Navigating PY26 changes ahead in Colorado

Plan footprint updates for PY 2026

UnitedHealthcare remains committed to offering solutions and competitive Affordable Care Act (ACA) products throughout Colorado, but changes in the regulatory review and rate approval process are needed before they can consider moving forward with their planned participation across Rating Area 3 counties.

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Emerging experience and updated market morbidity estimates indicate continued morbidity deterioration that exceeds the assumptions underlying  currently filed rates. For plan year 2026, a year characterized by unprecedented regulatory changes in the individual ACA market, the current maximum allowable risk and contingency margin does not adequately account for the increased uncertainty of emerging market risk.

If the Colorado Division of Insurance (DOI) decides to permit rate adjustments to account for the known deterioration in morbidity, that would allow UnitedHealthcare to cover anticipated risk and remain in Rating Area 3.

However, if changes are not allowed, UnitedHealthcare Individual & Family Plans (IFP) will have to follow through with the challenging decision to exit Denver market Rating Area 3 for plan year 2026. This rating area includes the following counties:

• Adams
• Arapahoec
• Broomfield
• Denver
• Douglas
• Elbert
• Jefferson

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UnitedHealthcare remains hopeful that they will be able to work with the Colorado Insurance Commissioner and the DOI to prevent members from losing coverage in plan year 2026.