Source: L. 97: Entire section added, p. 1334, § 1, effective July 1. L. 99: (3) amended, p. 320, § 4, effective July 1; (3) amended, p. 1047, § 1, effective June 1, 2000. L. 2003: (1) to (4), (6), and (7) amended, p. 1384, § 1, effective January 1, 2004. L. 2004: (3)(b)(I) amended, p. 988, § 7, effective August 4. L. 2005: (1)(c), (3)(b)(IV), (3)(b)(V), and (3)(b)(VI) added and (3)(b)(I) amended, p. 803, §§ 1, 2, effective January 1, 2006. L. 2008: (3)(b)(V), (4), and (5) amended, p. 83, § 1, effective August 5. L. 2013: Entire section amended, (HB 13-1266), ch. 217, p. 956, § 19, effective May 13. L. 2014: (1)(c) amended, (HB 14-1277), ch. 363, p. 1735, § 37, effective July 1. L. 2019: (3)(c) added, (HB 19-1269), ch. 195, p. 2128, § 6, effective May 16; (1)(c) amended, (HB 19-1172), ch. 136, p. 1654, § 44, effective October 1.
Editor's note: Amendments to subsection (3) by House Bill 99-1306 and Senate Bill 99-141 were harmonized.
Cross references: (1) For the legislative declaration contained in the 1999 act amending subsection (3), see section 1 of chapter 111, Session Laws of Colorado 1999.
(2) For the short title ("Behavioral Health Care Coverage Modernization Act") in HB 19-1269, see section 1 of chapter 195, Session Laws of Colorado 2019.
Structure Colorado Code
Article 16 - Health-Care Coverage
§ 10-16-103. Proposal of Mandatory Health- Care Coverage Provisions
§ 10-16-103.4. Essential Health Benefits - Requirements - Rules
§ 10-16-103.5. Payment of Premiums - Required Term in Contract - Rules - Definition
§ 10-16-104. Mandatory Coverage Provisions - Definitions - Rules
§ 10-16-104.2. Coverage for Contraception - Definitions
§ 10-16-104.6. Off-Label Use of Cancer Drugs
§ 10-16-104.7. Substance Use Disorders - Court-Ordered Treatment Coverage
§ 10-16-104.9. Geographic Areas for Small Employers
§ 10-16-105.2. Small Employer Health Insurance Availability Program
§ 10-16-105.3. Health Benefit Plans - Not Prohibited
§ 10-16-105.7. Health Benefit Plan Open Enrollment Periods - Special Enrollment Periods - Rules
§ 10-16-106. Group Replacement - Extension of Benefits
§ 10-16-106.3. Uniform Claims - Billing Codes - Electronic Claim Forms
§ 10-16-106.5. Prompt Payment of Claims - Legislative Declaration - Rules
§ 10-16-106.7. Assignment of Health Insurance Benefits
§ 10-16-107. Rate Filing Regulation - Benefits Ratio - Rules
§ 10-16-107.1. False or Misleading Information - Penalties
§ 10-16-107.2. Filing of Health Policies - Rules
§ 10-16-107.3. Health Insurance Policies - Plain Language Required - Rules
§ 10-16-107.5. Uniform Application Form - Use by All Carriers - Rules
§ 10-16-107.7. Nondiscrimination Against Providers
§ 10-16-108. Continuation Privileges
§ 10-16-108.5. Fair Marketing Standards - Rules
§ 10-16-110. Fees Paid by Health Coverage Entities
§ 10-16-111. Annual Statements and Reports - Rules
§ 10-16-112. Private Utilization Review - Health-Care Coverage Entity Responsibility - Definitions
§ 10-16-113. Procedure for Denial of Benefits - Internal Review - Rules - Definitions
§ 10-16-113.7. Reporting the Denial of Benefits to Division
§ 10-16-118. Prohibition Against Preexisting Condition Exclusions
§ 10-16-121. Required Contract Provisions in Contracts Between Carriers and Providers - Definitions
§ 10-16-122. Access to Prescription Drugs
§ 10-16-122.5. Pharmacy Benefit Manager - Audit of Pharmacies - Time Limits on On-Site Audits
§ 10-16-122.9. Prescription Drug Benefits - Real-Time Access to Benefit Information - Definitions
§ 10-16-123. Telehealth - Definitions
§ 10-16-124. Prescription Information Cards - Legislative Declaration
§ 10-16-124.5. Prior Authorization Form - Drug Benefits - Rules of Commissioner - Definitions
§ 10-16-124.7. Opioid Analgesics With Abuse-Deterrent Properties - Study - Definitions
§ 10-16-125. Reimbursement to Nurses
§ 10-16-126. Fee-for-Service Dental Plans
§ 10-16-127. Coinsurance and Deductibles
§ 10-16-128. Annual Report to General Assembly
§ 10-16-129. Health Savings Accounts
§ 10-16-130. Disclosure of Rate Increases to Public Entities - Legislative Declaration - Definitions
§ 10-16-134. Health-Care Transparency - Information Required - Website - Definition
§ 10-16-135. Health Benefit Plan Information Cards - Rules - Standardization - Contents
§ 10-16-137. Policy Forms - Explanation of Benefits - Standardization of Forms - Rules
§ 10-16-138. Pathology Services - Direct Billing Required
§ 10-16-139. Access to Care - Rules - Definitions
§ 10-16-140. Grace Periods - Premium Payments - Rules
§ 10-16-142. Physical Rehabilitation Services - Copayments and Coinsurance - Research
§ 10-16-143.5. Pharmacy Reimbursement - Substance Use Disorders - Injections - Patient Counseling
§ 10-16-144. Health-Care Services Provided by Pharmacists
§ 10-16-145. Step Therapy - Prohibited - Definition
§ 10-16-145.5. Step Therapy Prohibited - Stage Four Advanced Metastatic Cancer - Definition
§ 10-16-146. Periodic Updates to Provider Directory
§ 10-16-147. Parity Reporting - Commissioner - Carriers - Rules - Examination of Complaints
§ 10-16-148. Medication-Assisted Treatment - Limitations on Carriers - Rules - Definition
§ 10-16-149. Commissioner Report - Parity Effects on Premiums - Repeal
§ 10-16-151. Cost Sharing in Prescription Insulin Drugs - Limits - Definition - Rules
§ 10-16-153. Coverage for Opiate Antagonists Provided by a Hospital - Definition