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Major Premium and Provider Changes for Coloradans in 2017

June 9th, 2016 5:46pm


For 2017 there will be changes to the individual plans that are available to consumers as well as premium increases for individual plans and small group plans. However, the changes will have a greater effect on the individual market than the small group market. The following four companies will be either reducing or discontinuing their individual plan offerings that will be affecting open enrollment (November 1st through January 31st). However, Bright Health Plans, who is new to the Colorado market, will be selling individual plans both on off the exchange.

-Anthem Blue Cross and Blue Shield: The company has decided to not offer its preferred provider organization (PPO) individual plans for 2017. However, Anthem will continue to offer health maintenance organization (HMO) individual plans, which will be available to all affected customers. 

-United Healthcare: The company will not be offering individual plans for 2017.

-Humana Insurance: Humana will also not be providing individual plans in Colorado for 2017.

-Rocky Mountain Health Plans: Rocky Mountain will be reducing its individual plan offerings. The company will only offer plans in Mesa County through its Monument Health affiliate.

Requested premium Increases: There have been numerous requested premium changes; however, none have been approved at this time.

Requested Individual premium increase: Golden rule - 46%; Colorado Choice - 36.3%; Rocky Mountain HMO - 34.6%; Anthem - 26.8%; Kaiser Foundation Health Plaan of Colorado - 13.6%; Freedom Life Insurance - 10%; National Foundation Life - 10%; Cigna - 9.5%; Denver Health - .08%.

Requested Small Group premium changes: Rocky Mountain Health Care Options - 11.2%; Colorado Choice - 7.4%; Humana Health 6.4%; Rocky Mountain HMO - 5.1%; Humana Insurance Co. - 4.4%; Anthem HMO - 4.1 %; Kaiser Foundation Health Plan of Colorado - 3.7%; Anthem (Rocky Mountain Hospital and Medical Service) - 2.9%; Kaiser Permanente -  -0.9%; United Healthcare Colorado -  -1.6%; Aetna Life Insurance Co. -  -3.6%; Aetna Health Inc. -  -4.4%; United Healthcare Insurance Co. -  -7.7%.

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September 8th, 2015 11:52am


InTANDEM Human Resources, LLC offers small to mid-sized employers a secure and professional system for solving the human resource and benefits puzzle. Our Professional Employer Organization (“PEO”) brings employers together under one umbrella to gain buying power and the ability to attract and retain top talent by offering Fortune 500 level benefits.


Large Group Health Insurance Plans and Pricing, Large Group Dental, Large Group Vision, LTD & STD, Life Insurance, Flexible Spending Plans (unreimbursed Medical & Dependent Care), Voluntary Benefits, 401k Retirement Plan, Credit Union Membership, ACA Compliance


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State Exchange

August 21st, 2015 12:37pm - Posted By: Marianne Goodland

 State exchange could face tougher financial pressure


By Marianne Goodland


Is Connect for Health Colorado on solid financial footing? The next 10 months could be telling.

The exchange, a state-based marketplace for consumers to get health insurance, is going through its first year without new federal support. That means the exchange has to be on the path to self-support. But a budget document for calendar year 2016 shows it’s likely to run about $13.3 million in the red, and it gets tougher from there.

The exchange’s main sources of revenue are fees levied on those who buy health insurance through the marketplace, and fees imposed on private health insurance carriers. According to the budget approved by its board on June 1, the exchange will have to operate in 2016 at less than half of the money it had in 2015.

And that’s even with fees slated to rise substantially in 2016. The first fee is scheduled to go from 1.4 percent per policy to 3.5 percent per policy, beginning January 1. That’s paid for by consumers who buy health insurance through the exchange.

The second fee, paid for by private health insurance carriers, is scheduled to go from $1.25 per member per month to $1.80, also beginning January 1. The two fees make up the majority of the operating revenue for the exchange for 2016, with an expected total of $29.6 million.

But the private insurance carrier fee goes away at the end of 2016, unless renewed in the next legislative session by the General Assembly. That will be a tough sell in an election year, particularly with a Republican-controlled Senate that has not been a big fan of the exchange.

That fee originated with the state’s high-risk insurance policy, a little-used program called CoverColorado. After the Affordable Care Act went live in January 2014, state and federal high-risk policies were required to end a few months later, to allow time for those who were covered under those plans to switch to either the state-based or federal exchanges.

The General Assembly allowed the CoverColorado fee to continue to help fund the exchange, although it was substantially reduced from about $3.79 per policy, when it was under CoverColorado, to a limit of $1.80 per policy. The exchange lowered the cost to $1.25 for 2015.

The exchange’s budget document shows expected operating expenses in 2016 at $44.9 million, about $4.6 million short of their revenue projections. The budget also shows expected capital expenses of $8.7 million, though it doesn’t show any available revenue to cover that.

The budget document says it hopes to cover some of its expenses with grants, such as a $2.5 million grant submitted to the Colorado Health Foundation. Other revenue sources include Medicaid reimbursements from the Centers for Medicare and Medicaid Services, also expected to be at around $2.5 million.

Insurance plans sold through the exchange now cover 150,000 Coloradans, up about 25,000 in the past year. The average monthly premium in 2015 is $243 for an individual who does not need financial assistance. That’s down almost $40 per month from 2014.

For those who receive financial assistance, the average premium in 2015 is $160 per individual, about $30 higher than last year.

For 2016, however, the exchange budget says it needs to grow enrollment by 67,000 — and that means doing a better job of connecting with consumers.

The budget acknowledges the enrollment projections are “aggressive.” Achieving these targets “will require retaining our current customers and reaching and capturing under-served and hard-to-reach populations,” who need more individual attention and multiple contacts, the budget notes. “Success hinges on systems and processes working far better for consumers than they have in the first two open-enrollment periods.”

Exchange management acknowledged in April it would have to tighten its belt. At a presentation to the board, managers agreed the exchange could no longer rely on federal grants, such as the $6 million federal grant received in December 2014, which helped keep the exchange in the black this year. But the Affordable Care Act, which shelled out $4 billion in grants to states (including $183.7 million to Colorado’s exchange) made it clear exchanges would be on their own beginning in 2015. The exchange also had some unexpected costs and less revenue than anticipated, according to the presentation.

“Every year is critical,” according to Sharon O’Hara, who chairs the exchange board. “We are really committed to improving the customer experience, which will allow us to expand our customer base and improve our enrollment.”

The exchange will also have to face a more comprehensive state performance audit in the next year.

That comes in the wake of a limited audit in 2014 that found numerous problems with the way the exchange paid its bills. According to the audit, the exchange paid vendors and contractors without contracts, failed to comply with federal or contract requirements and, in some cases, made payments that were regarded as “unallowable or unreasonable use of federal funds.”

“I’m extremely comfortable with financial controls,” O’Hara told The Colorado Statesman, commenting on the 2014 audit. The exchange has been through more than a dozen federal audits in the past year, which she said confirms the organization is moving in the right direction. “I am more than confident those [financial] issues have been resolved.”

As to whether to ask the General Assembly to continue the private insurance carrier fee, O’Hara said the board hasn’t yet talked about that. The board wants to get more “into the year and look at our options.”

— info@coloradostatesman.com

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Boulder Chamber PEO

June 22nd, 2015 11:40am

The Boulder Chamber, InTANDEM HR and Anthem have announced an exciting new PEO opportunity for Boulder Chamber members. Rachel Zeman is an active committee memeber and is dedicated to provide a creative solution for Boulder County's business owners. Contact RiteHealth Solutions to find out more information and if this program can benefit you.

Pictured left to right: Monica Denler (InTANDEM HR), John Tayer (Boulder Chamber), John Marsh (Hofgard Benefits), Rachel Zeman (RiteHealth Solutions), Ben Miller (Anthem)

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RiteHealth Solutions/Maxwell Health

March 31st, 2015 1:04pm

RiteHealth Solutions revolutionizes the healthcare industry with Maxwell Health. Join us for a webinar on April 21st to learn more about this amazing partnership!


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Maxwell Health - Coming Soon to RiteHealth Solutions

July 31st, 2014 1:15pm - Posted By: www.insurancebroadcasting.com

Maxwell Health Unveils First Ever "Health as a Service" Platform

 BOSTON and NEW YORK, July 29, 2014 /PRNewswire/ -- Maxwell Health (Maxwell), a fast-growing industry leader in health IT, announced today a major release of their revolutionary operating system for employee benefits. For the first time ever, employers across the country can provide a comprehensive Health as a Service (HaaS) platform that enables and encourages a holistic view of health. This transformative, mobile-enabled platform provides a central place to access health and benefits services, and leverages data from those services to provide better, more informed health solutions.

The beautifully designed platform and user interface features Maxwell's intuitive lifestyle-based system for bundling employee benefits. With Maxwell, an employer can combine traditionally-offered employee benefits with complementary products and services, including wellness solutions, telemedicine, and a health care concierge. This allows for more comprehensive coverage for the employee within a simple, consumer-friendly experience tailored to an individual's unique needs.

Built to be a modular, fully scalable, and completely flexible private exchange platform, Maxwell can support a wide variety of product and service integrations, including all health, dental, vision, life, disability, and other insurance offerings. Maxwell can work with any insurance carrier, and supports EDI connections with all major medical and ancillary providers at no added cost. The platform is also a comprehensive benefits administration solution for HR and supports complex benefits strategies for groups of any size. Market leaders, including benefits brokers, TPAs, insurance companies, and PEOs partner with Maxwell Health to deliver an incredible health and benefits experience to their employer clients.

Maxwell's platform also integrates top-line services, including industry-leading concierge service Health Advocate, telemedicine solution Doctor on Demand, child, pet, home and senior care services through Care.com, healthy meal delivery through HelloFresh, identity theft protection and resolution services from ID Watchdog, online wellness and fitness classes via Powhow, and at-home health screening and analysis from BioIQ. These featured rollout partners will be joined by several other best-in-class services, to be announced soon.

Maxwell Health engages employees beyond benefits enrollment through a beautiful, consumer-friendly mobile app and turnkey wellness program that connects them to their benefits, simplifies navigating the healthcare system, and incentivizes healthy, balanced lifestyles. By streaming in employee fitness data through market-leading Jawbone UP and Fitbit fitness devices, the Maxwell app provides contextualized, relevant feedback to employees, and its in-app social layer includes challenges and company leaderboards. The easy-to-implement rewards program allows employers to fund gift cards or nonprofit donations that employees can redeem for healthy behaviors.

The system also integrates with leading payroll solutions, The Online 401(k) for retirement savings, ConnectYourCare and Discovery Benefits for HRA, HSA, FSA, commuter benefits and COBRA services, and best-in-class HRIS, including BambooHR, Tribe HR, and SilkRoad.

Veer Gidwaney, CEO and co-founder of Maxwell Health, said of the platform, "Maxwell Health is in the unique position to truly provide the first Health as a Service solution, consolidating disparate health and benefits services into one simple, beautiful experience."

About Maxwell Health

Maxwell Health, a fast-growing industry leader in health IT, is the first Health as a Service platform. This revolutionary operating system for employee benefits engages employees, incentivizes a holistic view of health, and provides a centralized place to access health and benefits services. Maxwell's web portal and mobile app enhances the benefits experience by leveraging data from integrated services, meaning better, more informed health solutions. Market leaders, including benefits brokers, TPAs, carriers, and other vendors, license Maxwell's technology to use with their employer clients.

131 Tremont Street Floor 3 

Boston, MA 02111 




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ERISA Compliance-Department of Labor Audits on the Rise

February 26th, 2014 1:34pm - Posted By: Rachel Zeman

TASC-There has been an increase in the number of audits by the Department of Labor since Health Care Reform has been enacted.

Here are a few things we have seen recently that are alarming:

 DOL has hired 1000 agents this year  DOL has a goal of collecting $1,100,000,000 in fines in 2014 alone.  Yes that’s over a billion.  DOL is finding that 95% of clients are not compliant relative to ERISA and the requirements below.  We are hearing that all clients will be audited in the next five years.

1)     ERISA requires:

a.     The Plan Sponsor and Plan Administrator (The Employer) have a Written Plan Document and Summary Plan Description (SPD) for each and every Health & Welfare Benefit (Medical, Dental, Vision, Group Term Life, AD&D, STD, LTD, Wellness, EAP and any Voluntary Benefits pre-taxed under a 125 plan)

      i.     The SPD and Certificates of coverage from your carriers do not meet         ERISA guidelines, nor are they required to.  From what I know about your       plans as your agent, you are not in compliance with this requirement.

b.     ERISA Benefit Notices be distributed to all eligible employees on enrollment and re-enrollment of your Health Plan

           2)  Specific performance under ERISA;

b.  $100/day penalty for every employee that is affected by violation under IRC until the violation is corrected;

           3)  Requires Mandatory Self-Reporting and tax for violation;

c.      Failure to self-report, even if violation is corrected will result in additional fines/penalties (Form 8928).  

d.   Groups with 100 or more plan participants file a 5500 and Summary Annual Report relative to their compliant ERISA Document.   

Join us for the FREE Webinar, April 3rd to learn more about ERISA and our partnership with TASC who can help you get compliant!

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InTANDEM HR-PEO Solutions for our clients

February 26th, 2014 1:21pm - Posted By: Rachel Zeman

Considering a PEO for 2014? You are in luck! InTANDEM HR partners with health insurance brokers (like us!) for the benefits piece so you can have the best of both worlds! RiteHealth Solutions and InTANDEM HR! Learn more about who they are below.


·         A locally owned and operated full service boutique Human Resources outsourcing firm that administers all HR functions for small to mid-sized businesses including payroll and tax filings, workers’ compensation, benefits, and employee administration.

·         An expert in Human Resources law and regulations – our partnership comes with HR legal expertise, customizable HR trainings, EEOC compliance, and unemployment insurance administration and representation.

·         A total compensation powerhouse with partnerships enabling access to the same benefits offerings as Fortune 500 companies to include 401(k), disability, medical, dental, and vision insurance, as well as ancillary optional benefits.

·         A partner to your business that includes a team of professionals including bi-lingual in Spanish staff, to communicate directly with your employees on all of their HR related concerns.

Register for the FREE webinar on April 17th to learn more about this partnership and why you may want to consider this new option for your business services!

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JOIN US: Free Webinar Series and Showcase on Healthcare 2014

February 14th, 2014 4:10pm


Spring IntoHealthcare Reform-2014

Don’t be left in the dark! Healthcare Reform is here and RiteHealth Solutions is ready! We have created an informative webinar series to present all of the new and exciting options for your 2014 benefits decisions.

Series Kickoff!                   REGISTER FOR WEBINAR HERE: Thu, Mar 6, 2014 9:00 AM - 10:00 AM MST


Healthcare Reform          REGISTER FOR WEBINAR HERE: Thu, Mar 13, 2014 9:00 AM - 10:00 AM MDT


Off-Exchange Small Group Market            REGISTER FOR WEBINAR HERE: Thu, Mar 20, 2014 9:00 AM - 10:00 AM MDT


SHOP Exchange               REGISTER FOR WEBINAR HERE: Thu, Mar 27, 2014 9:00 AM - 10:00 AM MDT


ERISA Compliance        REGISTER FOR WEBINAR HERE: Thu, Apr 3, 2014 9:00 AM - 10:00 AM MDT


Partially Self-Funded Products           REGISTER FOR WEBINAR HERE: Thu, Apr 10, 2014 9:00 AM - 10:00 AM MDT


Considering a PEO?          REGISTER FOR WEBINAR HERE: Thu, Apr 17, 2014 9:00 AM - 10:00 AM MDT


Direct Patient Care-Nextera Healthcare       REGISTER FOR WEBINAR HERE: Thu, Apr 24, 2014 9:00 AM - 10:00 AM MDT


Friday April 25th, 4-7 p.m.

Meet the Presenters and Health Insurance Representatives

Hampton Inn & Suites

6333 Lookout Road, Boulder, CO 80301 

RSVP HERE for the Showcase

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