You’ve Got Questions.

Learn the ins and outs of Southwest Health Alliance, individual plans, ICHRA, and more.

 

Individuals & Families

Businesses / ICHRA

About Peak Health

Quick Facts for Individuals and Families

When Can Individuals Sign Up?

Individuals may enroll for January 1 coverage November 1 through December 15, as mandated by Federal law. If you miss that deadline, you still have until January 15th, but your coverage will not start until February 1st.

You must enroll in a plan during the open enrollment period to get coverage for 2021, unless you have a “qualifying event”. For more information on this, please speak to your broker, an assistor, or visit Connect for Health, the marketplace for Colorado insurance.

 

I Just Received a Renewal Letter. What Should I Do?

If you have individual (not employer-provided or group) health insurance for 2020 (Including Bright/Peak plans), it will be in effect through the end of the year (assuming you pay your premiums as scheduled!).

Some insurers are asking you to renew now. We think you should explore all your options.

Rates and plans for 2021 will be introduced soon, giving you lots of time to sign up during Open Enrollment. 

Don’t cancel your current plan! It will automatically expire on 12/31.

Waiting to renew until after you’ve had a chance to shop won’t affect your 2021 rates. 

Want to be notified when open enrollment begins? We’ll email you! Just subscribe here.

How Will I Sign Up?

If you’ve signed up as an individual before, the process is the same. You have three options:

Remember, enrollment will start beginning November 1 through December 15th, as mandated by Federal law.

Will Tax Subsidies I've Received in the Past Still Apply?

Yes, our plans are eligible for federal tax subsidies just like other plans.

Our plans are compliant with the ACA, and like any other health insurance plan, if you qualify for subsidies or tax credits, you will with Southwest/Peak plans. You will receive a 1095 form from Bright Health at the end of the 2021 tax year.

My Tax Subsidy Went Down. What Happened?

There are a few factors that are impacting tax credits (known as the APTC, or Advanced Premium Tax Credit) this year.

One is that the federal government ties the amount of tax credits to the price of the premiums of certain plans. Because plans went down in price this year (Not just at Peak), the credit is less.

Does this mean your cost will go up? In some cases, compared to last year. What you can do, though, is SHOP AROUND.

Don’t just renew your plan from last year. Shop around and consider any changes that will help you maintain the same monthly cost.

And if your income levels changed, so will your tax credits.

For more information on the APTC or Tax Subsidies, we recommend checking out this page at Connect for Health, the state exchange.

How Much Will My Insurance Cost?

Your rates will depend on the same factors as found in most health insurance plans, including age, deductibles, desired benefits, and more.

Membership in Southwest Health Alliance is required to enroll in our plans. The fee for membership is $6/month per life, with a maximum of $24/month for families.

The membership fee is added to your monthly premium bill, so you only have to pay one bill each month.

Who Will Be My Insurance Carrier?

For individual plans, Bright Health will be your insurance carrier. You may reach them here.

Will I Receive an Insurance Card?

Yes

Is Southwest Health Alliance an Insurance Company?

No. Southwest Health Alliance negotiates and partners with insurance carriers who will underwrite the plans.

This year, we are proudly partnering with Bright Health Plan in all of our regions!

I Live Outside of Your Region. Can I Still Sign Up?

If your employer has signed up for an ICHRA plan, you are still eligible to be reimbursed for health insurance.

However, you will be shopping for plans only offered in your county of residence, which means you won’t see any Peak/Bright plans. You will have other options. Talk to your employer about how you might be impacted due to only having more expensive plans to choose from.

Do You Offer Dental or Vision Insurance?

Not for 2021, but we are continuing to explore expanded plan offerings. This may include dental and/or vision in the future.

Whom Do I Contact About My Plan Once I'm Enrolled?

Bright Health will be your contact point for insurance customer service once your plan is in effect.

They will be who sends you your premium bills, Explanation of Benefits (EOB), and making any and all decisions regarding eligibility, coverage, and more.

NOTE: If you get your insurance through your employer using ICHRA, your employer will be responsible for ensuring you get your reimbursement each month.

Are There Other Choices Besides Yours?

Yes. We will be among other insurance carrier plans available. You are not under obligation to select Bright/Southwest Health Plans.

But we expect, subject to final rate approvals, our 2021 plans will offer the lowest cost in the market for 2021 plus come with great benefits. We hope you’ll check them out but you’re under no obligation!

Quick Facts for Businesses/ICHRA

What is an ICHRA?

ICHRA (pronounced "ICH-rah") stands for Individual Coverage Healthcare Reimbursement Account. They're available to nearly any business of any size.

You can read up about ICHRA options here.

They allow a business to provide health insurance to their employees through a tax-free reimbursement in an amount the employer chooses. They allow the employee more choice in plans vs. traditional group plans, and they allow you to control the cost of your health insurance by having a fixed reimbursement that YOU choose.

They're new, so we recommend you click the link above to learn more or talk to your broker.

When Can Businesses Enroll?

Start planning today!

First, read up about ICHRA plans here.

Business owners can speak to their brokers today about Peak Health Alliance ICHRA plans.

Rates and plans will be released by the state in mid-October.

  • If you don't have a broker, Find a Broker
  • You may also choose to use your own platform, but we believe a broker is best suited to help, especially for businesses new to health insurance.
  • If you are self-insured, you should speak with your TPA about Peak.

Plans and coverage go into effect on January 1, 2021

Can I Work with My Existing Broker?

Yes.

Our Peak Preferred Broker program ensures brokers have been trained on ICHRA and Peak's plans and are able to help you decide what is best for you and your employees.

Need a broker? We can refer you to an expert. Just click here.

How Much Does an ICHRA Cost?

For small business/group, ICHRA plan costs depend on your reimbursement plans for your employees. Your broker can help you determine the details. The best part is you control the cost and your employee will do the shopping and selecting using the set amount you reimburse them.

If you are a self-insured employer, your third party administrator will work with you on benefit design.

Membership in Peak Health Alliance is required to enroll in our plans. The fee for membership is $6/month per life. Businesses who are members of certain Summit trade associations (Summit Chamber, Builders Assn., Summit Assn. of Realtors) will pay $5/month.

These fees are part of your monthly insurance premium so you don't have to pay an additional bill each month.

 

Can Employees Who Live Outside of a Peak/Southwest County Qualify?

Your employees who work for you can enroll in plans via ICHRA reimbursement regardless of where they live.

They will shop for insurance using the county where they live. So, if they live outside one of Peak/Southwest Health Alliance seven counties (Summit, Grand, Lake, LaPlata, Dolores, San Juan, Montezuma), they will be able to shop for insurance but will not see Peak plans in the list of available plans. 

You might choose to reimburse these employees at a different amount given that they will likely not have cheaper plans available in their home county.

Can I offer additional benefits to my employees?

Yes, and the contribution you make to your employee under ICHRA can be applied to certain costs associated with their health insurance (such as deductibles). Talk to your broker or your tax professional about the best way to go about offering additional benefits.

Whom Do I Pay Every Month?

For ICHRA plans, you will reimburse your employees directly. That's it. No writing checks to insurance carriers.

The employee will shop for an own their plan. You are giving them the reimbursement that they will apply to their premium bill.

Do You Offer Dental or Vision Insurance?

Not for 2021, but we are continuing to explore expanded plan offerings. This may include dental and/or vision in the future.

Do You Offer Discounted Pharmaceuticals

Your insurance carrier will offer prescription drug plans; the benefits and associated costs for which will vary by plan and carrier.

We are exploring pharmaceutical benefits for future plans. Stay tuned!

Who Will Be My Insurance Carrier?

Peak Health Alliance plans are carried by our friends at Bright Health Plan.

But, your insurance carrier under ICHRA will be whomever YOU choose for YOU and your family. Your employees can choose a different one.

With ICHRA, you and your employees will shop for and buy the plans that are offered on the state marketplace.

If you're using a broker, ask them about helping your employees with signup and selection and be sure to ask them about any fees they may charge to do so.

About Southwest Health Alliance

What is Southwest Health Alliance?

Southwest Health Alliance is a locally-lead and managed purchasing alliance operating as a partner of Peak Health Alliance based in Summit County.

We lower healthcare prices by using the purchasing power of the community and offer health insurance plans through carriers we select based on their ability to offer the most competitive rates and comprehensive plans.

While our ability to operate and offer plans is granted under Colorado law and enforced by the Division of Insurance, we are not a state agency.

For 2021, we have expanded Peak’s model to new counties in our region including La Plata, Montezuma, Dolores, and San Juan, and our plans are carried by Bright Health Plan. Peak Health is available under the Peak name in Summit, Grand, and Lake counties.

 

Are You an Insurance Company?

No. Southwest Health Alliance negotiates and partners with insurance carriers who will underwrite the plans. 

For 2021, our partner is Bright Health Plan.

Is This the Same as Obamacare?

No. However, our plans are compliant with Obamacare— otherwise known as the Affordble Care Act, or ACA for short.

Are Your Plans ACA-Compliant?

Yes. For 2020, all plans offered through Peak Health Alliance will meet or exceed Affordable Care Act (ACA) guidelines.

Are You Affiliated with a Specific Provider, Hospital, or Insurance Company?

No. We are an independent group governed by a Board of Directors who represent businesses, government entities, individuals, and more. Our organization was formed through state legislation and we are regulated by the Colorado Division of Insurance.

We negotiate and partner with various local, statewide, and specialty providers so we can bring down rates for everyone. We then select the best carrier to underwrite the plans.

How Can I Stay Updated ?

Please visit our home page and subscribe to stay updated about our site launch, for information regarding enrolling, and more.

We also invite you to follow us on social media, the links at the bottom of this page will take you to our page on your favorite network.

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