Eligibility

What is Colorado Continuation and Conversion?

Colorado Continuation and Conversion was created by the Colorado legislature to fill gaps left by COBRA. If you work for a small business, you may be offered Colorado Continuation and Conversion coverage.

Connect for Health Colorado does not administer COBRA or Colorado Continuation. Learn more about Colorado Continuation by visiting the Department of Labor’s website.

What is COBRA?

The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal law that gives certain employees and their dependents the right to choose to continue group health coverage (e.g. health coverage through their employer) for a limited period of time under certain circumstances, such as job loss or a reduction in work hours. Learn more about COBRA by visiting the Department of Labor’s website.

Can I apply for financial help through Connect for Health Colorado when other coverage is available?

In general, if you are enrolled in, or qualify for, any of the following types of coverage, you would not qualify for financial help through our Connect for Health Colorado Marketplace:

(1) Employer coverage, unless the coverage is unaffordable (defined as your contribution to the premium for self-only coverage costs more than 9.78% of your household income) or does not meet minimum value.

(2) Government-sponsored coverage, including Health First Colorado (Colorado’s Medicaid program), Child Health Plan Plus (CHP+), Medicare Part A coverage, Peace Corp coverage, Veterans Affairs (VA) health coverage and TRICARE coverage.

The best way to find out if you or members in your household qualify for financial help is to complete an application.

Can I enroll in a health plan outside of the Open Enrollment Period?

In general, if you are enrolled in, or qualify for, any of the following types of coverage, you would not qualify for financial help through our Connect for Health Colorado Marketplace:

(1) Employer coverage, unless the coverage is unaffordable (defined as your contribution to the premium for self-only coverage costs more than 9.78% of your household income) or does not meet minimum value.

(2) Government-sponsored coverage, including Health First Colorado (Colorado’s Medicaid program), Child Health Plan Plus (CHP+), Medicare Part A coverage, Peace Corp coverage, Veterans Affairs (VA) health coverage and TRICARE coverage.

The best way to find out if you or members in your household qualify for financial help is to complete an application.

Am I eligible to purchase health insurance through the Marketplace?

To be eligible to buy health insurance through Connect for Health Colorado, an individual must:

(1) Be lawfully present in the United States;

(2) Reside in and/or be a resident of Colorado;

(3) Not be incarcerated.

Individuals who are not eligible to buy a health insurance plan through Connect for Health Colorado can still apply for others in their household who are eligible.

What if I am eligible for Medicare but have stayed in my Marketplace plan?

Once your Medicare Part A coverage starts, you will not qualify for the premium tax credit through Connect for Health Colorado (you’d have to pay full price). In most cases, you should call us to end your coverage through Connect for Health Colorado before starting your Medicare coverage to avoid an overlap in coverage.

If you enroll in Medicare after your Initial Enrollment Period ends, you may have to pay a Part B late enrollment penalty for as long as you have Medicare. Call Social Security at 1-800-772-1213 for information about enrolling in Part B.

How do I appeal my application results?

You have the right to appeal your application results when you apply to buy a health plan or receive financial help from Connect for Health Colorado. If you were denied Health First Colorado (Colorado’s Medicaid program) or CHP+, you must file an appeal with the county office in which you reside. Connect for Health Colorado cannot process appeals for Health First Colorado or CHP+.

To appeal an eligibility result you received from Connect for Health Colorado, please submit an appeal request form within 30 days of your application results. You can find the appeal form and instructions on how to file an appeal in your application results notice, online, or by calling the Customer Service Center at 855-752-6749.

How do I know if my employer-sponsored plan is considered affordable?

An employer-sponsored plan is considered “affordable” based on the percentage the employee is required to contribute to the premiums for self-only coverage. The employee should not have to contribute more than a certain “contribution percentage” of their total household Modified Adjusted Gross Income.

For 2024, the contribution percentage is 8.39% (this percentage will increase annually).

Your employer-sponsored plan must also provide “minimum value.” A health plan meets the minimum value standard if:
(1) It pays at least 60% of the total cost of medical services and
(2) Its benefits include substantial coverage of physician and inpatient hospital services.

What is a Premium Tax Credit?

A Premium Tax Credit is a financial help program designed to lower the monthly cost of health insurance for individuals and families. To be eligible for a Premium Tax Credit, you must buy your health insurance plan through Connect for Health Colorado and meet the income requirements. You can take the Premium Tax Credit in advance and apply it to the monthly premium, or you can wait and take it when you file your federal income taxes.

If you qualify for a Premium Tax Credit, you may also qualify for additional financial help in the form of Cost-Sharing Reductions. You can determine which financial help programs you and your family qualify for by completing an application.

What is Minimum Essential Coverage?

“Minimum Essential Coverage” is a standard or type of coverage you need to meet the individual mandate requirement under the Affordable Care Act. Some examples of health insurance plans that qualify as Minimum Essential Coverage are:

• Any Connect for Health Colorado plan
• Medicare (certain Parts and conditions apply)
• Children’s Health Plan Plus (CHP+)
• TRICARE (for veterans and veteran families)
• Peace Corps
• Volunteer plans