Colo. Rev. Stat. § 10-16-105.6. Rate usage: Colorado Health Care Coverage Act – Colorado
Status: Enacted Year Enacted: 2013
Any insurance company that offers individual and small group plans must not require that individual to pay amount greater than the amount required by the premium.
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Colo. Rev. Stat. § 10-16-105.7. Health benefit plan open enrollment periods – special enrollment periods – rules: Colorado Health Care Coverage Act – Colorado
Status: Enacted Year Enacted: 2013
Mandates the need for and sets the date for the CoveredColorado Open Enrollment Period
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Colo. Rev. Stat. § 10-16-106.5. Prompt Payment of Claims-Legislative Declaration-Rules: Colorado Health Care Coverage Act – Colorado
Status: Enacted Year Enacted: 1999
Declares that patients and providers are entitled to receive the reimbursements to which they are entitled from a health plan/ carrier in a timely manner. Outlines what information should be provided to patients and providers.
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Colo. Rev. Stat. § 10-16-106.7. Assignment of health insurance benefits: Colorado Health Care Coverage Act – Colorado
Status: Enacted Year Enacted: 2005
Any insurance company shall allow, but not require, the covered person to assign payments under the policy. When a provider holds an assignment, it is the responsibility of the provider to notify the carrier of …
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Colo. Rev. Stat. § 10-16-107. Rate filing regulation-benefits ratio-rules: Colorado Health Care Coverage Act – Colorado
Status: Enacted Year Enacted: 1993
States that an insurance carrier cannot establish rates that are excessive in relation to the benefits provided. Specifically, any rates an insurance company sets cannot be excessive, inadequate or unfairly discriminatory.
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Colo. Rev. Stat. § 10-16-107.1. False or misleading information – penalties: Colorado Health Care Coverage Act – Colorado
Status: Enacted Year Enacted: 2008
Any person that knowingly withholds information that will effect the rates or charges associated with premiums will be liable for penalties under this section.
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Colo. Rev. Stat. § 10-16-107.3. Health insurance policies – plain language required – rules: Colorado Health Care Coverage Act – Colorado
Status: Enacted Year Enacted: 2010
Any insurance carrier offering a plan must right plan language at no greater than a 10th grade level. The plan must also have a table of contents that is no longer than 3 pages at …
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Colo. Rev. Stat. § 10-16-107.7. Nondiscrimination against providers: Colorado Health Care Coverage Act – Colorado
Status: Enacted Year Enacted: 2013
Any insurance company offering a plan may not discriminate against any provider acting within the scope of their license.
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Colo. Rev. Stat. § 10-16-111. Annual Statements and Reports-rules: Colorado Health Care Coverage Act – Colorado
Status: Enacted Year Enacted: 1993
Requires that non-profit hospitals, medical-surgery, and health services corporations file an annual statement with the Insurance Commissioner containing fee amounts and other information.
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Colo. Rev. Stat. § 10-16-112. Private utilization review – health care coverage entity responsibility: Colorado Health Care Coverage Act – Colorado
Status: Enacted Year Enacted: 1993
Includes the definition of “private utiization review organization“ and “utilization review“ and provides that any organization that provides utilization review acts as the direct representative of the insurance carrier.
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Colo. Rev. Stat. § 10-16-113. Procedure for denial of benefits – internal review – rules: Colorado Health Care Coverage Act – Colorado
Status: Enacted Year Enacted: 1997
Sets out the procedure by which an insurance company may deny benefits. The carrier must notify the beneficiary in writing and must offer tham a chance for an appeal.
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Colo. Rev. Stat. § 10-16-113.5. Independent external review of adverse determinations – legislative declaration – definitions – rules: Colorado Health Care Coverage Act – Colorado
Status: Enacted Year Enacted: 1999
Any adverse determinations made by an insurance company must be independently reviewed by a member of the company not party to the orginal determination. They must use medical and scientific evidence, including peer reviewed standards, …
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Colo. Rev. Stat. § 10-16-113.7. Reporting the denial of benefits to division: Colorado Health Care Coverage Act – Colorado
Status: Enacted Year Enacted: 2005
Each carrier must report the number and outcome of any appeals to the commissioner.
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Colo. Rev. Stat. § 10-16-116. Catastrophic health insurance-coverage-premium payments-reporting requirements-definitions-short title: Colorado Catastrophic Health Insurance Coverage Act – Colorado
Status: Enacted Year Enacted: 1994
Authorizes employers to offer catastrophic health care coverage to its employees. This includes offering health savings accounts, and the catastrosphic insurance plan must still meet all the federal and ERISA requirements such as offering coverage …
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Colo. Rev. Stat. § 10-16-116.5. State innovation waiver for nonemployer catastrophic health plans – notice of decision by secretary – effect of secretary’s decision – notice to revisor of statutes – definitions – rules – state measurement for accountable, responsive, and transparent (SMART) government act report – repeal: Healthcare Coverage – General Provisions – Colorado
Status: Enacted Year Enacted: 2018
The commisioner should conduct a study and review to determine if catastrophic health plans should be available to persons over 30 years of age who do not otherwise qualify for subsidies. If it is cost …
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Colo. Rev. Stat. § 10-16-118. Prohibition against preexisting condition exclusions: Colorado Health Care Coverage Act – Colorado
Status: Enacted Year Enacted: 1994
Provides that a carrier may not exclude an individual on the basis of a preexisting medical condition.
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