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NEWS RELEASE

For Immediate Release: June 6, 2016

Division of Insurance releases preliminary 2017 health
insurance information
Final approval expected in late September / early October.
DENVER - The Colorado Division of Insurance (DOI), part of the Department of Regulatory
Agencies (DORA), today released the preliminary information for proposed health plans
and premiums for 2017.
The DOI confirmed that four insurance companies either will not offer or will
significantly cut back individual plans (non-employer) next year. A new entrant into the
Colorado market will sell plans in the individual market. And a number of companies
currently offering individual plans are seeking significant premium increases for their
2017 individual plans.
“As we prepare for the fourth open enrollment of the Affordable Care Act, it’s worth
noting that we’re still in the stabilization phase,” said Colorado Insurance Commissioner
Marguerite Salazar. “Companies are still figuring it out — where to sell, how to sell, how
to price — which is why we’re seeing some companies pull back on individual plans or
requesting significant increases, while still other companies are coming into the market.
Some companies have done a better job of figuring out how to operate in this new
environment and compete for people’s business, while others must step back and
reevaluate their approach.”
Rocky Mountain Health Plans / Anthem PPO
As noted in a May 13 release, UnitedHealthcare and Humana Insurance will not offer
individual plans in 2017, which impacts approximately 20,000 consumers in Colorado
(UnitedHealthcare – 10,549; Humana – 9,914). In addition, Rocky Mountain Health Plans
(RMHP) determined that it will reduce individual plan offerings for 2017, offering
individual plans only in Mesa County, only via its Monument Health affiliate.
Approximately 10,000 people currently enrolled in an individual RMHP plan will have to
find another plan for 2017.
In addition, Anthem Blue Cross and Blue Shield decided it will not offer its PPO
(Preferred Provider Organization) individual plans for 2017, which impacts 62,310
people. However, Anthem will continue to offer HMO (Health Maintenance Organization)

Rocky Mountain Health Plans has been a key player in the mountain areas and Western Slope. “But in the larger picture. It seems what the market needs is innovation rather than the old operating model.” noted Commissioner Salazar. either through the state exchange. continue to get their health insurance through an employer.” continued the Commissioner. and these plans will be available to all consumers affected by the PPO decision. RMHP and Anthem will need to find other coverage for 2017 during open enrollment. At least 51 percent of people in Colorado. 2017.7 percent of Coloradans. All of these companies will continue to offer their small and large group plans for employers. a new entrant into the Colorado market. this could be an indication that there were too many options for the market to support. “They are focusing on efficient delivery of quality care through a healthcare partner. “I’d rather these companies continued in the individual market. or off the exchange.” “It’s also important to highlight that we are not seeing this market correction in the small group market. will sell individual plans both on and off the exchange.000 consumers with plans in the individual market represents approximately 7. and what UnitedHealthcare is doing in other states with its subsidiary. the free market is at work. Connect for Health Colorado. Bright Health Plans. around 2. This echoes what RMHP is doing through its Monument Health program. And it is important to recognize that this is a market correction taking place on a national scale.individual plans statewide. not just in Colorado. 2016–Jan. many companies have requested significant premium increases (see the chart below for a breakdown by company). “Where others have experienced challenges. 31. Bright sees opportunity with what they believe is an innovative approach. what’s taking place is a market correction. Harken Health. and its departure from the individual market will leave many areas with only one on-exchange insurance company — Anthem Blue Cross and Blue Shield’s HMO division – for individual plans. that market seems to be stable.” said Commissioner Salazar.” Premium Increases Ahead for the Individual Market For the individual market in 2017.000 people with individual plans from UnitedHealthcare.8 million.” Number of People Impacted Around 92. 1. The companies review what they paid out for health claims to doctors.000 Coloradans who get their insurance through the individual market. While it was good initially to have so many companies offering so many individual plans. This represents approximately 20 percent of the 450. “In many ways. Bright Health Plans As other companies work to readjust. Humana Insurance. Nov. hospitals and other providers this year in . Those 450.

DOI staff will examine each plan to make sure it complies with the Affordable Care Act (ACA) and state laws. The DOI also reviews the benefits and the plans’ networks of healthcare providers to make sure that they meet state and federal requirements.” In the small group market. The Division is also available as a resource for consumers. . but will review what the companies submitted to determine if requested increases or decreases are justified.   Study already underway of a single-geographic rating area . as well as for many consumers to afford them. gold (80 percent) and platinum (90 percent). Contact the Division of Insurance at 303894-7490 / 800-930-3745 (outside the Denver metro area) /DORA_insurance@state. the companies have indicated that the people enrolled in individual plans have used more healthcare services and with greater frequency than anticipated. passed this past legislative session.Throughout this process. companies are requesting single-digit increases or even decreases.     The DOI does not set insurance premiums. directs the DOI to study the feasibility of moving the state to a single geographic rating area. all of us in the industry must tackle the more pressing question of what is driving the increased health costs in the individual market that lead to higher premiums. The DOI checks to make sure the premiums are sufficient for the company to continue to pay its members’ claims. “While the DOI will evaluate information provided by the companies to determine if their requested premium increases are correct.” said Commissioner Salazar. even while we work to gain an understanding of what’s happening in the individual market.” noted the Commissioner.us. The Rate Review Process Over the summer. the Division of Insurance is ready and available to help answer consumer questions regarding their health insurance plans or their future options. “We should not lose site of the positive news in the small group market. The bill also directs the DOI to study how healthcare costs impact premiums.co. “In general. which will provide greater insight into how the Colorado individual market functions. that make it challenging for insurance companies to offer individual plans. Responding to the Changes The DOI recognizes there are forces at work in Colorado. The DOI verifies whether the plans meet the metal tier coverage levels: bronze (an average of 60 percent of medical expenses paid by the plan). The DOI has started a study that looks at the underlying costs of healthcare. silver (70 percent). DOI’s Consumer Services . and particularly in the individual market in certain areas of the state.House Bill 1336.order to set appropriate premiums for next year that will allow them to pay claims and remain in business.

NOTE .The information below on the number of plans and carriers and the requested premium changes for 2017 is preliminary. After DOI completes its review and analysis in late September / early October.8% New to market 9. the DOI will also provide summary information and analysis regarding the carriers and plans for 2017. not the final approved plans for 2017. 23 carriers will be offering individual and small group plans in Colorado. The DOI encourages consumers to submit comments no later than July 6. During the review period. 2016. At that time. Average REQUESTED Premium Change. Colorado consumers can submit public comments on the filings. it will notify carriers and Connect for Health Colorado of the approved plans for 2017. The user will be prompted to enter his/her name.5% 36. there will be a section for comments within each filing.Submitting Public Comments The filings from the companies are available for review on DOI’s Health Insurance Filings page. which will be reviewed and considered by the DOI. Click on the “Add” link in the “Comments” column of the filing of interest. and the comment.INDIVIDUAL Plans. by Company Company Anthem BCBS (HMO Colorado) Bright Health Plans*** Cigna Colorado Choice Denver Health Freedom Life Insurance Requested Overall Change* 26.08% 9. email address. The information only reflects what the carriers have requested. Tips on filing an online comment: When viewing the filings online.98% SERFF Tracking Number** AWLP-130560313 BRHP-130518475 CCGH-130510383 COHP-130547449 DVHH-130565984 USHG-130545454 . Number of Individual & Small Group Plans for 2017 On-exchange Off-exchange Total Individual 131 144 275 Small / Group 141 526 667 Total 272 670 942 Number of Carriers On / Off-Exchange for 2017 In total. so they can be included as part of the review of the filings. Any requested rate has to be justified by the insurance carrier. city and state of residence.33% 0. On-exchange Off-exchange Individual 7 10 Small / Group 5 13 Medical .

colorado. ### The Colorado Division of Insurance regulates the insurance industry and assists consumers and other stakeholders with insurance issues.Golden Rule Kaiser Foundation Health Plan of Colorado National Foundation Life Rocky Mountain HMO 40.4% Aetna Life Insurance Company -3.7% Kaiser Permanente Insurance -0. in all areas of Colorado where the company does business. Average REQUESTED Premium Change. ** The SERFF Tracking Number is way to search for the filing on the DOI’s system.1% UnitedHealthcare Insurance Company -7. for all ages. *** Bright Health Insurance Company is a new entrant into the health insurance market in Colorado.6% AMMS-130560610 KFHP-130552059 9.2% Rocky Mountain HMO 5. by Company Company Requested Overall Change* Aetna Health Inc. Visitwww.36% Kaiser Foundation Health Plan of Colorado 3. in all areas of Colorado where the company does business.1% Anthem BCBS (Rocky Mountain Hospital & 2.9% Rocky Mountain Healthcare Options 11.6% USHG-130545468 LEIF-130564677 * Averaged over all individual plans a company proposes to sell.6% 13. -4.9% Medical Service) Colorado Choice 7.6% SERFF Tracking Number** AETN-130554115 AETN-130535284 AWLP-130560332 AWLP-130560333 COHP-130547510 HUMA-130570800 HUMA-130570797 KFHP-130552141 KFHP-130552206 LEIF-130564669 LEIF-130564686 UHLC-130570593 UHLC-130572383 * Averaged over all small group plans a company proposes to sell. for all ages.7% UnitedHealthcare of Colorado -1.SMALL GROUP Plans.35% Humana Insurance Company 4. Consumer .gov/insurance for more information or call 303-8947499 / toll free 800-930-3745.dora. 6. Medical . ** The SERFF Tracking Number is way to search for the filing on the DOI’s system.6% Anthem BCBS (HMO Colorado) 4.38% Humana Health Plan Inc.98% 34. DORA is dedicated to preserving the integrity of the marketplace and is committed to promoting a fair and competitive business environment in Colorado.

gov for more information or call 303-894-7855/toll free 1-800-886-7675. Visit www.protection is our mission. .dora.colorado.