Individuals must apply for an exemption with the Federal Health Insurance Marketplace, Healthcare.gov, rather than Connect for Health Colorado. Eligible individuals will receive an Exemption Certificate Number from the federal government. Be sure to save this number for when you file your taxes. Individuals applying for an exemption based on coverage being unaffordable, membership in a health care sharing ministry, membership in a federally-recognized tribe or being incarcerated can claim these exemptions when they file their taxes and do not need to apply for an exemption beforehand.

Medicare is a health insurance program administered by the federal government for individuals who are age 65 or older, certain people with disabilities and other special populations. Connect for Health Colorado does not administer Medicare. Learn more about Medicare eligibility and enrollment, and how Medicare coverage may affect your coverage options through the Marketplace:

General Information on Medicare
Information on Medicare and the Marketplace

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.

If you experience a change that may affect your health insurance options, such as marriage, the birth or adoption of a child, a move, or a change in income, you should report it to Connect for Health Colorado within 30 days of the event. Connect for Health Colorado will determine if you qualify for a Special Enrollment Period or if your eligibility for financial help has changed.

Note: You should report changes to Connect for Health Colorado as soon as possible to avoid receiving more Premium Tax Credit than you qualify for. If you receive excess Premium Tax Credit during the year, you may be required to pay some or all of it back when you file your federal income taxes.

The income you report on your application that we use to determine how much financial help you can receive is called your Modified Adjusted Gross Income (MAGI). In general, it is your estimated adjusted gross income (the income you report when you file your federal taxes) plus any non-taxable Social Security, tax-exempt interest, or foreign income you have for the year for which you are applying. Remember to report income changes to Connect for Health Colorado to make sure you’re getting the right amount of Premium Tax Credit during the year.

Information about how to file taxes, including what incomes and allowances should be included, can be found on the IRS website.

A Special Enrollment Period is a period of time outside of the annual Open Enrollment Period during which you and your household can shop for and enroll in a health insurance plan. You might qualify for a Special Enrollment Period if you or someone in your household experiences a Life Change Event, such as losing health insurance coverage from a job, moving, getting married or having a baby.

An Open Enrollment Period is when you can sign up for a health insurance plan. There is one Open Enrollment Period every year. Open Enrollment begins on November 1 and runs through January 15.

Your coverage will automatically end at the end of the year. You will have the option to either automatically renew your coverage or actively select a new plan for the year. We will notify you whether your plan will be automatically renewed, when we will renew your plan, and any other steps you need to take ahead of the Open Enrollment Period, which begins Nov. 1. If you are not eligible for automatic renewal, we will notify you and ask you to submit a new application for financial help and a health plan.

Health First Colorado is a state-sponsored health insurance program that provides free or low-cost care for Coloradans who qualify. It is a type of medical assistance program and is administered by the Department of Health Care Policy and Financing. When you apply for financial help through Connect for Health Colorado, your eligibility for Health First Colorado will be assessed first. If you do not qualify for Health First Colorado, you may be eligible for financial help through Connect for Health Colorado.

“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