reglab/statecodes huggingface dataset:
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › PRENEED FUNERAL CONTRACTS (§§ 10-15-101 — 10-15-123) › Article 15 - PRENEED FUNERAL CONTRACTS (§§ 10-15-101 — 10-15-123) › Section 10-15-113 - Applicability of administrative procedure act

All procedures for the issuance, suspension, or revocation of licenses shall be pursuant to sections
24-4-104
to
24-4-107
, C.R.S., except where inconsistent with the provisions of this article. Any final action with respect to the issuance, suspension, or revocation of licenses shall be subject to judicial review by the court of appeals pursuant to section
24-4-106(11)
, C.R.S.
L. 95: Entire article R&RE, p. 1043, § 1, effective May 25.
This section is similar to former § 10-15-113 as it existed prior to 1995.
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › PRENEED FUNERAL CONTRACTS (§§ 10-15-101 — 10-15-123) › Article 15 - PRENEED FUNERAL CONTRACTS (§§ 10-15-101 — 10-15-123) › Section 10-15-114 - Investigations - actions against licensees

(1)
The commissioner may impose an administrative fine not to exceed one thousand dollars for each separate offense; may issue a letter of admonition; may place a contract seller on probation under the commissioner's close supervision on such terms and for such time as the commissioner deems appropriate; and may refuse to renew, may revoke, or may suspend the license of any contract seller if, after an investigation and after notice and a hearing pursuant to the provision of section
24-4-104
, C.R.S., the commissioner determines that the contract seller has:
(a)
Failed to comply with or has violated any provision of this article or any regulation or order lawfully made pursuant to and within the authority of this article; or
(b)
Used false or misleading advertising or made any false or misleading statement or concealment in the contract seller's application for licensure; or
(c)
Employed any device, scheme, or artifice which results in defrauding a contract buyer; or
(d)
Disposed of, concealed, diverted, converted, or otherwise failed to account for any funds or assets of any contract buyer which are subject to regulation pursuant to this article; or
(e)
Committed any act that constitutes a violation of the "Colorado Consumer Protection Act", article
1
of title
6
, C.R.S.; or
(f)
Been convicted of, or any officer, director, or controlling shareholder has been convicted of, a crime involving fraud or misappropriation or misuse of funds; or
(g)
Failed to provide appropriate records requested by the commissioner as part of an investigation of a complaint filed with the commissioner.
L. 95: Entire article R&RE, p. 1043, § 1, effective May 25.
This section is similar to former § 10-15-114 as it existed prior to 1995.
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › PRENEED FUNERAL CONTRACTS (§§ 10-15-101 — 10-15-123) › Article 15 - PRENEED FUNERAL CONTRACTS (§§ 10-15-101 — 10-15-123) › Section 10-15-115 - Injunctions - cease-and-desist orders

(1)
Whenever the commissioner has reasonable cause to believe that any person is violating any provision of this article or any rule or order promulgated pursuant to this article, the commissioner may:
(a)
In the name of the people of the state of Colorado, through the attorney general, apply for an injunction in any court of competent jurisdiction to perpetually enjoin such person from committing any act prohibited by this article; or
(b)
After notice and hearing pursuant to sections
24-4-104
and
24-4-105
, C.R.S., issue an order to cease and desist the act or acts violating any provision of this article. A copy of the cease-and-desist order shall be furnished to each party.
L. 95: Entire article R&RE, p. 1044, § 1, effective May 25.
This section is similar to former § 10-15-115 as it existed prior to 1995.
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › PRENEED FUNERAL CONTRACTS (§§ 10-15-101 — 10-15-123) › Article 15 - PRENEED FUNERAL CONTRACTS (§§ 10-15-101 — 10-15-123) › Section 10-15-116 - Surrender of license

(1)
A contract seller may surrender a license by:
(a)
Filing written notice with the commissioner;
(b)
Submitting a list of all outstanding preneed contracts, including the name of the contract buyer, the method of funding for the preneed contract, the preneed contract price, the amount of funds received, and the amount of funds held in trust;
(c)
Paying all outstanding fines and invoices due to the state of Colorado; and
(d)
Submitting the current certificate of authority.
(2)
Upon receipt of the notice, the commissioner shall review the preneed contract seller's trust funds and evidence of all outstanding preneed contracts.
(3)
Upon determining that the available assets are sufficient to meet any remaining preneed contract liabilities, the commissioner shall deactivate the license.
(4)
The contract seller shall continue to keep the trust fund intact and in trust after the license is inactive, and the trustee shall disburse the funds in trust in accordance with preneed contracts until the funds are exhausted.
(5)
The commissioner has jurisdiction over the inactive contract seller and to require the reports required by section
10-15-104
and inspect the records required by this article so long as there are funds in trust or preneed contracts that are not fulfilled. When the funds in trust are exhausted or each preneed contract is fulfilled, the commissioner shall finally cancel the license of the contract seller.
(6)
Upon a finding that an emergency exists that will harm consumers, the commissioner may by order administer preneed contracts and accounts if the business of the contract seller closes due to financial insolvency, criminal activity, or license suspension.
Amended by 2013 Ch. 287,§ 7, eff. 8/7/2013.
L. 95: Entire article R&RE, p. 1044, § 1, effective May 25. L. 2013: Entire section amended, (SB 13-125), ch. 287, p. 1520, § 7, effective August 7.
This section is similar to former § 10-15-116 as it existed prior to 1995.
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › PRENEED FUNERAL CONTRACTS (§§ 10-15-101 — 10-15-123) › Article 15 - PRENEED FUNERAL CONTRACTS (§§ 10-15-101 — 10-15-123) › Section 10-15-117 - Reinstatement of license

The commissioner may reinstate a suspended license or issue a new license to a person whose license has been revoked if no fact or condition then exists which clearly would have justified the commissioner in refusing originally to issue such license and the violations of this article which preceded the suspension or revocation of the license have been corrected.
L. 95: Entire article R&RE, p. 1045, § 1, effective May 25.
This section is similar to former § 10-15-117 as it existed prior to 1995.
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › PRENEED FUNERAL CONTRACTS (§§ 10-15-101 — 10-15-123) › Article 15 - PRENEED FUNERAL CONTRACTS (§§ 10-15-101 — 10-15-123) › Section 10-15-118 - Violation

(1)
Any person who violates any provision of this article 15 commits a class 2 misdemeanor and shall be punished as provided in section
18-1.3-501
. Any person who violates the trust fund provisions of this article 15 or any other misappropriation of funds commits theft pursuant to section
18-4-401
.
(2)
The commissioner may apply to a court of competent jurisdiction for the appointment of a receiver if the commissioner determines that such appointment is necessary to protect the interests of the contract buyers.
Amended by 2021 Ch. 462,§ 117, eff. 3/1/2022.
L. 95: Entire article R&RE, p. 1045, § 1, effective May 25. L. 2002: (1) amended, p. 1468, § 28, effective October 1.
(1) This section is similar to former § 10-15-118 as it existed prior to 1995.
(2) Section 803(2) of chapter 462 (SB 21-271), Session Laws of Colorado 2021, provides that the act changing this section applies to offenses committed on or after March 1, 2022.
For the legislative declaration contained in the 2002 act amending subsection (1), see section 1 of chapter 318, Session Laws of Colorado 2002.
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › PRENEED FUNERAL CONTRACTS (§§ 10-15-101 — 10-15-123) › Article 15 - PRENEED FUNERAL CONTRACTS (§§ 10-15-101 — 10-15-123) › Section 10-15-119 - Immunity from prosecution

(1)
If any person asks to be excused from attending and testifying or from producing any books, papers, records, correspondence, or other documents at any hearing on the ground that the testimony or evidence required of the person may tend to incriminate the person or subject the person to a penalty or forfeiture, and, notwithstanding such request, the commissioner directs such person to give such testimony or produce such evidence, such person shall nonetheless comply with such direction but the person shall not thereafter be prosecuted or subjected to any penalty or forfeiture for or on account of any transaction, matter, or thing concerning which the person testifies or produces evidence pursuant thereto; and no testimony so given or evidence so produced shall be received against such person upon any criminal action, investigation, or proceeding. However, no person who has filed a waiver pursuant to subsection (3) of this section shall be immune from prosecution on account of testimony given or evidence produced.
(2)
No person so testifying shall be exempt from prosecution or punishment for any perjury in the first degree committed by the person while so testifying, and the testimony or evidence so given or produced shall be admissible against the person upon any criminal action, investigation, or proceeding concerning such perjury; nor shall the person be exempt from the refusal, revocation, or suspension of any license, permission, or authority conferred, or to be conferred, pursuant to the laws of this state.
(3)
Any person may execute, acknowledge, and file in the office of the commissioner a statement expressly waiving his or her immunity or privilege with respect to any transaction, matter, or thing specified in such statement, and thereupon the testimony of such person or such evidence in relation to such transaction, matter, or thing may be received or produced before any judge or justice, court, tribunal, grand jury, or other authority, and if it is so received or produced, such individual shall not be entitled to any immunity or privilege on account of such testimony so given or evidence so produced. A waiver executed pursuant to this subsection (3) shall be valid only if it is:
(a)
Entered into voluntarily;
(b)
Executed by a person with the intellectual capacity to understand the consequences of executing such a waiver;
(c)
Not executed under threat, coercion, or duress; and
(d)
(I)
Entered into knowingly.
(II)
For purposes of this paragraph (d), a waiver is entered into knowingly when the person executing such waiver has been informed of his or her right to confer with independent legal counsel.
L. 95: Entire article R&RE, p. 1045, § 1, effective May 25.
This section is similar to former § 10-15-119 as it existed prior to 1995.
For perjury in the first degree, see § 18-8-502.
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › PRENEED FUNERAL CONTRACTS (§§ 10-15-101 — 10-15-123) › Article 15 - PRENEED FUNERAL CONTRACTS (§§ 10-15-101 — 10-15-123) › Section 10-15-120 - Rule against perpetuities inapplicable

No trust created pursuant to the provisions of this article, nor any interest therein, shall be deemed to be invalid by any existing law or rule against perpetuities or accumulations or suspension of the power of alienation and such trust and any interest therein may continue for such time as may be necessary to accomplish the purposes for which it may be created.
L. 95: Entire article R&RE, p. 1046, § 1, effective May 25.
This section is similar to former § 10-15-120 as it existed prior to 1995.
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › PRENEED FUNERAL CONTRACTS (§§ 10-15-101 — 10-15-123) › Article 15 - PRENEED FUNERAL CONTRACTS (§§ 10-15-101 — 10-15-123) › Section 10-15-121 - Other insurance laws applicable

In addition to the provisions of this article, the provisions of article
1
of this title and parts 9 and 11 of article
3
of this title, except as they are inconsistent with the provisions or purposes of this article, shall apply to any person regulated pursuant to this article.
L. 95: Entire article R&RE, p. 1046, § 1, effective May 25.
This section is similar to former § 10-15-121 as it existed prior to 1995.
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › PRENEED FUNERAL CONTRACTS (§§ 10-15-101 — 10-15-123) › Article 15 - PRENEED FUNERAL CONTRACTS (§§ 10-15-101 — 10-15-123) › Section 10-15-122 - [Repealed]

Added by 2017 Ch. 283,§5, eff. 6/1/2017.
L. 2017: Entire section added, (SB 17-249), ch. 283, p. 1544, § 5, effective June 1.
Subsection (2) provided for the repeal of this section, effective September 1, 2018. (See L. 2017, p. 1544.)
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › PRENEED FUNERAL CONTRACTS (§§ 10-15-101 — 10-15-123) › Article 15 - PRENEED FUNERAL CONTRACTS (§§ 10-15-101 — 10-15-123) › Section 10-15-123 - Repeal of article

This article 15 is repealed, effective September 1, 2029. Before the repeal, the department of regulatory agencies shall review the regulation of preneed funeral contracts in accordance with section
24-34-104
.
Amended by 2022 Ch. 309,§2, eff. 8/10/2022.
Added by 2017 Ch. 283,§6, eff. 6/1/2017.
L. 2017: Entire section added, (SB 17-249), ch. 283, p. 1544, § 6, effective June 1.
2022 Ch. 309, was passed without a safety clause. See Colo. Const. art. V, § 1(3).
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › HEALTH CARE COVERAGE (§§ 10-16-101 — 10-16.5-101) › Article 16 - HEALTH-CARE COVERAGE (§§ 10-16-101 — 10-16-1506) › Part 1 - GENERAL PROVISIONS (§§ 10-16-101 — 10-16-169) › Section 10-16-101 - Short title

This article shall be known and may be cited as the "Colorado Health Care Coverage Act".
L. 92: Entire article R&RE, p. 1617, § 1, effective July 1.
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › HEALTH CARE COVERAGE (§§ 10-16-101 — 10-16.5-101) › Article 16 - HEALTH-CARE COVERAGE (§§ 10-16-101 — 10-16-1506) › Part 1 - GENERAL PROVISIONS (§§ 10-16-101 — 10-16-169) › Section 10-16-103 - Proposal of mandatory health-care coverage provisions

(1)
Every person or organization which seeks legislative action which would mandate a health coverage or offering of a health coverage by an insurance carrier, nonprofit hospital and health-care service corporation, health maintenance organization, or prepaid dental care plan organization as a component of individual or group policies shall submit a report to the legislative committee of reference addressing both the social and financial impacts of such coverage, including the efficacy of the treatment or service proposed.
(2)
Guidelines for assessing the impact of proposed mandated or mandatorily offered health coverage to the extent that information is available shall include, but not be limited to, the following:
(a)
The social impact of such mandatory coverage, including, but not limited to, the following:
(I)
The extent to which the treatment or service is generally utilized by a significant portion of the population;
(II)
The extent to which the insurance coverage is already generally available to the general population;
(III)
The extent to which the lack of coverage results in persons avoiding necessary health-care treatments;
(IV)
The extent to which the lack of coverage results in unreasonable financial hardship;
(V)
The level of public demand for the treatment or service, including the public level of demand for insurance coverage of such treatment or service;
(VI)
The level of interest of collective bargaining agents in negotiating privately for inclusion of this coverage in group contracts;
(b)
The financial impact of such mandatory coverage, including, but not limited to, the following:
(I)
The extent to which the coverage will increase or decrease the cost of the treatment or service;
(II)
The extent to which the coverage will increase the appropriate use of the treatment or service;
(III)
The extent to which the mandated treatment or service will be a substitute for more expensive treatment or coverage;
(IV)
The extent to which the coverage will increase or decrease the administrative expenses of insurance companies and the premium and administrative expenses of policyholders;
(V)
The impact of this coverage on the total cost of health care in Colorado.
L. 92: Entire article R&RE, p. 1620, § 1, effective July 1.
This section is similar to former § 10-8-125 as it existed prior to 1992.
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › HEALTH CARE COVERAGE (§§ 10-16-101 — 10-16.5-101) › Article 16 - HEALTH-CARE COVERAGE (§§ 10-16-101 — 10-16-1506) › Part 1 - GENERAL PROVISIONS (§§ 10-16-101 — 10-16-169) › Section 10-16-103.3 - [Repealed]

L. 2003: Entire section added, p. 1791, § 1, effective May 20. L. 2005: (9) amended, p. 1026, § 1, effective June 2. L. 2007: (1)(b) amended, p. 176, § 4, effective March 22. L. 2008: (10) added, p. 2076, § 4, effective June 3.
Subsection (9) provided for the repeal of this section, effective July 1, 2010. (See L. 2005, p. 1026.)
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › HEALTH CARE COVERAGE (§§ 10-16-101 — 10-16.5-101) › Article 16 - HEALTH-CARE COVERAGE (§§ 10-16-101 — 10-16-1506) › Part 1 - GENERAL PROVISIONS (§§ 10-16-101 — 10-16-169) › Section 10-16-103.4 - Essential health benefits - requirements - rules

(1)
Carriers offering individual or small group health benefit plans in this state shall ensure that the coverage includes the essential health benefits package. This subsection (1) does not apply to grandfathered health benefit plans.
(2)
Except as provided in subsection (3) of this section, carriers subject to subsection (1) of this section shall offer health benefit plans that provide at least one of the following levels of coverage:
(a)
Bronze level.
A health benefit plan in the bronze level provides a level of coverage designed to provide benefits actuarially equivalent to sixty percent of the full actuarial value of the benefits provided under the plan.
(b)
Silver level.
A health benefit plan in the silver level provides a level of coverage designed to provide benefits actuarially equivalent to seventy percent of the full actuarial value of the benefits provided under the plan.
(c)
Gold level.
A health benefit plan in the gold level provides a level of coverage designed to provide benefits actuarially equivalent to eighty percent of the full actuarial value of the benefits provided under the plan.
(d)
Platinum level.
A health benefit plan in the platinum level provides a level of coverage designed to provide benefits actuarially equivalent to ninety percent of the full actuarial value of the benefits provided under the plan.
(3)
A carrier that offers an individual health benefit plan that does not provide a bronze, silver, gold, or platinum level of coverage, as described in subsection (2) of this section, meets the requirements of this section with respect to any policy year if the plan is a catastrophic plan, as defined in section
10-16-102(10)
.
(4)
If a carrier subject to subsection (1) of this section offers an individual health benefit plan in any level of coverage specified in subsection (2) of this section, the carrier shall also offer coverage in that level as child-only coverage.
(5)
A carrier subject to subsection (1) of this section shall ensure that the annual cost-sharing and annual deductible limitations imposed under the health benefit plan it offers do not exceed the limitations under federal law.
(6)
Exclusion.
This section does not apply to stand-alone dental plans offered separately or in conjunction with a health benefit plan.
(7)
The commissioner may adopt rules as necessary for the implementation and administration of this section and to ensure consistent requirements for pediatric dental benefits under this section regardless of the method by which a health benefit plan is purchased.
Amended by 2014 Ch. 7,§ 1, eff. 2/19/2014.
Added by 2013 Ch. 217,§ 2, eff. 5/13/2013.
L. 2013: Entire section added, (HB 13-1266), ch. 217, p. 919, § 2, effective May 13. L. 2014: (7) amended, (HB 14-1053), ch. 7, p. 89, § 1, effective February 19.
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › HEALTH CARE COVERAGE (§§ 10-16-101 — 10-16.5-101) › Article 16 - HEALTH-CARE COVERAGE (§§ 10-16-101 — 10-16-1506) › Part 1 - GENERAL PROVISIONS (§§ 10-16-101 — 10-16-169) › Section 10-16-103.6 - Copayment-only prescription payment structures - required inclusion in health benefit plans - rules

(1)
(a)
In addition to the requirements in section
10-16-103.4(2)
, for health benefit plans issued or renewed on or after January 1, 2023, each carrier that offers an individual or small group health benefit plan shall offer at least twenty-five percent of its health benefit plans on the exchange and at least twenty-five percent of its plans not on the exchange in each bronze, silver, gold, and platinum benefit level in each service area as copayment-only payment structures for all prescription drug cost tiers.
(b)
For each copayment-only payment structure for prescription drugs:
(I)
The copayment amount for the highest prescription drug cost tier must not be greater than one-twelfth of the health benefit plan's out-of-pocket maximum amount;
(II)
The copayment amounts between the two highest prescription drug cost tiers must have a cost difference of at least ten percent;
(III)
No more than fifty percent of the drugs on the prescription drug formulary used to treat a specific condition may be placed on the highest prescription drug cost tier; and
(IV)
Each carrier shall use "Rx Copay" at the end of the marketing names for each copayment-only payment structure.
(2)
The commissioner may promulgate rules to implement and enforce this section.
Added by 2022 Ch. 184, § 1, eff. 8/10/2022, app. to health benefit plans issued or renewed on or after 1/1/2023 ..
2022 Ch. 184, was passed without a safety clause. See Colo. Const. art. V, § 1(3).
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › HEALTH CARE COVERAGE (§§ 10-16-101 — 10-16.5-101) › Article 16 - HEALTH-CARE COVERAGE (§§ 10-16-101 — 10-16-1506) › Part 1 - GENERAL PROVISIONS (§§ 10-16-101 — 10-16-169) › Section 10-16-104.1 - Prohibition on discrimination for organ transplants based solely on disability - definition

(1)
A carrier that offers, issues, or renews a health benefit plan that provides coverage for anatomical gifts, organ transplants, or related treatments or services shall not, solely on the basis of a covered person's disability:
(a)
Deny coverage to a covered person for an organ transplant or related treatment or services;
(b)
Decline or limit coverage of a covered person solely for the purpose of avoiding the requirements of this section; or
(c)
Penalize a covered person or reduce or limit coverage for a covered person for health-care services related to organ transplantation, as determined in consultation with the attending physician and the covered person or the covered person's representative.
(2)
This section does not require a health benefit plan to provide coverage for the donation of an anatomical gift, an organ transplant, or related treatment or services.
(3)
For the purposes of this section, "anatomical gift" means the donation of part of a human body for the purpose of transplantation to another person.
Added by 2021 Ch. 99,§ 2, eff. 5/6/2021.
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › HEALTH CARE COVERAGE (§§ 10-16-101 — 10-16.5-101) › Article 16 - HEALTH-CARE COVERAGE (§§ 10-16-101 — 10-16-1506) › Part 1 - GENERAL PROVISIONS (§§ 10-16-101 — 10-16-169) › Section 10-16-104.3 - Health coverage for persons under twenty-six years of age - coverage for students who take medical leave of absence

(1)
(a)
A carrier that offers a health benefit plan in the state and that makes dependent coverage for children available under the health benefit plan shall make the coverage available for a child who is under twenty-six years of age. The carrier shall not deny or restrict coverage for a child who is under twenty-six years of age based on a factor such as:
(I)
Residency with the policyholder or any other person;
(II)
The presence or absence of financial dependence on the policyholder or any other person;
(III)
Marital or civil union status;
(IV)
Student status;
(V)
Employment status; or
(VI)
A combination of any of the factors listed in paragraphs (a) to (d) of this subsection (1).
(b)
A carrier shall not deny dependent coverage of a child based on the child's eligibility for other coverage.
(c)
Except as otherwise provided in state law, a carrier offering dependent coverage of children in a health benefit plan shall not vary the terms of coverage in the policy or contract based on age, except for premium rates for children who are twenty-one years of age or older.
(d)
Nothing in this subsection (1) requires a carrier to make coverage available for the child of a child receiving dependent coverage unless the grandparent becomes the permanent legal guardian or adoptive parent of that grandchild.
(2)
Repealed.
(3)
(a)
All individual and group sickness and accident insurance policies providing coverage within the state by an entity subject to the provisions of part 2 of this article and all group health service contracts issued by an entity subject to the provisions of part 3 or 4 of this article that provide dependent coverage to a child who is enrolled in a postsecondary educational institution shall not terminate coverage due to a medically necessary leave of absence before the date that is the earlier of:
(I)
One year after the first day of the medically necessary leave of absence; or
(II)
The date the coverage would otherwise terminate under the terms of the plan or health insurance coverage.
(b)
For purposes of this subsection (3), "medically necessary leave of absence" means a leave of absence from a postsecondary educational institution or a change in enrollment of the dependent at the institution that:
(I)
Begins while the dependent is suffering from a serious illness;
(II)
Is medically necessary; and
(III)
Causes the dependent to lose student status for the purpose of dependent coverage.
Amended by 2013 Ch. 217, § 4, eff. 5/13/2013.
L. 2005: Entire section added, p. 1503, § 1, effective 1/1/2006. L. 2009: (3) added, (HB 09 -1338), ch. 353, p. 1844, § 5, effective July 1. L. 2013: (1) R&RE and (2) repealed, (HB 13-1266), ch. 217, p. 925, § 4, effective May 13.
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › HEALTH CARE COVERAGE (§§ 10-16-101 — 10-16.5-101) › Article 16 - HEALTH-CARE COVERAGE (§§ 10-16-101 — 10-16-1506) › Part 1 - GENERAL PROVISIONS (§§ 10-16-101 — 10-16-169) › Section 10-16-104.4 - [Repealed]

Amended by 2013 Ch. 217,§5, eff. 5/13/2013.
L. 2011: Entire section added, (SB 11-128), ch. 133, p. 468, §3, effective April 29. L. 2013: (2)(b) amended, (HB 13-1266), ch. 217, p. 926, § 5, effective May 13.
Subsection (6) provided for the repeal of this section, effective January 1, 2014. (See L. 2011, p. 468.)
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › HEALTH CARE COVERAGE (§§ 10-16-101 — 10-16.5-101) › Article 16 - HEALTH-CARE COVERAGE (§§ 10-16-101 — 10-16-1506) › Part 1 - GENERAL PROVISIONS (§§ 10-16-101 — 10-16-169) › Section 10-16-104.5 - [Repealed]

Repealed by 2015 Ch. 106, § 3, eff. 1/1/2017.
L. 93: Entire section added, p. 956, § 3, effective May 28. L. 2009: Entire section amended, (SB 09-244), ch. 2118, p. 2118, § 4, effective 7/1/2010. L. 2015: (4) added by revision, (SB 15 -015), ch. 310, p. 310, §§ 3, 4.
Subsection (4) provided for the repeal of this section, effective January 1, 2017. (See L. 2015, p. 310 .)
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › HEALTH CARE COVERAGE (§§ 10-16-101 — 10-16.5-101) › Article 16 - HEALTH-CARE COVERAGE (§§ 10-16-101 — 10-16-1506) › Part 1 - GENERAL PROVISIONS (§§ 10-16-101 — 10-16-169) › Section 10-16-104.6 - Off-label use of cancer drugs

(1)
A health benefit plan that provides coverage for prescription drugs shall not limit or exclude coverage for any drug approved by the FDA for use in the treatment of cancer on the basis that the drug has not been approved by the FDA for the treatment of the specific type of cancer for which the drug is prescribed if:
(a)
The drug is recognized for treatment of that cancer in the authoritative reference compendia as identified by the secretary of the United States department of health and human services; and
(b)
The treatment is for a covered condition.
Amended by 2022 Ch. 126,§2, eff. 8/10/2022.
L. 2010: Entire section added, (HB 10-1355), ch. 229, p. 989, §1, effective August 11.
2022 Ch. 126, was passed without a safety clause. See Colo. Const. art. V, § 1(3).
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › HEALTH CARE COVERAGE (§§ 10-16-101 — 10-16.5-101) › Article 16 - HEALTH-CARE COVERAGE (§§ 10-16-101 — 10-16-1506) › Part 1 - GENERAL PROVISIONS (§§ 10-16-101 — 10-16-169) › Section 10-16-104.7 - Substance use disorders - court-ordered treatment coverage

(1)
An individual or group health benefit plan delivered or issued for delivery within this state by an entity subject to the provisions of part 2, 3, or 4 of this article 16 that provides coverage for treatment of a substance use disorder must provide coverage for such treatment regardless of whether the treatment is voluntary or court-ordered as a result of contact with the criminal justice or legal system. The health benefit plan is only required to provide coverage for benefits that are medically necessary and otherwise covered under the plan. Such coverage is subject to copayment, deductible, and policy maximums and limitations. Health benefit plans issued by an entity subject to the provisions of part 4 of this article 16 may provide that the benefits required pursuant to this section are covered benefits only if the services are deemed medically necessary and are rendered by a provider who is designated by and affiliated with the health maintenance organization.
(2)
Nothing in this section mandates or is meant to construe that any health benefit plan must provide coverage for treatment of a substance use disorder.
Amended by 2017 Ch. 263, § 36, eff. 5/25/2017.
L. 2002: Entire section added, p. 750, § 1, effective 1/1/2003. L. 2017: Entire section amended, (SB 17-242), ch. 263, p. 1264, § 36, effective May 25.
For the legislative declaration in SB 17-242, see section 1 of chapter 263, Session Laws of Colorado 2017.
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › HEALTH CARE COVERAGE (§§ 10-16-101 — 10-16.5-101) › Article 16 - HEALTH-CARE COVERAGE (§§ 10-16-101 — 10-16-1506) › Part 1 - GENERAL PROVISIONS (§§ 10-16-101 — 10-16-169) › Section 10-16-104.9 - Geographic areas for small employers

(1)
The commissioner shall promulgate a rule concerning geographic case characteristics, which may include metropolitan statistical areas for small employers. In promulgating such rule, the commissioner shall take testimony from all interested parties, including, but not limited to, consumer advocates and consumers, insurers, health-care providers, the state demographer, and producers. The rule shall include, without limitation, the following features:
(a)
If the rule establishes separate geographic areas, in rate filings to the commissioner, a carrier shall be required to show that rates reflect a relativity to rates for other areas in the state and that rates and relativities are not excessive, inadequate, or unfairly discriminatory in such geographic areas;
(b)
The rule shall contain a determination of the appropriate population base for statistical reliability in determining geographic areas or metropolitan statistical areas;
(c)
(I)
The rule shall provide justifications of why any separate geographic areas, which may include metropolitan statistical areas, serve the public interest in regard to ensuring that premium rates for different geographic areas of the state are not excessive, inadequate, or unfairly discriminatory;
(II)
If the commissioner determines that metropolitan statistical areas are no longer the best method for addressing geographic case characteristics, the commissioner shall provide detailed justifications concerning the separate geographic areas, in connection with which the commissioner shall make public the impact the geographic case characteristics may have on insurance premiums for the separate geographic areas; and
(d)
In adopting such rule, the commissioner may consider the cost of health care in a geographic area, experience of health care of any separate geographic area, and information including actuarial opinions or certifications and set loss ratios for loss ratio guarantees submitted by small employer carriers pursuant to section
10-16-107(1)
. The cost of health care and experience and the population that may be served may be a consideration when determining whether separate geographic case characteristics are necessary, but shall not be the sole factors of separate geographic case characteristics, nor shall it compromise the public interest of insureds and potential insureds of this state.
L. 2002: Entire section added, p. 1294, § 7, effective June 7. L. 2003: (1)(c)(I) amended, p. 1988, § 21, effective May 22.
This section was originally enacted as §
10-16-104.7
in House Bill 02-1003 but has been renumbered on revision for ease of location.
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › HEALTH CARE COVERAGE (§§ 10-16-101 — 10-16.5-101) › Article 16 - HEALTH-CARE COVERAGE (§§ 10-16-101 — 10-16-1506) › Part 1 - GENERAL PROVISIONS (§§ 10-16-101 — 10-16-169) › Section 10-16-105.3 - Health benefit plans - not prohibited

(1)
A carrier shall not be prohibited from offering to a small employer additional options of health benefit plans that:
(a)
Provide for different benefits for insureds and dependents of such insureds covered by the same policy; and
(b)
Encourage appropriate health-care condition management based on clinical guidelines by providing case management benefits to covered persons.
L. 2003: Entire section added, p. 1778, § 12, effective 1/1/2004.
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › HEALTH CARE COVERAGE (§§ 10-16-101 — 10-16.5-101) › Article 16 - HEALTH-CARE COVERAGE (§§ 10-16-101 — 10-16-1506) › Part 1 - GENERAL PROVISIONS (§§ 10-16-101 — 10-16-169) › Section 10-16-105.5 - [Repealed]

Repealed by 2013 Ch. 217,§28, eff. 5/13/2013.
L. 97: Entire section added, p. 637, § 5, effective May 1. L. 2001: (1) and (2) amended, p. 1049, § 32, effective June 5. L. 2009: (2) amended, (HB 09-1349), ch. 377, p. 2052, §2, effective June 1. L. 2013: Entire section repealed, (HB 13-1266), ch. 217, p. 978, § 28, effective May 13.
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › HEALTH CARE COVERAGE (§§ 10-16-101 — 10-16.5-101) › Article 16 - HEALTH-CARE COVERAGE (§§ 10-16-101 — 10-16-1506) › Part 1 - GENERAL PROVISIONS (§§ 10-16-101 — 10-16-169) › Section 10-16-105.6 - Rate usage

(1)
A carrier offering an individual or group health benefit plan shall not require any individual, as a condition of enrollment or continued enrollment under the plan, to pay a premium or, for group plans, a contribution that is greater than the premium or contribution for a similarly situated individual enrolled in the plan on the basis of any health-status-related factor in relation to the individual or to an individual enrolled under the plan as a dependent of the individual.
(2)
The prohibition in subsection (1) of this section does not:
(a)
Restrict the amount that a carrier may charge an employer for coverage under a group health benefit plan; or
(b)
Prevent a carrier from establishing premium discounts or rebates or modifying otherwise applicable copayments, coinsurance, or deductibles in return for adherence to programs of health promotion and disease prevention if otherwise allowed by state or federal law.
(3)
Repealed.
(4)
A small employer carrier may impose a premium surcharge of up to thirty-five percent above the modified community rate on a small employer group whose small group insurance has been discontinued because of nonpayment of premiums or fraud. The small employer carrier may impose the premium surcharge when the small business group reapplies for coverage in the small group market. A small employer carrier may require the increased premium to apply to the small business group for up to twelve months.
Amended by 2017 Ch. 283,§ 19, eff. 6/1/2017.
Amended by 2016 Ch. 210,§ 14, eff. 6/6/2016.
Added with amended and relocated provisions by 2013 Ch. 217,§ 9, eff. 5/13/2013.
Subsections (1) and (2) are similar to former § 10-16-107 (6); subsections (3)(a), (3)(b), and (3)(c) are similar to former § 10-16-105 (13)(a) ; subsection (3)(d) is similar to former § 10-16-105 (13)(d) ; and subsection (4) is similar to former § 10-16-105 (14)(a) , as those sections existed prior to 2013.
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › HEALTH CARE COVERAGE (§§ 10-16-101 — 10-16.5-101) › Article 16 - HEALTH-CARE COVERAGE (§§ 10-16-101 — 10-16-1506) › Part 1 - GENERAL PROVISIONS (§§ 10-16-101 — 10-16-169) › Section 10-16-106.3 - Uniform claims - billing codes - electronic claim forms

(1)
On or before July 1, 2002, all carriers shall accept the claim form adopted by the American dental association for use by all dental providers and carriers in the state, and the federal centers for medicare and medicaid services' claim forms CMS-1500 and CMS-1450, otherwise known as form UB-04, as amended, as the uniform health-care claim forms for use by all other health-care providers and carriers in the state. All carriers shall accept such claim forms from health-care providers in electronic form. A carrier shall not prohibit submission of health-care claims in hard copy form, nor shall a carrier be prohibited from requiring that a claim be submitted in hard copy form. A carrier shall not require submission of a claim on a form other than those set forth in this section, except as provided in subsection (3) of this section.
(2)
On or before July 1, 2002, the commissioner shall adopt a uniform list of required elements to be used on the uniform claim forms accepted by carriers pursuant to this section. Such elements shall be used by health-care providers in order for a claim to be considered a clean claim.
(3)
Concurrent with the effective date for implementation of the federal "Health Insurance Portability and Accountability Act of 1996", as amended, and the federal regulations implemented pursuant to such act, as amended, for claims filed electronically, carriers shall require the submission of electronic claims with the elements in the format required by such act and such regulations and shall not require the submission of forms and elements pursuant to subsections (1) and (2) of this section.
Amended by 2023 Ch. 303,§ 9, eff. 8/7/2023.
L. 2002: Entire section added, p. 312, § 1, effective April 19. L. 2007: (1) amended, p. 921, § 1, effective May 17.
2023 Ch. 303, was passed without a safety clause. See Colo. Const. art. V, § 1(3).
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › HEALTH CARE COVERAGE (§§ 10-16-101 — 10-16.5-101) › Article 16 - HEALTH-CARE COVERAGE (§§ 10-16-101 — 10-16-1506) › Part 1 - GENERAL PROVISIONS (§§ 10-16-101 — 10-16-169) › Section 10-16-107.1 - False or misleading information - penalties

(1)
A person or organization shall not knowingly withhold information that will affect the rates or premiums chargeable under this part 1 or knowingly give false or misleading information to the commissioner or any statistical agent, advisory organization, or carrier. A person or organization who violates this section shall be subject to the penalties in subsection (2) of this section.
(2)
Upon a finding that any person or organization has knowingly violated subsection (1) of this section, the commissioner may impose a penalty of not more than ten thousand dollars for each violation but, if the violation is found to be willful, a penalty of not more than twenty-five thousand dollars for each violation. The penalties may be in addition to any other penalty provided by law.
L. 2008: Entire section added, p. 2255, § 7, effective July 1.
In 2008, this section was enacted by the "Fair Accountable Insurance Rates Act". For the short title and legislative declaration, see sections 1 and 2 of chapter 439, Session Laws of Colorado 2008.
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › HEALTH CARE COVERAGE (§§ 10-16-101 — 10-16.5-101) › Article 16 - HEALTH-CARE COVERAGE (§§ 10-16-101 — 10-16-1506) › Part 1 - GENERAL PROVISIONS (§§ 10-16-101 — 10-16-169) › Section 10-16-107.2 - Filing of health policies - rules

(1)
All carriers authorized by the commissioner to conduct business in Colorado shall submit an annual report to the commissioner listing any policy form, endorsement, or rider for any sickness, accident, nonprofit hospital and health service corporation, health maintenance organization, or other health insurance policy, contract, certificate, or other evidence of coverage issued or delivered to any policyholder, certificate holder, enrollee, subscriber, or member in Colorado. Each carrier shall submit the annual report by December 31 of each year and shall include in the report a certification by an officer of the carrier that, to the best of the carrier's good-faith knowledge and belief, each policy form, endorsement, or rider in use complies with Colorado law. The commissioner shall determine the necessary elements of the certification.
(2)
All carriers authorized by the commissioner to conduct business in Colorado shall also submit to the commissioner a list of any new policy form, application, endorsement, or rider at least thirty-one days before using the policy form, application, endorsement, or rider for any health coverage. The carrier shall include in the listing a certification by an officer of the carrier that each new policy form, application, endorsement, or rider proposed to be used complies, to the best of the carrier's good-faith knowledge and belief, with Colorado law. The commissioner shall determine the necessary elements of the certification. A carrier shall not deliver or issue a new policy form, application, endorsement, or rider until the carrier files the listing and certification required by this subsection (2).
(3)
The commissioner shall promulgate rules, as needed, setting forth the standards for policy forms, endorsements, and riders marketed in Colorado.
(4)
The commissioner may examine and investigate carriers authorized to conduct business in Colorado to determine whether policy forms, endorsements, and riders comply with the certification of the carrier and statutory mandates.
Amended by 2013 Ch. 217, § 13, eff. 5/13/2013.
L. 92: Entire section added, p. 1745, § 5, effective June 2. L. 2005: (2) amended, p. 741, § 1, effective 1/1/2006. L. 2006: (2)(b)(I) amended, p. 1077, § 5, effective 1/1/2007. L. 2010: (2)(c) added, (HB 10 -1242), ch. 222, p. 966, § 1, effective August 11. L. 2013: Entire section amended, (HB 13-1266), ch. 217, p. 950, § 13, effective May 13.
(1) Although the effective date for the repeal and reenactment of this article was July 1, 1992, this section was added, effective June 2, 1992.
(2) The former subsection (2)(b) was relocated to §
10-16-107.5
in 2013.
For the legislative declaration contained in the 2006 act amending subsection (2)(b)(I), see section 1 of chapter 236, Session Laws of Colorado 2006.
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › HEALTH CARE COVERAGE (§§ 10-16-101 — 10-16.5-101) › Article 16 - HEALTH-CARE COVERAGE (§§ 10-16-101 — 10-16-1506) › Part 1 - GENERAL PROVISIONS (§§ 10-16-101 — 10-16-169) › Section 10-16-107.5 - Uniform application form - use by all carriers - rules

(1)
The commissioner, by rule, shall develop a uniform application form for health benefit plans and shall require all carriers providing health benefit plans that are authorized by the commissioner to conduct business in Colorado to exclusively use the uniform application form for the conduct of business in this state. By a date specified by the commissioner, all carriers that provide health benefit plans shall use the uniform application form for their health benefit plans.
(2)
The commissioner may permit carriers to use a modified electronic version of the uniform application form.
Added with amended and relocated provisions by 2013 Ch. 217,§ 14, eff. 5/13/2013.
This section is similar to former § 10-16-107.2 (2)(b) as it existed prior to 2013.
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › HEALTH CARE COVERAGE (§§ 10-16-101 — 10-16.5-101) › Article 16 - HEALTH-CARE COVERAGE (§§ 10-16-101 — 10-16-1506) › Part 1 - GENERAL PROVISIONS (§§ 10-16-101 — 10-16-169) › Section 10-16-107.7 - Nondiscrimination against providers

(1)
A carrier offering an individual or group health benefit plan in this state shall not discriminate with respect to participation under the plan or coverage against any provider who is acting within the scope of his or her license or certification under applicable state law.
(2)
This section does not:
(a)
Require a carrier to contract with any provider willing to abide by the terms and conditions for participation established by the plan or carrier; or
(b)
Prevent a carrier from establishing varying reimbursement rates based on quality or performance measures.
Added by 2013 Ch. 217,§ 15, eff. 5/13/2013.
L. 2013: Entire section added, (HB 13-1266), ch. 217, p. 952, § 15, effective May 13.
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › HEALTH CARE COVERAGE (§§ 10-16-101 — 10-16.5-101) › Article 16 - HEALTH-CARE COVERAGE (§§ 10-16-101 — 10-16-1506) › Part 1 - GENERAL PROVISIONS (§§ 10-16-101 — 10-16-169) › Section 10-16-108.3 - [Repealed]

L. 2009: Entire section added, (HB 09-1349), ch. 377, p. 2049, §1, effective June 1.
Subsection (10) provided for the repeal of this section, effective January 1, 2010. (See L. 2009, p. 2049.)
2023 Colorado Revised Statutes › Title 10 - INSURANCE (§§ 10-1-101 — 10-23-110) › HEALTH CARE COVERAGE (§§ 10-16-101 — 10-16.5-101) › Article 16 - HEALTH-CARE COVERAGE (§§ 10-16-101 — 10-16-1506) › Part 1 - GENERAL PROVISIONS (§§ 10-16-101 — 10-16-169) › Section 10-16-109 - Rules

Pursuant to article
4
of title
24
, C.R.S., the commissioner may promulgate reasonable rules consistent with this article that are necessary or proper for implementing and administering this article, including rules necessary to align state law with the requirements imposed by federal law regarding health-care coverage in this state.
Amended by 2013 Ch. 217,§ 18, eff. 5/13/2013.
L. 92: Entire article R&RE, p. 1655, § 1, effective July 1. L. 2013: Entire section amended, (HB 13-1266), ch. 217, p. 956, § 18, effective May 13.
The provisions of this section are similar to provisions of several former sections as they existed prior to 1992.