CO| Amended Colorado Regulation 4-2-81, effective June 30, 2026, requires all carriers offering individual and small group health benefit plans to provide standardized Colorado Option bronze, silver, and gold plans for 2027, with specific naming conventions, filing requirements, embedded deductibles/OOP maximums, and compliance with federal law, MHPAEA, and Colorado Title 10 provisions. It mandates coverage of essential health benefits as defined in Regulation 4-2-42, prohibits tiered networks within these plans, and prescribes detailed cost‑sharing designs in Appendix A, including $0 primary care, preventive services, prenatal/postnatal, and mental/behavioral health office visits across metal tiers, standardized five‑tier prescription drug copays, and no cost‑sharing for diabetes supplies such as continuous glucose monitors.
The Appendix sets actuarial values and key cost‑share parameters for each plan (Gold AV 78%, Silver AV variations at 70/73/87.1/94.5%, Silver off‑exchange at 70%, Bronze AV 63.5%), and requires carriers to maintain a public, plan‑specific web list of covered diabetic supplies; noncompliance may trigger civil penalties, cease‑and‑desist orders, or licensure actions by the Division of Insurance.