Peak Health Alliance offers new plans for small businesses, works to expand into more counties | SummitDaily.com
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Peak Health Alliance offers new plans for small businesses, works to expand into more counties

Peak Health Alliance CEO Tamara Pogue speaks Sept. 9, 2019, at the Keystone Lodge in Keystone about a reduction in health insurance premiums in Summit County.
Photo by Liz Copan / Summit Daily archive

DILLON — As the reinsurance enrollment period looms, Summit County’s own Peak Health Alliance is getting ready for an increase in demand.

The Colorado Department of Insurance announced 2021 premium rates for its reinsurance program Thursday, Oct. 8. Open enrollment for the individual market will be from Nov. 1 to Jan. 15. The program aims to bring down insurance costs by reimbursing insurers for the highest-cost claims. 

In 2021, the program is expected to save consumers 20.8% compared to what they would be paying without reinsurance, according to a news release. For people in Summit County and the rest of the Western Slope, those savings are projected at nearly 38%. 

People who purchase insurance on the individual market, rather than using what is provided through an employer, will see premiums decrease an average of 1.4% compared to 2020, according to the release. 

People who use Peak Health Alliance, an insurance purchasing collaborative based in Summit County, are expected to save even more — on average 8% more than what they saved last year. That’s because Peak Health is able to negotiate between carriers and providers to get the best rate. 

“Health care is so complex that you don’t see decreases in premiums unless a lot of forces are working together,” Peak Health Executive Director Tamara Pogue said. 

Peak Health acts as a middle man between consumers, providers and insurance carriers. For 2021, it has partnered with Bright Health Plan as its carrier and works with providers like Centura Health, UC Health and other individual practices.

The program works because Peak Health is able to negotiate with providers on behalf of a larger market share than individual carriers, which can advocate only for themselves. 

“We’re trying to find ways to encourage people to come back and use their local health care,” she said. “It increases utilization of that hospital … which means they do more volume instead of having higher prices.”

Pogue said the nonprofit has seen a huge increase in interest and demand for its services, especially from small businesses. For 2021, the nonprofit has added Individual Coverage Health Reimbursement Arrangement plans to its offerings. 

The ICHRA plan allows employers to set up a health reimbursement account for each employee. The employer puts their contribution to the insurance premium into the account, which then allows employees to go and buy whichever insurance they want on the individual market. 

The rates offered through the plan are about 15% to 20% less than a typical group plan, Pogue said. 

“This ICHRA approach ends up saving businesses substantial amounts of money,” she said. 

The plan is especially helpful to businesses that have been hit hard during the pandemic. 

“Small businesses and restaurant owners have been really trying to figure out how they’re going to make it through the rest of however long we’ve got to deal with COVID in this county,” Peak Health spokesperson David Rossi said.

Rossi said the plan allows for businesses to use insurance premiums to their advantage when recruiting employees. It also provides a cost-control method for business owners. 

“For a lot of small businesses, after payroll, health care is the next largest expense,” Pogue said. “A 20% reduction on your health care, particularly right now, goes a long way.”

Businesses that are interested in the plan should pick one of Peak Health’s preferred brokers, which can be found at PeakHealthAlliance.org. The broker will help the business find the right platform for them. 

Going forward, the nonprofit — which is currently in Summit, Grand, Lake, La Plata, Montezuma, San Juan and Dolores counties — has plans to expand into even more areas of the state. It also is working to come up with plans for pharmaceutical care, Pogue said. 

“We’re definitely working pretty hard on our pharmaceutical strategy for 2023 because that’s about 40% of the health care dollar,” she said. “If we can figure out savings in that space, it will create another premium decrease.”


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