The Division would like to provide notice that the Commissioner has adopted the following regulations and repeals:
The purpose of this regulation is to set forth guidelines for carrier compliance with the provisions of §§ 10-3-1104(1)(h), 10-16-409(1)(a), and 10-16-113, C.R.S., in situations involving utilization review and certain denials of benefits for treatment, as well as rescission, cancellation, or denial of coverage based on an eligibility determination, as described herein. Among other things, § 10-3-1104(1)(h), C.R.S., requires carriers to adopt and implement reasonable standards for the prompt investigation of claims arising from health coverage plans; promptly provide a reasonable explanation of the basis in the health coverage plan in relation to the facts or applicable law for denial of a claim or for the offer of a compromise settlement; and refrain from denying a claim without conducting a reasonable investigation based upon all available information.
The purpose of this regulation is to establish the requirements, process, and form to be utilized by carriers, contracted pharmacy benefit management firms, and private utilization organizations for the prior authorization process for prescription drug benefits.
The purpose of this regulation is to establish the requirements, processes, and forms to be utilized by carriers to ensure compliance with the required disclosure of prior authorization requests and exemptions pursuant to § 10-16-112.5 (2)(c)(I) and (2)(c)(IV), C.R.S. and prior authorization reporting applicable to the prescription drug formulary for each health benefit plan pursuant to § 10-16-124.5(3.5)(a), C.R.S. The regulation also requires carriers offering health benefit plans to attest to the Commissioner of Insurance compliance with these annual reporting requirements.
The purpose of this regulation is to establish rules for the required bronze, silver, and gold Standardized plans to be offered by all carriers offering individual and small group health benefits plans issued or renewed on or after January 1, 2026.
The purpose of this regulation is to provide standards for including payments to carriers pursuant to C.R.S. § 10-16-1205(1)(b)(III) in rate filings for health benefit plans regulated by the Colorado Division of Insurance and guidelines for the Colorado Option Silver Enhanced Benefit Plan.
These regulations will be effective on January 1, 2026.
This regulation was promulgated to establish a special enrollment period in accordance with federal changes to Medicare. This regulation is being repealed as it is no longer necessary.
This regulation was promulgated in response to Section 10-3-1119, C.R.S. This section was repealed effective May 31, 2024, making this regulation no longer applicable.
- Repeal of Regulation 5-2-3 Concerning Requests for Commercial or Personal Automobile Policy Information from a Complainant or Complainant’s Attorney
- Repeal of Bulletin B-1.33 Process for a Claimant or a Claimant’s Attorney to Request Commercial or Personal Automobile Policy Information from an Insurer
- Repeal of Bulletin B-1.34 Guidance for Insurers Providing Automobile Liability Information Pursuant to § 10-3-1117,C.R.S.
These bulletins and regulation are being repealed as they are no longer necessary. They were issued as industry guidance at the passage of § 10-3-1117, C.R.S., and such guidance is no longer needed. The repealed bulletins are effective November 10, 2025.
These repeals will be effective on December 30, 2025.
Regulations that have been adopted, but are not yet effective can be found on the Division's website.