Code of Colorado Regulations
700 - Department of Regulatory Agencies
702 - Division of Insurance
3 CCR 702-4 - LIFE, ACCIDENT AND HEALTH
3 CCR 702-4 Series 4-2 - LIFE, ACCIDENT AND HEALTH, Series 4-2 Accident and Health (General)
- Regulation 4-2-1 - REPLACEMENT OF INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE
- Regulation 4-2-2 - HOSPITAL INDEMNITY AND DISABILITY INCOME POLICIES
- Regulation 4-2-3 - ADVERTISEMENTS OF ACCIDENT AND SICKNESS INSURANCE
- Regulation 4-2-5
- Regulation 4-2-6 - CONCERNING THE DEFINITION OF THE TERM "COMPLICATIONS OF PREGNANCY"
- Regulation 4-2-8 - CONCERNING REQUIRED HEALTH INSURANCE BENEFITS FOR HOME HEALTH SERVICES AND HOSPICE CARE
- Regulation 4-2-9 - CONCERNING NON-DISCRIMINATORY TREATMENT OF ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS) AND HUMAN IMMUNODEFICIENCY VIRUS (HIV) RELATED ILLNESS BY LIFE AND HEALTH CARRIERS
- Regulation 4-2-10 - FILING REQUIREMENTS FOR MULTIPLE EMPLOYER WELFARE ARRANGEMENTS (MEWAS)
- Regulation 4-2-11 - RATE FILING SUBMISSIONS FOR HEALTH INSURANCE, LIMITED BENEFIT PLANS, EXCESS/STOP LOSS INSURANCE, LONG-TERM CARE INSURANCE, MEDICARE SUPPLEMENT INSURANCE, SICKNESS AND ACCIDENT INSURANCE, DISABILITY INCOME, OTHER THAN HEALTH BENEFIT PLANS
- Regulation 4-2-13
- Regulation 4-2-15 - REQUIRED PROVISIONS IN CARRIER CONTRACTS WITH PROVIDERS, CARRIER CONTRACTS WITH INTERMEDIARIES NEGOTIATING ON BEHALF OF PROVIDERS, AND CARRIER CONTRACTS WITH INTERMEDIARIES CONDUCTING UTILIZATION REVIEWS
- Regulation 4-2-16
- Regulation 4-2-17 - PROMPT INVESTIGATION OF HEALTH CLAIMS INVOLVING UTILIZATION REVIEW AND DENIAL OF BENEFITS AND RULES RELATED TO INTERNAL CLAIMS AND APPEALS PROCESSES
- Regulation 4-2-18
- Regulation 4-2-19
- Regulation 4-2-20 - CONCERNING THE SUMMARY OF BENEFITS AND COVERAGE FORM AND THE COLORADO SUPPLEMENT TO THE SUMMARY OF BENEFITS AND COVERAGE FORM
- Regulation 4-2-21 - External Review of Benefit Denials of Health Coverage Plans
- Regulation 4-2-22
- Regulation 4-2-23 - PROCEDURE FOR PROVIDER-CARRIER DISPUTE RESOLUTION
- Regulation 4-2-24 - CONCERNING CLEAN CLAIM REQUIREMENTS FOR HEALTH CARRIERS
- Regulation 4-2-25
- Regulation 4-2-26
- Regulation 4-2-27 - PROCEDURES FOR REASONABLE MODIFICATIONS TO INDIVIDUAL AND SMALL GROUP HEALTH BENEFIT PLANS
- Regulation 4-2-28 - CONCERNING THE PAYMENT OF EARLY INTERVENTION SERVICES FOR ELIGIBLE CHILDREN
- Regulation 4-2-29 - CONCERNING THE RULES FOR STANDARDIZED CARDS ISSUED TO PERSONS COVERED BY HEALTH BENEFIT PLANS AND DENTAL COVERAGE PLANS
- Regulation 4-2-30 - CONCERNING THE RULES FOR COMPLYING WITH MANDATED COVERAGE OF HEARING AIDS AND PROSTHETICS
- Regulation 4-2-31 - ANNUAL HEALTH REPORTING AND DATA RETENTION REQUIREMENTS
- Regulation 4-2-32 - STANDARDIZED ELECTRONIC IDENTIFICATION AND COMMUNICATION SYSTEMS GUIDELINES FOR HEALTH BENEFIT PLANS
- Regulation 4-2-33
- Regulation 4-2-34 - SECTION NAMES AND THE PLACEMENT OF THOSE SECTIONS IN POLICY FORMS BY CARRIERS
- Regulation 4-2-35 - REQUIRED INFORMATION FOR CARRIERS TO PROVIDE ON EXPLANATION OF BENEFITS FORMS
- Regulation 4-2-36
- Regulation 4-2-37 - REQUIRED INFORMATION FOR CARRIERS TO OBTAIN ON ALL FULL-LENGTH APPLICATIONS FOR INDIVIDUAL HEALTH BENEFIT PLANS
- Regulation 4-2-38 - CONTRACEPTIVE BENEFITS
- Regulation 4-2-39 - CONCERNING PREMIUM RATE SETTING FOR NON-GRANDFATHERED INDIVIDUAL, SMALL AND LARGE GROUP HEALTH BENEFIT PLANS
- Regulation 4-2-40 - CONCERNING THE ELEMENTS OF CERTIFICATION FOR CERTAIN LIMITED BENEFIT HEALTH PLANS, CREDIT LIFE AND HEALTH, PRENEED FUNERAL CONTRACTS, EXCESS/STOP-LOSS INSURANCE FORMS, SICKNESS AND ACCIDENT INSURANCE, AND OTHER LIMITED BENEFIT HEALTH PLANS
- Regulation 4-2-41 - CONCERNING THE ELEMENTS FOR FORM FILINGS FOR HEALTH BENEFIT PLANS, ACA-COMPLIANT STAND-ALONE DENTAL PLANS, STUDENT HEALTH INSURANCE COVERAGE, AND SHORT-TERM LIMITED DURATION HEALTH INSURANCE POLICIES
- Regulation 4-2-42 - CONCERNING ESSENTIAL HEALTH BENEFITS
- Regulation 4-2-43 - ENROLLMENT PERIODS RELATING TO INDIVIDUAL AND GROUP HEALTH BENEFIT PLANS
- Regulation 4-2-44
- Regulation 4-2-45 - UNIFORM INDIVIDUAL AND SMALL GROUP HEALTH BENEFIT PLAN APPLICATIONS
- Regulation 4-2-46 - CONCERNING PREMIUM RATE SETTING FOR GRANDFATHERED INDIVIDUAL, SMALL GROUP, AND LARGE GROUP HEALTH BENEFIT PLANS AND STUDENT HEALTH COVERAGE
- Regulation 4-2-47 - CONCERNING THE REQUIRED BENEFIT FOR APPLIED BEHAVIOR ANALYSIS THERAPY FOR THE TREATMENT OF AUTISM SPECTRUM DISORDERS FOR A CHILD
- Regulation 4-2-48 - CONCERNING GRACE PERIODS FOR POLICYHOLDERS RECEIVING ADVANCE PAYMENT TAX CREDITS
- Regulation 4-2-49 - CONCERNING THE DEVELOPMENT AND IMPLEMENTATION OF A UNIFORM DRUG BENEFIT PRIOR AUTHORIZATION PROCESS, THE REQUIRED DRUG APPEALS PROCESS, AND THE COVERAGE OF CERTAIN OPIOID DEPENDENCE AND OTHER SUBSTANCE USE DISORDER TREATMENT DRUGS
- Regulation 4-2-50 - CONCERNING PEDIATRIC DENTAL COVERAGE REQUIREMENTS
- Regulation 4-2-51 - CARRIER DISCONTINUANCE OR MARKET EXIT OF HEALTH BENEFIT PLANS OR STUDENT HEALTH INSURANCE COVERAGE POLICIES
- Regulation 4-2-52
- Regulation 4-2-53 - NETWORK ADEQUACY STANDARDS AND REPORTING REQUIREMENTS FOR ACA-COMPLIANT HEALTH BENEFIT PLANS
- Regulation 4-2-54 - NETWORK ACCESS PLAN STANDARDS AND REPORTING REQUIREMENTS FOR ACA-COMPLIANT HEALTH BENEFIT PLANS
- Regulation 4-2-55 - STANDARDS AND REPORTING REQUIREMENTS FOR ACA-COMPLIANT HEALTH BENEFIT PLAN PROVIDER DIRECTORIES
- Regulation 4-2-56 - CONCERNING NETWORK ADEQUACY AND CONTINUITY OF CARE REQUIREMENTS FOR ACA-COMPLIANT HEALTH BENEFIT PLANS
- Regulation 4-2-57 - NETWORK ADEQUACY STANDARDS AND REPORTING REQUIREMENTS FOR ACA-COMPLIANT STAND-ALONE DENTAL MANAGED CARE PLANS
- Regulation 4-2-58 - NON-DISCRIMINATORY COST-SHARING AND TIERING REQUIREMENTS FOR PRESCRIPTION DRUGS
- Regulation 4-2-59 - CONCERNING PREMIUM RATE SETTING FOR SHORT-TERM LIMITED DURATION HEALTH INSURANCE POLICIES
- Regulation 4-2-60 - CONCERNING NETWORK ADEQUACY FILINGS FOR DENTAL PLANS, VISION PLANS, PHARMACY PLANS, SHORT-TERM LIMITED DURATION HEALTH INSURANCE POLICIES AND OTHER NON-AFFORDABLE CARE ACT MANAGED CARE PLANS
- Regulation 4-2-61 - CONCERNING THE PAYMENT PARAMETERS FOR THE COLORADO REINSURANCE PROGRAM
- Regulation 4-2-62 - CONCERNING INSURANCE UNFAIR PRACTICES ACT PROHIBITIONS ON DISCRIMINATION BASED UPON SEXUAL ORIENTATION OR GENDER IDENTITY
- Regulation 4-2-63 - CONCERNING MEANINGFUL DIFFERENCE STANDARDS FOR HEALTH BENEFIT PLANS
- Regulation 4-2-64 - CONCERNING MENTAL HEALTH PARITY IN HEALTH BENEFIT PLANS
- Regulation 4-2-65 - CONCERNING THE ESTABLISHMENT OF A CARRIER PAYMENT ARBITRATION PROGRAM FOR OUT-OF-NETWORK PROVIDERS S
- Regulation 4-2-66 - CONCERNING THE PAYMENT METHODOLOGY FOR NON-CONTRACTED SERVICE AGENCIES THAT PROVIDE EMERGENCY AMBULANCE SERVICES
- Regulation 4-2-67 - CONCERNING CARRIER DISCLOSURES FOR EMERGENCY AND NON-EMERGENCY OUT-OF-NETWORK SERVICES
- Regulation 4-2-68 - CONCERNING PRESCRIPTION INSULIN DRUG COST SHARING AND LIMITATIONS
- Regulation 4-2-69
- Regulation 4-2-71 - CONCERNING CARRIER CARE MANAGEMENT PROTOCOLS FOR THE COLORADO REINSURANCE PROGRAM
- Regulation 4-2-72 - CONCERNING STRATEGIES TO ENHANCE HEALTH INSURANCE AFFORDABILITY
- Regulation 4-2-73 - CONCERNING HUMAN IMMUNODEFICIENCY VIRUS PRE-EXPOSURE PROPHYLAXIS PRESCRIPTION DRUGS AND BASELINE AND MONITORING SERVICES
- Regulation 4-2-74 - CONCERNING DATA REPORTING REQUIREMENTS FOR CARRIERS' OUT-OF- NETWORK REIMBURSEMENTS
- Regulation 4-2-75 - CONCERNING REQUIREMENTS FOR REPORTING MEDICATION-ASSISTED TREATMENT COVERAGE
- Regulation 4-2-76 - CONCERNING THE HEALTH INSURANCE AFFORDABILITY FEE ASSESSMENT AND COLLECTION PROCESS
- Regulation 4-2-77 - CONCERNING PAYMENTS TO CARRIERS FOR THE COLORADO REINSURANCE PROGRAM
- Regulation 4-2-78 - CONCERNING COST SHARING REDUCTION ENHANCEMENTS
- Regulation 4-2-79 - CONCERNING THE REQUIREMENTS FOR PROVIDER DATA REQUESTS AND CARRIER RESPONSES CONFIRMING OUT-OF-NETWORK PAYMENT METHODOLOGY UTILIZATION
- Regulation 4-2-80 - CONCERNING NETWORK ADEQUACY STANDARDS AND REPORTING REQUIREMENTS FOR COLORADO OPTION STANDARDIZED HEALTH BENEFIT PLANS
- Regulation 4-2-81 - CONCERNING COLORADO OPTION STANDARDIZED HEALTH BENEFIT PLAN
- Regulation 4-2-82 - CONCERNING CARRIER NOTICES TO POLICYHOLDERS FOR REASONABLE MODIFICATIONS, DISCONTINUANCES, MARKET EXITS AND CARRIER RENEWAL FOR OFF-EXCHANGE PLANS
- Regulation 4-2-83 - CONCERNING HEALTH INSURANCE AFFORDABILITY ENTERPRISE SUBSIDIES FOR QUALIFIED INDIVIDUALS THROUGH PREMIUM WRAP AND COST SHARING REDUCTION ENHANCEMENTS ON THE COLORADO OPTION SILVER PLAN
- Regulation 4-2-84 - CONCERNING THE SPECIAL ASSESSMENT ON HOSPITALS FOR THE COLORADO HEALTH INSURANCE AFFORDABILITY ENTERPRISE
- Regulation 4-2-85 - CONCERNING THE METHODOLOGY FOR CALCULATING PREMIUM RATE REDUCTIONS FOR COLORADO OPTION STANDARDIZED HEALTH BENEFIT PLANS
- Regulation 4-2-86 - CONCERNING THE METHODOLOGY FOR CALCULATING THE HEALTHCARE COVERAGE COOPERATIVE EXEMPTION FOR THE COLORADO OPTION STANDARDIZED HEALTH BENEFIT PLANS AND PREMIUM RATE REDUCTION REQUIREMENT
- Regulation 4-2-87 - CONCERNING OCCUPATIONAL ACCIDENT INSURANCE COVERAGE
- Regulation 4-2-88 - CONCERNING GAG CLAUSES IN INDIVIDUAL AND GROUP HEALTH BENEFIT PLANS
- Regulation 4-2-89 - COMPENSATION DISCLOSURES FOR HEALTH INSURANCE CARRIERS
- Regulation 4-2-90 - CONCERNING COVERAGE FOR COVID-19 VACCINES
- Regulation 4-2-91 - CONCERNING THE METHODOLOGY FOR CALCULATING REIMBURSEMENT RATES TO SUPPORT PREMIUM RATE REDUCTIONS FOR COLORADO OPTION STANDARDIZED HEALTH BENEFIT PLANS
- Regulation 4-2-92 - CONCERNING COLORADO OPTION PUBLIC HEARINGS
- Regulation 4-2-95 - CONTRACEPTIVE BENEFIT REQUIREMENTS FOR HEALTH BENEFIT PLANS
- Regulation 4-2-96 - CONCERNING PRIMARY CARE ALTERNATIVE PAYMENT MODEL PARAMETERS
- Regulation 4-2-97 - CONCERNING THE REQUIREMENTS FOR PHARMACY BENEFIT MANAGERS TO REGISTER IN COLORADO
- Regulation 4-2-98 - CONCERNING COVERAGE OF THE RESPIRATORY SYNCYTIAL VIRUS IMMUNIZATIONS AS A PREVENTIVE SERVICE
- Regulation 22-E-20 - HEALTH-CARE SHARING PLAN OR ARRANGEMENT REQUIRED REPORTING
- Regulation 23-E-01 - CONCERNING COLORADO OPTION STANDARDIZED HEALTH BENEFIT PLAN
- Regulation 22-E-02 - CONCERNING THE METHODOLOGY FOR CALCULATING PREMIUM RATE REDUCTIONS FOR COLORADO OPTION STANDARDIZED HEALTH BENEFIT PLANS
- Regulation 23-E-08 - CONCERNING COVERAGE OF THE RESPIRATORY SYNCYTIAL VIRUS IMMUNIZATIONS AS A PREVENTIVE SERVICE
- Regulation 24-E-01 - CONCERNING COVERAGE OF THE RESPIRATORY SYNCYTIAL VIRUS IMMUNIZATIONS AS A PREVENTIVE SERVICE
Current through Register Vol. 47, No. 5, March
10, 2024
For history of this section, see Editor's Notes in the first section, 3 CCR 702-4
3 CCR 702-4 has been divided into smaller sections for ease of use. Versions prior to 09/01/2011 and rule history are located in the first section, 3 CCR 702-4. Prior versions can be accessed from the All Versions list on the rule's current version page. To view versions effective after 09/01/2011, select the desired part of the rule, for example 3 CCR 702-4 Series 4-1, or 3 CCR 702-4 Series 4-6.
Disclaimer: These regulations may not be the most recent version. Colorado may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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