The Division is seeking comments on the following draft proposed emergency regulations and draft proposed amended regulation:
The purpose of this emergency regulation is to establish rules for the required Colorado Option standardized bronze, silver, and gold health benefit plans to be offered by all carriers offering individual and small group health benefits plans issued or renewed on or after January 1, 2025.
The Division of Insurance finds, pursuant to § 24-4-103(6)(a), C.R.S, that immediate adoption of this emergency regulation is imperatively necessary to comply with state and federal law, including federal regulation, and for the preservation of public health, safety, or welfare and compliance with the requirements of § 24-4-103, C.R.S., would be contrary to the public interests. On November 15, 2023, the Department of Health and Human Services (“HHS”) released the Draft 2025 Actuarial Value Calculator Methodology, pursuant to 45 C.F.R. 156.135(g). Carriers are required to use the 2025 Actuarial Value Calculator Methodology for benefit year 2025, pursuant to 45 C.F.R. 156.135(a). Carriers must also notify the Division of Insurance by March 1, 2024, whether they have achieved the premium rate reduction requirements for their 2025 standardized plans, pursuant to § 10-16-1306(2)(b), C.R.S. This Emergency Regulation implements the Draft 2025 Actuarial Value Calculator Methodology developed by HHS in order for carriers to develop and adjust their Standardized plans in accordance with the requirements in Appendix A to ensure compliance with state law, including the March 1, 2024, notification deadline under § 10-16-1306(2)(b), C.R.S., and federal law.
The purpose of this emergency regulation is to establish rules for the required premium reduction methodology for the Colorado Option standardized bronze, silver and gold health benefits plans to be offered by all carriers offering individual and small group health benefits plans issued or renewed on or after January 1, 2025.
The Division of Insurance finds, pursuant to § 24-4-103(6)(a), C.R.S., that immediate adoption of this emergency regulation is imperatively necessary to comply with state and federal law, including federal regulation, and for the preservation of public health, safety, or welfare and compliance with the requirements of § 24-4-103, C.R.S., would be contrary to the public interests. On November 15, 2023, the Department of Health and Human Services (“HHS”) released the Draft 2025 Actuarial Value Calculator Methodology, pursuant to 45 C.F.R. § 156.135. Carriers are required to use the 2025 Actuarial Value Calculator Methodology for benefit year 2025, pursuant to 45 C.F.R.§ 156.135. Carriers must also notify the Division of Insurance by March 1, 2024, whether they have achieved the premium rate reduction requirements for their 2025 Standardized plans, pursuant to § 10-16-1306(2)(b), C.R.S. This emergency regulation implements the Draft 2025 Actuarial Value Calculator Methodology developed by HHS, which will allow carriers to develop and adjust their Standardized plans. This will help carriers ensure compliance with state law, including the March 1, 2024, notification deadline under § 10-16-1306(2)(b), C.R.S., and federal law.
The purpose of this regulation is to provide the necessary guidance to carriers on network adequacy filing procedures for short-term limited duration health insurance policies, non-ACA medical plans, dental plans, vision plans, pharmacy plans, short-term limited duration health insurance policies, and other managed care health coverage plans.
This regulation is being amended to revise network adequacy standards and reporting for non-Affordable Care Act (ACA) managed care plans. This includes revisions made by the Centers for Medicare and Medicaid (CMS)/Center for Consumer Information and Insurance Oversight (CCIIO), separating medical and short-term limited duration (STLD) network adequacy requirements from access to services, waiting time, and continuity of care standards and requirements for dental, vision, pharmacy and other non-ACA networks.
The Division is requesting comments be submitted no later than 5 PM, February 2, 2024, to DORA_INS_RulesandRecords@state.co.us.
These draft proposed regulations, as well as other draft regulations currently released for informal public comment, can be found on the Division's DRAFT Regulations and Bulletins for Informal Public Comment website.