Each carrier shall report the number and outcome of second-level internal appeals pursuant to section 10-16-113 to the division by February 1 of each year. On at least an annual basis, the division shall compile the information reported by each carrier along with the number and outcome of third-level external appeals of each health coverage plan and make such information available on the division website and for public inspection. The commissioner may specify the format in which the information shall be submitted by a carrier.
Source: L. 2005: Entire section added, p. 805, § 4, effective January 1, 2006.
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