Colorado Open Enrollment Period for Child Health Insurance Coverage

The state of Colorado has established an open enrollment period for child-only health plans which began January 1, 2011 and runs through January 31, 2011.  A second open enrollment period will open August 1, 2011 and run through August 31, 2011 (updated dates!).

During the biannual open enrollment periods, consumers in Colorado will be able to enroll their children in a “child-only” Colorado health insurance plan without danger of the child being declined due to his or her medical history.

In a press release from last September, Division of Insurance Commissioner Marcy Morrison said that “without defined open enrollment periods, Colorado consumers may be left with few choices for insurance coverage for children with pre-existing conditions.”  The creation of the new open enrollment period is intended to broaden access to such coverage in the state.

As we did for the child-only enrollment period in the state of California, eHealthInsurance has also compiled a list of answer to common questions to help Colorado consumers better understand how the new biannual enrollment periods work:

Question: “The federal health reform law is supposed to allow me to enroll my child in private health insurance, regardless of my child’s health condition. When can I begin doing that in Colorado?”

Answer: Colorado’s new biannual open enrollment periods for child-only health insurance policies occur in the months of January and August, beginning this year, and run for the entirety of each month.  During this open enrollment period, any child under age 19 can be enrolled in a private, individual health insurance plan. During the open enrollment periods, the insurer cannot deny a child’s application due to pre-existing medical conditions.

These open enrollment periods will recur each year.  Other special enrollment opportunities (lasting 30 days) may be triggered throughout the year when a “qualifying event” such as the following occurs:

• Birth
• Adoption
• Marriage of a parent
• Divorce of a parent
• Loss of employer-sponsored health insurance coverage
• Loss of eligibility for Medicaid or Children’s Basic Health Plan
• Valid court order mandating the child be covered
• Loss of other existing coverage for any reason other than fraud, misrepresentation, or failure to pay monthly premiums

Question: “Why does there need to be an annual enrollment period? Why aren’t children simply allowed to enroll in individual health coverage at any time of year?”

Answer: The state has established annual enrollment periods for child-only health insurance policies to prevent consumers from simply waiting until a child gets sick to sign them up for health insurance.  If children were only enrolled when ill, it could possibly cause a spike in the cost of child-only coverage. The creation of specific biannual enrollment periods for “child only” health insurance policies is an effort by the state of Colorado to promote broader consumer access to individual health insurance for children under the age of 19.

Question: “Are rates for child-only health insurance policies going to change?”

Answer:  Monthly sample premiums for child-only health insurance plans in Colorado are currently quoted through the eHealthInsurance.com website starting at $79 per month1.  It is not yet clear how the federal health reform law or Colorado regulations will affect rates of coverage over the long term.

Question:  “Does this mean that a sick child with documented health problems will pay the same monthly health insurance premiums as children in good health if enrolled during the open enrollment period?”

Answer: Not necessarily. While insurers offering child-only plans may not decline applications for health issues during the open enrollment periods, insurers may still have the option to charge high-risk children monthly premiums higher than those they charge for children at the standard risk level.  Check with the Colorado Division of Insurance to learn more.

Question: “What counts as a pre-existing medical condition?”

Answer:  A pre-existing medical condition may be any past or present medical diagnosis, whether or not the child is still suffering from or being treated for the condition.  Not all medical conditions are of concern to health insurance carriers and different carriers may be more, or less, concerned by different conditions.

Question: “Where can I go to find health insurance policies for children in Colorado during the new biannual enrollment periods?”

Answer: eHealthInsurance.com is a good resource for consumers who want to find, compare and enroll in child-only health insurance plans during the Colorado open enrollment periods.  eHealthInsurance.com offers support from licensed agents and allows consumers to compare health insurance policies side-by-side, find plans accepted by your favorite doctor, and apply for coverage online.

New child-only products may be added to the eHealthInsurance.com website throughout the year. Consumers interested in a particular insurance company whose products are not currently listed on the eHealthInsurance website can contact the insurer directly or reach eHealthInsurance’s customer care center at 1-800-977-8860 for more information.

Other resources for consumers shopping for child-only health insurance plans may be found through the Colorado Division of Insurance website.

Notes:
1 Based on quotes generated January 5, 2011 through www.ehealthinsurance.com for a five-year-old male living in Denver.  Actual rates and benefits may vary by county, effective date of the policy, and other factors.