Colorado Child Health Insurance Rates and Applications for a Private Policy

How much something costs plays a big part in how people choose medical plans. For this reason, it is helpful to know what factors affect premiums. Following are the variables that are considered when determining Colorado child health insurance rates:

  • The age of the child as of January 1st of the current year. If the child is applying on a family plan, the rates will be based on the age of the parent or legal guardian.
  • The child’s zip code.
  • Medical history. The premium may be rated-up, depending on a child’s medical history. If the child is enrolling on a family plan, any applicable rate-up will be either 20% or 40% and it will be applied on the premium for the whole family. If the application is for the child only, the rate-up will be either 50% or 100% of the child’s rate.
  • If the child had prior health insurance that was cancelled, and there has been a lapse of more than 63 days, then, a 50% surcharge will be applied on a child-only application. This surcharge does not apply when a child is enrolled on a family plan.
children with stethoscopes

Enrolling Children and Qualifying Events

In Colorado, a child may enroll for Kaiser Permanente insurance under a family plan or on an individual basis either during an open enrollment period or on a qualifying event status, if applicable. The individual child health insurance rates in Colorado are the same whether the child applies at open enrollment or on a qualifying event basis. The state of Colorado recognizes certain life events as “qualifying events”. When a child has a qualifying event, it allows them to enroll for health insurance without waiting for an open enrollment period. To see the list of qualifying events and supporting documentation required, click Qualifying Events. Note: Proof is required when a child is applying for single subscriber insurance outside of an open enrollment.

Submitting a Colorado Child Health Insurance Application

Family applications can be submitted online. You can choose an effective date of either the 1st or the 15th of the month. A child may apply year-round under a family application with at least one parent or a legal guardian. The child cannot be denied due to pre-existing conditions. The adults, however, can be denied for medical reasons. If the adults’ application is not approved, the child’s application will be cancelled.

Child-only enrollments can be effective the 1st of the month only. Complete one application per child. If you are applying outside of the open enrollment period, then, proof of a qualifying event is required. Without the documentation, the application will be returned unprocessed. If you are applying for an individual child policy, the Colorado child health insurance rates will be the same whether you apply during open enrollment or on a qualifying event basis. A child-only application cannot be denied health coverage for health issues, but it can be denied if the child has other creditable coverage, such as Medicare, Medicaid, or Children’s Basic Health Plan through the State.

Existing Members

When a child is a current Kaiser member on a family plan, but the parent(s) or legal guardian comes off the plan, the child could potentially lose their policy. It depends on when the family plan was initially issued:

  • If the family insurance was first effective prior to March 23, 2010, the date Health Reform became law, then, the policy is considered “grandfathered” and the policy can remain in force with the child or children only.
  • If the family insurance was issued on or after March 23, 2010 and the parents or guardian were deleted, then, the policy would be cancelled. Any children can be insured on a policy individually, on a qualifying events basis. The Colorado child insurance rates are subject to change.