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Colorado Issues Amended Regulation on Health Plan Modifications for Individual and Small Group Markets

CO| Colorado Division of Insurance Notice of Adoption of Amended Regulation 4-2-27 outlines procedures for reasonable modifications to individual and small group health benefit plans in Colorado, governed by the Division of Insurance. The regulation provides guidelines for carriers on submitting modifications to both grandfathered and non-grandfathered plans, ensuring compliance with federal and state requirements […]

Colorado Adopts New Regulation to Ensure Non-Discriminatory Prescription Drug Cost-Sharing and Tiering in ACA Health Plans

CO| The Amended Regulation 4-2-58 from the Colorado Division of Insurance, establishes new non-discriminatory cost-sharing and tiering requirements for prescription drugs in ACA-compliant individual and small employer health plans, effective May 30, 2025. The regulation aims to ensure fair access to prescription drugs, prevent discriminatory plan designs, and standardize copayment structures across plans. Key provisions: […]

Colorado Sets New Standards to Boost Primary Care Investment and Value-Based Health Payments

CO| The Colorado Division of Insurance’s Amended Regulation 4-2-72 establishes new standards for health insurance carriers to improve affordability by increasing investments in primary care and shifting toward value-based alternative payment models (APMs). The regulation requires carriers to incrementally raise the proportion of total medical expenditures allocated to primary care by one percentage point annually […]

Colorado Updates Health Insurance Notification Rules to Enhance Consumer Protections

CO| The Amended Regulation 4-2-82, from the Colorado Division of Insurance, establishes standardized requirements for health insurance carriers to notify policyholders about plan modifications, discontinuations, market exits, and prescription drug formulary changes for individual, small group, and off-exchange health plans. The regulation provides specific notice templates and timelines to ensure policyholders are informed of their […]

Colorado Mandates Prescription Drug Contract Transparency for Health Plans and PBMs

CO| Colorado’s new Regulation 4-2-104, adopted by the Colorado Division of Insurances, which requires health insurance carriers and pharmacy benefit managers (PBMs) to disclose prescription drug contract terms to policyholders for group health benefit plans starting in 2025. The regulation establishes clear disclosure requirements, compliance attestations, and possible exemptions for certain carriers, with enforcement provisions […]

Rhode Island Mandates Annual Cybersecurity Compliance Filings for Insurers

RI| The Rhode Island Insurance Bulletin 2025-1 outlines the implementation of the new Insurance Data Security Statute, effective January 1, 2025, which aligns with the NAIC Insurance Data Security Model and applies to both domestic and foreign insurers operating in Rhode Island. Domestic insurers must file an annual certification of compliance by April 15, while […]

ELANY Adds Three Foreign Insurers to Eligible E&S List

NY| The Excess Lines Association of New York (ELANY) updates their Eligible Excess & Surplus Lines Insurers List. New Additions to ELANY’s List of Eligible E&S Insurers: Click here to see ELANY Bulletin No. 2025-10