New Colorado Option Regulation Sets Detailed Playbook for Carrier Hearings, Provider Rates, and Consumer Voice

Share

CO| The Colorado Insurance Division has amended Regulation 4-2-92 establishing the procedures for noticing, conducting, and administering Colorado Option public hearings when carriers fail, or are alleged to have failed, to meet statutory premium rate reduction or network adequacy requirements for Colorado Option Standardized Plans. It applies to hearings occurring on or after January 1, 2026, to carriers offering individual and small group Colorado Option Standardized Plans on or after January 1, 2027, and to hospitals and health-care providers that may be identified as causes of a carrier’s noncompliance. The regulation defines key terms, requires detailed March 1 filings from carriers (including premium reduction notifications, identification of “Material Providers,” negotiated rate data, actuarial analyses, and network adequacy attestations), and outlines how complaints, cross-complaints, answers, disclosures, and limited discovery are handled. It also specifies who may be a party, how public comment is incorporated, how documents are served and posted, and how confidential information is claimed, protected, and used, including special handling for negotiated rate and premium data and access rules for the Insurance Ombudsperson.

Click here to see CO Amended Regulation 4-2-92

  • Bulletin
  • Colorado
  • Department of Insurance

Other information from Colorado: