Reinsurance Program

Seeking Focus Group Participants to Discuss Health Insurance - Experiences, Preferences and Concerns

Focus Group Details

The Colorado Health Institute, on behalf of the Division of Insurance, wants to hear from Coloradans across the state who have purchased health insurance through Connect for Health Colorado and are eligible for financial assistance to purchase coverage. Interested participants must register by 11/30. Discussions will be via Zoom, and participants will receive a $25 gift card as a thank you for their time. Click on the button above for additional details.

Reinsurance works by paying a portion of high-cost claims, allowing insurance companies to lower the premiums for individual health insurance plans. 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 Reinsurance Program 

Monthly Public Meetings - The Colorado Division of Insurance will host monthly public meetings to provide updates on the Colorado Reinsurance Program, established under HB 19-1168. All meetings will be virtual until further notice, are open to the public, and include dedicated time for public comments. Meetings will cover program updates unless other Reinsurance topic areas are specified. To register for an upcoming Reinsurance stakeholder meeting, click on the link below and follow the registration instructions provided. Please regularly check the Division's Reinsurance Program website for meeting updates.

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

Presentation from 6/30/20 Public Forum on Colorado Reinsurance Program

Reinsurance Payment Parameters for 2021 Benefit Year - Revised June 2, 2020

B-4.109 Collection of Reinsurance Program Data from Carriers and Hospitals - issued April 30, 2020

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