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August 26, 2025 8 mins
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Episode Transcript

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Speaker 1 (00:00):
All right, I'm joined in studio by Shane Thomas, who
is one of my morning show partners who is on seasonally.

Speaker 2 (00:06):
Typically.

Speaker 1 (00:07):
He is the founder the proprietor of Integrity Health Advisors,
where I recommend that folks go if you've got questions
about individual and family health insurance plans, also Medicare. We
will talk about Medicare another day as we get closer
to the Medicare.

Speaker 2 (00:24):
Sign up season.

Speaker 1 (00:25):
But there was some news here in Colorado about individual
and family plans, some potentially very big news, some big
changes that Shane brought to my attention, so I asked
him to come in to explain what's going on.

Speaker 2 (00:38):
So, welcome back to the studio. It's good to see you.
Always a pleasure to be here. Thanks for having me.
So what's this news.

Speaker 3 (00:44):
So when we're talking about individual family plans, we're talking
about self insurance. Right, individuals, they just need healthcare. They
don't have a three employer things like that. And so
whether you're new to that market or people that are
existing in that market, the news we've is from two
very large carriers. So when we say Rocky Mountain Health Plans,

(01:04):
they are part of United Healthcare. So either one and
the other one is Anthem. So they go buy Elevants
Health now, so just for namesake, so people know who
they are go by what now Elevhants Health. Okay, so
elevating your health all different carriers, et cetera about marketing.
But anyway, as far as we know locally, Rocky Mountain
health plan or which is United or Anthem. And so

(01:28):
the big announcement last week was first from United Healthcare
Rocky Mountain is that they were not going to renew
their current plan for January one of twenty twenty six
in seven counties in Denver metro. So we're sitting here
in Arapaho, so all these neighboring counties of you know, Denver, Douglas,
things like that, right.

Speaker 1 (01:48):
Yeah, And I'm just a quick thing here. I'm looking
at a Colorado Sun article about this. It says the
decision would mean that roughly ninety six thousand people would
have to shop for new health coverage from a different
and ensure next year. That's nearly a third of the
estimated three hundred thousand people who buy health coverage on
their own in Colorado.

Speaker 2 (02:06):
That's a big number, that is correct.

Speaker 3 (02:09):
So when you combine the exit of United and Anthem.

Speaker 2 (02:14):
That's how you get to that number.

Speaker 3 (02:15):
So the majority of those are sitting with Anthem about
seventy thousand, because they're in more counties, so they're exiting
a lot more counties. So when we're talking about United,
which is just Denver Metro Proper, and then you got
Anthem in Denver Metro Proper, but then you got them
in South North things like that, so it is affecting
more Anthem members. The biggest thing to know for these
members currently that are getting announcements or that are worried

(02:39):
is that they have continuation of their coverage to the
end of the year. So please don't freak out lose
that you're going to lose coverage tomorrow.

Speaker 2 (02:46):
Things that are scheduled, things like that. Right, So, what we're.

Speaker 3 (02:48):
Really trying to get ahead of is that this is
happening today, but there's always things in the works. Right
is now there's so many people that are going to
be maybe uninsured and have to reevalue. Like you're saying,
is that United is going back to the DOI and saying, hey,
we wanted to offer plans, you didn't approve them because

(03:09):
of all these things that are affecting the bottom line
of expenses. Right, we have to be offering these rates
that are higher than you want us to put it in.
But now now you have all these members, what are
you going to do to help the Insurance of Colorado?

Speaker 1 (03:23):
So is this as simple as insurance company says to
the regulator who approves or disapproves, we can keep offering
this plan, but we need to raise the rate by
twenty nine percent otherwise we're going to be losing money,
and we're simply not going to operate while we're losing money.
And then the regulator says, we'll let you do twenty
four percent, and then the plan says, no, we gave

(03:45):
you our bottom line already.

Speaker 2 (03:47):
We're leaving now. Correct.

Speaker 3 (03:48):
And I know you made those numbers up, but that's
exactly it. Right, Is United Anthem anybody that does the
answer all their numbers right with their actuaries and say, okay,
we need to be here in order to make this work.
And the DOI says, well, that's higher than the market,
or it's higher than we want you guys to inflate
your rates. And because of all the tax subsidies that

(04:09):
we know are going away, they're having to reformulate that,
and especially because the morbidity rates were much higher than
they were anticipated, so meaning their expenses, right, they're reevaluating
these numbers, and that's why that's happening. But the gray
area right now is if they go back and they're saying, Okay,
we do allow higher rates or whatever, there may be

(04:31):
some changes. But if there's no changes as of right now,
it goes back to what you said, all these current
members are going to be uninsured and they really do
need to call us at Integrity Health Advisors and say, Okay,
how do we find a new plan for us for
January one.

Speaker 1 (04:47):
We're talking with Shane Thomas from Integrity Health Advisors Integrity
Health Advisors dot com. We have just a couple of
minutes left. So Colorado liked every state has very populous
parts of the state and much less populous parts of
the state, and the insurance situations are rather different, right,
Like the insurance market around Denver might be quite different

(05:07):
from Grand Junction, which might be quite different from Alamosa. Right,
So these counties that we're talking about now, are they
mostly around Denver, are the western slope?

Speaker 2 (05:16):
Is it across the state. So I'll give you a
two part question.

Speaker 1 (05:19):
You can tackle that, and it'll probably be the last
thing we have time for today. In these areas where
the where the health insurance plans are going away.

Speaker 2 (05:30):
Is there still a competitive market?

Speaker 1 (05:31):
Is there's still going to be some decent products available
that you'll be able to offer it, because I do
think that some of this is going to affect some
rural counties in the Western Slope and not just Denver.

Speaker 3 (05:45):
Correct, You're absolutely right, majority of those are going to
be in the Denver metro. Right, Anthem is the one
that's going to be in more of your rural counties,
and so we do have a list of those counties.
If you guys want, we can obviously provide that. But
I would say that as options go, right, are there
other carriers in the market that if United in an

(06:06):
Anthem do actually exit?

Speaker 2 (06:08):
Are there options? Yes?

Speaker 3 (06:10):
So as a brokerage house, we contract with Select Health
and signa Kaiser, etc.

Speaker 2 (06:15):
So there'll be other options.

Speaker 3 (06:18):
And so one of the big things that the consumer
needs to be aware of is if I'm losing my plan,
I have to go to another carrier.

Speaker 2 (06:26):
It's a great time to say, Okay.

Speaker 3 (06:28):
I really need these physicians in these medications, so each
carrier is going to be able to cover me. So
there's not a simple switch as like hey, just go
take something else. Because as you and I know, we
were just talking about medical before we got on the call,
it's really important to have a hospital system or the
physician that you want at the time of need. And

(06:50):
that's insurance, right, you need it when you know you
plan for the future.

Speaker 1 (06:54):
That's a great point. It's not just an immediately generic,
substitutable product. If you're already in medical care, you're already
in treatment. You've got a doctor who knows you and
has been working with you for years and is really specialized,
and it would be really bad if that doctor weren't
in network with you anymore. If you're in one of
these plans, what you want to do is sit down
with Shane or a member of his team and see

(07:16):
which of the other options not just exist as a
potential option, but actually include that doctor. That's going to
take some work so you can get started. At Integrity
Health Advisors dot com. Sit down with Shane and his team.
By the way, they're not going to charge you anything, right,
They'll just sit down with you and try to help
you sort it out. You want to add anything in
the last few seconds.

Speaker 3 (07:34):
Yeah, The thing that we want to talk about is
we're just trying to get some education out there, right,
and so we're happy to talk to you the enrollment period, right,
and the biggest key is you have your plan till the.

Speaker 2 (07:44):
End of the year.

Speaker 3 (07:45):
But November one is our magic date, right when all
the plans actually do get stamped and released, and we'll
be able to find options for you based on what
we know as fact out there in the marketplace, and
we do make a change for January one would be
the transition date, but November one to December fifteenth, So.

Speaker 1 (08:03):
Right now, what you might tell them would be your
sort of best educated guests. But it's possible that these
plans can change either prices, well I don't know about prices,
but who's in network any of the.

Speaker 2 (08:17):
Prices even we don't even know all right, Integrity.

Speaker 1 (08:21):
Health Advisors dot Com and folks, especially if you're one
of the one hundred thousand ish Colorado's in the Anthem
or Rocky Mountain health plans in the individual and family
plan market, get on this right away.

Speaker 2 (08:32):
Get in touch with Shane and his team. Integrity health
advisors dot com. Thanks for being here, Shane, I appreciate it.
Thank you.

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