Let’s Get Down to Basics.

Answers to many questions about Peak Health Alliance, health insurance, and more.

Quick Facts for Individuals and Families

How do I sign up?

There are several options:

  • You can enroll directly through Elevate/Denver Health Medical Plan.
  • You can sign up directly through Colorado’s health insurance marketplace, Connect for Health Colorado. If you believe you may qualify for subsidies / tax credits, you must enroll through Connect for Health. Many people who think they do not qualify for subsidies/tax credits are surprised to find they do, so it is worth checking if you are unsure.
  • You can use an enrollment assister/health navigator that will guide you through enrollment and help you select the best plan for your needs. Find one here.
  • You can use your broker or select one from Connect for Health’s list of certified brokers.
  • Please note: If you are seeking financial assistance or tax credits, you must sign up through Connect for Health Colorado.

Chat with us below for any questions!

When can individuals and families sign up?

Open enrollment for 2024 coverage is over, but you can still enroll in our plans if you qualify for a special enrollment period. (Learn more about special enrollment here).

Open Enrollment for coverage in 2025 begins November 1, 2024, and runs through January 15, 2025. Your coverage will be effective January 1, 2025 if you sign up before December 15, and your coverage will be effective February 1, 2025 if you sign up between December 15 and January 15.

If you’ve lost your job-based insurance, experience a change in income, or other qualifying event, you may be able to sign up for coverage outside the normal Open Enrollment period. More information here.

What counties do you serve?

We serve Summit, Grand, Lake, and Park counties in the mountain region and La Plata, Montezuma, San Juan, Dolores, and Archuleta in the Southwest region of the state. Click here to view our service area map.

Will I be able to access local healthcare providers in my county?

Yes! We have assembled a robust network of local physicians, hospitals, and other providers in our counties. If you are curious about a particular clinical professional, visit our provider directory. In addition, you have access to facilities in the Denver metro area for specialized care that may not be available in your local community.

How do I find out if my favorite doctors are in your network?

You can find out if your favorite doctor is in the Denver/Elevate Health Plans network by visiting our provider directory

How do I find a pharmacy in network near me?

Many local pharmacies are in network, including most pharmacies located in grocery stores (City Market, Safeway, King Soopers, etc.), CVS, and others. Use this link to verify that your pharmacy is included.

How do I find out what drugs are covered?

The list of drugs covered by Elevate Health Plans is available at this link.

What resources are available to help me choose the right plan?

There are several options:

What is the relationship between Peak Health Alliance and Elevate Health Plan (Denver Health Medical Plan)?

Peak Health Alliance is offering health insurance plans in partnership with Elevate Health Plans (sponsored by Denver Health Medical Plan or DHMP) starting in 2024. Peak Health Alliance is not an insurance company. State law requires Peak Health Alliance to partner with an insurance carrier to administer health insurance plans. After careful consideration, we have chosen Elevate Health Plans to partner with us based on their shared mission of local, affordable, and high-quality care. DHMP is a nonprofit health insurance company that is dedicated to serving local communities. They are not beholden to shareholders, and instead reinvest cost savings and profits back into improving the quality of care received. Learn more about them here https://www.denverhealthmedicalplan.org/about

Who will be my insurance carrier?

Elevate Health Plans are offered by Denver Health Medical Plan (DHMP). DHMP will be your insurance carrier.

Do your plans follow the standardized Colorado Option plan design?

Yes. We offer a Bronze, Silver, and Gold tiered plan that are compliant with the Colorado Option plan design. These plans include:

$0 preventative care services
$0 to low-cost primary care visits
$0 to low-cost mental health outpatient visits

In addition, we offer a Bronze HSA that does not follow the Colorado Option plan designs but is ACA compliant.

Who do I contact about my plan once I'm enrolled?

Please contact Elevate Health Plans/DHMP member services:
303-602-2090
Or:
1-855-823-8872 (toll free)

Is Peak Health Alliance an insurance company?

No, Peak Health Alliance is a locally led nonprofit health insurance purchasing alliance. Our role is advocacy on behalf of communities. We negotiate fair contracts with clinical professionals such as physicians, hospitals, mental health counselors and others. As a community-based organization we ensure any savings offered by the providers are passed on to you in the form of lower premiums.

The fact that our partner, Elevate Health Plans/DHMP, is also a non-profit and has no shareholders looking for a return on their investment makes passing these savings on to you much easier.

What does it mean to be a member of Peak Health Alliance?

Once you sign up for one of our plans, you are automatically a member of Peak Health Alliance.

Membership in Peak Health Alliance means you have access to our affordable, high-quality network of clinical professionals who are giving back to the community. Being a member of Peak Health Alliance means you and your family have a local advocate.

How much does it cost to be a Peak Health Alliance member?

The membership fee is $7 per member per month. The membership fee is embedded into your premium, so you only have to pay one bill a month. This membership fee supports our organization and the work we do to secure affordable and high-quality health insurance for all of our members. So, thank you!

If I don't live in a Peak Health Alliance county, can I still sign up?

Unfortunately, no. However, if you are interested in bringing Peak Health Alliance to your county, feel free to connect with us!

Do you offer dental or vision insurance?

We do not offer adult dental or vision insurance with our plans. However, pediatric dental and vision is covered under our plans.

I am a Summit or Grand County government employee. What changes can I expect to my coverage in 2024?

Our partnership with Elevate Health Plans does not impact Summit County and Grand County Government employees. If you have questions about your 2024 coverage, please reach out to your human resources administrator.

Questions About Businesses/ICHRA

What is an ICHRA plan?

ICHRA (pronounced “ICH-rah”) stands for Individual Coverage Health Reimbursement Arrangement. They’re available to nearly any business of any size. You can read up about ICHRA plans here. ICHRA plans allow a business to provide health insurance to their employees through a tax-free reimbursement in an amount the employer chooses. They’re new, so we recommend you click the link above to learn more or talk to your broker.

When can businesses enroll?

You can set up an ICHRA any time of year. Once you do, your employees will have a 60-day Special Enrollment Period in which to sign up. 

 

Can I work with my existing broker?

You can administer your ICHRA on your own using an online platform, or you may choose to have your broker do this for you. The National Association of Benefits and Insurance Professionals is developing a list of brokers who have been trained on ICHRA plans. As soon as that list is available, we will provide a link to it. Meanwhile, please send an e-mail to info@peakhealthalliance.org expressing your interest in ICHRAs and we will do our best to connect you with a trained broker.

How much does an ICHRA plan cost?

ICHRA costs depend on your reimbursement plans for your employees and how you set it up. As an employer, you control the amount you reimburse your employees, and there is no maximum contribution. However, you need to consider the ACA Affordability guidelines. There is also an ICHRA platform administration fee, which varies depending on the vendor you use.

Can employees still get a tax credit with an ICHRA plan?

By offering your employees an ICHRA, you are offering access to an array of Affordable Care Act compliant health benefit plans. Each employee gets to choose the plan they want. However, they will not be eligible for a tax credit on the Connect for Health Colorado marketplace. 

Please note, there is an exception if your employee’s net premium, after your ICHRA contribution, is considered “unaffordable.” The definition of “unaffordable” is when the cost of your employee’s premium, after reimbursement, is 9.13% of income or greater in 2023 (the percentage may be adjusted for 2024). If so, this will generate a tax credit that will be calculated when you set up your ICHRA. Employees who are eligible will receive notice within 90 days.

Who do I pay every month for my ICHRA plan?

You have options as an employer.

  • You can pay your employees directly the defined contribution you have allocated.
  • You can have your reimbursement come through a payroll addition.

The last option is to pay the full premium directly to the carrier and do a payroll deduction for your employees. This option is only available on certain ICHRA platforms and is meant to mimic a traditional group plan.

If you’re an employee, ask your employer about how you’re expected to pay for plans.

Do you offer discounted pharmaceuticals?

Your insurance carrier will cover prescription drugs as part of your plan; the benefits and associated costs will vary by plan and carrier.

Who will be our insurance carrier?

Peak Health Alliance plans are underwritten by Denver Health Medical Plan and marketed as Elevate Health Plans.

For ICHRA plans, the insurance carrier may be different for each employee, as they can shop for any ACA compliant plan offered in the marketplace.

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

Questions About Peak Health Alliance

What is Peak Health Alliance?

Peak Health Alliance offers health insurance plans in partnership with Elevate Health Plans (sponsored by Denver Health Medical Plan or DHMP). Peak Health Alliance is a locally led nonprofit health insurance purchasing alliance licensed and regulated by the State of Colorado. Our role is community advocacy on behalf of individuals like you with healthcare providers, healthcare facilities, the state of Colorado, and insurance companies. We negotiate lower health insurance premiums by using the purchasing power of the community. We offer health insurance plans through a carrier we select based on their ability to offer the most competitive rates and comprehensive plans.

Peak was first initiated as a special project out of the Summit Foundation. Today it is operated independently as a 501c3 nonprofit organization.

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.

What is Peak Health Alliance’s relationship with Elevate Health Plans?

Peak Health Alliance is offering health insurance plans in partnership with Elevate Health Plans (sponsored by Denver Health Medical Plan or DHMP) starting in 2024. Peak Health Alliance is a nonprofit that is not an insurance company, and therefore must partner with an insurance carrier to administer health insurance plans. After careful consideration, we have chosen Elevate Health Plans underwritten by DHMP to partner with us based on their shared mission of local, affordable, and high-quality care. DHMP is a nonprofit health insurance company that is dedicated to serving the local community.

How does Peak Health Alliance advocate for the communities it serves?

By analyzing local claims data from the communities we serve, Peak Health Alliance identifies what our residents are paying for healthcare. That analysis is the starting point for negotiations with hospitals, other health care providers, and insurance carriers. We then negotiate and design ACA-compliant plans based on each community’s needs. Our work is grounded in collaboration. We are a member-owned nonprofit that harnesses the purchasing power of the communities we serve.

Peak Health Alliance actively involves our communities by organizing steering committees comprised of local community and business leaders in each county or region. These steering committees help us tailor our approach to the individual needs of each community or region. These committees also help us identify groups and organizations that can benefit from additional education provided by Peak Health Alliance.

How does Peak Health Alliance identify doctors and other healthcare providers who will be part of the network?

We welcome all local physicians and other healthcare providers to join our network. Our goal is to collaborate with as many local clinical professionals as possible to agree on rates that are both sustainable for the providers and allows room for insurance premium reductions for our members. Our network meets all network adequacy requirements, and includes a mix of local independent healthcare professionals, local hospitals and other healthcare facilities. Additionally, the Peak Health Alliance network includes physicians and healthcare facilities in the Denver metro area for specialty care that is not available in our local communities.

What role do physicians, hospitals, and insurance companies play in helping Peak Health Alliance reduce health insurance costs and increase quality/benefits for its members?

All the players help. It’s important to note that Peak Health Alliance is an independent nonprofit organization. We do not provide health insurance. We negotiate and partner with community-minded hospitals, physicians, other healthcare providers, and insurance companies to bring down rates for everyone—individuals, families, and employers. We also work with our insurance carrier partner, Elevate Health Plans, to design robust and comprehensive plan designs that reduce barriers and increase access to healthcare.

Is Peak Health Alliance affiliated with Colorado PEAK?

No. These are two completely separate entities. Colorado PEAK is a portal operated by the State of Colorado to apply for and manage state benefits. Peak Health Alliance is an independent, nonprofit organization working to bring affordable health insurance to the communities we serve.

Is Peak Health Alliance an insurance company?

No. By law, Peak Health Alliance is not allowed to bear risk. We negotiate with physicians, other providers, and hospitals, then partner with insurance carriers who underwrite the plans.

Is Peak Health Alliance the same as Southwest Health Alliance?

In the summer of 2021, we transitioned the Southwest Health Alliance to operate as Peak Health Alliance. The Southwest Health Alliance name was retired. However, we maintain local leadership in the Four Corners region through our partnership with the Local First Foundation.

Are your plans ACA-compliant?

 Yes. Elevate Health Plans are compliant with the Affordable Care Act. As such, they are guaranteed to be issued to all eligible applicants. The plans cover pre-existing conditions. The plans cover all essential health needs. And there are no lifetime coverage maximums.

How is Peak Health Alliance funded?

Our ongoing operations are primarily funded by membership fees, paid through the monthly premiums of Peak Health Alliance plans. We also receive grant funding from various independent philanthropic organizations.

How can I stay updated?

Please visit our home page and subscribe to our email list to stay updated about our site launch, for information regarding the open enrollment window (which will begin Nov. 1) 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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