Notice of Adoption New Bulletin B-4.112 - Policy Directives for Coverage of HIV Prevention Ancillary Services

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The Division would like to provide notice that the Commissioner has adopted the following new bulletin:

Colorado law, 10-16-104(18) C.R.S., requires insurers, excluding grandfathered health plans, to cover items or services that have a rating of “A” or “B” in the current recommendations of the United States Preventive Services Task Force (“USPSTF”) without cost-sharing. The USPSTF issued an “A”-rated recommendation that clinicians offer pre-exposure prophylaxis (PrEP) with effective antiretroviral therapy to persons who are at high risk of human immunodeficiency virus (HIV) acquisition.

The Division of Insurance (Division) adopted Regulation 4-2-73 concerning coverage of PrEP consistent with the USPSTF recommendations beginning January 1, 2021. The purpose of this bulletin is to provide guidance to insurers regarding health insurance coverage for tests and services related to PrEP adherence, including baseline and follow-up testing and monitoring.

This bulletin is intended to provide guidance to all insurers marketing and issuing health benefit plans, including student health plans, in the State of Colorado on or after January 1, 2021. This bulletin does not apply to grandfathered plans.

This bulletin, and other Division bulletins, can be found on the Division's Bulletins page.

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