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.
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.
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.
Talk with a Care Navigator Today
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.
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).
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.
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.
CO-OP staff are ready to assist you by phone or email: For help enrolling or getting a quote, contact Sales at (855) 697-1656 or firstname.lastname@example.org. For help with your existing Colorado HealthOP health insurance plan, contact Member Services at (866) 915-6619 or email@example.com. Provider Services may be reached at (866) 785-7265 or firstname.lastname@example.org.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.