CO| Amended Colorado Regulation 4-2-85, effective June 30, 2026, sets out the detailed methodology Colorado carriers must use to demonstrate required premium reductions for Colorado Option standardized bronze, silver, and gold plans relative to 2021 premiums, after adjusting for medical inflation, and then to cap future annual increases at no more than medical inflation beginning with the 2026 benefit year.
It defines key terms (e.g., actuarial value, Baseline Plan, CSR load, induced demand factor, EHB, AV calculator) and establishes a county/metal/market-specific “2021 Baseline Plan Unadjusted Premium” as the starting point, then applies a sequence of standardized adjustment factors for changes in plan AV and federal AV calculators, CSR load (individual silver), induced demand, EHB benchmark changes, non‑EHB content, and medical inflation, as well as the statutory required rate reduction (5% in 2023, 10% in 2024, and 15% in 2025 and all subsequent years) to derive a Maximum Colorado Option Standardized Plan Premium for a 21‑year‑old non‑tobacco enrollee.
Carriers’ filed Colorado Option standardized plan premiums must be at or below this maximum to be compliant, and for 2026 and later benefit years, carriers must notify the Commissioner by March 1 (via a specified SERFF “Colorado Option Rate Reduction Notice” using the Division’s template) whether their Colorado Option plans will meet the required reductions, with the regulation also providing standard severability, incorporation‑by‑reference to federal AV and CSR rules, and enforcement language (including potential civil penalties, cease and desist orders, and license actions).