Colorado Option

Versión en español de este sitio web

 

 

Starting in 2023, the Colorado Option will be available to all Coloradans who buy their health insurance on the individual market (i.e. not from an employer) and small employers with less than 100 employees. With appropriate federal approval, Colorado Option plans will lower health insurance premiums for individuals, families, and small businesses by 15% by 2025.


As part of the Colorado Option, the Division of Insurance (the Division) will create a standardized plan which will allow consumers and businesses to easily compare plans and choose the plan that is right for them. This plan will cover all essential health benefits required by the Affordable Care Act, provide many high value services without consumer cost sharing, and be designed to reduce racial health disparities and improve health equity.

Questions and comments about the Colorado Option Program can be sent to dora_ins_co_option@state.co.us

Colorado Option Frequently Asked Questions (English)

Colorado Option Timeline - Key Dates 2021-2023

Colorado's Section 1332 Innovation Waiver Amendment Request

Public Review & Comment Process

January 3, 2021 Letter from CMS: Preliminary determination that Colorado application is complete - This marks the beginning of 180-day full review of the application, and the 30-day Federal public notice and comment period (comment period will end on February 2, 2022).

  • Stakeholders may submit comments to CMS through stateinnovationwaivers@cms.hhs.gov from January 3, 2022 through February 2, 2022. Please include Colorado section 1332 waiver comments in the subject heading, and include your name, organization (if any), and email address with the comments.

On November 30, 2021 the Division submitted its Section 1332 Innovation Waiver Amendment to the federal government. The final waiver amendment application is linked below. The Division's responses to public comments can also be found in the final application below.

Final - Colorado Section 1332 Innovation Waiver Amendment - 11/30/21

The Division is seeking public comments and feedback on the Draft - Colorado Section 1332 Innovation Waiver Amendment - Revised 11/5/21

  • The current draft waiver amendment (revised on Nov 5, 2021) replaces previous versions of the wavier amendment that were posted on Nov 1, 2021 and Oct 15, 2021. The revised waiver amendment includes updated language regarding the provision of federal law the Division is proposing to waive. 
  • Public Comment Period: 10/15/21 - 11/22/21 (based on feedback, the public comment period has been extended from 11/15/21 to 11/22/21). Submit Comments to DORA_Ins_Co_Option@state.co.us (no later than 5 pm MT on 11/22/21)

Public Comments Received by 11/22/21

Public Meetings on 1332 Amendment Request and Process - The purpose of these meetings is for the Division to provide information on the federal Section 1332 waiver that the Division will request for the Colorado Option. At the meetings, the DOI will provide an overview of the Colorado Option, as well as review the process for submitting a 1332 waiver. Each meeting will cover the same information, so there is no need to attend both. 

Nov. 9, 2021, 5:00 - 6:30 PM - Meeting Slides / Presentation Recording

Nov. 10, 2021, 5:00- 6:30 PM - Meeting Slides

Please complete the following form to request accessibility services for either meeting, at the time or registration or no later than October 26, 2021:


Colorado's Letter of Intent to Apply for a Waiver Amendment and Response

1332 Waiver Amendment Stakeholder Materials (Google Drive Folder)

Stakeholder Engagement

Premium Rate Reduction Targets

Colorado Option Standardized Plans are required to lower health insurance premiums for individuals, families, and small businesses by 15% by 2025. 

Scheduled Stakeholder Meetings

The Division is hosting public, virtual meetings to discuss the draft methodology for the premium rate reduction requirements for the 2023 plan year:

All interested stakeholders are invited. These meetings will be an opportunity for the public to learn more about the potential methodology and ask questions.

Date Topic Materials Recording
Wednesday, December 15, 2021: 3:30 PM - 5:00 PM Review DRAFT 2023 Premium Rate Reduction Methodology

Presentation Slides

Colorado Option Rate Target Methodology - DRAFT

Meeting Recording
Thursday, January 13, 2022: 12:00 PM - 1:30 PM Review DRAFT 2023 Premium Rate Reduction Methodology

Presentation Slides

Draft Emergency Regulation 22-E-XX

(Comments due by 5pm on 1/20/22. Comments should be emailed to email DORA_Ins_RulesandRecords@state.co.us)

Meeting Recording

Standardized Plan

The Colorado Division of Insurance (DOI) invited individuals and organizations to participate in fifteen (15) stakeholder meetings to discuss the framework for the Colorado Option standardized plan. The Division continues to seek input from interested parties on how to structure the plan to improve health equity, reduce disparities, and incentivize high value services. During the public health emergency, these meetings were held virtually.

Individuals working in or representing communities that are diverse in regards to race, ethnicity, immigration status, age, ability, sexual orientation, gender identity, or geographic region were specifically invited to participate. Physicians, members of the healthcare industry, consumer representatives, and individuals who are or represent health care workers were also invited to participate. In addition, the Division sought participation from people from the many geographic regions within our state.

Emergency Regulation 21-E-16 Standardized Plan (adopted 12.2.21)

Draft Proposed Regulation 4-2-81 Standardized Plan (noticed for hearing 12.15.21)

The draft proposed new regulation, 4-2-81, has been noticed for virtual hearing on January 18, 2022. You can find registration details for the virtual hearing here. To view the changes from the Emergency Regulation to the Draft Proposed Permanent Regulation click here.

 

Meeting materials and recordings can be accessed by clicking and expanding the green bar below.

2021 Standardized Plan Stakeholder Meeting Materials and Recordings
Date Topic Materials Recording
Thursday, July 29th, 10:30 AM - 12:00 Noon Overview of the legislation and stakeholder engagement process Presentation Slides Meeting Recording
Thursday, August 12th, 11:30 AM - 1:00 PM Required benefits and introduction to cost-sharing and benefit design

Presentation Slides

Feedback Form  (PDF version)

Meeting Recording 
Thursday, August 26, 1:00 PM - 2:00 PM For Health Insurance Companies, Insurance Brokers & Employers Presentation Slides Meeting Recording
Tuesday, August 31, 11:00 AM - 12 Noon For Hospitals and Other Health Care Facilities Presentation Slides Meeting Recording
Thursday September 2, 10:00 AM - 11:00 AM For Disability Community members Presentation Slides Meeting Recording
Wednesday, September 8, 6:00 PM - 7:00 PM For Consumer Advocates and Communities Presentation Slides Meeting Recording
Thursday, September 9th, 11:30 AM - 1:00 PM Incentivizing high-value care: How can it reduce health disparities and improve health equity? 

Presentation Slides

Feedback Form (PDF Version)

Meeting Recording
Friday, September 10, 12:00 PM - 1:00 PM For Physicians and Other Health Care Providers Presentation Slides Meeting Recording
Monday, September 13, 6:00 PM - 7:00 PM For Rural Communities Presentation Slides Meeting Recording 
Friday, September 24th, 10:30 AM - 12:00 Noon Plan Design and Cost Sharing Part 1

Presentation Slides (and Wakely Sample Plan Designs)

Feedback Form (PDF Version)

Meeting Recording
Friday, October 8th, 12:00 PM - 1:30 PM Plan Design and Cost Sharing Part 2

Presentation Slides

DRAFT Preliminary Emergency Regulation 21-E-XX Concerning Colorado Standard Option Health Benefit Plan

Meeting Recording
Tuesday, October 26, 11 AM - 12 Noon For Physicians and Other Health Care Providers Presentation Slides Meeting Recording 
Wednesday, October 27, 6 PM - 7 PM For Consumer Advocates and Community Members Presentation Slides Meeting Recording
Thursday, October 28, 1 PM - 2 PM - For Health Insurance Companies, Insurance Brokers & Employers Presentation Slides Meeting Recording
Thursday, November 4th, 10:30 AM - 12:00 Noon Summary of work and overview of Colorado Option plan

Presentation Slides

DRAFT Proposed Emergency Regulation 21-E-XX Concerning Colorado Standard Option Health Benefit Plan - released 11.2.21

Meeting Recording

Culturally Responsive Provider Networks

The Division invited individuals and organizations to participate in three (3) stakeholder meetings to discuss the framework for the Colorado Option standardized plan culturally responsive provider network. The Division is seeking input from interested parties on how to design a provider network to improve health equity, reduce disparities, and be responsive to the community it services. During the public health emergency, these meetings will be held virtually. 

Individuals working in or representing communities that are diverse in regards to race, ethnicity, immigration status, age, ability, sexual orientation, gender identity, or geographic region are specifically invited to participate. Physicians, members of the healthcare industry, consumer representatives, and individuals who are or represent health care workers are also invited to participate. In addition, the Division seeks participation from people from the many geographic regions within our state.

Draft Proposed Regulation 4-2-80 Culturally Responsive Network (released 11.30.21)

The draft proposed new regulation, 4-2-80, has been noticed for virtual hearing on January 4, 2022. You can find registration details for the virtual hearing here.

 

Meeting materials and recordings can be accessed by clicking and expanding the green bar below.

2021 Culturally Responsive Networks Stakeholder Meeting Materials and Recordings
Date Topic Materials Recording
Tuesday, September 14, 2021 3:00 PM - 4:30 PM Overview of current network adequacy requirements and network requirements specific to the Colorado Option

Presentation Slides

NCQA Fact Sheet on Multicultural Health Care

Meeting Recording
Wednesday, October 13, 2021, 6:00 PM - 7 PM Summary of Colorado Option Network requirements and discussion

Presentation Slides

Meeting Recording
Wednesday, October 27, 2021, 11:00 AM - 12:00 PM Overview of the Colorado Option Standardized Plan Culturally Responsive Network draft regulation

Presentation Slides

DRAFT Proposed Regulation 4-2-XX Concerning Network Adequacy Standards and Reporting Requirements for Colorado Option Standardized Health Benefit Plans

Meeting Recording

1332 State Innovation Waiver Amendment Application

States can pursue innovative strategies to provide access to high-quality, affordable health insurance by changing or waiving parts of the Affordable Care Act (ACA). If a State can reduce the cost of health insurance for its residents, and by doing so, save the federal government money, a 1332 waiver allows a State to receive those federal savings in the form of “federal pass-through funding.” 

The Division's goals for this 1332 waiver amendment application is to:

  1. Control health care costs and support coverage by reducing health insurance premiums. 
  2. Utilize pass-through funding derived from the waiver to support state-based subsidies for health insurance affordability and access. 

Final - Colorado Section 1332 Innovation Waiver Amendment - 11/30/21

Meeting materials and recordings can be accessed below.

Date Topic Materials Recording
Tuesday, November 02, 2021 Tribal Consultation Presentation Slides This meeting was not recorded
Tuesday, November 09, 2021 Public Hearing on 1332 Amendment Request and Process Presentation Slides Presentation Recording
Wednesday, November 10, 2021 Public Hearing on 1332 Amendment Request and Process Presentation Slides The meeting recording is not available due to technical issues

 

Questions and comments about the Colorado Option Program can be sent to dora_ins_co_option@state.co.us

Previous Work Completed

Colorado Health Insurance Option Recommendation
Submitted Stakeholder Presentations
Written Comments from Stakeholders

These letters do not represent the opinions of the Department of Health Care Policy and Financing, the Division of Insurance or the State of Colorado. These are written comments submitted by stakeholders regarding the HB19-1004 Proposal for a State Health Care Coverage Option.

 

Final Proposal / Report
Draft Proposal / Report

Draft Report for Colorado's State Coverage Option - released October 7, 2019
Draft Report for Colorado's State Coverage Option - En Español
Oct. 8, 2019 State Option Stakeholder Presentation - English
Oct. 8, 2019 OPCIÓN DE COLORADO Presentación En Español

Stakeholder Engagement Meetings on Draft Proposal

  • November 7, 2019 - Edwards
  • October 23, 2019 - Grand Junction
  • October 22, 2019 - Hugo
  • October 12, 2019 - Durango
  • October 8, 2019 - Denver, Watch the webcast recorded presentation
  • October 8, 2019 - Pueblo
  • October 8, 2019 - Briefing for Eastern Plains Hospitals