Colorado Code
Part 1 - General Provisions
§ 10-16-116. Catastrophic Health Insurance - Coverage - Premium Payments - Reporting Requirements - Definitions - Short Title

























Source: L. 94: Entire section added, p. 742, § 1, effective January 1, 1995; (2) amended, p. 1917, § 10, effective July 1. L. 2000: (2)(a), (2)(b), (2)(e), (2)(f), IP(2)(h), and (2)(h)(II) amended and (2)(i) added, p. 171, § 1, effective January 1, 2001. L. 2002: (3) added, p. 1293, § 4, effective January 1, 2003. L. 2004: (1), (2)(a), (2)(b), (2)(d), (2)(g), (2)(h)(II), and (3) amended, p. 989, § 8, effective August 4. L. 2007: (3) amended, p. 451, § 4, effective January 1, 2008. L. 2009: (3) amended, (HB 09-1204), ch. 344, p. 1808, § 5, effective January 1, 2010. L. 2013: Entire section amended with relocations, (HB 13-1266), ch. 217, p. 970, § 21, effective May 13.
Editor's note: Subsection (1) is similar to former § 10-16-114; subsection (4) is similar to former § 10-16-117 (1); subsection (5) is similar to former § 10-16-117 (2), (3), and (4); and subsection (6) is similar to former § 10-16-115, as those sections existed prior to 2013.
Cross references: For the legislative declaration contained in the 2009 act amending subsection (3), see section 1 of chapter 344, Session Laws of Colorado 2009.

Structure Colorado Code

Colorado Code

Title 10 - Insurance

Article 16 - Health-Care Coverage

Part 1 - General Provisions

§ 10-16-101. Short Title

§ 10-16-102. Definitions

§ 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

§ 10-16-104.1. Prohibition on Discrimination for Organ Transplants Based Solely on Disability - Definition

§ 10-16-104.2. Coverage for Contraception - Definitions

§ 10-16-104.3. Health Coverage for Persons Under Twenty-Six Years of Age - Coverage for Students Who Take Medical Leave of Absence

§ 10-16-104.6. Off-Label Use of Cancer Drugs

§ 10-16-104.7. Substance Use Disorders - Court-Ordered Treatment Coverage

§ 10-16-104.8. Behavioral, Mental Health, or Substance Use Disorder Services Coverage - Court-Ordered

§ 10-16-104.9. Geographic Areas for Small Employers

§ 10-16-105. Guaranteed Issuance of Health Insurance Coverage - Individual and Small Employer Health Benefit Plans

§ 10-16-105.1. Guaranteed Renewability - Exceptions - Individual and Small Employer Health Benefit Plans - Rules

§ 10-16-105.2. Small Employer Health Insurance Availability Program

§ 10-16-105.3. Health Benefit Plans - Not Prohibited

§ 10-16-105.6. Rate Usage

§ 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

§ 10-16-109. 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

§ 10-16-112.5. Prior Authorization for Health- Care Services - Disclosures and Notice - Determination Deadlines - Criteria - Limits and Exceptions - Definitions - Rules

§ 10-16-113. Procedure for Denial of Benefits - Internal Review - Rules - Definitions

§ 10-16-113.5. Independent External Review of Adverse Determinations - Legislative Declaration - Definitions - Rules

§ 10-16-113.7. Reporting the Denial of Benefits to Division

§ 10-16-116. Catastrophic Health Insurance - Coverage - Premium Payments - Reporting Requirements - Definitions - Short Title

§ 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,...

§ 10-16-118. Prohibition Against Preexisting Condition Exclusions

§ 10-16-119. Requirements for Excess Loss or Stop-Loss Health Insurance Used in Conjunction With Self-Insured Employer Benefit Plans Under the Federal "Employee Retirement Income Security Act" - Data Collection 2013-18 - Rules

§ 10-16-119.5. Stop-Loss Health Insurance for Small Employers of Not More Than Fifty Employees - Requirements - Definitions - Rules

§ 10-16-121. Required Contract Provisions in Contracts Between Carriers and Providers - Definitions

§ 10-16-121.5. Prohibited Contract Provisions in Contracts Between Carriers and Providers for Dental Services - Definition

§ 10-16-121.7. Prohibited Contract Provisions in Contracts Between Carriers and Eye Care Providers - Definitions

§ 10-16-122. Access to Prescription Drugs

§ 10-16-122.1. Contracts Between Pbms and Pharmacies - Carrier Submit List of Pbms - Prohibited Practices - Exception - Short Title - Definitions

§ 10-16-122.3. Pharmacy Benefit Management Firm Payments - Retroactive Reduction Prohibited - Enforcement - Rules - Definitions

§ 10-16-122.5. Pharmacy Benefit Manager - Audit of Pharmacies - Time Limits on On-Site Audits

§ 10-16-122.7. Disclosures Between Pharmacists and Patients - Carrier Prohibitions - Short Title - Legislative Declaration - Preemption by Federal Law

§ 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

§ 10-16-124.8. Colorado Consortium for Prescription Drug Abuse Prevention - Create Process for Recovery - Report

§ 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

§ 10-16-133. Health Carrier Information Disclosure - Website - Insurance Producer Fees and Disclosure Requirements - Legislative Declaration - Rules

§ 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

§ 10-16-141. Medication Synchronization Services - Cost Sharing for Partial Refills - Dispensing Fees

§ 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

§ 10-16-145.5. Step Therapy - Prior Authorization - Prohibited - Stage Four Advanced Metastatic Cancer - Opioid Prescription - Definitions

§ 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

§ 10-16-150. Primary Care Payment Reform Collaborative - Created - Powers and Duties - Report - Definition - Repeal

§ 10-16-151. Cost Sharing in Prescription Insulin Drugs - Limits - Definition - Rules

§ 10-16-152. Hiv Prevention Medication - Limitations on Carriers - Step Therapy - Prior Authorization

§ 10-16-153. Coverage for Opiate Antagonists Provided by a Hospital - Definition

§ 10-16-154. Disclosures - Physical Therapists - Occupational Therapists - Chiropractors - Acupuncturists - Patients - Carrier Prohibitions - Enforcement