We've Moved

The news and ideas haven't stopped, starting on September 7, 2006 you can find the Colorado Health Insurance Insider here... http://www.healthinsurancecolorado.net/blog1/. With more tools, we think you'll like the new location much better.

Skeptical about Aetna

After a five-year hiatus, insurance heavyweight Aetna Inc. has returned to Colorado's small-group health insurance market.
The insurer has been meeting with brokers and already has sold plans with a Sept. 1 effective date. The company is offering 13 plans for small employers, including two high-deductible plans that are compatible with health savings accounts.
In 2001, Aetna announced it was pulling out of Colorado, saying it couldn't turn a profit on its plans for small businesses.
It dealt a huge blow to the state's small-group market, which includes self-employed individuals and groups of two to 50 people. In 2000, Aetna's was the state's second-largest small-group carrier, and the move affected about 100,000 members, who had to either find new coverage or go without it.
Bill Berenson, Aetna's regional head of sales, based in Chicago, said the company is "completely different" than it was five years ago. It has a new management team and a better understanding of which products are profitable, an understanding it lacked five years ago.
Aetna grew rapidly before it pulled out of Colorado's small-group market -- from fewer than 30,000 members in 1999 to more than 100,000 in 2001. Aetna's plans for small employers were the cheapest in Colorado. But the prices were so low, the insurer couldn't turn a profit.

Of course, we will include them in our comparisons for our small business clients to get an idea of what their options are. When people are given this information and are aware that the company has recently pulled out of Colorado, about half will still decide to take the risk if the price is right.

But Aetna's return to Colorado comes as the state's small-group market has been shrinking. The number of people getting health insurance through Colorado's small-group market dropped for the fifth year in a row in 2005, according to the Colorado Division of Insurance. Last year, there were 358,264 employees and dependents covered in small groups, compared with 456,151 in 2001. That's a 27 percent decrease.

Irresponsible?

An article in the Denver Post yesterday talked about the number of people age 19 to 29 without health insurance.

As snowboarding season approaches, so does the time of year when Katie Neal's mom really freaks out.

What bothers her mom, Neal said, is not the speed at which the 26-year-old slashes through powder.

It's that she does it without health insurance.

Nationwide, about 13.7 million people ages 19 to 29 didn't have insurance in 2004, making them the largest group of uninsured adults in the country, according to a report by the Commonwealth Fund, a nonprofit health- research foundation.

That is true in Colorado as well, according to the Colorado Health Institute.

Young adults 19 to 29 make up 17 percent of the population but account for 30 percent of those younger than 65 who don't have health insurance, Commonwealth Fund noted in its report, "Rite of Passage? Why Young Adults Become Uninsured and How New Policies Can Help."

Neal, a server at Governor's Park tavern, knows she's not invincible.

Neal's employer does offer insurance. She just can't afford it.

"I would like to have it," Neal said.

At about $200 a month, health insurance would eat up about a quarter of Neal's monthly income.

"I'm working my way out of debt, and having another bill, I just can't do that," she said.

I'm also a snowboarder. When I graduated from college and didn't have any money, snowboarding was a lower priority than health insurance. I missed several years of it and got a bit rusty, but I didn't risk having tens of thousands more in debt from an unpaid hospital bill.

For $96/month, Neal could get a $5,000 deductible / 100% coinsurance policy from Tonik, or she could pay $77.43/month for a $5,000 deductible plan from Rocky Mountain Health Plans - like they talk about in the article.

The best deal on lift tickets in Colorado is the Buddy Pass (unlimited to Keystone, Arapahoe Basin, and Breckenridge) for $349. She might have gotten a used snowboard/bindings for around $300, and another couple hundred for gear (coat, pants, socks, gloves, etc).

There are examples out there of people who can't afford health insurance yet make too much to qualify for medicaid. But there are far too many examples of people who can afford health insurance, yet have their priorities mixed up. As Bob Vineyard from InsureBlog pointed out in today's post:

According to U.S. Census Bureau data released Monday, Americans with annual incomes between $50,000 and $75,000 per year saw the biggest increase in uninsured rates, up to 8.3 million, an increase of 600,000 people. 800,000 more people with annual incomes of over $75,000 are now uninsured.

Why are more and more people making health insurance less of a priority? If health insurance isn't mandatory, what could make it more of a priority than the consequences of not having it?

Mergers Limiting Choice - Part III

In a follow up to this post about United Healthcare and HCA (HealthOne): to date, UnitedHealthcare and HCA (HealthOne) have been unable to reach an agreement in Colorado. Effective September 1, 2006, hospitals and surgery centers owned by HCA (HealthOne) are considered out-of-network. As always, emergency services will not be considered out-ofnetwork. Some physicians and other medical providers who were network members through the HCA (HealthOne) system may also no longer be in the network. You should check with your provider before your next visit.

Boulder County Kaiser Permanente Announcement

If you have an employer group plan from Kaiser Permanente and have the Triple Option Point of Service plans and PPO plans in Boulder County, Colorado, there are some very important changes.

PHCS Network Changes:
Boulder Community Hospital and the Boulder Valley IPA, participating/preferred providers for Added Choice Triple Option and PPO members, notified Private Health Care Systems (PHCS) that effective Sept. 1, 2006 they would no longer be a participating provider for Kaiser Permanente Added Choice Triple Option and PPO members. This includes the following facilities:
a. Boulder Community Hospital
b. Boulder Medical Center
c. Boulder Ambulatory Surgery Center
d. Community Medical Center
e. Community Reference Laboratory
f. Mapleton Center for Rehabilitation Services
g. Mapleton Center for Rehabilitation Services-Longmont,
h. Mapleton Behavioral Health Services,
i. Miriam R Hart Regional Radiation Therapy Center,
j. Boulder Community Homecare,
k. Boulder Center for Sports Medicine
l. Therapy Clinic at Gunbarrel
m. Endoscopy Center of the Rockies.

Kaiser is actively working with Boulder Community Hospital and Boulder Valley IPA to reach an agreement as late as August 30th. Kaiser Permanente is committed to providing high quality, affordable care to the residents of Boulder County and Boulder Valley. Kaiser Permanente continues to have a network of participating/preferred providers in Boulder County and Boulder Valley available to our Added Choice Triple Option and PPO members. This network includes hospital and physician providers.

Kaiser Permanente will support members in the transition of care by continuing to cover all services received from these providers as Tier 2 Participating providers for Added Choice Triple Option plans and In-Network Preferred providers for PPO plans through November 30, 2006. Any member in the third trimester of pregnancy will be covered for services received through delivery. After November 30, 2006, Kaiser Permanente Added Choice Triple Option and PPO members can continue to access Boulder Community Hospital and Boulder Valley IPA providers however out-of-network charges will apply.

A letter is being mailed to all employer groups with members enrolled in the Added Choice Triple Option and PPO plans to inform them of this important change and Kaiser Permanente’s transition of care plan. In addition, PPO and POS members will be receiving a letter to inform them of this important change.

Smaller Check, Higher Deductible

The median income in Colorado has fallen while the number of people without health insurance in the state remained flat, according to a U.S. Census Bureau study released Tuesday.
The Census Bureau said the median household income fell from $52,729 (a two-year average for 2003-04) to $51,518 (a two-year average for 2004-05).
For the three-year average median household income, covering 2003-05, Colorado's $52,011 put it 11th in the nation.
Meanwhile, the Census Bureau said the number of people without health insurance coverage in Colorado stood at 16.9 percent of the population for 2003-04 and 16.8 percent for 2004-05.
The national average for 2004-05 was 15.7 percent.

Colorado residents are now covering more of their healthcare costs with less money.

Colorado Uninsured Rising

The portion of Coloradans with employment-based health insurance has dropped 7 percent in five years as rising health-care costs push insurance policies out of reach.
The portion of the workforce under 65 covered by work-based insurance fell to 64 percent in 2005, according to a U.S. Census study released Tuesday.
The Denver Post reports: The total number of Colorado residents without insurance reached an all-time high of 788,000, or 17 percent of the state's population, the study said.
Driving the insurance decline is a 10 percent annual increase in medical costs, according to Dr. Gary VanderArk, president of the Colorado Coalition for the Medically Underserved.
"Employees are expected to pick up bigger and bigger co-pays and bigger deductibles, and it drives some out," he said.
Some employers are either not offering insurance or cutting back on benefits, said Carrie Curtiss, associate director of the Colorado Consumer Health Initiative.

As health care costs continue to increase; employers are covering less and less and employees essentially end up with a smaller income.