CO | The Colorado Division of Insurance today announced the adoption of two new insurance regulations and the amendment of four others. Click on the links below to read the official notices of adoption.
- Amended Regulation 4-2-39 Concerning Premium Rate Setting for Non-Grandfathered Individual, Small and Large Group Health Benefit Plans provides guidance for carriers in complying with Colorado’s health benefit plan rating laws.
- Amended Regulation 4-2-80 Concerning Network Adequacy Standards and Reporting Requirements for Colorado Option Standardized Health Benefit Plans explains the requirements carriers must meet to ensure that they offer a culturally responsive network of providers and outlines action plan requirements for entities that do not meet these requirements.
- Amended Regulation 4-2-82 Concerning Carrier Notices to Policyholders for Reasonable Modifications, Discontinuances, Market Exits, Drug Formulary Modifications and Carrier Renewal for Small Group Plans and Off-Exchange Plans provides carriers with the policyholder notice templates for a range of plan changes.
- New Regulation 4-2-93 Concerning Prescription Drug Benefit Formulary Modifications establishes the requirements for a health insurer offering a health benefit plan on the individual market that includes a prescription drug benefit to modify its prescription drug formulary during the current plan year.
- New Regulation 4-2-94 Concerning Health Insurer Reporting of Prescription Drug Rebates and Discounts establishes the reporting requirements for health insurers to demonstrate that all prescription drug rebates and discounts received are used to reduce costs for policyholders.
These new and amended regulations become effective on May 30, 2023.
Amended Regulation 4-2-43 Enrollment Periods Relating to Individual and Group Health Benefit Plans establishes rules governing enrollment periods for individual and group health benefit plans in accordance with state and federal law, including the Affordable Care Act (ACA). This regulation becomes effective on June 1, 2023.