Do I need a form for my taxes if I enrolled through Connect for Health? +

Don’t sweat your taxes! If you enrolled last year through Connect for Health Colorado, the state’s health insurance marketplace, you should have received a Form 1095-A (Health Insurance Marketplace Statement). If you haven’t gotten the form yet, visit Connect for Health’s website or call 855-752-6749 by Wednesday, April 1.

Categorized as: Individuals , Members

What if I need care after hours? +

From time to time you might find yourself seeking care when your doctor’s office is closed.

If you are experiencing a medical emergency, call 9-1-1, or visit either an emergency room or urgent care depending on your needs.

Per state regulation, practitioners should provide patients with a way to seek care outside of their regular office hours. We encourage Colorado HealthOP members to try to contact their primary care provider for their non-emergent healthcare needs.

If you are seeking non-emergent care and cannot get a hold of your primary care provider, please call Colorado HealthOP Member Services at 866-915-6619.

For all members, beginning May 2015, a 24-hour nurse line service will be available. Stay tuned for details.

Categorized as: Individuals , Members , Providers

Help Finding a Primary Care Doctor +

Care Navigators

Colorado HealthOP’s Care Navigators can provide you with a list of primary care doctors that we have special rates with to help you get the highest quality of care while saving you money.

Learn more

Talk with a Care Navigator Today

855-796-7680 toll-free

Categorized as: Navigators

How do I log into the Member Portal? +


myHealthOP from Colorado HealthOP is your personalized member portal designed to help you:

  • Access your plan details and be rewarded for completing simple Health Actions*
  • Manage your health, access lab results, and create your personal health plan for 2015.
  • Manage your claims, check on claims status, and manage payments.
  • Access health tools and get answers to your questions from a trusted source.

Learn more about what else you can do with

Categorized as: Individuals , Members

How does a licensed Colorado health insurance broker work with Colorado HealthOP? +

If you’re rearin’ to go to tell your customers about Colorado HealthOP plans, getting appointed to sell our health insurance is easy! Visit our Brokers page to complete the necessary paperwork which will get you started.

Categorized as: Producers

Where can brokers request Colorado HealthOP marketing materials? +

We have a simple order form for you to use to order packets of our health insurance brochures.

Categorized as: Producers

What prescription drugs does Colorado HealthOP cover? +

Our pharmacy benefits (formulary) can be found on the Colorado HealthOP website for 2015 plan benefits. Check the lists out to find your medications to see if they are covered.

Categorized as: Our Plans

Is Colorado HealthOP the same thing as Connect for Health Colorado? +

No. Colorado HealthOP is the state’s non-profit cooperative health insurer. Connect for Health Colorado is the state’s health insurance marketplace where individuals can shop for benefits. Think of Connect for Health as Travelocity, where you would shop for flights from Southwest Airlines (or other carriers).

Categorized as: About CO HealthOP

How can I get reimbursed by Colorado HealthOP for a medical service or claim? +

You can download the Colorado HealthOP Health Action Credit Form and mail the completed form and service receipt(s) to:

Colorado HealthOP
Health Action Notification
P.O. Box 14327
Reading, PA 19612-4326

Categorized as: Individuals , Our Plans

What is Colorado HealthOP? +

Colorado HealthOP isn’t really a “what,” as much as we are a “who.” We’re Colorado’s only nonprofit health insurance cooperative (CO-OP) and we were established in response to the growing demand for easy, affordable healthcare for individuals and small businesses across Colorado. We recognize how in the health insurance industry, premiums keep growing, and coverage keeps decreasing. By using a nonprofit CO-OP business model, we’re able to change that. We’re able to reinvest all of our profits into the CO-OP, to lower premiums for everyone, and broaden our coverage and benefits. Keep clicking around and learn more, or just give us a call at (855) 697-1656.

Categorized as: About CO HealthOP

What is a cooperative? +

A cooperative is a business that consists of a group of people working together for a mutual economic, social, and cultural benefit. Members sit on our board of directors and have a voice in the organization’s direction, including what is covered under benefit plans, how profits are reinvested into the company, and who runs business operations.

Categorized as: About CO HealthOP

How can I get tax credits to help pay for my health insurance? +

Income-based federal tax credits are available for some families and individuals via Connect for Health Colorado, the state’s health insurance marketplace. Give us a call at (855) 697-1656 if you’d like help figuring this out, or visit Connect for Health Colorado for more assistance.

Categorized as: Individuals , Our Plans

How can I sign up for Colorado HealthOP? +

Open enrollment for 2015 coverage runs from November 15, 2014 through February 15, 2015. You can sign up through our website online or through Connect for Health Colorado. You can also contact our call center toll free at (855) 697-1656, or get help enrolling through a statewide network of brokers. To prepare for enrollment learn more about our plans here.

Categorized as: Employers , Individuals , Navigators , Our Plans

Is your customer service available in Spanish? +

Si. Nuestros miembros son importantes por eso ofrecemos excellente servicio al consumidor en Ingles y Espanol. Llame al (855) 796-7677 si desea servicio en Espanol.

We care about our members, and offer great customer service in both English and Spanish.  Please call (855) 796-7677 and ask for a Spanish speaker.

Categorized as: Employers , Individuals

How is Colorado HealthOP different? +

We offer medical health insurance coverage and prescription drug coverage like any other health insurance company, but as a nonprofit CO-OP, our mission is fundamentally different. We exist for the sole purpose of keeping our members healthy at a low cost, rather than making profits.

Categorized as: About CO HealthOP , Our Plans

Does Colorado HealthOP have a robust provider network? +

Colorado HealthOP offers a choice of plans with different provider networks. For our PPO (Preferred Provider Organization) plan, we partner with the Cofinity network, which has a statewide coverage with thousands of providers and facilities. Our EPO (Exclusive Provider Organization) plan is a restricted plan that primarily partners with Centura and Banner Health facilities and physicians in targeted geographic areas. These high-quality networks, while more limited, are also more affordable.  They do not offer any coverage outside of the EPO network, so potential members should carefully consider their needs and check to see if their doctors of choice are in the EPO network before buying.

Categorized as: Our Plans , Providers

Will my doctor accept Colorado HealthOP insurance? +

Good question. Let’s find out. Call (855) 697-1656 and we’ll see what plans your doctor is covered under.  Or, find your doctor with our handy tool.

Categorized as: Employers , Individuals , Providers

Can businesses sign up all year? +

Yes, small businesses can sign up at any time.  Contact Colorado HealthOP Small Group Sales at (720) 627-8900 or via email for answers or to enroll.

Categorized as: Employers , Our Plans

Can small businesses get financial help for covering retirees who are ages 55-64? +

Yes. Employer-based plans that provide health insurance to retirees who are ages 55-64 can now get financial help through the Early Retiree Reinsurance Program. This program is designed to lower the cost of premiums for all employees and reduce employer health costs.

Categorized as: Employers , Our Plans

Can small businesses get tax credits for insuring employees? +

Yes, you better believe it. All businesses can receive a tax credit of up to 50 percent of the cost to provide insurance (up to 35 percent for nonprofits) if they have fewer than 25 employees, pay average annual wages below $50,000, and provide health insurance to their employees.

Categorized as: Employers

Are there incentives for a small business to participate in wellness programs? +

Yes. We like your thinking. Employers can adjust their contributions and premiums based upon employee participation in wellness programs that promote healthier lifestyles.

Categorized as: Employers

Will Colorado HealthOP cover employees in another state? +

No, Colorado HealthOP is only available to Colorado residents. If you’re having trouble convincing your employees to move here, try taking them on a nice trip to see the aspens in the fall. Gets ‘em every time.

Categorized as: About CO HealthOP , Our Plans

Can businesses join without a broker? +

Yes. Small businesses and non-profits with fewer than 50 employees can shop on Colorado HealthOP’s quoting tool, which gives them buying power similar to larger businesses.

Categorized as: Employers , Our Plans

Does Colorado HealthOP cover healthcare received out of its provider network? +

If it is an emergency, yes. We always cover our members in cases of emergency, no matter where they are. If it’s not an emergency, it depends on whether you have a PPO (Preferred Provider Organization) or EPO (Exclusive Provider Organization) plan. In our PPO plans, you can choose a provider who is outside of the Colorado HealthOP network, but your costs may be higher. In our EPO plans, healthcare received outside of the Colorado HealthOP network generally is not covered, except in the case of an emergency.

Categorized as: Our Plans , Providers

How do value-based benefits work? +

In our silver and gold plans, when a member takes three health actions (completing a health survey, biometric screening, and wellness visit), they are upgraded from our “Standard” plan to our “Enhanced” plan. In the enhanced plan, they will often pay less out of pocket when they see a doctor, and in some plans, will get money on a debit card to help pay for health expenses.

Categorized as: Our Plans

How is Colorado HealthOP funded? +

Our initial funding came through a $69 million start-up loan from the U.S. Department of Health and Human Services under the Federal Patient Protection and Affordable Care Act. We were also sponsored by the Rocky Mountain Farmers Union Educational and Charitable Foundation. We’ve been careful to make sure that every dollar we spend goes toward building a better health insurance company for our members.

Categorized as: About CO HealthOP

How can I become part of the Colorado HealthOP provider network? +

Contact us to learn more about partnering with Colorado HealthOP, or complete this easy form to get started.

Categorized as: Providers

How can my patients sign up for Colorado HealthOP? +

You can sign up your patients right here on our website, or by having them call (855) 697-1656.

Categorized as: Providers

What is Utilization Management (UM)? +

Utilization management (UM) or Utilization Review (UR) is how we evaluate health care services, procedures, and settings. Through a variety of techniques, we determine whether or not a procedure is experimental in a given circumstance. It’s about getting you the right care at the right time in the right way. UM or UR are a set of formal techniques designed to monitor the use of, or evaluate the clinical necessity, appropriateness, effectiveness or efficiency of health care services, procedures or settings. Techniques include ambulatory review, prospective review, second opinion, certification, concurrent review, case management, discharge planning or retrospective review. UR also includes reviews for the purpose of determining coverage based on whether or not a procedure or treatment is considered experimental or investigational in a given circumstance, and reviews of a covered member’s medical circumstance when necessary to determine if an exclusion applies in a given situation.


Categorized as: Our Plans

How do I stay informed about my healthcare options? +

You can visit CO-OP Connect to sign up for updates to stay informed about healthcare news and new plan offerings.

Categorized as: About CO HealthOP , Our Plans

How do the changes in healthcare apply to me? +

As of January 1, 2014, most Americans were required to have health insurance. All Coloradans have the opportunity to get health insurance by purchasing plans on Connect for Health Colorado, the state’s online health insurance marketplace. If you sign up on CO-OP Connect to receive updates from Colorado HealthOP, we’ll keep you informed of any new changes.

Categorized as: Employers , Individuals , Navigators

Can I sign up for Colorado HealthOP if I live outside of Colorado? +

Sorry, but you have to be a Colorado resident. That said, in case you ever want to live in the beautiful Rocky Mountains, you can subscribe at CO-OP Connect to keep up with changes in healthcare and get tips on health and wellness.

Categorized as: Individuals , Navigators , Our Plans