What's New?
COLORADO OPTION SMALL GROUP PLANS. Colorado Option plans are affordable for both small businesses and consumers and provide rich benefits at a lower cost than many other plan options. Visit this webpage to get started with a small group plan.
Frequently Asked Questions (FAQs) on Colorado Option Culturally Responsive Provider Network Reporting Requirements. Frequently Asked Questions for providers regarding the culturally responsive provider network reporting requirements are included in Colorado Insurance Regulation 4-2-80. See this FAQ document for more information.
Saving People Money
The Colorado Option is 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. Health insurance plans are required to lower premiums on Colorado Option plans by 15% by 2025. The Commissioner will enforce premium reductions through the Division's rate review and a new public hearing process. Click the button below to learn more about the public hearings.
Upcoming Meetings
Colorado Option Advisory Board Meeting
Wednesday, April 24, 3:30 PM - 5:30 PM
Questions?
Questions and comments about the Colorado Option Program can be sent to dora_ins_co_option@state.co.us or please review our Overview Presentation & FAQ below.
Improving access, affordability and equity
As part of the Colorado Option, the Division has designed a Standardized Plan which allows consumers and businesses to easily compare plans and choose the plan that is right for them. These plans cover all essential health benefits required by the Affordable Care Act (ACA), provides free ($0) primary care and mental health office visits, and is designed to reduce racial health disparities and improve health equity.
Click on the image to the left to learn more about these new plan options or read this report on our 2024 plans.
Colorado Option Standardized Plans are required to lower health insurance premiums for individuals, families, and small businesses by 15% by 2025. Due to the entrance of Standardized Plans in the market, the Division was able to submit a federal Section 1332 waiver. The waiver documents how the Division is able to control health care costs and support coverage by reducing health insurance premiums. Funds from the waiver will be used to support state-based subsidies for health insurance affordability and access designed by Colorado's Health Insurance Affordability Enterprise.
Amendment Application Materials
- Letter of Intent to Apply for Waiver Amendment and CMS Response
- Public Meeting Materials on Waiver Amendment Submission
- Public Comments received on Draft Application by Nov 22, 2021
- Final Application submitted Nov 30, 2021
- Letter of preliminary determination that Colorado application is complete (January 3, 2022)
- Letter of approval for Colorado's 1332 Waiver Amendment (June 23, 2022)
Annual 1332 Waiver Public Forum materials can be found here.
1332 Waiver 2023 Draft Annual Report can be found here (download to see full PDF).
To ensure the work of the Colorado Option is transparent and informed by a variety of stakeholders, HB21-1232 requires the Governor to appoint members of the Colorado Option Advisory Board. The Advisory Board will consist of up to 11 members with varied experience in health care.
- Membership (effective July 1, 2022)
- 2024 Meeting Schedule
- Meeting Materials (presentations, recordings, minutes)
Insurance Ombudsman / Consumer Advocate for Colorado Option Plans
- Contact via email - hcpf_insuranceombudsman@state.co.us
Standardized Plan Design
- Standardized Plan Regulation (4-2-81)
Enhanced Network Adequacy Requirements
- Culturally Responsive Provider Network Regulation (4-2-80)
- FAQs on Colorado Option Culturally Responsive Provider Network Reporting Requirements
Premium Rate Reduction Requirements
- Premium Rate Reduction Methodology Regulation (4-2-85)
- Purchasing Alliance Exemption Regulation (4-2-86)
Enforcement of Premium Rate Reduction Requirements
- Public Hearing Process Regulation (4-2-92)
- Cost Benefit Analysis for Regulation 4-2-92
- Hospital/Provider Reimbursement Rate Setting Regulation (4-2-91)
- Cost Benefit Analysis Regulation 4-2-91
- 2025 Hospital-Specific Reimbursement Floors
- Section 10-16-1310(3), C.R.S. report (Quality & Acuity Adjustment recommendations)
Hospital Workforce Trends Report (10-16-1310, C.R.S.)
Hospital Reimbursement Rate Methodology Report (Section 10-16-1310(3), C.R.S.)
- Standardized Health Benefit Plan Colorado Option, House Bill 21-1232 - signed into law June 16, 2021
- Standardized Plan stakeholder meeting announcement
- Standardized Plan stakeholder meeting materials
- Culturally Responsive Provider Network stakeholder meeting materials
Draft Proposal
- Draft Report for Colorado's State Coverage Option - released October 7, 2019
- Draft Report for Colorado's State Coverage Option - En Español
Stakeholder Engagement Meetings on Draft Proposal
- State Option Draft Report Stakeholder Presentation - English
- State Option Draft Report Stakeholder Presentation - En Español
- 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
Final Report
- Final Report for Colorado's Public Option (includes appendices I - IV) - delivered to the General Assembly November 15, 2019
- Appendix V - Public Comments
- Summary of Final Report
Information can also be referenced on Colorado's Department for Healthcare Policy and Financing: https://hcpf.colorado.gov/proposal-affordable-health-coverage-option