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
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 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.
“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.”
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 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.
May 22, 2013
Technical problems slow launch of Colorado health insurance website | Michael
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.
May 22, 2013
Big differences in costs for Colorado small-group coverage under health reform | Ed
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
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
“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.
“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
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
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.
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
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
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,
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 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
“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
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.
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
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
June 5, 2013
Colorado consumer group reviews new health insurance rates and calls them “just
right” | Michael Booth
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.
June 16, 2013
Health Care Options
Health insurers are applying to offer individual coverage on the new Affordable Care Act exchanges for Oct. 1.
June 28, 2013
Colorado HealthOP now using social media to help consumers understand insurance
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.
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
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 6, 2013
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
“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 & 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.
July 15, 2013
Middle of the Pack | Rich Daly
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
“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
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.
“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.
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 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.
August 16, 2013
Whether to buy or not to buy health insurance | Ed Sealover
August 19, 2013
Colorado Exchange Releases Health Insurance Rates | Eric Whitney
Colorado released its
rates on Friday, joining 13
states and the District of
Columbia in making rates
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.
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.
August 21, 2013
Colorado DOI Approves Exchange Plan Carriers And Rates | Amy Lotven
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
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
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
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
• 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 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
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.
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
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
“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
“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
“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.
September 11, 2013
Health co-op first to rule that transgender exclusions are wrong | Katie Kerwin
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.”
“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
“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
“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
“I’m hoping that since the Colorado HealthOP has set the bar, others will meet it.”
September 17, 2013
Consumer Controlled Health Insurance: A Necessary and Welcome Shift | Julia
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.
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.
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,
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.
Kaiser Permanente will now cover services for transgender Coloradans in its insurance plans, the company said
“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
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
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.
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
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.”
September 25, 2013
New player on health insurance scene | Loretta Sword
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.
September 30, 2013
Sign up for ‘Obamacare’ starting today | John Colson
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
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
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
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
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
“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
October 2, 2013
Flexing its muscle, while weak in spots | Michael Booth
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
[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
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 |
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
October 1, 2013
Obama Hires Half-Naked People to Promote Obamacare
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
Obamacare organizers in Colorado are taking Obamacare
promotion to a new low – at least in terms of their dress
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:
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
The Affordable Care Act’s coverage model depends on
enrolling 7 million Americans, including at least 2.5 million
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
Enrolling Colorado residents into the state’s new health
care exchange market is as simple as a bit of public nudity,
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
“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
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
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,
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.
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
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
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.”
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.”