You are on page 1of 6


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, its worth
noting that were 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 were 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 peoples 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)

individual plans statewide, and these plans will be available to all consumers affected by
the PPO decision.
All of these companies will continue to offer their small and large group plans for
Rocky Mountain Health Plans has been a key player in the mountain areas and Western
Slope, and its departure from the individual market will leave many areas with only one
on-exchange insurance company Anthem Blue Cross and Blue Shields HMO division
for individual plans.
Id rather these companies continued in the individual market, noted Commissioner
Salazar. But in the larger picture, whats taking place is a market correction; the free
market is at work. And it is important to recognize that this is a market correction taking
place on a national scale, not just in Colorado. While it was good initially to have so
many companies offering so many individual plans, this could be an indication that there
were too many options for the market to support.
Its also important to highlight that we are not seeing this market correction in the
small group market, continued the Commissioner. In many ways, that market seems to
be stable.
Number of People Impacted
Around 92,000 people with individual plans from UnitedHealthcare, Humana Insurance,
RMHP and Anthem will need to find other coverage for 2017 during open enrollment,
Nov. 1, 2016Jan. 31, 2017. This represents approximately 20 percent of the 450,000
Coloradans who get their insurance through the individual market, either through the
state exchange, Connect for Health Colorado, or off the exchange. Those 450,000
consumers with plans in the individual market represents approximately 7.7 percent of
Coloradans. At least 51 percent of people in Colorado, around 2.8 million, continue to
get their health insurance through an employer.
Bright Health Plans
As other companies work to readjust, a new entrant into the Colorado market, Bright
Health Plans, will sell individual plans both on and off the exchange.
Where others have experienced challenges, Bright sees opportunity with what they
believe is an innovative approach, said Commissioner Salazar. They are focusing on
efficient delivery of quality care through a healthcare partner. This echoes what RMHP is
doing through its Monument Health program, and what UnitedHealthcare is doing in
other states with its subsidiary, Harken Health. It seems what the market needs is
innovation rather than the old operating model.
Premium Increases Ahead for the Individual Market
For the individual market in 2017, many companies have requested significant premium
increases (see the chart below for a breakdown by company). The companies review
what they paid out for health claims to doctors, hospitals and other providers this year in

order to set appropriate premiums for next year that will allow them to pay claims and
remain in business.
In general, the companies have indicated that the people enrolled in individual plans
have used more healthcare services and with greater frequency than anticipated, said
Commissioner Salazar. While the DOI will evaluate information provided by the
companies to determine if their requested premium increases are correct, 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.
In the small group market, companies are requesting single-digit increases or even
decreases. We should not lose site of the positive news in the small group market,
even while we work to gain an understanding of whats happening in the individual
market, noted the Commissioner.
Responding to the Changes
The DOI recognizes there are forces at work in Colorado, and particularly in the
individual market in certain areas of the state, that make it challenging for insurance
companies to offer individual plans, as well as for many consumers to afford them. The
DOI has started a study that looks at the underlying costs of healthcare. The Division is
also available as a resource for consumers.

Study already underway of a single-geographic rating area - House Bill 1336,

passed this past legislative session, directs the DOI to study the feasibility of
moving the state to a single geographic rating area. The bill also directs the DOI
to study how healthcare costs impact premiums, which will provide greater
insight into how the Colorado individual market functions.
DOIs Consumer Services - Throughout this process, the Division of Insurance is
ready and available to help answer consumer questions regarding their health
insurance plans or their future options. Contact the Division of Insurance at 303894-7490 / 800-930-3745 (outside the Denver metro area)

The Rate Review Process

Over the summer, DOI staff will examine each plan to make sure it complies with the
Affordable Care Act (ACA) and state laws.

The DOI does not set insurance premiums, but will review what the companies
submitted to determine if requested increases or decreases are justified.
The DOI checks to make sure the premiums are sufficient for the company to
continue to pay its members claims.
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), silver (70
percent), gold (80 percent) and platinum (90 percent).
The DOI also reviews the benefits and the plans networks of healthcare providers
to make sure that they meet state and federal requirements.

Submitting Public Comments

The filings from the companies are available for review on DOIs Health Insurance Filings
page. During the review period, Colorado consumers can submit public comments on the
filings, which will be reviewed and considered by the DOI. The DOI encourages
consumers to submit comments no later than July 6, 2016, so they can be included as
part of the review of the filings.
Tips on filing an online comment: When viewing the filings online, there will be a section
for comments within each filing. Click on the Add link in the Comments column of
the filing of interest. The user will be prompted to enter his/her name, city and state of
residence, email address, and the comment.
After DOI completes its review and analysis in late September / early October, it will
notify carriers and Connect for Health Colorado of the approved plans for 2017. At that
time, the DOI will also provide summary information and analysis regarding the carriers
and plans for 2017.
NOTE - The information below on the number of plans and carriers and the
requested premium changes for 2017 is preliminary. The information only reflects
what the carriers have requested, not the final approved plans for 2017. Any
requested rate has to be justified by the insurance carrier.
Number of Individual & Small Group Plans for 2017



Small / Group


Number of Carriers On / Off-Exchange for 2017

In total, 23 carriers will be offering individual and small group plans in Colorado.



Small / Group

Medical - INDIVIDUAL Plans, Average REQUESTED Premium Change, by Company

Anthem BCBS (HMO Colorado)
Bright Health Plans***
Colorado Choice
Denver Health
Freedom Life Insurance

Requested Overall
New to market

SERFF Tracking

Golden Rule
Kaiser Foundation Health Plan of
National Foundation Life
Rocky Mountain HMO





* Averaged over all individual plans a company proposes to sell, in all areas of Colorado
where the company does business, for all ages.
** The SERFF Tracking Number is way to search for the filing on the DOIs system.
*** Bright Health Insurance Company is a new entrant into the health insurance market
in Colorado.
Medical - SMALL GROUP Plans, Average REQUESTED Premium Change, by Company


Requested Overall
Aetna Health Inc.
Aetna Life Insurance Company
Anthem BCBS (HMO Colorado)
Anthem BCBS (Rocky Mountain Hospital & 2.9%
Medical Service)
Colorado Choice
Humana Health Plan Inc.
Humana Insurance Company
Kaiser Foundation Health Plan of Colorado 3.7%
Kaiser Permanente Insurance
Rocky Mountain Healthcare Options
Rocky Mountain HMO
UnitedHealthcare Insurance Company
UnitedHealthcare of Colorado

SERFF Tracking

* Averaged over all small group plans a company proposes to sell, in all areas of
Colorado where the company does business, for all ages.
** The SERFF Tracking Number is way to search for the filing on the DOIs system.
The Colorado Division of Insurance regulates the insurance industry and assists
consumers and other stakeholders with insurance
issues. for more information or call 303-8947499 / toll free 800-930-3745.
DORA is dedicated to preserving the integrity of the marketplace and is committed to
promoting a fair and competitive business environment in Colorado. Consumer

protection is our mission. Visit for more information or

call 303-894-7855/toll free 1-800-886-7675.