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Navigating insurance territory

Colorado will be among first to activate new marketplace for health coverage

The New Year brings many questions, and this year, one of the biggest questions for Colorado is what to expect as sweeping statewide health-care reform begins.

The Colorado Health Benefit Exchange is expected to open in October, making Colorado one of the first states to act on the Patient Protection and Affordable Care Act passed by Congress in 2010. Health plans purchased in the exchange will begin to take effect in January 2014.

The exchange’s board of directors has been working for months to make arrangements, including finding staff, establishing a financial management system and building business partnerships. In December, Colorado became one of six states to have a reform plan approved by the federal government.

The program, proposed in Colorado Senate Bill 11-200, sets up a website where people can go to shop for health insurance specific to their needs, similar to an Amazon for health insurance.

The exchange, which doesn’t have a final name yet, hopes to have about 250,000 Coloradans enrolled in the first two years of operation, out of a state with 860,000 uninsured residents.

“People can expect to see more and more information in 2013 from community organizations, employers and other groups about the exchange and how it will work when it opens next October,” said Myung Kim, director of communications and outreach for the exchange.

The federal government requires all businesses to alert employees of adjustments taking place under the exchange by March.

The board will prepare for the opening of the site by selecting “navigators” – local companies that will provide direction to those shopping for health insurance through the exchange. Applications will be sent out in April.

Many questions remain about what the final face of the exchange will look like.

One concern is how the needs of people living in rural communities like unincorporated La Plata County can be met.

Ken Burns, owner of Durango Insurance Professionals, said there is a the lack of insurance carriers available to those in this region. In La Plata County, the only two large insurance carriers are Rocky Mountain Health and Blue Shield Insurance.

“Because we have such a small county, most carriers don’t want to take time do develop contracts with providers,” he said. “We need more choices”

Kim said the navigators will conduct outreach in their communities and provide in-person assistance on the exchange when it opens.

Though many details of the navigator program have yet to be decided, a major goal is for it to support small businesses.

“We are strongly committed to serving the business community,” Kim said. “They have really struggled with the rising health-care costs,”

The Small Business Health Options Program will focus on this area.

“We are planning to do much more active education and outreach with small business and small nonprofits to educate them about the exchange, how it will help them provide benefits to employees,” Kim said.

These efforts would include meetings with business partners and launching a marketing and advertising campaign in the spring.

“We plan to have a very active presence across the state and to actively be doing outreach and education,” she said.

Burns, whose company Durango Insurance Professionals helps companies select plans, said he was unsure what effect these programs would have on area small businesses.

“The first thing employers look at is cost,” he said. “We’ve seen a lot of small employers doing away with group plans,” he said.

Companies with more than 50 employees are required by the new health-care law to provide insurance. Burns said many of them are planning instead to pay the penalty for not offering insurance because it is a less-expensive option.

“More and more employers are canceling group plans because of cost and hoping employees will jump into the exchange,” he said.

Kim said the exchange is working hard to develop a beneficial plan.

“There is a tremendous benefit for small employers that they don’t have today. When the exchange opens we will allow employers to give employees greater choice of health plans,”

Burns predicts it will take a little while for the benefits of the exchange to become apparent.

Bern Heath, director of AXIS Health System, said the ends justify the means.

“People can expect a certain level of confusion, and a certain level of frustration trying to pick what plan they want,” he said “No transitional start-up goes smoothly.”

He said there would be changes and adjustments, but ultimately he said the exchange is “the most brilliant, far-sighted and best approach we can be taking.”

Burns also noted the intrinsic uncertainty of creating something new.

“We’re going into uncharted waters,” he said. “We’re not sure what’s going to happen.”

herald@durangoherald.com

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