This story was produced in partnership with the

Jim Noon, owner of Denver cardboard box seller Centennial Container, has offered his employees health care coverage for three decades, but he isn’t sure he will continue to offer the benefit after this year.

“I don’t know what I’m going to do, but it’s on the table to just let them all go to the exchange and get out of the health insurance business,” he said. “It’s one viable option, especially if it’s going to be as complicated as it is now.”

Late last year, Noon received an early renewal offer from his insurance company that will be good through the end of the year with an 8.6 percent premium increase. To get a policy compliant with Affordable Care Act requirements — one that covers birth control, which his current plan doesn’t — would have cost Noon 50 percent more, according to documents Noon provided from his broker.

“I hate to be paying double the rates doing it as an employer if people can go to the exchange (as individuals) and pay less and qualify for subsidies,” he said.

About half of small businesses in Colorado are seeing double-digit premium increases under the ACA while the other half are seeing the typical single-digit increases they have had for years, said Jim Sugden, small-business marketplace manager for the state exchange. He was not surprised that some companies are getting out of providing health insurance for employees.

“We anticipated there was going to be a market shift,” he said. “Businesses have to do what’s best for themselves and their employees.”

Businesses with fewer than 50 employees don’t have to buy health insurance for their workers, and can opt to drop their coverage. Companies with 50 to 99 workers must cover their workers beginning in 2016 or face fines, while businesses with 100 or more must start buying coverage next year.

Neither the exchange, Connect for Health Colorado, nor the Colorado Division of Insurance has numbers of how many small-group plan employers with 50 employees or less are dropping coverage or signing up for the first time through the exchange.

The number opting to buy coverage through the exchange is small. About 220 small employers had enrolled as of April 14, the exchange said.

In 2012, there were about 31,000 small businesses with health plans covering about 252,000 employees in the state. There were an additional 5,100 businesses with a single employee who obtained health care, according to an insurance division report. The report showed people covered under small groups dropping steadily for the past decade.

Anecdotal information from insurance brokers shows about 10 percent of small businesses dropped their health insurance as a result of ACA changes, Sugden said.

But some small employers are signing up through the exchange for the first time.

The Colorado Latino Leadership, Advocacy & Research Organization decided to start offering its three employees insurance in September, and this year used the exchange to find a plan that saved the nonprofit about $250 a month for all three employees and cut the employees’ deductibles by more than half.

“Our mission is to support the Latino community, and if we’re out in the community, it’s important for us to make sure employees have health care,” said Amanda Gonzalez, who was executive director until last week. “But there’s always a sticker shock when looking at health insurance.”

To offset some of the shock, small organizations buying insurance through the exchange can get tax credits for up to 50 percent of premiums for businesses and 35 percent for nonprofits.

Gonzalez, using a calculator on the exchange website, estimated the nonprofit will get about $1,200 in tax credits for providing health insurance.

Sugden said 6 percent to 8 percent of small businesses have obtained credits, but many business owners may not realize they may qualify.

Noon, who has been active in conservative causes and chaired the Colorado Republican Business Coalition, received a couple of thousand dollars in credits in 2012, but he says it’s so complicated that he is not sure what he will get now if he goes through the exchange.

“They keep changing the rules, so who knows what the rules will be?” he said.

Rule changes are one of the biggest complaints small businesses have about the ACA.

“In general, there’s so much uncertainty,” said Tony Gagliardi, state director of the Colorado Federation of Independent Business. “Every day when we turn on the news, there’s a change.”

The changing rules and increasing costs led Colorado Springs insulation company Scandvic Enterprises to drop health insurance for its employees after providing it for 20 years.

“We decided that we’re out of it,” said executive vice president Mike Scandrett. “It’s up to the guys to take care of it.”

Scandvic offered to subsidize health care for his employees by increasing their salaries if they went to the exchange, but so far none have taken him up on the offer.

“I would say we’re saving money because of it, but it’s not the way we wanted to do it,” he said. “We wanted to pay for their coverage.”

Dropping insurance from employer coverage also has tax ramifications. Employees who receive insurance on the exchange have to pay premiums with post-tax dollars, though they might qualify for a subsidy, while most employer plan contributions come out of pre-tax dollars. And employers pay any subsidies in the form of higher salary with taxable dollars.

This <a target="_blank" href="/insurance/health-law-presents-challenges-for-colorado-small-businesses/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

This story was produced in partnership with the

Colorado’s health care exchange has spent nearly $8 million marketing itself to residents, passing out more than 150,000 exchange-branded packets of sunscreen and lip balm worth $46,000, and driving to the four corners of the state in a custom-wrapped RV.

Connect for Health Colorado conducted surveys to measure the effectiveness of its marketing. It found that the share of people who had heard of the exchange increased from 19 percent in April to 60 percent in December.

But the survey also showed apparent setbacks in key areas. The share of those who said they believe the exchange is for them dropped 19 percentage points, and those who thought it was for small business dropped 20 points. Those who oppose creation of a health insurance marketplace increased 6 points. 

Support for the exchange remained steady at 47 percent.

Just over 100,000 Coloradans had signed up for private health insurance through the exchange as of March 17. Open enrollment ends March 31. The exchange in early 2013 projected enrollment ranging from 73,000 to 203,000 by the end of March.

Sign-ups started slowly in Colorado, in part because of widely publicized problems with the federally run exchange website, but have picked up momentum considerably in the past few months.

State Sen. Kevin Lundberg, a Berthoud Republican who serves on the Legislative Health Benefit Exchange Implementation Review Committee, questioned the effectiveness and cost of the marketing campaign.

“I’m troubled whenever government has to sell itself and sell programs at taxpayers’ expenses,” said Lundberg, who opposed the Affordable Care Act. “I believe the government should have a different way to communicate than just spending money on media.”

While the exchange is a quasi-public nonprofit created by the legislature and not a state agency, the marketing money is currently coming from a federal grant funded with tax dollars.

The exchange needs a large marketing budget to get the word out and drive people to the website, said state Rep. Beth McCann, D-Denver, who chairs the exchange-implementation review committee. But she said she is concerned that maybe the word isn’t getting out in the right way.

“It’s something we want to take a look at,” she said. “I haven’t seen survey results. If you find the marketing strategy is not successful, you make adjustments, and that’s something we might want to discuss at our next meeting.”

Exchange spokeswoman Myung Oak Kim said the marketing clearly is effective because Colorado ranks as one of the states with the highest enrollment in private plans from state-based exchanges.

“Recognition tripled of people who knew who we are, and a vast majority knew what we did,” she said. “Our job was not just to build a new shopping website and customer-support network to help Coloradans purchase health insurance and access new tax credits. We also needed to educate the entire state in a short time period about the new marketplace, how Coloradans can benefit and why they should shop with us.”

Kim said the 20 percent drop in people who thought the exchange was for them was due to people who have insurance from their employer realizing they have no need for the exchange.

Opposition to the marketplace, she said, increased because of media coverage of the technical problems that plagued the federally run exchange – of which Colorado is not a part – during the program’s rollout last fall.

The 20 percent drop in those who believe the exchange will help small business cover their workers is a concern, Kevin Raines, a principal at Corona Insights, which conducted the exchange’s surveys, wrote in an e-mail.

“That leaves the one mystery – the huge decline in people who say that Connect for Health is designed to meet the needs of small business,” he wrote. “Again, 6 to 7 percentage points of that decline may just be the rise in general opposition, but why did it fall so much further? I really don’t have a good theory on that yet.”

Raines theorized that small business may have gotten lost in the discussion or people may have seen stories about cost increases for small business.

“I think this is worth monitoring more, because it’s important,” he wrote.

Despite the mixed results, Kim said the $8 million in marketing, public relations and outreach was effective. Exchange officials will decide whether and how to spend another $7 million after open enrollment ends.

During an interview last month, she could not say exactly what the exchange will buy with those tax dollars. “We’re still working on that plan,” she said.��

Kim later sent a statement saying that the exchange will focus on customer sign-up and retention. Marketing also will focus on getting people eligible for premium tax credits, young people, small business, areas with more uninsured people and minority groups.

This story was produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.

This <a target="_blank" href="/insurance/colorado-exchange/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

This story was produced in partnership with the

Jim Noon, owner of Denver cardboard box seller Centennial Container, has offered his employees health care coverage for three decades, but he isn’t sure he will continue to offer the benefit after this year.

“I don’t know what I’m going to do, but it’s on the table to just let them all go to the exchange and get out of the health insurance business,” he said. “It’s one viable option, especially if it’s going to be as complicated as it is now.”

Late last year, Noon received an early renewal offer from his insurance company that will be good through the end of the year with an 8.6 percent premium increase. To get a policy compliant with Affordable Care Act requirements — one that covers birth control, which his current plan doesn’t — would have cost Noon 50 percent more, according to documents Noon provided from his broker.

“I hate to be paying double the rates doing it as an employer if people can go to the exchange (as individuals) and pay less and qualify for subsidies,” he said.

About half of small businesses in Colorado are seeing double-digit premium increases under the ACA while the other half are seeing the typical single-digit increases they have had for years, said Jim Sugden, small-business marketplace manager for the state exchange. He was not surprised that some companies are getting out of providing health insurance for employees.

“We anticipated there was going to be a market shift,” he said. “Businesses have to do what’s best for themselves and their employees.”

Businesses with fewer than 50 employees don’t have to buy health insurance for their workers, and can opt to drop their coverage. Companies with 50 to 99 workers must cover their workers beginning in 2016 or face fines, while businesses with 100 or more must start buying coverage next year.

Neither the exchange, Connect for Health Colorado, nor the Colorado Division of Insurance has numbers of how many small-group plan employers with 50 employees or less are dropping coverage or signing up for the first time through the exchange.

The number opting to buy coverage through the exchange is small. About 220 small employers had enrolled as of April 14, the exchange said.

In 2012, there were about 31,000 small businesses with health plans covering about 252,000 employees in the state. There were an additional 5,100 businesses with a single employee who obtained health care, according to an insurance division report. The report showed people covered under small groups dropping steadily for the past decade.

Anecdotal information from insurance brokers shows about 10 percent of small businesses dropped their health insurance as a result of ACA changes, Sugden said.

But some small employers are signing up through the exchange for the first time.

The Colorado Latino Leadership, Advocacy & Research Organization decided to start offering its three employees insurance in September, and this year used the exchange to find a plan that saved the nonprofit about $250 a month for all three employees and cut the employees’ deductibles by more than half.

“Our mission is to support the Latino community, and if we’re out in the community, it’s important for us to make sure employees have health care,” said Amanda Gonzalez, who was executive director until last week. “But there’s always a sticker shock when looking at health insurance.”

To offset some of the shock, small organizations buying insurance through the exchange can get tax credits for up to 50 percent of premiums for businesses and 35 percent for nonprofits.

Gonzalez, using a calculator on the exchange website, estimated the nonprofit will get about $1,200 in tax credits for providing health insurance.

Sugden said 6 percent to 8 percent of small businesses have obtained credits, but many business owners may not realize they may qualify.

Noon, who has been active in conservative causes and chaired the Colorado Republican Business Coalition, received a couple of thousand dollars in credits in 2012, but he says it’s so complicated that he is not sure what he will get now if he goes through the exchange.

“They keep changing the rules, so who knows what the rules will be?” he said.

Rule changes are one of the biggest complaints small businesses have about the ACA.

“In general, there’s so much uncertainty,” said Tony Gagliardi, state director of the Colorado Federation of Independent Business. “Every day when we turn on the news, there’s a change.”

The changing rules and increasing costs led Colorado Springs insulation company Scandvic Enterprises to drop health insurance for its employees after providing it for 20 years.

“We decided that we’re out of it,” said executive vice president Mike Scandrett. “It’s up to the guys to take care of it.”

Scandvic offered to subsidize health care for his employees by increasing their salaries if they went to the exchange, but so far none have taken him up on the offer.

“I would say we’re saving money because of it, but it’s not the way we wanted to do it,” he said. “We wanted to pay for their coverage.”

Dropping insurance from employer coverage also has tax ramifications. Employees who receive insurance on the exchange have to pay premiums with post-tax dollars, though they might qualify for a subsidy, while most employer plan contributions come out of pre-tax dollars. And employers pay any subsidies in the form of higher salary with taxable dollars.

This <a target="_blank" href="/insurance/health-law-presents-challenges-for-colorado-small-businesses/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">

This story was produced in partnership with the

Colorado’s health care exchange has spent nearly $8 million marketing itself to residents, passing out more than 150,000 exchange-branded packets of sunscreen and lip balm worth $46,000, and driving to the four corners of the state in a custom-wrapped RV.

Connect for Health Colorado conducted surveys to measure the effectiveness of its marketing. It found that the share of people who had heard of the exchange increased from 19 percent in April to 60 percent in December.

But the survey also showed apparent setbacks in key areas. The share of those who said they believe the exchange is for them dropped 19 percentage points, and those who thought it was for small business dropped 20 points. Those who oppose creation of a health insurance marketplace increased 6 points. 

Support for the exchange remained steady at 47 percent.

Just over 100,000 Coloradans had signed up for private health insurance through the exchange as of March 17. Open enrollment ends March 31. The exchange in early 2013 projected enrollment ranging from 73,000 to 203,000 by the end of March.

Sign-ups started slowly in Colorado, in part because of widely publicized problems with the federally run exchange website, but have picked up momentum considerably in the past few months.

State Sen. Kevin Lundberg, a Berthoud Republican who serves on the Legislative Health Benefit Exchange Implementation Review Committee, questioned the effectiveness and cost of the marketing campaign.

“I’m troubled whenever government has to sell itself and sell programs at taxpayers’ expenses,” said Lundberg, who opposed the Affordable Care Act. “I believe the government should have a different way to communicate than just spending money on media.”

While the exchange is a quasi-public nonprofit created by the legislature and not a state agency, the marketing money is currently coming from a federal grant funded with tax dollars.

The exchange needs a large marketing budget to get the word out and drive people to the website, said state Rep. Beth McCann, D-Denver, who chairs the exchange-implementation review committee. But she said she is concerned that maybe the word isn’t getting out in the right way.

“It’s something we want to take a look at,” she said. “I haven’t seen survey results. If you find the marketing strategy is not successful, you make adjustments, and that’s something we might want to discuss at our next meeting.”

Exchange spokeswoman Myung Oak Kim said the marketing clearly is effective because Colorado ranks as one of the states with the highest enrollment in private plans from state-based exchanges.

“Recognition tripled of people who knew who we are, and a vast majority knew what we did,” she said. “Our job was not just to build a new shopping website and customer-support network to help Coloradans purchase health insurance and access new tax credits. We also needed to educate the entire state in a short time period about the new marketplace, how Coloradans can benefit and why they should shop with us.”

Kim said the 20 percent drop in people who thought the exchange was for them was due to people who have insurance from their employer realizing they have no need for the exchange.

Opposition to the marketplace, she said, increased because of media coverage of the technical problems that plagued the federally run exchange – of which Colorado is not a part – during the program’s rollout last fall.

The 20 percent drop in those who believe the exchange will help small business cover their workers is a concern, Kevin Raines, a principal at Corona Insights, which conducted the exchange’s surveys, wrote in an e-mail.

“That leaves the one mystery – the huge decline in people who say that Connect for Health is designed to meet the needs of small business,” he wrote. “Again, 6 to 7 percentage points of that decline may just be the rise in general opposition, but why did it fall so much further? I really don’t have a good theory on that yet.”

Raines theorized that small business may have gotten lost in the discussion or people may have seen stories about cost increases for small business.

“I think this is worth monitoring more, because it’s important,” he wrote.

Despite the mixed results, Kim said the $8 million in marketing, public relations and outreach was effective. Exchange officials will decide whether and how to spend another $7 million after open enrollment ends.

During an interview last month, she could not say exactly what the exchange will buy with those tax dollars. “We’re still working on that plan,” she said.��

Kim later sent a statement saying that the exchange will focus on customer sign-up and retention. Marketing also will focus on getting people eligible for premium tax credits, young people, small business, areas with more uninsured people and minority groups.

This story was produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.

This <a target="_blank" href="/insurance/colorado-exchange/">article</a&gt; first appeared on <a target="_blank" href="">KFF Health News</a> and is republished here under a <a target="_blank" href=" Commons Attribution-NonCommercial-NoDerivatives 4.0 International License</a>.<img src="/wp-content/uploads/sites/8/2023/04/kffhealthnews-icon.png?w=150&quot; style="width:1em;height:1em;margin-left:10px;">