ACA Benchmark Plan for Colorado
The benchmark plan establishes the minimum essential health benefits for ACA health plans in Colorado. The benchmark plan for 2023 and beyond can be found here ACA Benchmark Health Insurance Plan.
The Colorado Division of Insurance (DOI) is proposing to change the State's benchmark health insurance plan for the 2027 plan year to add coverage for abortion services. Under Colorado law, health insurance carriers are required to cover abortion services starting in Plan Year 2025; this proposed benchmark update does not affect the existing statutory requirement.
All changes to Colorado's benchmark plan will require approval by the Centers of Medicare and Medicaid services (CMS). At this time, the Division is inviting comments on the proposed changes that will be submitted to CMS for consideration.
The Division has posted all proposed changes to the benchmark plan and associated documents for public notice and comment (45 CFR § 156.111.c). To submit comments on the proposed changes to the benchmark plan, please email Tara Smith (tara.smith@state.co.us) and Leilani Russell (leilani.russell@state.co.us). Comments will be accepted until September 24, 2024.
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 benchmark health insurance plan, and 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 required approval by the Centers of Medicare and Medicaid services (CMS). DOI posted all final proposed changes to the benchmark plan and associated documents for public notice (45 CFR § 156.111.c). Final versions of the documents submitted to CMS regarding the proposed changes to the benchmark plan, are found below.
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. This benchmark plan was effective through December 31, 2022.