46,000 a year, because they will qualify for subsidies to make insurance more affordable. The subsidies will be on a sliding scale, so people with lower incomes will get larger subsidies. The Division of Insurance released sample rate information for the new plans earlier this week. It shows that premiums for a 27-year-old non-smoker will range from $135.57 a month for the lowest-cost catastrophic coverage plan to $566.80 for “platinum” level coverage in the individual market. Prices range from $183.72 to $662.32 a month in the small group market, which will not offer catastrophic nor platinum plans. A 40-year-old can expect to pay from $176.89 a month for a bronze plan on the individual market to $967.85 for a platinum policy in the small group market. The greatest number of plans in Colorado’s exchange will be offered by not-for-profit Rocky Mountain HMO, with 52 individual and 30 small group offerings, followed by Kaiser Permanente, with 27 individual and 24 small group plans. (Kaiser Health News is not affiliated with Kaiser Permanente.) People in cities will have more plans to choose from than those in rural areas, but all Coloradans will have several plans to choose from For-profit carriers including Cigna, Anthem and Humana have far fewer plans. Cigna and Humana are offering 11 and seven individual plans, respectively, and none in the small business market. Anthem is offering two small business plans only. Colorado’s new health insurance cooperative, Colorado HealthOP, established through the Affordable Care Act, will offer eight individual and six small business plans. It is estimated that about 800,000 Coloradans are currently uninsured, about 15% of the state’s population.
  • page 41 August 21, 2013 Colorado DOI Approves Exchange Plan Carriers And Rates | Amy Lotven
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  • page 43 August 26, 2013 Coloradans Unaware of New Health Insurance Requirements According to a June 2013 Gallup poll, nearly half (43 percent) of uninsured Americans are unaware that they are required by law to carry health insurance by January 1, 2014. In Colorado, that translates to more than 350,000 Coloradans who may not know that they have less than five months to find health insurance coverage. The new health insurance requirements come with penalties for those who do not comply. Consumers who do not secure health insurance coverage in 2014 may have to pay fines of $95 per adult or 1 percent of adjusted family income – whichever is greater. Fines will escalate in future years. With October’s open enrollment period just around the corner, now is the time to get educated. To help prepare Coloradans for new health insurance requirements, Colorado HealthOP, Colorado’s first statewide nonprofit health insurance cooperative (CO-OP), offers advice to help individuals make the best choices for their personal and financial health. “Recent changes in healthcare make it possible for more people than ever to have access to affordable, quality health insurance,” said Julia Hutchins, chief executive officer of Colorado HealthOP. “The biggest challenge the healthcare community faces is educating Coloradans – whether they are uninsured, underinsured or unhappy with their current health insurance – about the options that are now available and how to access them.” In preparation for these new health insurance requirements, Colorado HealthOP recommends Coloradans follow six steps to get health insurance coverage: 1. Learn more about how health reform affects you and your family. Changes in healthcare affect every Coloradan. Colorado HealthOP offers details about how the changes may impact you and your family on its website www.COHealthOP.org. 2. Ask your employer about coverage. If you are employed, find out if your employer will offer health insurance in 2014. Recent changes in healthcare make it more affordable for many small employers to cover their employees. 3. Familiarize yourself with Connect for Health Colorado. If you do not receive healthcare coverage through your employer, you have the option of purchasing an individual plan through Connect for Health Colorado, the state’s online health insurance marketplace. Enrollment begins October 1, and you will start receiving coverage January 1. **digital outreach**
  • page 44 4. Find out if you qualify for tax credits. Many individuals and families are now eligible for tax credits to help cover the cost of health insurance. Colorado HealthOP can help you determine whether you qualify. Visit Colorado HealthOP’s website or call 720.627.8900 to speak with an insurance expert. 5. Do your homework. Individuals and families will have access to a variety of health insurance plans from multiple carriers. While many will look at cost as a major factor in their decision-making, there are other important considerations, such as: • Do you prefer working with a nonprofit or a for-profit health insurance company? • Does the company offer wellness benefits or incentives to help your family stay healthy and save money? • Does the company have a reputation for good customer service? Visit www.COHealthOP.org for more information about Colorado HealthOP’s plans. 6. Sign up! Be informed before open enrollment starts. Sign up to receive information so that you’re ready to enroll for health insurance coverage in October. “Unfortunately, the people who are most affected by the new health insurance requirements are those who are least aware of what they need to do,” Hutchins continued. “As a health insurance cooperative, we are committed to providing affordable, quality and hassle-free coverage. We are also dedicated to helping Coloradans take charge of their own healthcare decision-making.” For more information about Colorado HealthOP or to learn more about how changes in healthcare affect you or your family, visit www.COHealthOP.org.
  • September 2013
  • page 46 September 1, 2013 An Alternative to Traditional Medicine | Kate Alfano
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  • page 49 September 1, 2013 Health Co-op Sets New Standard For Healthcare Reform | Eric Peterson Colorado’s market mix of health insurers hasn’t changed much in years. A new entrant set to launch in full in January 2014 – the Colorado Health Insurance Cooperative – hopes to upend the status quo in more ways than one with its member-driven, nonprofit model. “There have been no new health insurers in Colorado in a long time,” says Julia Hutchins, CEO of the Colorado Health Insurance Cooperative, or Colorado HealthOP. “The barriers to entry are so high.” Colorado HealthOP, the first statewide nonprofit health insurance cooperative, is breaking that dry spell with a model that challenges decades of for-profit assumptions about the healthcare industry. Colorado HealthOP grew from a cooperative started by the Rocky Mountain Farmers Union, which has about 20,000 members in Colorado. “They’ve always struggled getting health insurance for their members,” explains Hutchins. The Affordable Care Act’s (ACA) push for “more consumer-operated and -oriented plans,” says Hutchins, was a result of a compromise on the concept of a nationwide public option. “It allowed for at least one nonprofit, consumer-driven health cooperative per state.” In Colorado, four different applicants vied for the federal loan guarantees that would fund the startup of such a cooperative. Staked with $71,000 in seed funding from the Colorado Health Foundation, the Colorado HealthOP won rights to nearly $70 million in funding in July 2012. Where is all that money going? “Most of the $70 million is actually a line of credit,” says Hutchins. The loan makes certain that the cooperative meets the reserve requirements of the state Department of Regulatory Agencies (DORA) Division of Insurance. There are 24 cooperatives set to launch across the country. Including Colorado, 22 states will have one cooperative, and Oregon will have two. This critical mass could help push the co-op model into the mainstream. “We have a national network,” says Hutchins. “Being nonprofit, being local, and being consumer focused was well received by people, including healthcare professionals. Healthcare is very local.” History & Future “Health insurance was started by nonprofits,” says Hutchins, citing the beginning of Blue Cross in 1929 and other “community-based nonprofit groups.” The for-profit model eclipsed the nonprofits on the long and winding road to Obamacare. “Over time in most states -- including here – they were bought out by for-profit companies,” says Hutchins.
  • page 50 Health maintenance organizations (HMOs) were mandated by Congress in 1973, and helped amplified the profit motive in healthcare. As Nixon aide John Ehrlichman put it at the time, “All the incentives are toward less medical care, because the less care they give them, the more money they make.” This philosophy permeated the rise of the HMO in the 1970s and 1980s. The federal support of cooperatives indicates a reversal of the philosophy. While the profit motive proved effective in many respects, there were more than a few unintended consequences. Many observers think new co-ops funded by the ACA could “move the needle” on healthcare reform, among them Jill Zorn of United Healthcare Foundation of Connecticut in a story published in the February 2013 Grantmakers in Health Bulletin. “While the co-op program is a very small part of the ACA, it has the potential to have major impact on health reform in the states and markets where they compete,” writes Zorn. If co-ops can gather a critical mass of members in the first two years of the operation of the health insurance exchanges, they have the structure and nimbleness to become market leaders in delivery and payment transformation.” Logistics & Implementation “We like to say we’re turning healthcare on its head,” says Hutchins of Colorado HealthOP. “It is member- governed. That alone makes us different than any other health insurer out there today.” Current volunteer board members will be replaced via elections in 2015 and 2016. Hutchins says shareholder control inherent in for-profit coverage tends to dwell more on the short term, something that’s not always compatible with good healthcare. “In the long run, the co-op has a chance to improve healthcare in Colorado and lower partner costs,” says Hutchins. “Our benefits are much more focused on sustainable health,” she asserts. Co-payments are lower, for example, when they are related to preventative care. “When people do those things, they get a broader benefit package as a result.” While the ACA is likewise putting a greater emphasis on preventative medicine, Colorado HealthOP takes it a step further where there are no mandates. “We provide unique financial benefits to people,” says Hutchins. “It makes the benefits of preventative care even richer.” For example, new members will be encouraged to come in for a visit to have blood drawn and fill out a health questionnaire. Once they do, Colorado HealthOP opens a health incentive account with $100 that can cover anything from office visits to prescriptions. Hutchins says she expects Colorado HealthOP premiums to be “very competitive.” The rollout coincides with that of Connect for Health Colorado, the state’s health insurance exchange, in October, when individuals and small businesses can first apply for ColoradoHealthOP. The first plans will go live for members in January 2014. The goal: 25,000 members by the beginning of 2017. “One of our biggest needs is getting the word out,” says Hutchins.
  • page 51 “The co-op model is so powerful,” she adds. “It is about shared responsibility to meet a market need.” Debra Judy, policy director at the Colorado Consumer Healthcare Initiative, echoes this sentiment. “The consumer operation and control is critical,” she says of ColoradoHealthOP. “For people who are insured or uninsured, it’s a new option.” That element of shared responsibility is often missing in the modern insurance industry, with all of its publicly traded mega-conglomerates and their often overwhelming focus on profits. Colorado HealthOP is currently building a provider network with two tiers: a broad provider network comparable to existing health plans in the state, and a more specialized network of preferred partners. Members will be able to choose a plan that best fits their needs, and may pay lower costs if they use a provider partner. “Many insurers are asking, ‘How do I get patients to engage?’” says Hutchins. “This is how we do it: The co-op is our company. We all have a duty and a responsibility. It really creates an incentive for the members.” For information, visit cohealthop.org or call 720-627-8900.
  • page 52 September 11, 2013 Health co-op first to rule that transgender exclusions are wrong | Katie Kerwin McCrimmon A new health insurance company that is offering some of the lowest prices for health coverage on Colorado’s new exchange is now the first to decide that it will cover transgender care. Colorado HealthOP, a new nonprofit member-owned health cooperative formed with federal grants under Obamacare, has vowed that it will not discriminate against any groups. Currently most plans sold in Colorado and around the country specifically bar medical care for transgender people. That means most health carriers won’t pay for hormone treatments or gender reassignment surgeries. Now that the U.S. Supreme Court has strengthened gay marriage and civil unions are legal in Colorado, the battle for equal access to health care has become a new civil rights frontier for LGBT activists. Colorado’s Division of Insurance issued a bulletin in March barring discrimination based on gender identity or sexual orientation. It’s unclear, however, whether carriers will comply with the order on a narrow case-by-case basis or join Colorado HealthOP in eliminating exclusions. A transgender teen in Colorado also settled a civil rights case with Kaiser Permanente earlier this year. (Click here to read more about Alex Manigualt.) Under its agreement with Colorado’s Civil Rights Commission, Kaiser is supposed to be convening meetings about transgender care, but those meetings have not happened yet. A Kaiser spokeswoman, Amy Whited, declined to comment on whether Kaiser would follow Colorado HealthOP’s lead and bar exclusions related to transgender care. Whited said announcements about the meetings related to transgender care would be coming soon. Solutions also contacted other large health insurance companies in Colorado. None were able to say whether they would join Colorado HealthOP in removing exclusions. Anthem Blue Cross and Blue Shield initially denied chest surgery to a transgender man, Kelly Costello, who shared his story with Solutions. Then Anthem reversed itself. But it’s unclear if Anthem will cover similar surgeries in all cases or will remove all transgender exclusions from its policies sold in Colorado. “We’re in the process of deciding how we will proceed on this, but at this point, we’re unable to comment,” said Anthem spokeswoman Joyzelle Davis. Colorado HealthOP made its move after a written request from the LGBT advocacy group, One Colorado, and other groups seeking non-discriminatory health plans. Colorado HealthOP recently notified the groups that none of its plans will have “arbitrary condition-specific exclusions that target any population.”
  • page 53 “There is no place for discrimination in health care. Colorado HealthOP aspires to provide health insurance options for ALL Coloradans, based solely on medical necessity,” Lindy Wallace, chair of Colorado HealthOP, wrote in a letter to One Colorado and the other groups. “We hope to provide all Coloradans with a high standard of comprehensive, affordable coverage, and to allow small group customers to treat their employees equally,” Wallace wrote. “We believe our organization represents a true change in health insurance.” Ashley Wheeland, an attorney and health policy director for One Colorado, said Colorado HealthOP’s decision marks a huge step forward for transgender health in Colorado. “Most transgender Coloradans live in fear of what their health plans will cover,” Wheeland said. She said Colorado HealthOP’s decision “is a big deal because I haven’t seen a plan yet that doesn’t include exclusions. “Our ultimate goal is not to have any exclusions that are based on gender identity.” While insurers should be complying with the Division of Insurance bulletins, Wheeland said most have been denying services to transgender patients arbitrarily — in many cases even when the patients’ doctors deemed the services to be medically necessary. “The HealthOP is leading the way in opting not to follow the discriminatory use of these exclusions to limit care that many individuals need.” Dede de Percin is an advocate for health access along with LGBT issues. She also heads a nonprofit that contracts for health insurance for its employees. De Percin, executive director of the Colorado Consumer Health Initiative, said she plans to switch to Colorado HealthOP. “It’s great to have at least one carrier that is clear that they’re not going to discriminate against transgender people. None of the other carriers have taken that step,” de Percin said. She said she receives grants for LGBT advocacy groups that require her to offer non-discriminatory health insurance options. In the past, de Percin said she could not find a policy without transgender exclusions. “Now there is clearly a plan that does not discriminate,” she said, adding that she has internal non- discriminatory language. Now that a plan is available, de Percin has determined that she must switch to it both because she believes it’s the right thing to do and because an employee could sue her if she didn’t. “Now that there’s a product available, you could have your funding yanked or you could be sued by an employee for violating internal policies,” de Percin said. Her group signed the One Colorado letter to the Colorado HealthOP and de Percin’s group is now checking the language on each of hundreds of new health plans that will be offered in Colorado to determine which ones include exclusions. “I’m hoping that since the Colorado HealthOP has set the bar, others will meet it.”
  • page 54 September 17, 2013 Consumer Controlled Health Insurance: A Necessary and Welcome Shift | Julia Hutchins Consumers in Colorado and 25 other states will soon have a new opportunity to buy health insurance through consumer-governed health plans. These non-profit, consumer operated and oriented plans, or CO-OPs, enable consumers to have a voice in the way the companies are run. While CO-OPs have long been a part of the farming industry and food CO-OPs are common across the nation, the CO-OP philosophy is a relatively new entrant to the health insurance marketplace. So why is this a big deal? The short answer is: consumer-run CO-OPs have the potential to fundamentally change the value of health insurance and the role it plays in people’s lives. It is no secret that health insurers hold the purse strings that fuel the health care industry. They make decisions every day about who gets coverage, what benefits are covered and how services are covered. These decisions are heavily impacted by governance structure and associated business purpose. Delivering profit to shareholders is the dominant criterion for decision making in for-profit enterprises. CO-OPs, on the other hand, exist to maximize economic and social (happiness, health) returns to their members. This philosophy is different even from non-profit organizations, which exist for social purposes that may be broader than or distinct from the interests of their membership. Using these criteria, consider how governance structure might lead to different decisions when considering whether to cover preventative dental services for children under 3 (sealants and fluoride treatment): • For-profit: Probably not. Coverage is unlikely to deliver short-term profit. • Non-profit: Maybe. The decision depends on the organization’s social mission. • CO-OP: Yes. Tooth decay is a leading chronic disease in children. Covering this benefit is good for members’ health and saves members money in the long run. While some might argue that making decisions that balance economic and social returns could be difficult for a consumer-operated board, it is something we all do every day. In fact, CO-OPs are actually better positioned to address both the affordability and the value of health insurance because of the unique economic and social relationship among the board of directors, the CO-OP’s management and the CO-OP members.
  • page 55 Can a consumer-governed company sit back and accept a 20 percent uninsurance rate or a 10 percent annual increase in medical inflation? It is not as easy for a CO-OP as it might be for another carrier to simply pass these costs on to its membership. Because the board and the management answer to members, and not to shareholders, their priorities have to shift. And that’s not a bad thing. As CO-OPs become available to consumers across the U.S. – and here in Colorado – in 2014, the power dynamic of the health insurance industry will begin to shift – returning consumers to the driver’s seat and elevating better health and lower healthcare costs above all.
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  • page 57 September 18, 2013 Giddy Up! | Nic Garcia
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  • page 59 September 18, 2013 Colorado insurer offers trans coverage A new health insurance company that is offering some of the lowest prices for health coverage in Colorado said last week it will also cover transgender care, Solutions, a project of the Buechner Institute for Governance at the School of Public Affairs at the University of Colorado, Denver, reported. Colorado HealthOP, a new non-profit member-owned health cooperative formed with federal grants money under Obamacare, has vowed that it will not discriminate, the project reported. Currently most plans sold in Colorado and around the country specifically bar medical care for transgender people. That means most health carriers won’t pay for hormone treatments or gender reassignment surgeries, the article said.
  • page 60 Kaiser Permanente will now cover services for transgender Coloradans in its insurance plans, the company said Tuesday. “Kaiser Permanente is committed to reducing health disparities and providing culturally competent care to all of our patients,” the HMO said in a statement. “ In March, the Colorado Division of Insurance issued a directive reminding insurers that it is against state law to discriminate based on sexual orientation, including those who are transgender. After that directive, Kaiser began reviewing its policies on transgender services, the company stated. “ The availability of coverage for Transgender health services is an evolving area in the health care industry,” Kaiser Permanente stated. “We look forward to further guidance from the Division of Insurance, and participation in this important, ongoing discussion with other stakeholders.” Kaiser Permanente joins only the Colorado HealthOP cooperative insurance plan as the only insurers covering transgender health care, according to One Colorado, an advocacy group for the states lesbian, gay, bisexual and transgender residents. Kaiser said, “For patients with a diagnosis of gender dysphoria in plans that are under Colorado Division of Insurance oversight, coverage includes many medical services, including behavioral health, medical testing, hormone therapy for members who have a drug benefit, and transgender surgery. General exclusions and limitations that apply to all services also apply to transgender services.” “But two insurers is not enough,” One Colorado health policy director Ashley Wheeland said in a statement. “We believe that transgender Coloradans and their employers deserve the same options in picking any health plan, and we hope we can soon say in the state of Colorado that all of our health plans cover the services that our transgender friends need.” September 24, 2013 Kaiser Permanente now covering transgender services in plans | Joey Bunch
  • page 61 September 24, 2013 ‘Obamacare’ and you: Resistance in Texas, where many are uninsured Julia Hutchins was interviewed for a story on healthcare reform and the launch of the Exchange. Full video available upon request.
  • page 62 September 25, 2013 Kaiser to cover transgender services in its plans | Amy Gillentine A year ago, transgender people in Colorado were facing trouble getting health insurance plans to cover medically necessary treatments. People around the state were having trouble getting both routine tests and specific treatments paid for by insurance.. No longer. Now at least two health insurance plans have pledged to cover all services for all Coloradans. Kaiser Pemanente announced earlier this month that it would cover services for transgender Coloradans in its plans, which is hailed as a major step forward for the state’s LGBT community. Colorado HealthOP, a new member-governed, nonprofit cooperative health insurance plans also does not specifically exclude transgender health care in their plans. The move follows the state’s Division of Insurance edict that health insurance plans cannot discriminate based on transgender status – and must cover any treatment deemed medically necessary by a doctor. “Kaiser Permanente is committed to reducing health disparities and providing culturally competent care to all of our patients,” Kaiser Permanente said in a statement. “Last March, following new guidance from the Colorado Division of Insurance, Kaiser Permanente began reviewing our medical review polices related to transgender services. Effective September 10, 2013, Kaiser Permanente now provides coverage for additional services to treat gender dysphoria in plans that are under the oversight of the Colorado Division of Insurance.” One Colorado, a nonprofit that focuses on LGBT rights and the Colorado Consumer Health Initiative sent a letter to Kaiser earlier this year, signed by 31 small Colorado employers that asked the company to remove its transgender health exclusions. While the decision by Kaiser is a step in the right direction, advocates say there is still more work to be done. “We look forward to working with Kaiser Permanente to implement this very important and very just decision – it’s not only the right thing to do, it’s Colorado law,” said Ashley Wheeland, health policy director at One Colorado. “But two insurers is not enough. We believe that transgender Coloradans and their employers deserve the same options in picking any health plan, and we hope we can soon say in the state of Colorado that all of our health plans cover the services that our transgender friends need.”
  • page 63 September 25, 2013 New player on health insurance scene | Loretta Sword
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  • page 65 September 26, 2013 Colorado health insurance providers offer coverage to transgender people Next Tuesday, health insurance marketplaces all over the country will open as one of the main provisions of the Affordable Care Act goes into effect. Uninsured people will begin shopping ahead of a March 31, 2014 deadline to be insured. Earlier in this summer, the Obama Administration issued a memo saying it would be illegal for insurers that receive federal funds to deny health coverage to transgender people, a revelation cheered by rights advocates. But how that will play out in the coming months is still far from clear. In Colorado’s Health Exchange, there are now two insurers that will offer coverage to the state’s transgender residents. Kaiser Permanente made the announcement this week, joining the nonprofit Colorado HealthOP. Transgender people have historically had a difficult time finding health coverage says Courtney Gray with the GLBT Community Center of Colorado. “Several years ago on the individual market, I applied to every single health insurance company in the state of Colorado. I didn’t qualify for low income, and every other health insurance company when they found out I was transgender decided not to cover me at all.” Earlier this year, the Colorado Division of Insurance issued a bulletin that state anti-discrimination law does apply to health insurance, and therefore plans must cover the same services for transgender people as they would for others. Consequently, all health insurers must offer coverage for the transgender population, but only two have done so up to this point. Full audio not available.
  • page 66 September 30, 2013 Sign up for ‘Obamacare’ starting today | John Colson
  • page 67 Too often, the Affordable Care Act, dubbed Obamacare, leaves most people up in arms. Yet, when you look at the Affordable Care Act as a collection of its parts, people on both sides of the aisle should be able to find programs they can embrace. The newly created health insurance cooperative program is one of them. Both Democrats and Republicans approved a provision in the act to allow the creation of non-profit, private, co-op health plans in every state as a viable alternative to a public insurance option. This is because of widespread agreement that health care costs are out of control, and competition reduces costs and increases accountability. The co-op model has long been an integral part of the farming industry, and here in Colorado, food, agricultural and electric co-ops are abundant. While health insurance co-ops are certainly not a new idea, the business model is well-tested and has the potential to fundamentally change the face of the health insurance industry as we know it. Starting Tuesday, new health insurance co-ops will begin selling health insurance in 22 states, including Colorado. When these co-ops are open for business, their benefits will be clear. The co-ops are privately held, non-profit insurance companies that are member-governed, which means members have a say in how the company is run. They are non-profit, which means that any revenues must go toward increasing benefits, decreasing premiums or improving quality of care. They are focused on decreasing health care costs, which means that they partner with higher value health care providers and provide health care pricing transparency to their members. And they have a strong focus on preventive care, which means that they incentivize their members to make healthy decisions. So why should this matter during a time when political disagreement about health care reform may result in a government shutdown? Right now, we’re focused on the wrong crisis. We need to put politics aside and consider the larger crisis: quality affordable health care. Health care costs are spiraling. In fact, annual health care spending in Colorado is growing more than 7 percent each year, according to the Kaiser Family Foundation. September 30, 2013 Health insurance co-ops will help Coloradans see benefits of Obamacare | Julia Hutchins
  • page 68 What’s more, too many Coloradans simply do not have the insurance coverage to help them pay for medical expenses. According to the Colorado Trust, nearly one in three Coloradans have either no health insurance at all, or their health insurance does not adequately cover necessary medical costs. Furthermore, 85 percent of uninsured Coloradans say cost is the reason they do not have health insurance. Add to these statistics the fact that rates of the most expensive chronic diseases continue to rise every year, and it is easy to see we are facing a full-blown crisis. Whether you are a proponent of the Affordable Care Act or against it, it’s difficult to dispute that a solution to this crisis is necessary. We need a shared commitment to increasing access to insurance, decreasing costs and promoting better health. Health insurance co-ops are one of the vehicles that can carry this commitment. Playing political all-or-nothing ignores the foundation of bipartisan support that enabled the creation of health insurance co-ops. This foundation has the potential to usher in an era of unprecedented choice for health care consumers and fundamentally improve Americans’ health care options. Let’s focus on improving health, not on playing politics. Julia Hutchins is chief executive officer of Colorado HealthOP, Colorado’s first statewide non-profit health insurance cooperative.
  • October 2013
  • page 70 Colorado opened its health exchange marketplace Tuesday after more than two years of planning—but the exchange website temporarily was overwhelmed by tens of thousands of visitors, briefly preventing consumers from creating new accounts. The problem was resolved quickly, and Connect For Health Colorado executives said the first day went well, with 100,000 page views per hour through midafternoon. There were 3,000 phone calls to a call center set up to handle questions. But the website ran a banner at midday advising consumers that new accounts couldn’t be opened because of a high volume of visitors—more than 34,500, according to spokesman Ben Davis. The problem was resolved shortly thereafter. “As expected, we encountered several challenges when our system went live today,” exchange CEO Patty Fontneau said in a statement Tuesday afternoon. “These challenges were addressed quickly and efficiently with minimal impact on the customer experience.” Customers who need health insurance can use the site to find out what their choices are, what their premiums will be and whether they qualify for subsidies to reduce their payments. The exchange has taken out television ads promoting the site and has hired “navigators” statewide to explain the new shopping site to the uninsured. Events were held Tuesday to rally attention for the site, perhaps none splashier than a promotion by Colorado HealthOP, a nonprofit health insurance cooperative. The cooperative hired scantily clad models to hand out flyers about the new exchange to pedestrians on a busy downtown Denver thoroughfare. On a warm fall day, male and female models wore little except shorts with the message “GET COVERED CO” across the behinds. Colorado officials insisted the state wouldn’t be affected by any potential federal shutdown prompted by a congressional stalemate over the health law. Colorado is one of 17 states that opted to create its own exchange, rather than rely on the federal government to run it. President Barack Obama said Monday that a shutdown wouldn’t affect implementation of the health law in any state. Most of the law’s funding does not come from annual appropriations. “That funding is already in place. You can’t shut it down,” Obama said. October 1, 2013 Colo. exchange site briefly overwhelmed on 1st day | Kristen Wyatt
  • page 71 October 2, 2013 Flexing its muscle, while weak in spots | Michael Booth
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  • page 73 Despite Harry Reid’s professed certainty that Obamacare “is working” and that in time “people will love it more than they do now,” the future of the law and its implementation remain a question mark. As James Taranto memorably put it: [W]hether ObamaCare ‘works’ will be determined not by how many people are signing up but what kind of people. ObamaCare relies on price controls that jack up premiums on the young and healthy in order to keep them low on the old and sickly. If the latter but not the former are signing up in huge numbers — that is, if people are responding rationally to incentives — then the scheme is unsustainable. This harsh reality suggests that Reid and his ilk are whistling past the graveyard. But that doesn’t mean they aren’t putting up a positive front. Take 30-year-old Brendan Mahoney, a University of Connecticut law student, whose story the Hartford Courant shares as an affirmation of the law’s eventual success among Millennials. Mahoney, who already had low-cost insurance through a plan at school, decided to sign up for Obamacare. After an initial false start, he managed to log on to the system and enroll. So how many elderly and/or infirm Americans will his premium help offset? The Courant answers that question: [B]y filling out the application online, Mahoney discovered he was eligible for Medicaid. So, beginning next year, he won’t pay any premium at all. Across the country, in Denver, promoters and health insurers are not just presenting a positive front but a positive rear. The Denver Post explains: Colorado HealthOP, a consumer-run cooperative selling insurance plans on the exchange, sent models in skimpy clothing — and sporting signs with information — to greet Denver’s 16th Street Mall lunch crowds. The signs include the hashtag #GetCovered, which is meant as a double entendre. Just to make sure the message takes, Colorado HealthOP is hedging its bets by tweeting: As nearly naked people remind everyone to #GetCoveredCO, we remind you to call 855-796-7676 today or visit http://www.cohealthop.org. Some will say the approach, which was common outside strip clubs in New York City’s Times Square before Mayor Rudolph Giuliani gentrified the area, smacks of desperation. It may yet work as long as the weather remains fair — and provided the sign carriers avoid getting arrested on obscenity charges. October 2, 2013 Models stripped down to skivvies take to Denver streets to hawk Obamacare | Howard Portnoy
  • page 74 From the Denver Post: Promoters and health insurers fanned out with multimedia ads to encourage sign-ups. Colorado HealthOP, a consumer-run cooperative selling insurance plans on the exchange, sent models in skimpy clothing — and sporting signs with information — to greet Denver’s 16th Street Mall lunch crowds. October 1, 2013 Obama Hires Half-Naked People to Promote Obamacare
  • page 75 Colorado HealthOP’s “Get Covered CO” campaign around the Exchange launch was featured on HLN-TV during its Morning Express show. Full video available on DVD at the back of the clipbook. October 2, 2013 Obama Gets the Word Out | Robin Meade
  • page 76 Obamacare organizers in Colorado are taking Obamacare promotion to a new low – at least in terms of their dress code. A health insurance provider is sending 20-something activists out on the streets of Denver in their underwear to persuade young people to ‘get covered.’ The resulting photos and video footage, which the organization published on Instagram this week, has a protest flavor that comes complete with a Twitter hashtag: #getcoveredCO. And U.S. taxpayers are footing the bill for the risque street performances through a federal government loan. ColoradoHealthOP, a statewide insurance co-op that favors full enrollment in Obamacare and sells the policies through the state’s exchange, says it was ‘approved for federal funding within the Affordable Care Act in July 2012.’ The group’s Instagram photos show a cadre of five college- age activists in their skivvies, carrying strategically placed ‘Get Covered’ signs while they talk to their recruitment targets. The Affordable Care Act’s coverage model depends on enrolling 7 million Americans, including at least 2.5 million young people. Without the insurance premiums from the young and healthy to offset the higher costs associated with being old and sick, the Obamacare system won’t be funded enough to sustain itself. October 3, 2013 Obamacare activists STRIP to their underwear in taxpayer-funded, PETA-style stunt to persuade young Coloradoans to ‘get covered’ | David Martosko
  • page 77 Enrolling Colorado residents into the state’s new health care exchange market is as simple as a bit of public nudity, apparently. The Denver Post reports: “Promoters and health insurers fanned out with multimedia ads to encourage sign-ups. Colorado HealthOP, a consumer- run cooperative selling insurance plans on the exchange, sent models in skimpy clothing — and sporting signs with information — to greet Denver’s 16th Street Mall lunch crowds.” “Exposed” young ladies prancing around the streets in flesh-colored underwear to advertise Obamacare — a real victory in that whole “War on Women” thing, eh? This girl even has #GetCoveredCO scrawled across her bum. How cheeky. Clearly no objectification of women going on here… October 3, 2013 Colorado Advertises Obamacare Exchange with ‘Nearly Naked People’ | Meredith Jessup
  • page 78 Unsurprisingly, there weren’t a lot of grabby images associated with week one of Obamacare -- unless you count occasional health-exchange error messages. But there was a notable exception: Earlier this week on the 16th Street Mall, ColoradoHealthOP.org promoted insurance coverage via spokesmodels who were almost entirely uncovered -- as in barely clothed. Good thing the event wasn’t scheduled for today. Check out additional Colorado HealthOP photos below, and click here for information about another Obamacare event sponsored by the organization, scheduled for 1 p.m. tomorrow at the Lakewood Library. Although, presumably, the presenters will be fully dressed. October 4, 2013 Photos of the Day: Nearly uncovered people promote health-care coverage | Michael Roberts
  • page 79 October 4, 2013 Inside the Beltway: Stripping down for Obamacare | Jennifer Harvey Attractive women wearing nothing but a smile and flesh-colored underwear emblazoned with the motto “Are You Covered?” strolled the most popular shopping areas of Denver in the name of the Affordable Care Act this week. Oh, and there were blondes in the shortest of short shorts plus muscular young men in gray flannel boxers — and that is all — also on parade. They sported beribboned signs reading “Without health insurance, you’re exposed.” The earnest models were handing out information to startled passers-by, hired by Colorado HealthOP, a nonprofit insurance company eager to get the message about the new health care law to the public. Some of the locals were not impressed. “So now we have to dress like Miley Cyrus to sell Obamacare?” asked Kelly Maher, a politically inclined Denver mother, who took her multiple protests to Twitter. “Hey feminists, doesn’t this objectify women. Hello? Anyone?” responded Christian Cama, a conservative Florida lobbyist and founder of the Reaganista.com blog. The insurance company in question entered the social media fray to defend itself. The underwear model outreach was “a light-hearted event to call attention to a serious issue: 829 thousand uninsured Coloradans,” the company responded in its own tweet.
  • page 80 Consumers shopping for health insurance in the Obamacare online marketplaces, or exchanges, are likely to spot insurance companies they’ve never heard of before, including some startups known as “co-ops.” The exchanges will introduce at least two dozen or so Consumer Operated and Oriented Plans -- co-ops, for short -- which are new nonprofit, private insurers that will operate in a manner similar to credit unions. “Essentially co-ops, (which are) owned by the members, are groups of people who contract with insurers for better rates on coverage than individuals or small business could negotiate separately,” explains E. Denise Smith, assistant professor of health care management with the Godbold School of Business at Gardner-Webb University in Boiling Springs, N.C. Co-ops are part of health care law The Affordable Care Act, President Barack Obama’s historic health care redo, included $6 billion in funding to create co-ops, though congressional budget deals slashed that pool of low-interest loan money to $1.9 billion. For now, your state may have a co-op, or maybe not. “Some states may have fewer insurance companies (in their) exchanges,” Smith says. “In those cases, it may be more advantageous for groups to form co-ops.” Some two dozen co-ops were expected to be ready for the opening of the exchanges in two dozen states, according to the trade group the National Alliance of State Health Cooperatives, or NASHCO. John Morrison, the NASHCO president and former state insurance commissioner for Montana, says he expects many more co- ops to form in subsequent years. Will a co-op really save you money? “Health care co-ops are truly nonprofit and consumer-driven,” says Morrison, noting that the companies have a mandate to reinvest any profit in either broader benefits or reduced premiums. But whether co-ops will actually make health insurance more efficient and less expensive is not an easy question to answer. “There are critics who argue that co-ops will have a hard time saving money because of high startup costs, even with initial government funding,” says Gerry Wedig, a professor and health care economist with the Simon School of Business at the University of Rochester. “But the co-ops argue that they’ll be able to cut costs because they can be more efficient and won’t have to pay profits to shareholders.” Co-ops can indeed be cost-effective, asserts Julia Hutchins, CEO of Colorado Health Op, a Denver-based co-op. Because the Obamacare health insurance co-ops are starting fresh, she says they don’t face the potentially costly transition to paperless systems that many older health insurers are facing. October 6, 2013 Health insurance co-ops under Obamacare | Michael Estrin
  • page 81 Also, Hutchins insists co-ops will be able to emphasize the sorts of things that can help bring down costs, such as wellness programs and preventive care. Oregon offers a snapshot The data out of Oregon suggest health insurance co-ops will be competitive with other carriers. The state planned to open its Cover Oregon exchange with two co-ops in the mix: Oregon’s Health CO-OP and Health Republic Insurance Co. In the Portland area, both planned to charge close to the local average for an Obamacare plan that might be considered typical: a “silver”-level plan for a 40-year-old nonsmoker. Health Republic’s monthly rate for 2014 will be $256, and Oregon’s Health CO-OP’s premium will be $271. They’ll be vying in that market with 10 other plans. The average monthly premium for all 12 is $260, before federal subsidies. The lowest premium approved by the state’s insurance division was $215, and the highest was $329. How does a co-op operate? “For the typical member, a co-op will most likely work a lot like their private insurer currently does, but with some key differences,” Hutchins says. While professional administrators will carry out day-to-day functions, members (that is, the consumers) will help shape policy by electing boards and giving input through regular surveys. “The members are my bosses,” Hutchins says. “Not the shareholders.” Though co-ops will be available in only about half the states in 2014, co-op members will be able to use their coverage in their home state and elsewhere, she says. “Just like a private insurance company, we have the ability to contract with providers and establish rates for out-of-network service,” Hutchins says. And what about the network -- and your selection of doctors? It may depend on where you live. “In rural areas, they may not have a lot of choice because there aren’t a lot of providers,” Hutchins says. “But we expect members living in urban areas to have several choices.” Is a co-op right for you? Consumers curious about the new co-ops may wonder about the safety of a new and unfamiliar health insurance company. Morrison says Obamacare exchange shoppers can choose co-ops with confidence. “The chances of a consumer not getting their claims paid because their co-op failed are practically nil,” he says. “It’s important to realize that all of the Affordable Care Act co-ops are very well-funded, so the chances of a failure are also very remote.” When sizing up a health insurance co-op, Hutchins advises consumers to consider more than just price. “One of the most important things is benefit design,” she says. “Thankfully, the exchanges will help consumers do an apples-to-apples comparison so they understand what all the different plans will and won’t cover.”
  • page 82 She says customer service is important, too. The hope is that a more transparent marketplace will eventually allow consumers to shop for health insurance by looking not only at price and benefits, but also at how quickly claims and disputes are dealt with, and how easily a customer service rep can be reached on the phone. “We won’t have ratings on service just yet because exchanges are new,” she says. “But eventually, we expect consumers to be able to use service ratings as they shop for coverage.”
  • page 83 October 8, 2013 Colorado HealthOP Officially Open for Business As healthcare marketplaces open across the country, Colorado HealthOP, one of 23 new health insurance cooperatives was launched nationwide a week ago as a result of the Affordable Care Act. Last Tuesday Colorado HealthOP announced it is selling health insurance plans to Coloradans. Colorado HealthOP’s health insurance policies are available on Connect for Health Colorado, the state’s online health insurance exchange, and through a statewide network of brokers. Coverage becomes effective in 2014. As part of its emergence on the health insurance market, Colorado HealthOP, Colorado’s only statewide consumer-operated and oriented health plan, launched an aggressive campaign to help Coloradans without health insurance Get Covered. The campaign kicked off the morning the exchange opened, October 1, with “exposed” models on Denver’s high traffic 16th Street Mall handing out “Get Covered” cards designed to awaken consumers to the need for health insurance and outline the steps to buy coverage. “More than 1.5 million people in Colorado lack adequate health insurance, which leaves them exposed to health problems and high medical bills. As a CO-OP focused on improving health, it’s our mission to raise awareness and help all Coloradans get covered with quality, affordable health insurance,” said Julia Hutchins, CEO of Colorado HealthOP. As a health insurance CO-OP, Colorado HealthOP is turning health insurance upside down: 1. Colorado HealthOP is governed by its members Colorado HealthOP does not have shareholders; instead members have a voice in how the company is run. Members elect and can serve on the board of directors. When the organization’s revenue is greater than costs, Colorado HealthOP members influence how the excess is used — by lowering premiums, adding benefits or making other improvements. 2. Colorado HealthOP’s plans reward healthy behaviors Colorado HealthOP protects its members when they’re sick or injured—but the CO-OP also helps members get and stay healthy. After enrolling in most Colorado HealthOP insurance plans, members can take simple preventive health actions to upgrade to an enhanced plan. In an enhanced plan, members will pay less out-of- pocket when they see a doctor, and receive money on a debit card they can use to pay for health expenses. 3. Colorado HealthOP offers members choices that can reduce costs Colorado HealthOP offers a range of plans so that individuals and families can make a choice that meets their financial and healthcare needs. The health insurance plan options include those that offer flexibility with a robust provider network, as well as tailored plans with more limited networks that people can purchase at a lower cost. Colorado HealthOP members in some health insurance plans can also keep their healthcare costs lower by choosing from a list of preferred providers who are committed to improving quality and reducing cost. **digital outreach**
  • page 84 “Coloradans have been waiting for a health insurance plan like ours, one that has their best interests at heart,” Hutchins said. “We are excited to have this opportunity to help more Coloradans get insured.” How to Enroll Coloradans can sign up for Colorado HealthOP health insurance by visiting Connect for Health Colorado’s website or calling Colorado HealthOP toll-free at 855-796-7676. The CO-OP’s local customer service representatives can help Coloradans enroll and answer questions about Colorado HealthOP plans. Local brokers can also help Coloradans find and enroll in plans. Tax credits are available to people who qualify to help reduce the cost of their health insurance. Colorado HealthOP provides a free online health insurance tax credit calculator to help individuals determine if they may be eligible. For more information about Colorado HealthOP or to learn more about changes in healthcare, visit www.COHealthOP.org.
  • page 85 October 9, 2013 Young and not so invincible | Katie Kerwin McCrimmon The hottest targets for health insurance this fall are the so- called “young invincibles.” It’s no coincidence that an upstart selling some of the lowest- priced plans that might appeal to young people in Colorado, the Colorado HealthOP, deployed beautiful young models to try to make the decidedly unalluring topic of health insurance sexy. Buff, shirtless men and nearly naked young women prowled downtown Denver’s 16th Street Mall last week as Colorado’s health exchange opened. They wore little more than signs reading: “Without health insurance, you’re exposed: #GetCoveredCO.” Less sexy street teams working directly for the state’s health exchange, Connect for Health Colorado, are hitting places where young people hang out from festivals to college football games. And the exchange’s advertising agency is targeting invincibles with neon ads that show a skateboarder going for a big move. The tag line: “If you push yourself, protect yourself.” Connect for Health is also marketing health plans with very high deductibles by calling them CYA plans rather than the stuffy, old-school term, catastrophic plans. In Colorado, nearly 30 percent of young adults don’t have insurance. The trend is even more exaggerated among young Latinos, nearly half of whom are uninsured, according to the Colorado Health Access Survey conducted by the Colorado Health Institute and The Colorado Trust. These healthy 20-somethings get portrayed as shallow, bungee-jumping, coffee-drinking, navel-gazers whose biggest worries center on what extreme sport they’ll master next while delaying reality and living in their parents’ basements. In fact, when you chat with these allegedly invincible young people, you find that many hardly think of themselves as bulletproof. Instead, they are facing economic obstacles like record-high student loan debt and bleak job prospects that could keep them from affording health insurance. “I’m anything but invincible,” says 24-year-old Evan Pilate, of Aurora, who’s working to build a business teaching piano while staying covered on his parents’ health insurance. “I work hard to stay healthy.”
  • page 86 The historian who coined the term millennials thinks the label “young invincibles,” is off the mark. He says a more apt nickname for this generation might be the “young carefuls.” “Boomers took a lot more risks. We were doing all this death-defying stuff: riding Harleys, taking drugs and jumping off cliffs,” said Neil Howe, an expert on generations and social change who co-authored the book, “Millennials Rising,” in 2000 and now runs a consulting firm called LifeCourse Associates. Howe says that by almost every measure, millennials are actually risk averse. Crime rates have plummeted among the young along with teen pregnancy, alcohol use, cigarette smoking, and drinking and driving, Howe says. “They trust big institutions much more than Xers or boomers. They trust big government. They trust their parents and their families,” said Howe. “They’re risk averse. Plus they think they’re special. This leads them to have an overall bias in favor of health care, in favor of benefits,” Howe said. Millennials talk and text with their parents constantly. Howe expects moms across the land who can no longer cover children on their own health insurance policies to encourage 20-somethings to sign up for their own plans and he thinks we all will be surprised by the relatively high number who do. In order for Obamacare to succeed, young, healthy people need to opt in to the system in droves so their insurance premiums can help fund the older sicker folks who may be first to sign up. Young people will pay about one-third the price that older people do. That’s still far less than most will cost the system and some could balk at subsidizing their health plans for relatively well-off Boomers in their parents’ generation. Anyone interested in buying health insurance through federal and state exchanges has until March 31 to sign up if they want any coverage in 2014. The six-month open-enrollment period that started on Oct. 1 will answer the critical question: will they or won’t they sign up? Economic obstacles still high While many millennials may want health insurance, economic forces could keep them out of the market. Hardly invincible, many young people instead feel inundated — inundated with student loans and high unemployment rates. Take Kiel Lauer for example. At 28, he is a doctoral candidate in music arts at the University of Colorado in Boulder. Since he’s a student, the university requires him to have health insurance, but the university’s plan is expensive for him, so he’s been hunting on the open market. He’s keeping an eye on rates through Colorado’s new health exchange, but had to get covered before it opened, so he bought month-to-month insurance outside of the exchange that costs about $130 a month. Lauer is currently working as a freelance trombonist, picking up jobs in symphonies and ensembles around the state. He also works as a part-time brass instructor at Wheat Ridge High School. None of his jobs comes with health insurance.
  • page 87 “Music is an insanely difficult field,” said Lauer. The prospects for high-paying jobs are nearly nil. And getting health insurance with a job in music is exceedingly rare too. Nonetheless, Lauer stands firm on following his passion. “I love playing jazz. I love teaching trombone. I want to play and I want to play in a solid orchestra. If teaching comes along with it, that’s great,” he said. Along with facing low salaries, Lauer has thousands of dollars in student loan debt. He didn’t want to say exactly how much he owes, but debt will hover over him for years. “Oh heck, at this point, I’ll probably be close to retiring by the time I pay it off. I don’t like having it….but I know this is the way it’s going to need to be for me.” Lauer has an audition for an orchestra in Charlotte, N.C., and would be thrilled to get the job. “Just about any of these salaried jobs would please me to death,” he said. He thinks better job prospects are critical for young people like him. “If we can get more full-time jobs, more people will be working so the government can get taxes to do what it needs to do,” he said. Data from the Colorado Health Access Survey support the theory that a tough economy has been hard on young people, spurring a significant increase in the percentage of 20-somethings who went without health insurance as the Great Recession escalated. Young people ages 19 to 29 had an unemployment rate in 2011 that was 12 percent, significantly higher than the jobless figure that same year for adults ages 30 to 64, which hovered closer to 7 percent, according to U.S. Census data and the “Young Invincibles” report from The Colorado Trust and the Colorado Health Institute. Even if “young invincibles” have jobs, the health access survey found that only about one-third could get insurance through their jobs. That was down significantly from the last survey when analysts found than about 47 percent of young people had insurance through a job in 2008-09. Sometimes employers offer young people insurance and they don’t take it. The No. 1 reason that people of all ages turn down health insurance from an employer is that it’s too expensive. Invincibility seems to rank low on the list of reasons young people skip health coverage. The Colorado Health Access Survey found that only 12 percent of uninsured young people thought they didn’t need health coverage. In fact, the top three reasons young people don’t have insurance were high cost, lack of access to insurance through a job or losing eligibility for a government plan like Medicaid or CHP+, public insurance for low-income children. Kiel Lauer wants to be covered even though he’s relatively healthy and doesn’t use any prescription
  • page 88 medications. He fits Neil Howe’s description of the “young carefuls.” “There’s that off-chance that you’d have that one thing happen to you and you’d go, ‘Oh my goodness. Now I owe $300,000.’” And, surprisingly Lauer doesn’t want to accept Medicaid or subsidies to make his health costs more affordable. “I don’t like the idea of somebody else having to pay for me to benefit,” he said. While young people get accused of not thinking long-term, Lauer worries about the future impact of making health care seem more affordable than it is. “I was actually looking at Connect for Health and the subsidy issue (bothers me). There should be an incentive to keep insurance rates down without having to use taxpayer money,” he said. “There should be an incentive for insurance companies to get the prices lower versus keeping the price high and have taxpayers subsidize (health plans). “I will be happy to pay everything if I can get a job.” First step: Find a job Jesse Carpenter, who turned 26 this week, also wants a job. Then he figures he’ll be able to afford health care. Carpenter was hanging out recently at CU in Boulder where he attended school and studied electrical engineering. He’s part of a Boulder juggling club and was spending a beautiful afternoon throwing clubs beneath a sprawling shady tree. Like Lauer, Carpenter has been interviewing for jobs and would eagerly get covered if he got a job. “At 26, I’m ready to get health insurance,” he said. Dental coverage may be even more helpful. “My family has a history of bad teeth.” Lauer knows he’s vulnerable. “The truth of the matter is that it’s luck,” he said. “I don’t want to have to worry. Let’s say I get into a bike crash. Being healthy is vitally important.” When it comes to appealing to young people, Lauer thinks Obamacare would work best if young people got incentives, not slaps on the wrist if they don’t sign up. Under the Affordable Care Act, nearly all Coloradans will be required to buy insurance or face a tax penalty.
  • page 89 The penalty is very low the first year, starting at just $95 a year. It increases to $695 per person by 2016. That won’t go over well with 20-somethings, Carpenter predicted. “You should just leave out people from (ages) 15 to 30. They’re too rebellious,” he said. “It’s important to offer people an option to say no because (if they have to buy insurance) they will resent it for the rest of their lives.” The key to success may be a lot of handholding that convinces young people that health coverage is good for them and helps them navigate a confusing system, said Howe, the expert on millennials. After all, most of them are accustomed to regular care. “They’ve had a lot of contact with health care professionals. They’ve been diagnosed with food allergies and something like 20 percent of males, by the time they’ve graduated from high school, has been diagnosed with ADHD,” Howe said. “They are accustomed to a team including a parent, teacher, counselor and doctor looking over them.” Too much choice could frustrate millennials and prevent them from signing up. “It implies that you don’t care what I do. You don’t care if I choose utterly the wrong thing,” Howe said. Perhaps because helicopter parents have hovered over them their whole lives, they want guidance from mentors. “The millennial is always accustomed to someone older that they trust helping them,” Howe said. He advises corporations with many young employees that they’re looking for parent-style advice. They want counseling. They want help with tax prep and selecting their 401K options. Why not give them plenty of health advice too? While 20-somethings who are earning good salaries probably already have health insurance and those who are unemployed or are barely earning any money will probably qualify for Medicaid or federal tax subsidies, Howe said the group to watch is those in the middle. Many are working as consultants or entrepreneurs without access to any health insurance. They’re busy trying to impress big companies and affording health insurance will be a struggle. The key to getting them to enroll may be their parents. “They’re much closer to their parents” than previous generations, Howe said. He predicts their parents will tell them to check out health exchanges and a surprising number will do so. “The surprise will be on the upside,” Howe predicted. “Most will opt in because they believe in insurance. They believe someone should be looking after them. They are not risk-takers and they don’t want to cause a lot of pain for their parents.”
  • page 90 Question: My small company (under 50 full-timers) already provides health insurance for our employees. Now that the annual open enrollment period is coming up, is there anything special we need to do for Obamacare or to help our employees with the transition? Answer: If you’re happy with your company insurance plan and feel that providing health benefits is a competitive advantage for your company, as well as the right thing for your employees, there’s nothing special you need to do for open enrollment. In fact, many insurance companies are offering discounts to clients who renew their policies now, so that might be something you could take advantage of this year. You should have already sent out notices to your employees informing them about the new health insurance marketplaces. And it’s certainly a smart idea to document that you have fewer than 50 full-time employees (or their equivalent in part-timers) and that your business is therefore not mandated to offer insurance under the Affordable Care Act, says Shelby George, a practice leader in benefits solutions at asset manager Manning & Napier (MN) in Fairport, N.Y.. Even though you do offer insurance, you may one day need that documentation for audit purposes. The health insurance reform act makes many complex changes to existing law, but the vast majority of Americans will continue to get coverage through their employer-sponsored insurance plans in the near future, Michael Gomes, a senior vice president at Dallas-based employee benefits and payroll provider BenefitMall, writes in an e-mail. “If the plan you offer is affordable and valuable, then it is likely a better option for the majority of your employees” than buying insurance as individuals on the online Obamacare marketplaces. If your employees are confused by some of the rhetoric surrounding the ACA, you could help ease their concerns with some basic information, Gomes writes: “I suggest focusing heavily on communication and education to employees. This communication should be about the benefits you offer, what is and isn’t included, and the availability of the marketplaces. Keeping employees informed, letting them know they aren’t alone in this, and clearly explaining their options October 17, 2013 Explaining Obamacare to Small Employers Already Providing Health Insurance | Karen E. Klein
  • page 91 will go a long way to ensuring they get the health benefits that best meet their needs.” Although you are not under any pressure to make changes, this could be a good time for you to research your long-term options under the new health-care landscape, George says. Particularly with the rising cost of providing insurance for your employees, you might do a competitive analysis to determine whether offering insurance is the norm for your industry. Could you retain valued employees and save money if you drop your policy and give employees additional compensation that they could use to buy their own insurance through an Obamacare marketplace? What do the exchange prices look like in your state, and would many of your employees qualify for government subsidies that would lower their cost? Small business insurance marketplaces, called SHOPs, are expected to begin selling small group policies in November after being delayed by a month. Would that alternative save you some expense without sacrificing quality of coverage? There are also myriad tax implications to consider, George notes, both for your company and for your employees. “There are so many moving parts to health-care reform that these decisions can only be made on an individual basis,” she says. “The trap for employers is that they may rely only on what their insurance broker tells them, or make a decision based on something the CFO or CEO heard” that is inaccurate. Julia Hutchins is facing many of those decisions herself, as chief executive officer of Colorado HealthOP, a Denver insurance cooperative that started 18 months ago to sell coverage on the Colorado health insurance exchange. “We have 30 employees and last year decided to purchase a group health plan,” Hutchins says. “We’re all insurance geeks—we know this stuff—but it’s not easy for us either. We’re struggling with the same challenges everyone else is.” The time and effort it takes to navigate the expanded choices that small employers now have when it comes to benefits should not be underestimated, Hutchins says. She recommends getting professional help from an accountant (or another expert who is not trying to sell you something) who can lay out your coverage choices. Along with the implications for your bottom line, don’t forget to take into account how changes will affect your employees. Some may feel very strongly about keeping their existing doctors and health plans, while others may be happier buying their own insurance policies, tailored to their health needs, and knowing they can keep that coverage even if they leave your company.
  • page 92 A Colorado healthcare co-op stopped in Grand Junction Thursday afternoon to answer questions about the Affordable Healthcare Act. All who attended the seminar at Main Street Bagels were looking to clear the air on any questions they had about the new upcoming law, whether it was about signing up or problems dealing with tax credits. The CEO of the co-op says that nearly one in five Coloradans are uninsured, and sessions like this are necessary to get people prepared for the mandatory coverage deadline in February next year. The company putting on the event are on a state-wide tour and say they are the first non-profit health insurance cooperative in Colorado. October 17, 2013 Healthcare Questions Answered in Seminar | Travis Khachatoorian
  • page 93 October 23, 2013 New health insurance co-ops are in jeopardy | Jerry Markon
  • page 94
  • page 95 Almost a month since Colorado launched its health care exchange, only 3,164 people have enrolled. When CALL7 Investigator Theresa Marchetta asked why, she found that technology may not be the biggest challenge. CEO Julia Hutchins is anxious to see how her firm, Colorado Health Op, a health insurance cooperative, is stacking up against the 17 other competitors in Colorado’s marketplace. “We’re all anxious,” she says. “We can’t wait for people to get the insurance coverage they need.” The health care exchange at http://connectforhealthco.com/ was built as required by the Patient Protection and Affordable Care Act, sometimes known as “Obamacare.” The law was signed by President Barack Obama on March 23, 2010, after being controversially passed by the Democrat- controlled congress. Marchetta asked Hutchins, “As of today, do you know who has signed up for your program?” “We don’t know,” she answered. “We are so eager to meet our future members.” Hutchins went on to say they haven’t even gotten an estimated number of subscribers. Data posted Tuesday on the Connect For Health Colorado website show 316,326 people have visited the page and 44,935 have created accounts. Some 30,862 people have called with questions. But only 7 percent of the accounts have actually been used to enroll in coverage. Hutchins suggests confusion over Medicaid, Medicare and her organization’s own status as a non- profit and available tax credits could be to blame. “We want people to access tax credits, but we also want them to be aware if they’d have broader coverage through other public programs, so it is a tricky process,” she said. October 29, 2013 Only 3,164 Coloradans have enrolled for Obamacare through Connect for Health Colorado website | Theresa Marchetta
  • page 96 Ultimately, health care providers should find out who has signed up so far by Nov. 4. “These things are complicated and it does take time to work through,” Hutchins said. “I think this is what we expected.” There was a technical glitch after Colorado’s marketplace was created that temporarily preventing visitors from creating new accounts, but it was resolved within the first day. The federal marketplace, healthcare.gov, also suffered from problems that led to public criticism and even congressional hearings. Full video available upon request.
  • November 2013
  • page 98 November 4, 2013 Colorado HealthOP Secures Funding from the Colorado Health Foundation The Colorado Health Foundation awarded Colorado HealthOP, the state’s first non-profit health insurance cooperative, a $170,000 grant to educate Coloradans about the importance of enrolling in a sustainable health insurance plan. “We are grateful that the Colorado Health Foundation understands how a cooperative health insurer can advance health care in Colorado,” said Julia Hutchins, chief executive officer of Colorado HealthOP. “Nearly one in five Coloradans are uninsured, which leaves them exposed to significantly higher costs and potentially untreated health problems. Grants like this allow us to engage with people across our state to ensure that they get the coverage that they need.” Both Colorado HealthOP and the Foundation share the goal of facilitating sustainable health for individuals and communities across Colorado. The Foundation’s grant award will be used to raise awareness about the cooperative and its unique benefits that reward individuals for taking responsibility for their own health. Colorado HealthOP’s cooperative business model, focus on preventive care, and value-based benefits make their health insurance plans sustainable healthcare options for Colorado consumers. Coloradans can currently enroll in Colorado HealthOP’s plans through the state’s online health insurance marketplace, Connect for Health Colorado. Colorado HealthOP members will be eligible to receive benefits starting January 1, 2014. **digital outreach**
  • page 99 November 7, 2013 TED is mind-blowing experience | Linda Navarro TED, a nonprofit devoted to “ideas worth spreading,” has become the one-name representation of blow-your- mind thinking. Now TEDx community events, spread from TED.com, are challenging minds. The latest, featuring two local women, is TEDxMile High: “Women 2013 Values and Instincts.” It’s Nov. 16 at Newman Center for the Performing Arts, Gates Concert Hall, on the Denver University campus. One mind-challenging speaker will be Sara Volz, who made local headlines as a Cheyenne Mountain High School senior winning the 2013 Intel Science Talent Search. Now she’s a freshman at MIT studying molecular biology and continuing her research into producing “algae biofuels using artificial selection.” Also featured is Colorado College professor Katherine Giuffre, called a “changemaking professor doing research on the social structures most conducive to fostering creativity and innovative thinking.” Others scheduled: - Songwriter/artist Esm?Patterson, who toured and performed on television with her band Paper Bird. - Ashlynn Damers from the international youth slam poet group, Minor Disturbance, and “a fighter for justice, equality, and human rights through spoken word.” - Julia Hutchins, CEO of Colorado HealthOP, a “believer that health care can, and should, work better for more people through collaboration and consumer engagement.” Tickets: $39.50-69.50, http://tinyurl.com/m2q4jbg. Information: tedxmilehigh.com
  • page 100 November 6, 2013 Connect for Health Colorado site makes upgrades to ease customer wait time for tax credit approval | Theresa Marchetta and Catherine Shelley New features added to the Connect for Health Colorado health care exchange website are designed to make enrollment for a related tax credit simpler. Connect for Health Colorado is the health care exchange required under the federal Affordable Care Act, often known as Obamacare. It is built on different technology and different operations than the federal site, meaning Coloradans don’t have to go to the federal website in order to purchase insurance. According to Connect for Health Colorado there have been 3,408 enrollments, 52,542 accounts created and another 6,000 people who have called in with questions since its launch date on October 1. One of the biggest complaints documented by the CALL7 Investigators is of the long delays for people who chose to apply for the tax credit. They are forced to apply for Medicaid, wait for a denial and then continue the sign-up process-- the providers telling CALL7 Investigator Theresa Marchetta that this is something they have been equally frustrated with. An update launched Wednesday streamlines the website more than ever before for people who want to apply for the tax credit. Customers must still receive a Medicaid denial before being approved for a tax credit, but an upgrade in the system allows customers to apply for the tax credit without having to leave the website. Lindy Hinman, COO of Connect for Health Colorado, says that you should still plan to spend up to 2 hours to complete the application process if you have your income tax information on-hand. CALL7 checked with health care providers like Colorado Health-Op, who said they expected to see who signed up for their plans by Monday, but we learned those enrollment files became available for the first time Wednesday. Hinman assured that Connect for Health Colorado is “getting the carriers what they need so that they can make sure people are enrolled and are getting their services by January 1.”
  • page 101 But CALL7 uncovered the roll-out of enrollment information to the 17 providers in Colorado will be a continuous process throughout the month of November. Providers are required to turn that data into tangible insurance coverage by January 1. A big marketing push is underway to target younger Coloradan’s who qualify to sign-up. CALL7 requested the demographics of those who have signed-up and for what plans, but the information is not available yet. Full video available upon request.
  • page 102 November 14, 2013 In Colorado, insurers will decide on canceled plans | Brandon Rittiman It’s unclear how Colorado will be affected by President Barack Obama’s decision to allow the continued sale of insurance plans that would have been cancelled by year’s end because they don’t comply with the Affordable Health Care Act. The state’s Insurance Division is still looking into the implications of Obama’s announcement. Insurance Commissioner Marguerite Salazar said in a statement that some carriers may choose to allow “early renewal,” or keeping a current plan through 2014. Nearly 250,000 Coloradans have received health insurance cancellation notices. Salazar said that the decision whether to keep existing plans is up to insurance companies. She said that keeping an existing plan “may be a reasonable choice” for some, but she warned that those extended plans won’t comply with new federal insurance mandates. Full video available not available.
  • page 103 November 19, 2013 Nonprofit health insurer appoints 3 to board Colorado Health OP, nonprofit health insurance cooperative, today announced the appointment of three new board members, including one from Hospice of Northern Colorado. Marc Ringel, medical director of Hospice of Northern Colorado and senior clinical instructor in the University of Colorado School of Medicine’s Department of Family Medicine was one of the three new members appointed to the board of Colorado HealthOP, a nonprofit organization sponsored by the Rocky Mountain Farmers Union Educational and Charitable Foundation. The other two new board members are Melinda Harper, founder of Harper Hofer & Associates, a CPA firm, and George Lyford, health care attorney for the Colorado Center on Law and Policy. Colorado HealthOP was founded in March 2012 to offer coverage to individuals and employers that began open enrollment last month as part of Connect for Health Colorado, the state’s health insurance exchange. Hospice of Northern Colorado is based in Greeley.
  • page 104 November 21, 2013 Colorado HealthOP names three new board members Newly Appointed Board Members add to Colorado HealthOP’s Already Robust Roster of Healthcare Experts Colorado HealthOP, Colorado’s first statewide non-profit health insurance cooperative, today announced the appointment of three new board members. These prominent leaders bring more than a century of healthcare, law and accounting experience to the CO-OP’s board of directors. Joining Colorado HealthOP’s board of directors are Melinda Harper, CPA/ABV/CFF, CFE, founder of Harper Hofer & Associates, LLC, George Lyford, healthcare attorney for the Colorado Center on Law and Policy, and Marc Ringel, MD, medical director of the Hospice of Northern Colorado and senior clinical instructor in the University of Colorado School of Medicine’s Department of Family Medicine. Harper has more than 40 years of experience in public accounting, with specific expertise in damages, valuation, standard of care, bankruptcy and investigatory accounting. As a certified public accountant, in 2004, Harper founded Harper Hofer & Associates, a CPA firm focused on litigation, business valuation, marital dissolution and tax services. She previously served as director of Litigation and Valuation Services for CBIZ Accounting, Tax & Advisory Services. Among a wealth of appointments to a variety of professional and legal organizations, Harper has served as a member of the Legal Aid Foundation of Colorado, on the board of directors of the Colorado Health Foundation, as a member of the Board of Governors for HCA-HealthONE, LLC, and as a member of the Disciplinary Panel and the Client Protection Fund of the Colorado Supreme Court. Harper received her bachelor of science in business administration from West Virginia University. “Being a part of the Colorado HealthOP Board, with its emphasis on service and coverage, is congruent with my beliefs in a not-for-profit health system,” said Harper. “I am thrilled to be a part of this dynamic and progressive organization.” Lyford, a healthcare attorney for the Colorado Center on Law and Policy, brings a breadth of knowledge in healthcare advocacy, health reform and health insurance law. He has previously served as a staff attorney for the Nebraska Appleseed Center for Law in the Public Interest’s Health Care Access Program, and as an attorney specializing in HIPAA compliance and Social Security disability for Mary Kay Hansen Law & mediation, PC LLO. Lyford received his undergraduate and law degrees from the University of Nebraska. “I look forward to helping Colorado HealthOP implement its progressive, member-managed health insurance model,” Lyford said. “The Affordable Care Act brings with it new and improved health care options for tens of thousands of Coloradans. I am excited to work with the Colorado HealthOP board and management team to further our goal of providing affordable, sustainable health insurance.” **digital outreach**
  • page 105 Dr. Ringel has been practicing medicine for more than 40 years, with a focus on rural health. He currently serves as medical director of the Hospice of Northern Colorado and is a senior clinical instructor in the University of Colorado School of Medicine’s Department of Family Medicine.. He is also a consultant on medical staff issues, rural health, website development, telehealth and medical education and serves as chair of the Medical Advisory Board for HealthStream, Inc., a provider of online continuing medical education, enduring materials and live conferences. A recognized expert in family practice in the rural setting, Dr. Ringel has always maintained an active family practice, which has served as the starting point for his consultation, writing and teaching. He has previously served as medical director for a number of rural health facilities, including hospice and senior care centers, and he has developed training programs for family medicine residents who plan to enter rural practice. Additionally, he has held academic appointments at the University of Colorado, University of Northern Colorado and the University of Wisconsin. Board certified in family medicine, with a certificate of added qualification in hospice and palliative medicine, Dr. Ringel received his undergraduate degree from Tulane University and his medical degree from the University of Illinois. He speaks fluent Spanish. “I am thrilled to be a member of the Colorado HealthOP team because this position gives me the opportunity to leverage some of what I’ve learned, through years of study and experience, in service of bringing quality healthcare to a community of empowered patients, a goal I’ve held dear since I entered medical school in 1970,” Dr. Ringel said. Colorado HealthOP’s cooperative business model and value-based benefits allows the organization to provide a sustainable healthcare option to Colorado consumers. Coloradans can currently enroll in Colorado HealthOP plans through the state’s online health insurance marketplace, Connect for Health Colorado. Colorado HealthOP members will be eligible to receive benefits starting January 1, 2014.
  • December 2013
  • page 107 December 6, 2013 Nonprofit Insurance Co-Ops Thriving Despite ObamaCare Web Struggles | Zach Halper While the rollout of the Affordable Care Act’s (ACA) healthcare marketplaces has been marred by technical glitches on the national website, nonprofit health insurance co-ops established by the law are experiencing modest success. The law popularly known as ObamaCare debuted its most talked about provision when the initial enrollment period for the health insurance marketplace went live on Oct. 1. That rollout was bumpy, to say the least, with many people unable to register to buy coverage due to the volume of visitors to the site, Healthcare.gov. A less talked-about provision of the marketplaces was the nonprofit health insurance co-ops. Unlike traditional health insurance companies, members have a voice in the day-to-day operations of the co-op. Profit is not a concern with these entities because members essentially operate as shareholders. When the ACA was in its early stages, co-ops were initially supposed to be in all 50 states. Those plans fell through after the Center for Medicare and Medicaid Services (CMS) announced the original $6 billion funding model would be reduced to $2 billion for 23 low-interest co-ops in 24 states. All 23 of the co-ops that CMS has provided loans to through this program are nonprofit. While these reductions in funding and federal restrictions have been problematic for some of the co-ops – one in Vermont had to close its doors after the U.S. Department of Health and Human Services (HHS) terminated its contract – that experience is not shared across the board, according to Julia Hitchens, chief executive at Colorado HealthOp. Hutchins acknowledged that some of the federal restrictions have been challenging but haven’t exactly set them up to fail. “In some way we don’t see these as restrictions, per say, since they’ve been part of this program from the beginning,” explained Hutchins. One of the restrictions forbids co-ops from using federal money for marketing. To get around this, Hutchins dispatched scantily clad models into Denver to educate the public on the benefits of getting covered by health insurance plans. While acknowledging that marketing that way is “difficult,” Hutchins said the results were a success, as it led to “countless” media requests and inquiries from the general public. Hutchins explained that co-ops have additional benefits for members compared to traditional insurers. For example, members can receive gifts (such as a $100 debit card) for completing certain requirements each year, such as taking a health risk questionnaire. In addition, excess revenue goes back into improving quality, benefits and reducing premiums. While Hutchins could not provide specific enrollment numbers as of this writing, she said that 50,000 people in Colorado signed up for accounts on the website.
  • page 108 An equally sunny picture is being painted on the other side of the country by Debra Friedman, president and CEO of Health Republic Insurance of New York. Friedman said that neither the federal restrictions nor budget cuts have had much impact as of now. In fact, she said the co-op exceeded its goals regarding outreach, engagement and enrollment, though they did not yet have specific numbers to share. “We are pleased with our progress and momentum since the exchange opened on October 1,” said Friedman. Health Republic Insurance of New York has also been involved with local nonprofits. Friedman noted that the co-op has an active outreach and education program focused on driving member engagement. “We partner with local community centers, churches, synagogues, etc., throughout the state in an effort to continue to drive excitement about Health Republic Insurance’s innovative offerings,” explained Friedman. Without identifying the specific nonprofits with which Health Republic Insurance of New York has worked, Friedman further elaborated that they generally partner with organizations likely to have uninsured members that have been overlooked by traditional health insurance providers. “Whether it be social organizations, arts groups or local business improvement districts, our efforts have been centered on engaging the potential member or business owner in the neighborhoods they live and work,” explained Friedman. “It might be at a street fair or an art show representing unknown artists, but we are there with the same message.” Colorado HealthOp has been working with local nonprofits to educate the public, which Hutchins said has been a big help. One such organization is the Colorado Consumer Health Initiative (CCHI), a coalition of nonprofit health care advocacy groups. Part of Colorado HealthOp’s partnership with CCHI included a blog that Hutchins posted in September, which explained the benefits of the services. According to Adam Fox, director of strategic engagement at CCHI, these kind of efforts are necessary due to the unfamiliar nature of the co-ops. “I think there’s just a huge unfamiliarity with co-ops, which is why we’re trying to raise awareness and show how they are different from other insurers,” said Fox. “Consumers in Colorado don’t think of the co-op model as being used for health insurance.” CCHI has been heavily involved in its own engagement, not just about the co-ops, but also the new healthcare options provided by the ObamaCare healthcare exchanges. Fox said they have been particularly active in social media, where they just finished up their “Got Insurance?” campaign, in partnership with ProgressNow Education Colorado. Using primarily Twitter and Facebook, the campaign was styled after the “Got Milk” campaign, and included staged photos of people with injuries or sickness and connecting it to the need to get insurance. Fox said they have been pushing the message in local and national media, having 40 Colorado-specific media hits related to the “Got Insurance Campaign?” and 52 more outside of Colorado. “It’s all about education,” said Laura Morsch-Babu, director of public affairs and community outreach at Colorado HealthOp. “We have a dedicated outreach team that has been setting up a many meetings as possible with nonprofit organizations — particularly health-related ones — around the state.” As Healthcare.gov continues to grapple with its rocky rollout, the representatives from Colorado HealthOp and Health Republic Insurance of New York are both grateful that their experiences have been nowhere near as troubled as the national effort.
  • page 109 “We’re fortunate that Colorado’s marketplace has seen fewer tech issues than the federal site,” said Hutchins. The only problem Hutchins anticipates is the continuing need to make citizens aware of services. The continuous community out­reach through Colorado, combined with engaging media and marketing campaigns that educate people about the co-op, has Hutchins optimistic that Col­o­rado Health­Op will continue to grow. For Health Republic Insurance of New York, the main challenge going forward is getting people to believe that co-ops can survive being solely nonprofit. Friedman has been active in trying to explain their model to potential customers. “The co-op structure is centered around members and, coupled with a superior business model and lean corporate structure, makes it possible for us to deliver low rates without sacrificing the size of our network or the quality of our care,” said Friedman. The “unknown” quantities — how many members they will have in 2014, their needs, who their providers are, etc., also worry Friedman. That said, she projected an air of confidence about their prospects going forward, particularly because of the constant outreach to the community. “We hope to learn a great deal about our members in our first year, and use that to continue to improve our business and services,” said Freidman. “As a co-op, members are at the center of everything we do and will be actively engaged in the process of continuing to better our plans year over year.”
  • page 110 December 13, 2013 Your epic fail could cost you $18K without health insurance — get covered We’ve all done it … tried to dunk a basketball to show off to our friends, gotten overconfident and taken the double black diamond instead of our usual blue, or jogged over some black ice because we were running late. Whether we were trying to show off or simply unaware of our surroundings, we’ve all likely experienced an absent-minded #FAIL. And too many of us choose not to get health insurance for the very same reason. But the scary truth is, you could get hurt. And if you don’t have health insurance, getting hurt could cost you everything. An Unintentional Fail Can Put You in the Red Without health insurance, a small misstep could take a big bite out of your annual income. Here are a few estimates of costs an individual without insurance might pay for treatment of injuries caused by simply being clumsy*: — Drop a box on your foot and break your toes: $18,000 without insurance. — Slice your hand cooking and get an infection: $12,300 without insurance. — Walk into a sliding glass door and break your nose: $4,000 without insurance. An Epic Fail Can Leave You with Nothing in the Bank Yes, we all know that you will for sure land that [insert way-too-advanced-for-you athletic move here]. But what if you don’t? Your fail could epically drain your savings account. Here are a few estimates of costs an individual without insurance might pay for treatment of injuries caused by overconfidence*: — “Bet I can ride this half pipe…” Dislocate your shoulder: $11,500 without insurance. — “Maybe I can dunk this basketball…” Broken leg: $15,200 without insurance. — Try cow tipping a bull, end up with broken ribs and a collapsed lung: $10,000 without insurance. Not Sweating the Small Stuff Can Quickly Add Up While investing in an adult-sized roll of bubble wrap might keep you from injuring yourself (we don’t recommend this), even the healthiest person can’t avoid getting sick. Although many people can make it through this year’s common cold without a visit to the doctor, many illnesses require medical attention. Here are a few estimates of costs an individual without insurance might pay for treatment of illnesses*: — An asthma attack and visit to the ER: $4,000 without insurance. ­— A kidney infection and five-day hospitalization: $8,200 without insurance. — A heart attack and five-day hospitalization: $10,500 without insurance. **digital outreach**
  • page 111 Get Covered, Colorado! The simple truth: The costs of being uninsured are too high. One accidental misstep, ill-advised stunt or circumstance that’s out of your control can send your healthcare costs spiraling and launch you into serious debt. The good news is that recent changes in healthcare have made getting health coverage more affordable. If you’re between the ages of 18 and 29, you may also be eligible to purchase a Colorado Young Adult, or CYA, plan available on Connect for Health Colorado. These CYA plans, also known as catastrophic plans, are designed for young people who are in good health. Because they’re intended to protect you from high cost medical emergencies, they cost you less in monthly premiums. You may also qualify for help paying for your insurance, which may help you significantly lower costs. Find out if you qualify.
  • page 112 December 17, 2013 The young & the defenseless | Greg Ruland Colorado’s first statewide nonprofit health insurance cooperative launched a new awareness campaign last week to educate “young invincibles” about the potential costs of not having health insurance. The name young invincibles comes from a term used in the insurance industry that refers to young adults who choose to go without health insurance because of their perceived invincibility — that is, they don’t feel they need it, according to the Colorado Trust. This may be because they are healthy, feel invulnerable and don’t anticipate needing health care, or that they’re more willing than older adults to take the risk of not having coverage, the trust said. As the Dec. 23 health insurance enrollment deadline approaches, healthy but uninsured Coloradans may overlook the high cost of an unanticipated or unexpected medical issue, said Julia Hutchins, chief executive officer of the Colorado Health Insurance Cooperative. In 2011, more than one in 10 Americans experienced an unintentional injury or poisoning, according to data from the Centers for Disease Control and Prevention, said Dr. Jack Westfall, the cooperative’s chief medical officer. The data also show unintentional injury is the leading cause of death among Americans under 45, Westfall said. Dubbed “#FAIL,” Colorado HealthOP’s online campaign highlights how expensive a careless act can be, Hutchins said. “This is really about calling attention to things that happen in everyday life — accidents with unintended consequences that happen simply by living,” she said. “Those sorts of things happen to everybody regardless of who you are and what you’re doing and they can be pretty costly.” The campaign runs through the end of January. It includes a series of #FAIL memes that illustrate the hard costs associated with relatable but scatterbrained injuries. For example, if you drop a box on your foot and break your toes, it could cost you $18,000 without insurance, according to Healthcarebluebook.com, an online resource that helps consumers determine fair prices for health care services in their area. “It can happen to teens, it can happen to young adults, it can happen to old adults, and it’s very provocative,” Westfall said. “Everybody thinks about stubbing their toe or twisting their ankle.” One of the examples given in the #FAIL campaign related to an incident Westfall experienced. “I felt that I was not young but was still invincible and could dunk a basketball,” Westfall said. “I’ve never been able to dunk the basketball. Why I thought two weeks ago that I could dunk the basketball is beyond me, but I did.”
  • page 113 Westfall ended up with a sprained shoulder, but not a massive health care bill. “I’m OK and I’m going to survive and it did not cost me $6,000, but it got me thinking about ‘what if?’ ” The cooperative offers some products tailored-made for youth called “CYA plans.” “It can stand for a number of different things, but it also stands for Colorado young adults,” Hutchins said. CYA plans are higher deductible plans, some with deductibles as high as $6,000. Two primary care doctor visits are covered, she said. “Those plans are about helping people pay for unintended events that are way beyond their means to be able to afford,” she said. “Six thousand dollars is a lot of money, but $15 (thousand), $20 (thousand), $30,000 is something that could set you back financially for a long time.” Hutchins and Westfall denied they are attempting to frighten young people into buying insurance. “We’re encouraging a conversation about coverage in a different kind of way than they’re used to from a typical insurance company,” Hutchins said. Westfall said the campaign focuses on accidents instead of illness because the company did not want to point blame at anybody. “We didn’t want to talk about smoking, diabetes, or even obesity right now,” Westfall said. “That’s not really a particularly exciting conversation.” The campaign is solely produced by Colorado HealthOP and is not connected to or endorsed by the state’s health insurance marketplace, Connect for Health Colorado.
  • page 114 December 23, 2013 ‘Twas the #FAIL before Christmas… In less than one week, jolly Saint Nick will take off from the North Pole and make the rounds to deliver Christmas gifts to boys and girls. But sometimes Santa’s Christmas Eve adventures include unforeseen mishaps. These accidents could be costly—if Santa doesn’t have health insurance. Down the chimney Saint Nicholas came with a bound… A crackling fire can be the perfect addition to a cold winter’s night. Unfortunately, leftover embers could cause second-degree burns for Father Christmas. And without health insurance, this fireplace blunder could cost Santa some major dough. He was chubby and plump, a right jolly old elf… Kris Kringle loves to indulge in delicious cookies and ice-cold milk youngsters leave out for him. But when eager beavers set milk out too early, it could wind up sour by the time Santa makes his appearance. And without health insurance, food poisoning, courtesy of sour milk, could clean out dear ol’ Saint Nick’s reindeer-shaped piggy bank. When out on the lawn there arose such a clatter… Small kiddos aren’t the only ones fighting to stay awake and listen for the telltale signs of Father Christmas. Fido, the family pooch, is on high alert Christmas Eve, barking and growling at unfamiliar noises. Fido’s protective instincts could go awry if he thinks Santa Claus is actually a burglar and attacks, leading to a costly injury for Santa if he doesn’t have health insurance. He spoke not a word, but went straight to his work… Santa Claus fills stockings and places gifts under the tree, always careful to leave houses as he found them; but what happens when Santa tries to do you a favor and unknowingly plugs your Christmas lights into an overloaded socket? It could mean mild electric shock for good ol’ Saint Nick. **digital outreach**
  • page 115 ‘Tis the season to get covered, Colorado… There’s no denying it: Even the jolliest of the jolly need health insurance. In fact, without insurance, Santa’s #FAIL could cost him upwards of $11,600,* which could really put a damper on Santa’s pocket book. However, thanks to recent changes in healthcare, getting health coverage is easier and more affordable—for residents of the North Pole and Colorado. Many Coloradans may also qualify for help paying for insurance, which may help significantly lower costs. Find out if you qualify. Learn more about new health insurance options at COHealthOP.org and follow the Get Covered, Colorado! campaign on social media with #GetCoveredCO. And remember, in order to be covered by January 1, 2014, you need to sign up for health insurance by December 23, 2013. If you’re not able to sign up by December 23, you can continue to sign up for a new plan through March 31, 2014. “He sprang to his sleigh, to his team gave a whistle, And away they all flew like the down of a thistle. But I heard him exclaim, ‘ere he drove out of sight, ‘Happy Christmas to all, and to all a good-night!’” -‘Twas the Night Before Christmas Poem *https://healthcarebluebook.com/