The bill creates a financial relief program, available from July 1, 2018, through December 31, 2019, to provide financial assistance to individuals and their families who reside in a county within one of the 3 most costly geographic insurance rating areas of the state and who spend more than 20% of their household income on individual health insurance premiums. The Colorado health benefit exchange (exchange) is to oversee the program, and counties may elect to administer the program in their counties. For any county that opts not to administer the program, the exchange is to administer the program in that county.
Financial relief is available to individuals and families determined eligible based on the following:
- The individual or family enrolled in and paid premiums for a bronze, silver, or gold level individual health benefit plan purchased through the exchange;
- The individual or family has a household income of more than 400%, but not more than 500%, of the federal poverty line;
- The individual or family does not have access to a government-sponsored program, such as medicaid or medicare, or an affordable employer-sponsored plan; and
- The individual or family pays more than 20% of the household income on premiums for the plan.
The exchange is to certify that an individual or family has enrolled in one of the specified health benefit plans, the premium amount of the plan, the household income of the individual or family, and that the individual or family does not have access to a government-sponsored program or employer-sponsored plan.
The amount of financial relief is calculated based on the cost of the premium for the lowest-cost bronze health benefit plan available to the individual or family through the exchange, minus an amount equal to 20% of the individual's or family's household income. The general assembly is to appropriate not more than $6 million from the general fund to provide financial assistance to individuals who qualify under the program.
A carrier offering individual health benefit plans on the exchange must permit an individual to purchase an individual health benefit plan on the exchange during a special enrollment period that begins June 1, 2018, and ends August 1, 2018, for plans effective through December 31, 2018. For the 2019 plan year, individuals are subject to the standard open enrollment period specified in law.
The program repeals on September 1, 2020, unless congress enacts and the president signs legislation repealing the advance premium tax credit authorized under federal law, in which case the program repeals upon the date of the repeal of said tax credit.
(Note: This summary applies to this bill as introduced.)