Winter in Colorado is a time for outdoor recreation -- skiing, snowboarding and more. But all that outdoor fun increases the risk of injury.

It's more important than ever to get insured so you are protected should the unexpected happen, even if you are young and feel like insurance is irrelevant in your life. Here are five things to consider when taking that step.

1. What is health insurance?

Health insurance protects you and your family financially against the costs of an unexpected illness or injury. The principle of is simple: People pay premiums to cover the possibility of needing medical attention and protect themselves financially. Health insurance is a way for people and insurance companies to share the risk of medical costs. People -- whether healthy or sick -- pay premiums into a pool of money, administered by an insurance company, so that there is money to pay for services when someone in the pool of insured people needs medical attention.

2. What are the benefits of health insurance?

Research shows people with health insurance are healthier than those without it. If you have insurance, you are more likely to have an ongoing relationship with a family doctor who can monitor your health and diagnose conditions that might arise. You are also more likely to get helpful preventive treatments. Health insurance also protects the financial security of an individual or family. Unexpected illnesses or injuries can be expensive and insurance helps with those high costs.

3. How do I get health insurance?

Many people get health insurance through their workplace. Others buy it from a website, an insurance agent, directly from an insurance company or through the state's health insurance exchange, Connect for Health Colorado. If you have questions about your insurance, or are experiencing problems or difficulties in working with your insurance company, or you are shopping for health insurance and need help understanding the process, you can call the Colorado Division of Insurance at 800-930-3745. DOI works with consumers to answer their questions and help them understand their health insurance.

4. What does health insurance cover?

Health insurance typically covers things like doctor's visits, prescription medicines, hospitalizations and emergency care. Preventive services are now covered without an additional office charge to the patient. When you first receive your health insurance plan, DOI encourages you to read it and make sure you understand it - and to ask questions if you don't. If you have questions, issues or concerns regarding your health insurance, DOI can help.

5. What rights do consumers have?

No one can be denied insurance because of a pre-existing condition. If you have health insurance and have a claim denied, you have the right to question that denial. Consumers can contact DOI to learn about all their rights, responsibilities and options.

DOI has online resources at www.dora.colorado.gov/insurance, and a team of experts ready to answer your questions at 303-894-7490 or 800-930-3745. They can help you understand your policy and make sure you receive the benefits for which you pay. They also can help you understand your responsibilities and the role of your doctor, insurer, employer and agent.

DOI's mission is consumer protection, and one of the best ways to do this is by helping Coloradans become their own best advocates. Being informed means we can all make better decisions from the start and be better prepared when we need health insurance the most.

Vince Plymell is communications manager for the Colorado Division of Insurance.



Briefs: Insurance agency chief joins MODC board

Toby Stark has been named to the executive board of the Monmouth-Ocean Development Council.



When you put down thousands of dollars to purchase a home, youre taking a potentially serious financial risk: You could lose some or all of that money if the value of the house declines or a job transfer, illness or other life event forces you to sell the property during a dip in market demand.

But would you be willing to pay an insurer a one-time premium to protect your down payment against loss? Theres never been such an option, so you cant be sure. But beginning next January thats likely to change with the projected nationwide rollout of something called +Plus by ValueInsured.

The basic idea is straightforward. For an upfront premium that under some circumstances could be part of the interest rate you pay on your mortgage, your down payment, all the way up to $200,000, would be insured with you as the beneficiary. If the value of your house declines and you sell at a loss, youd be eligible to make a claim for up to the full amount of your original down payment.

The premiums are expected to average around $1,200 on a $20,000, 10 percent down payment on a $200,000 house. If you purchase the coverage as part of a lender credit toward closing expenses, rather than paying cash for the coverage at closing, the +Plus premium could be rolled into the interest rate on the entire loan, raising the rate slightly. It could also be a supplement to lender-paid mortgage insurance, with a higher rate on your mortgage.

Sounds intriguing, right? But as with all insurance products, youve got to look hard at the details, especially the terms governing when and how much youll receive if you make a claim for a loss. The sponsor of the plan is a company in Dallas, ValueInsured (www.valueinsured.com). For the +Plus program, ValueInsured is partnering with Texas-based specialty insurer Houston International Insurance Group, and Everest Re Group Ltd., a reinsurance company headquartered in Bermuda.

In an interview last week, Joe Melendez, founder and CEO of ValueInsured, told me that the goal of +Plus is to take the risk element off the table and give (buyers) more confidence.

So how much risk is really taken off the table? Start with the conditions that have to be met to qualify for a payment on a claim. Simply documenting that you suffered a loss after a sale wont necessarily get you your down payment money back. You cant file a claim during the first two years after your purchase or after seven years.

Next comes the really tricky part. The +Plus plan keys its payouts in part to a property value index published by the Federal Housing Finance Agency (www.fhfa.gov/DataTools/Tools/Pages/HPI-Calculator.aspx). If your state index hasnt dropped during the period of your ownership, but the sale price of your house has gone down, or if the FHFA index hasnt declined as much as your homes value since the date of purchase, youre not likely to get all of your money back. Or maybe nothing at all.

Heres an example provided by ValueInsured: You put $20,000 down on a $100,000 house. Five years later you sell at a loss of 20 percent, $20,000. If your state home price index as measured by the FHFA has declined by only 10 percent, the most you can obtain on a claim is $10,000. If your house declined in sales price by 30 percent, but the FHFA index remained flat, youd get zero on your loss. But if the index declined by 30 percent and your home price also declined by 20 percent, you could claim your full $20,000 back.

The payout formula is this: +Plus will pay the lesser of: (1) your original down payment, (2) the actual equity you lost, or (3) the purchase price or your house times the reduction in your states FHFA index.

Not so simple. For this sort of down payment insurance to provide you maximum coverage, your house essentially cannot be losing value faster than the statewide average, which of course, may not show any decline at all.

Good deal or not? It might make sense for you if unexpected economic reverses depress property values in your state. It might make sense as peace-of-mind coverage.

But do the math and figure the likelihood that the premium you pay, which could raise your interest rate for long beyond the point where your coverage expires if its included in your mortgage rate, is worth the coverage youll receive.



CHEYENNE - The recent announcement that WINhealth will pull out of Wyomings health insurance marketplace next year means thousands of people will have to re-enroll for insurance.

On Thursday, WINhealth issued a release saying that it does not intend to offer insurance through the federal marketplace for 2016. Existing customers covered under the Affordable Care Act will still be insured through WINhealth through Dec. 31, but theyll be on their own afterward.

In its release, WINhealth cited new costs coming from the Centers for Medicare and Medicaid Services as a big factor in its decision. The company said CMS recently established a risk corridor program that aims to balance costs to insurers by requiring companies that take in more than they pay out to put money into the risk corridor program.

That money would then be given to insurers who pay more in claims than they take in. But WINhealth said the rate of repayments was too uncertain to guarantee it could continue meeting its cost obligations.

The financial impact of the federal governments decision on WINhealth amounts to approximately 4.4 million, WINhealths statement read.

The ambiguity of federal government repayments, both in timeline and amount, have created an environment of uncertainty and increased risk in the individual environment.

Its decision to pull out of the federal marketplace means about 8,200 people currently covered under WINhealth will have to look for a new insurer. But they wont have to look far, since there is only one in-state option for health insurance left: Blue Cross Blue Shield of Wyoming.

Wyomings new situation is not unprecedented. In West Virginia, Highmark Blue Cross Blue Shield was the only insurance provider on the states federal marketplace exchange through 2014 and 2015, though thats set to change next year with CareSource offering plans across 15 of the states 55 counties.

Still, its rare to find a state with just one company offering insurance through the federal exchange. Part of it has to do with the unique challenges insurers face in Wyoming, with its small, spread-out population making it difficult and more expensive to provide regular and emergency health-care services consistently.

But Jeff Rude, deputy commissioner for the Wyoming Department of Insurance, said just because WINhealth is pulling out of the market doesnt mean the sky is falling for Wyomings uninsured.

Certainly more choice is better than less choice, Rude said. Obviously this isnt a good thing. But for consumers, itll be business as usual.

Rude said its important to remember that the ACA has explicit cost controls in place, meaning just because Blue Cross Blue Shield is the only game in town, the company wont be able to exploit that fact to its benefit.

In the end, CMS looks to ensure at least 80 cents of every dollar spent (on health insurance) goes to claims, Rude said. One company cant just raise its rates arbitrarily.

While Wyomingites already do pay some of the highest health insurance premiums in the country, WDI senior policy analyst Denise Burke said thats not because insurance companies have been trying to soak consumers.

The insurance rates are set by the cost of health-care delivery, not the other way around, Burke said. Furthermore, in some states the rate setting is done by the Department of Insurance; but in Wyoming, its done by CMS. And theyve already set the rates for Blue Cross Blue Shield for 2016.

Rick Schum, the president and CEO of Blue Cross Blue Shield of Wyoming, added that while those new rates wont be made public until the next ACA open enrollment period, WINhealths departure will have no bearing on them.

It has no impact at all on any function of our rate setting, Schum said.

If reassurance is what were looking at, I would highly doubt any of our customers - or future customers - are in for any sticker shock.

And despite being the state exchanges only remaining health insurance provider, Schum said Blue Cross Blue Shield attempts to provide a wide range of coverage options, rather than a one-size-fits-all plan.

We wanted to make sure people have a choice, he said.

So we tried to arrange an array of products that addresses individuals needs; were offering 28 different products through the insurance exchange.

Even so, Rude said he acknowledges the importance of healthy competition in Wyomings insurance marketplace. He said the Department of Insurance has been in talks with several out-of-state providers interested in joining the states exchange as early as 2017.

Weve also talked with some individuals with CMS whove said that they will do whatever they can to encourage them to come here also, Rude said. So there are people that are looking at our market.

But, in the short term at least, Burke said that anyone who is currently enrolled with WINhealth through the federal exchange will have to re-enroll through Blue Cross Blue Shield if they want to stay covered. To that end, she said, WINhealth customers should consider reviewing their options at www.healthcare.gov or by calling Wyoming 211 for assistance.

Right now they can still see their medical providers; coverage is there. But anything that occurs after Dec. 31 is a different consideration, Burke said.

During open enrollment, those people will need to enroll in a new plan, and theyll need to enroll in a plan before Dec. 15 in order to have a plan in place by Jan. 1 of 2016.

Open enrollment for 2016 coverage begins Nov. 1 and runs through Jan. 31.


Published on: Friday, Oct 09, 2015 - 11:48:40 pm MDT



Portsmouth-based TowneBank announced Friday that Invincia Insurance Solutions, Total Insurance Planning and BH Baird Insurance will affiliate with Towne Insurance, a wholly owned subsidiary of TowneBank.

The three additions to its insurance portfolio are expected to help TowneBank's expansion in the Richmond area.