Let’s Get Down to Peak Basics.

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

Individuals & Families

Businesses / ICHRA

About Peak Health

Quick Facts for Individuals and Families

When Can Individuals Sign Up?

Open Enrollment for plans that begin 2022 will begin November 1.

However, if you’ve lost your job-based insurance, had a change in income, or other qualifying event, you may be able to sign up for coverage. Click here for information.

Due to changes from the ARPA, many members may now qualify for subsidies even though they did not when they signed up for coverage. We recommend those members check this page to see if they are eligible for additional savings.

 

How Do I Sign Up?

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

If you are seeking financial assistance or tax credits, you must sign up through Connect for Health. If you’re shopping for a new plan during the 2021 Special Enrollment Period, you must also shop through Connect for Health to ensure adequate savings and tax credits. Chat with us below for any questions!

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

Update: Changes to tax subsidies due to the 2021 American Rescue Plan Act have increased the subsidies and lowered the income qualification. You may be eligible for additional savings. Please visit this link to learn more.

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 Peak plans. You will receive a 1095 form from Bright Health at the end of the 2021 tax year.

Please read our FAQ about the changes in the amount of federal tax subsidies offered this year as some changes may impact your credit.

My Tax Subsidy Went Down. What Happened?

Update: Changes to tax subsidies due to the 2021 American Rescue Plan Act have increased the subsidies and lowered the income qualification. You may be eligible for additional savings. Please visit this link to learn more.

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 Peak Cost?

Update: Changes to tax subsidies due to the 2021 American Rescue Plan Act have increased the subsidies and lowered the income qualification. You may be eligible for additional savings. Please visit this link to learn more.

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

Membership in Peak Health Alliance is required to enroll in our plans. For 2021, fee for membership is $6/month per person insured, 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.

Can I Qualify for Lower Premiums?

Changes to tax subsidies due to the 2021 American Rescue Plan Act have increased the subsidies and lowered the income qualification.

Many Coloradans will be eligible for additional savings. Please visit this link to learn more.

Who Will Be My Insurance Carrier?

Bright Health will be your insurance carrier. You may reach them here.

How Do I Earn Member Rewards from Bright?

Our carrier for 2021 and 2022, Bright Health Care, offers a cash rewards program to help our members manage their care. By setting up their member hub and selecting a primary care doctor, our members can earn $200 up front. Bright adds various rewards through the year. You can log in to your Member Hub if you’re already a member. Or, learn more about the rewards by visiting this page.

Will I Receive an Insurance Card?

Yes

Is Peak Health Alliance an Insurance Company?

No. Peak 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!

If I don't live in a Peak county, 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.

For 2021, Peak offers plans in Summit, Grand, Lake, La Plata, Dolores, Montezuma, and San Juan counties. In 2022, Park County will be added.

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. Setting up your account at their member hub is a great first step to managing your plan digitally (and you can download your ID card!)

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, please ask your employer to help you understand how your premiums will be handled each month.

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.

Quick Facts for Businesses/ICHRA

What is an ICHRA Plan?

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 plans here.

They 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 one of the software platforms available to you, or you may choose to have your broker do this for you.

Our Peak Preferred Broker program ensures brokers have been trained on ICHRA and our 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?

ICHRA costs depend on your reimbursement plans for your employees and how you set it up (e.g. if your business has 10 or more employees, you may create classes to reimburse different amounts based on the ‘type’ of employee, like full or part time, etc.).

You control the amount you reimburse your employees, and there is no maximum contribution.

To get a fast preliminary estimate for your business’ ICHRA, click here!

 

Can Employees Still Get a Tax Credit with an ICHRA?

By offering your employees an ICHRA, you are offering a full health benefit and they will not be eligible to redeem a tax credit on the marketplace. 

The exception:

If your employee’s net premium, after your ICHRA contribution, is considered “unaffordable”. If the cost of their premium, after reimbursement, is 9.5% of income or greater, it’s considered “unaffordable”, allowing a tax credit.

This will be calculated when you set up your ICHRA and any employees in question will receive notice within 90 days.

 

Can Employees Who Live Outside of a Peak/Southwest County Use my ICHRA Plan?

Yes! 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?

You can contribute just toward monthly premiums, or you can contribute toward out of pocket expenses like deductibles, etc.

The amount you contribute on additional benefits is still up to you. Be sure to inquire about setting this up when you set up your ICHRA so your staff can take advantage.

You may offer traditional dental and vision plans in addition to ICHRA.

Whom Do I Pay Every Month?

You have options as an employer.

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

The last option is to pay the carrier(s) directly the full price of the premium, 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 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.

You may, however, offer these benefits and plans to your staff in addition to an ICHRA.

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 Peak Health Alliance

What is Peak Health?

Peak Health (known as Southwest Health Alliance in the Four Corners) is a health insurance purchasing alliance founded in Summit County in 2018. We negotiate lower healthcare rates by using the purchasing power of the community. We offer health insurance plans through carriers we selected based on their ability to offer the most competitive rates and comprehensive plans.

Peak was first initiated as a special project of the Summit Foundation. Today it is operated independently and based out of The Keystone Center in Keystone Colorado.

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.

Is Peak Health Alliance an Insurance Company?

No. Peak does not bear risk.

We negotiate with providers and hospitals, then partner with insurance carriers who underwrite the plans

Is Peak the Same as Southwest Health Alliance?

In the summer of 2021, we transitioned the Southwest Health Alliance to operate as Peak. We retired the name, and now operate under one! However, we still maintain local leadership in the Four Corners.

Is Peak Health Alliance 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.

How is Peak Health Funded?

Peak Health Alliance was underwritten through the generosity of the Summit Foundation and local government organizations. Our ongoing operations are primarily funded by membership fees, paid through the monthly premiums of Peak Health Alliance plans

Is Peak Affiliated with a Specific Provider, Hospital, or Insurance Company?

No. We are an independent Summit County-based non-profit and 501(c)3 organization, governed by a Board of Directors who represent businesses, government entities, individuals, and more.

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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