Reinsurance Program

Reinsurance works by paying a portion of high-cost claims, allowing insurance companies to lower the premiums for individual health insurance plans. Consumers who purchase individual health insurance plans receive these premium reductions automatically - they do not need to sign up for the reinsurance program to get its benefits. As the reinsurance program brings health insurance premiums down, the amount of money the federal government spends on Affordable Care Act (ACA) tax credits also goes down. But rather than letting the federal government pocket the money, the federal government passes that money through to the state to fund the reinsurance program and maintain lower premiums and market stability.

Colorado's reinsurance program was extended through 2026 by SB 20-215 and a federal 1332 waiver extension from the Centers for Medicare and Medicaid Services (CMS). See "CMS 1332 Waiver Extension" section below for more information. 

Colorado Reinsurance Program 

Colorado Publishes Payment Parameters for the 2023 plan year: In accordance with the requirements of HB19-1168, the Commissioner of Insurance is publishing the payment parameters for the reinsurance program for the 2023 benefit year.  

  Payment Parameters for the 2023 plan year

 

Draft 2021 Annual 1332 Waiver Innovation Report: In accordance with the Specific Terms and Conditions of Colorado's Section 1332 Innovation Waiver the Division of Insurance is posting the draft 2021 annual progress report. The Division will post the final report to this webpage. If there are questions about the report please send those to the Reinsurance Director, Laura Mortimer (Laura.Mortimer@state.co.us)  

Draft Section 1332 Waiver Reinsurance 2021 Annal Report

Reinsurance SMART Act Report Delivered to Colorado Legislature - Oct. 28, 2020

HB19-1168, The State Innovation Waiver Reinsurance Program was passed by the Colorado Legislature in 2019 and signed into law by Governor Polis on May 17, 2019. In addition to establishing a two-year reinsurance program for 2020 and 2021, the law requires the Division to submit an application to the Federal Government for a 1332 State Innovation Waiver for a reinsurance program.

HB19-1168 and 1332 State Innovation Waiver Application

Draft Reinsurance Program Timeline

  • October 1, 2019: Permanent regulation containing the payment parameters for the 2020 plan year will become effective.
  • Late November 2019: The Division expects to issue draft regulations for reinsurance implementation
  • Early December 2019: Stakeholder meetings for draft regulations 
  • Late December 2019: Regulations finalized 
  • January 1, 2020: Division submits payment schedule to CMS
  • January 2020: First provider payments collected (monthly thereafter)
  • February 28th, 2020: Division submits first quarterly report 
  • March 15, 2020: Payment parameters for the 2021 plan year will be established by the Commissioner via rule.
  • April 2020: The federal pass-through money is provided to the Division

HB19-1168, The State Innovation Waiver Reinsurance Program was passed by the Colorado Legislature in 2019 and signed into law by Governor Polis on May 17, 2019. In addition to establishing a two-year reinsurance program for 2020 and 2021, the law requires the Division to submit an application to the Federal Government for a 1332 State Innovation Waiver for a reinsurance program.

HHS Approval Letter for Colorado's 1332 Waiver for Reinsurance (includes specific terms and conditions) - Issued July 31, 2019

Colorado's 1332 State Innovation Waiver Application for a Reinsurance Program (includes final actuarial analysis) - submitted on May 20, 2019 to the Centers for Medicare & Medicaid Services (CMS)

Addendum to Colorado 1332 State Innovation Waiver Application: Responding to Federal Comments - July 31, 2019

June 5, 2019 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 July 5, 2019).

Public Meetings and Preliminary Actuarial Analysis:

SB17-300 - High-Risk Health Care Coverage Program

In 2017, the Colorado Legislature passed SB17-300, which directed the Division of Insurance to "explore the feasibility of maintaining healthcare coverage for high-risk individuals and reducing premiums through a reinsurance program or other high-risk programs." The information below contains the actuarial studies and reports that were the outcome of that bill, as well as information and materials from the numerous stakeholder meetings that were convened on this topic throughout 2017.

Actuarial Studies / Reports:

SB17-300 Stakeholder Meetings and Materials