Changes to Colorado's benchmark plan for the 2023 plan year
On 10/12/21, CMS approved Colorado's benchmark plan to start in the 2023 plan year.
Oct. 12, 2021 CMS Letter Approving Colorado's EHB-Benchmark Plan
News Release - CMS Approves New Colorado Benchmark Plan
Mental Wellness Examination Coverage Letter to Department of Health and Human Services
Alternatives to Opioids Coverage Letter to Department of Health and Human Services
Public Notice: On 5/7/21 DOI submitted all required materials to CMS to update Colorado's benchmark plan for the 2023 plan year.
The Colorado Division of Insurance (DOI) worked with stakeholders and the actuarial consulting firm Wakely from January - April of 2021 to evaluate the State's current benchmark health insurance plan, and has developed a set of proposed changes to that plan for the 2023 plan year. The benchmark plan is the plan used to set minimum standards for essential health benefits (EHBs) within Colorado for individual and small group plans.
All changes to Colorado's benchmark plan will require approval by the Centers of Medicare and Medicaid services (CMS), with a final determination expected by the Summer of 2021. DOI has posted all final proposed changes to the benchmark plan and associated documents for public notice (45 CFR § 156.111.c). Final versions of the proposed changes to the benchmark plan can be found here:
Benchmark plan changes - submission documents
DOI thanks everyone who participated in the stakeholder meetings and/or submitted comments throughout this process. At this time the public comment period is closed. The Division submitted the 2023 benchmark plan to CMS on Friday May 7, 2021.
DOI Workgroup - State Benchmark Health Insurance Plan for 2023
Information on the workgroup, including meeting materials and background information, can be found by clicking the following links:
Workgroup to Review State Benchmark Health Insurance Plan 2021 Workgroup materials
Current ACA Benchmark Plan for Colorado
ACA Benchmark Health Insurance Plan - Includes Required Benefits
The benchmark plan establishes the minimum essential health benefits for ACA health plans in Colorado. On June 30, 2015, the Division of Insurance (DOI) and the Governor's Office selected the State of Colorado Kaiser HMO Plan as the benchmark health insurance plan for health plans for 2017 and beyond. This benchmark plan is effective through December 31, 2022.