C.R.S. § 10-22-101 Short title
10-22-101. Short title. This article is known and may be cited as the "Colorado Health Benefit Exchange Act".
Colorado Health Benefit Exchange
C.R.S. tit. 10, art. 22
in effectC.R.S. § 10-22-102 Legislative declaration - intent
10-22-102. Legislative declaration - intent. The general assembly determines and declares that with the March 23, 2010, enactment of the federal "Patient Protection and Affordable Care Act", Pub.L. 111-148, and the March 30, 2010, enactment of the "Health Care and Education Reconciliation Act of 2010", Pub.L. 111-152, which allow each state to establish a health benefit exchange through state law or opt to participate in a national health benefit exchange operated by the federal department of health and human services, and although there are numerous federal lawsuits challenging the constitutionality of the federal act in multiple federal courts, the best option for the state of Colorado is to establish a health benefit exchange at the state level. The general assembly further finds that the federal act requires each state to establish a health benefit exchange to perform certain duties and to assume certain responsibilities set forth in the federal act or make sufficient progress in the creation of a health benefit exchange by January 1, 2013, or default to a federally run national health benefit exchange. Therefore, the general assembly intends to create a health benefit exchange to fit the unique needs of Colorado, seek Colorado-specific solutions, and explore the maximum number of options available to the state of Colorado. The Colorado health benefit exchange, including an American health benefit exchange, is intended to facilitate the access to and enrollment in health plans in the individual market in this state and include a small business health options program to assist small employers in this state in facilitating the enrollment of their employees in health plans offered in the small employer market. The intent of the Colorado health benefit exchange is to increase access, affordability, and choice for individuals and small employers purchasing health insurance in Colorado.
C.R.S. § 10-22-103 Definitions
10-22-103. Definitions. As used in this article 22, unless the context otherwise requires:
(1) "Board" means the board of directors of the exchange, appointed in accordance with section 10-22-105.
(2) "Committee" means the Colorado health insurance exchange oversight committee created in section 10-22-107.
(3) "Exchange" means the Colorado health benefit exchange created in this article.
(4) "Federal act" means the "Patient Protection and Affordable Care Act", Pub.L. 111-148, as amended by the "Health Care and Education Reconciliation Act of 2010", Pub.L. 111-152.
(5) "Group health plan" means an employee welfare benefit plan as defined in 29 U.S.C. sec. 1002 (1) of the federal "Employee Retirement Income Security Act of 1974" to the extent that the plan provides health-care services, including items and services paid for as health-care services, to employees or their dependents directly or through insurance reimbursement or otherwise. A "group health plan" includes a government or church plan.
(6) "Health benefit plan" has the same meaning set forth in section 10-16-102; except that the term includes a dental plan.
(6.5) "Health-care coverage affordability program" means:
(a) A medical assistance program under the "Colorado Medical Assistance Act", articles 4, 5, and 6 of title 25.5;
(b) The "Children's Basic Health Plan Act", article 8 of title 25.5; or
(c) A health benefit plan offered through the exchange for which a premium tax credit or cost-sharing reductions are available.
(7) "Insurer" means any entity that provides group health plans or individual health benefit plans subject to insurance regulation in this state, as well as any entity that directly or indirectly provides stop-loss or excess loss insurance to a self-insured group health plan including a property and casualty insurance company.
(8) "Medicaid" means federal insurance or assistance as provided by Title XIX of the federal "Social Security Act", as amended.
(9) "Medicare" means federal insurance or assistance as provided by Title XVIII of the federal "Social Security Act", as amended.
(10) "Number of lives insured" means the number of employees and retired employees and individual policyholders or subscribers in the individual and group markets on March 1 of the previous calendar year for which a special fee is being assessed. For insurers providing stop-loss, excess loss, or reinsurance, "number of lives insured" does not include employees, retired employees, or individual policyholders or subscribers who have been counted by the primary insurer or primary reinsurer.
(11) "Secretary" means the secretary of the United States department of health and human services.
C.R.S. § 10-22-104 Health benefit exchange - creation
10-22-104. Health benefit exchange - creation. There is hereby created a nonprofit unincorporated public entity known as the health benefit exchange. The board of directors shall govern the operation of the exchange. The board shall determine and establish the development, governance, and operation of the exchange. The exchange is an instrumentality of the state; except that the debts and liabilities of the exchange do not constitute the debts and liabilities of the state, and neither the exchange nor the board is an agency of the state. The board does not have the authority to promulgate rules pursuant to the "State Administrative Procedure Act", article 4 of title 24, C.R.S. The exchange shall not duplicate or replace the duties of the commissioner established in section 10-1-108, including rate approval, except as directed by the federal act. The exchange shall foster a competitive marketplace for insurance and shall not solicit bids or engage in the active purchasing of insurance. All carriers authorized to conduct business in this state may be eligible to participate in the exchange.
C.R.S. § 10-22-105 Exchange board of directors
10-22-105. Exchange board of directors. (1) (a) There is created the board of directors of the exchange. The board consists of twelve members, including nine voting members appointed pursuant to subsection (1)(b) of this section and three nonvoting, ex officio members as set forth in subsection (1)(c) of this section.
(b) (I) The governor shall appoint five voting members to the board, and the president of the senate, the minority leader of the senate, the speaker of the house of representatives, and the minority leader of the house of representatives shall each appoint one voting member to the board. The governor shall not appoint more than three members from the same political party.
(II) Appointed members of the board may be removed by their respective appointing authorities for cause. The appointing authority making the original appointment shall fill a vacancy by appointment for the remainder of an unexpired term.
(III) The term of an appointed member is four years; except that the terms shall be staggered so that no more than five members' terms expire in the same year. Members may serve a maximum of two consecutive terms. If a member is appointed to fill a vacancy and serves for more than half of the unexpired term, the member shall be eligible for appointment to only one more consecutive term.
(IV) The appointing authorities shall coordinate appointments to ensure that there is broad representation within the skill sets specified in this subsection (1)(b)(IV) and shall consider the geographic, economic, ethnic, and other characteristics of the state when making the appointments. A majority of the voting members must be business representatives or individuals who are not directly affiliated with the insurance industry, and none shall be state employees. Each person appointed to the board should have demonstrated expertise in at least two, and in any case shall have demonstrated expertise in no less than one, of the following areas:
(A) Individual health insurance coverage;
(B) Small employer health insurance;
(C) Health benefits administration;
(D) Health-care finance;
(E) Administration of a public or private health-care delivery system;
(F) The provision of health-care services;
(G) The purchase of health insurance coverage;
(H) Health-care consumer navigation or assistance;
(I) Health-care economics or health-care actuarial sciences;
(J) Information technology; or
(K) Starting a small business with fifty or fewer employees.
(c) The executive director of the department of health care policy and financing, or his or her designee; the commissioner of insurance, or his or her designee; and the director of the office of economic development and international trade, or his or her designee, shall serve as nonvoting, ex officio members of the board.
(d) The board shall elect one of its members as chair of the board.
(2) Each member of the board is responsible for meeting the requirements of this article and all applicable state and federal laws, rules, and regulations; serving in the public interest of the individuals and small businesses seeking health-care coverage through the exchange; and ensuring the operational well-being and fiscal solvency of the exchange.
(3) (a) Board members shall not receive compensation for performance of services for the board but may receive a per diem and reimbursement for travel and other necessary expenses while engaged in the performance of official duties of the board. Per diem and reimbursement expenses are paid through grant moneys received by the board.
(b) A member of the board shall not perform an official act that may have a direct economic benefit on a business or other undertaking in which the member has a direct or substantial financial interest.
t for travel and other necessary expenses while engaged in the performance of official duties of the board. Per diem and reimbursement expenses are paid through grant moneys received by the board.
(b) A member of the board shall not perform an official act that may have a direct economic benefit on a business or other undertaking in which the member has a direct or substantial financial interest.
(c) A board member or an officer or employee of the exchange is not liable for an act or omission when acting in his or her official capacity, in good faith, without intent to defraud, and in connection with the administration, management, or conduct of this article.
(4) (a) Board members are subject to articles 6, 18, and 72 of title 24, C.R.S.
(b) All moneys received by the board for the exchange are subject to audit by the legislative audit committee. The board shall report all moneys received for the exchange to the legislative audit committee.
(c) The state auditor may conduct or cause to be conducted a performance audit of the exchange, including the operation, contract management, project management, and performance of the shared eligibility system and any other related or corresponding state systems in order to ensure a complete and thorough audit of the operation of the exchange. Upon completion of a performance audit, the state auditor shall submit a written report to the legislative audit committee, together with any findings and recommendations. The state auditor has continuing authority to conduct performance audits of the exchange whenever the state auditor or the legislative audit committee deems appropriate.
(5) Any information provided to a board member pursuant to this article that is exempt from disclosure under either section 24-72-204, C.R.S., or part 4 of article 6 of title 24, C.R.S., shall be and remain confidential and may be used only by the board.
C.R.S. § 10-22-106 Powers and duties of the board
10-22-106. Powers and duties of the board. (1) The board is the governing body of the exchange and has all the powers and duties necessary to implement this article 22. The board shall:
(a) Appoint an executive director to administer the exchange, subject to approval by the committee;
(b) Create an initial operational and financial plan, subject to approval by the committee;
(c) Apply for planning and establishment grants made available to the exchange pursuant to the federal act and apply for, receive, and expend other gifts, grants, and donations. Each grant application is subject to the review and unanimous approval of the board chair and the chair and vice-chair of the committee prior to the submission of the application. If there is not unanimous approval, each grant application is subject to review and the majority approval of the committee.
(d) Create technical and advisory groups to operate on an ongoing basis and to report to the board and provide guidance at the direction of the board on issues that directly or indirectly affect consumers. The board shall use reasonable efforts to ensure that the technical and advisory groups reflect geographic diversity and diverse opinions on issues affecting consumers. The technical and advisory groups shall meet as necessary to discuss issues related to the exchange and to make recommendations to the board.
(e) Provide a written open enrollment report to the governor and the general assembly annually and present an open enrollment update to the senate health and human services committee and the house of representatives health and human services committee, or their successor committees, during each legislative session;
(f) Review the internet portal operated and maintained by the secretary and the model template for an internet portal made available by the secretary for use by the state exchanges and review other appropriate internet portals. The review must include an examination as to whether the model template may be used to direct individuals and employers to health plans, to assist individuals and employers in determining whether they are eligible to participate in the exchange or eligible for a premium tax credit or cost-sharing reduction, and to present standardized information regarding health plans offered through the exchange to assist consumers in making health insurance choices.
(g) Consider the desirability of structuring the exchange as one entity that includes two underlying entities to operate in the individual and the small employer markets, respectively;
(h) Consider the appropriate size of the small employer market under the exchange, taking into consideration the definition of "small employer" pursuant to section 10-16-102;
(i) Consider the unique needs of rural Coloradans as they pertain to access, affordability, and choice in purchasing health insurance;
(j) Consider the affordability and cost in the context of quality care and increased access to purchasing health insurance; and
e small employer market under the exchange, taking into consideration the definition of "small employer" pursuant to section 10-16-102;
(i) Consider the unique needs of rural Coloradans as they pertain to access, affordability, and choice in purchasing health insurance;
(j) Consider the affordability and cost in the context of quality care and increased access to purchasing health insurance; and
(k) Investigate requirements, develop options, and determine waivers, if appropriate, to ensure that the best interests of Coloradans are protected.
(2) The board may enter into information-sharing agreements with federal and state agencies and other state exchanges to carry out its responsibilities under this article so long as the agreements include adequate protections with respect to the confidentiality of the information that is shared and comply with all state and federal laws, rules, and regulations.
(3) The board may create a separate program that shares resources and infrastructure with the exchange to offer ancillary products.
(4) The board may enter into an agreement with the department of personnel to authorize administrative law judges employed by the office of administrative courts to hear and decide matters arising from eligibility and other determinations made by the exchange consistent with applicable state and federal law.
(5) (a) The board, with public input, shall set a policy that makes clear which actions by the exchange require public scrutiny and shall make the policy available to the committee. In determining which actions require public scrutiny, the board shall consider the effects the exchange's actions have on consumers.
(b) Prior to taking an action that requires public scrutiny, the exchange shall post notice of the planned action on the exchange website at least three weeks prior to the date of the board meeting at which the action will be discussed. The exchange shall provide time for public comments and questions at the board meeting and post the final action on the exchange website.
(c) The board may adopt an action without compliance with paragraph (b) of this subsection (5) if the board finds that immediate adoption is necessary to avoid disruption of the continuing operation of the exchange. The exchange shall make the action and the reasons for the action available to the public and the committee.
C.R.S. § 10-22-107 Colorado health insurance exchange oversight committee - creation - duties
10-22-107. Colorado health insurance exchange oversight committee - creation - duties. (1) (a) For the purposes of guiding implementation of an exchange in Colorado, making recommendations to the general assembly, and ensuring that the interests of Coloradans are protected and furthered, there is hereby created the Colorado health insurance exchange oversight committee. The committee shall meet at the call of the chair at least one time during each calendar year when the general assembly is not in session but no more than seven times during each calendar year when the general assembly is not in session. The committee may meet an unlimited number of times at the call of the chair when the general assembly is in session. The committee may use the legislative council staff to assist its members in researching any matters.
(b) Repealed.
(2) (a) The president of the senate shall appoint three members to the committee. Two appointees must be members of the senate health and human services committee; the senate business, labor, and technology committee; the legislative audit committee; or their successor committees. One appointee must be a representative of the senate at large.
(b) The speaker of the house of representatives shall appoint three members to the committee. Two appointees must be members of the house of representatives health and human services committee, the house of representatives business affairs and labor committee, the legislative audit committee, or their successor committees. One appointee must be a representative of the house of representatives at large.
(c) The minority leader of the senate shall appoint two members to the committee. One appointee must be a member of the senate health and human services committee; the senate business, labor, and technology committee; the legislative audit committee; or their successor committees. One appointee must be a representative of the senate at large.
(d) The minority leader of the house of representatives shall appoint two members to the committee. One appointee must be a member of the house of representatives health and human services committee, the house of representatives business affairs and labor committee, the legislative audit committee, or their successor committees. One appointee must be a representative of the house of representatives at large.
(e) Members of the committee shall serve at the pleasure of the appointing authority.
(3) Members of the committee shall serve without compensation; except that each member shall receive the sums specified in section 2-2-307 (3)(a) and (3)(b), C.R.S., for attendance at meetings of the committee when the general assembly is in recess for more than three days or is not in session.
(4) During odd-numbered years, the president of the senate shall appoint the chair, and the speaker of the house of representatives shall appoint the vice-chair of the committee. During even-numbered years, the speaker of the house of representatives shall appoint the chair, and the president of the senate shall appoint the vice-chair of the committee.
(5) (a) In any year, the committee may report up to eight bills or other measures to the legislative council created in section 2-3-301. These bills are exempt from any applicable bill limit imposed on the individual committee members sponsoring such bills if the bills have been approved by the legislative council under joint rules of the senate and house of representatives.
(b) Repealed.
(6) The committee shall review grants applied for by the board to implement the exchange.
(7) The exchange shall annually present to the committee the financial and operational plans of the exchange and the major actions taken by the board, particularly actions that affect consumers. The committee shall review the financial and operational plans of the exchange and the major actions taken by the board.
C.R.S. § 10-22-108 Moneys for implementation, operation, and sustainability of the exchange
10-22-108. Moneys for implementation, operation, and sustainability of the exchange. Moneys received by the board for the implementation of this article, and for building reserves for the operation and sustainability of the exchange pursuant to section 10-22-109, must be transferred directly to the exchange for the purposes of this article. The board shall deposit any moneys received in a banking institution within or outside the state. Moneys from the general fund shall not be used for the implementation of this article, except for the sums specified in section 10-22-107 (3) and for legislative staff agency services. The account of the banking institution must be insured by the federal deposit insurance corporation and compliant with the "Public Deposit Protection Act", article 10.5 of title 11, C.R.S.
C.R.S. § 10-22-109 Funding for the operation of the exchange and reserves - special fees - rules
10-22-109. Funding for the operation of the exchange and reserves - special fees - rules. (1) On and after January 1, 2014, among other funding sources derived through the operation of the exchange, funding for the exchange may be from the following sources:
(a) Special fees assessed against insurers as provided in subsection (2) of this section; and
(b) Any moneys accepted through gifts, grants, or donations received by the board for operation, reserves, and sustainability of the exchange, including contributions received pursuant to the premium tax credit allocation in section 10-22-110.
(c) Repealed.
(2) (a) On and after January 1, 2014, through December 31, 2016, the board shall assess special fees against insurers in an amount necessary to provide funding for the exchange. The board shall determine the amount of the special fees based on the board-approved financial plan and anticipated budgetary needs for the upcoming year to comply with this article and associated federal requirements. The special fees must not exceed one dollar and eighty cents per number of lives insured per month; except that the special fees assessed for lives insured under dental plans must not exceed eighteen cents per number of lives insured per month. The board shall use special fees assessed pursuant to this section for the operating expenses of the exchange, the reserves of the exchange, and related agreements.
(b) The board shall use any money received pursuant to section 10-8-536 (2), as enacted in House Bill 13-1115, enacted in 2013, from the reserves of CoverColorado, as created by part 5 of article 8 of this title, and any moneys received from the unclaimed property trust fund to offset the amount of the fees assessed against insurers pursuant to this subsection (2); except that the money received must not be used to offset the special fees paid by dental plans.
(c) Amounts assessed against insurers to be paid to the exchange pursuant to this subsection (2) are not considered premiums for any purpose, including the computation of gross premium tax or agents' commission.
(d) If an insurer fails to pay the special assessment fee, the commissioner may, after proper notice and hearing, suspend or revoke the insurer's certificate of authority to transact insurance business in this state.
(3) The commissioner shall promulgate rules to implement this section that include:
(a) The reasonable time periods for the billing and collection of the special fees; and
(b) The process for determining the allocation of the assessment among insurers, including the process for obtaining accurate information about the number of policies issued and lives insured by an insurer within the six months prior to the assessment.
C.R.S. § 10-22-110 Tax credit for contributions to the exchange - allocation notice - rules - repeal
10-22-110. Tax credit for contributions to the exchange - allocation notice - rules - repeal. (1) (a) For the tax year 2013 and each tax year thereafter, a credit against the tax imposed by sections 10-3-209 and 10-6-128 is allowed to any insurance company that becomes a qualified taxpayer by making a contribution to the exchange pursuant to this section.
(b) A qualified taxpayer claiming a credit against premium tax liability under this section is not required to pay any additional retaliatory tax as a result of claiming the credit.
(2) The commissioner may promulgate rules necessary for the administration of the tax credit allowed by subsection (1) of this section in accordance with article 4 of title 24, C.R.S.
(3) (a) Subject to subsection (4)(c) of this section, an insurance company shall become a qualified taxpayer if all of the following conditions are met:
(I) The insurance company declares with its quarterly tax payment due on or about July 31 in the manner prescribed by the commissioner its intent to contribute to the exchange on or before October 31 an amount of money equal to the premium taxes paid by the company pursuant to the July 31 tax payment or a lesser amount as specified by the commissioner if required pursuant to paragraph (b) of subsection (4) of this section;
(II) The total amount of the tax credits granted by the commissioner does not exceed five million dollars; except that, on and after September 1, 2022, through August 31, 2028, the total amount of the tax credits does not exceed nine million dollars; and
(III) The insurance company receives an allocation notice from the commissioner and the insurance company makes the contribution to the exchange as specified in the allocation notice on or before October 31.
(b) Subject to paragraph (c) of subsection (4) of this section, an insurance company that becomes a qualified taxpayer may claim the tax credit on one or more subsequent quarterly or annual tax payments beginning on or about October 31.
(c) The board shall promptly notify the commissioner when it receives a contribution pursuant to this section of the amount and date of the contribution and the name of the contributor.
(4) (a) Subject to paragraph (c) of this subsection (4), by September 30 of each year, the commissioner shall:
(I) Send an allocation notice to each insurance company whose declaration of intent to contribute to the exchange has been accepted pursuant to this subsection (4). The allocation notice shall specify the amount of tax credits allocated to the insurance company and the amount of cash the insurance company must contribute to the exchange by October 31, which amounts shall be identical and not exceed the amount of premium taxes paid by the insurance company in its quarterly tax payment due on or about July 31.
(II) Post on the division's website whether the full amount of tax credits authorized to be allocated each year has been allocated.
surance company and the amount of cash the insurance company must contribute to the exchange by October 31, which amounts shall be identical and not exceed the amount of premium taxes paid by the insurance company in its quarterly tax payment due on or about July 31.
(II) Post on the division's website whether the full amount of tax credits authorized to be allocated each year has been allocated.
(b) (I) Subject to subsection (4)(c) of this section, the commissioner shall allocate no more than the following total amounts of premium tax credits per year:
(A) Before September 1, 2022, a total of five million dollars;
(B) On and after September 1, 2022, through August 31, 2028, a total of nine million dollars; and
(C) On and after September 1, 2028, a total of five million dollars.
(II) Except as provided in subsection (4)(b)(III) of this section, the commissioner shall allocate to an insurance company that has declared its intent to contribute to the exchange pursuant to this section tax credits in an amount equal to the amount of premium taxes paid by the insurance company in its quarterly tax payment due on or about July 31 in the order in which the division receives such quarterly tax payments until the full amount of credits available pursuant to this section has been allocated.
(III) If the amount of premium taxes or the sum of all the premium taxes filed by all the insurance companies on any one day would exceed, singly or in the aggregate, the annual maximum aggregate amount of tax credits available under this section, the commissioner shall reduce the allocation to the insurance company whose contribution first exceeds the annual maximum aggregate to the amount needed to satisfy the annual maximum aggregate. If the commissioner is unable to determine the order of receipt of tax payments on that day, the commissioner shall allocate the tax credits to the company or among the companies on a pro rata basis based on the ratio such company's quarterly tax payment bears to the total amount of all such companies' quarterly tax payments until the full amount of credits available pursuant to this section has been allocated.
(c) (I) The commissioner shall allow insurance companies to declare their intent to contribute to the exchange pursuant to this section on the insurance companies' quarterly tax payments due on or about October 31 and shall send such companies allocation notices by February 1 if:
(A) The full amount of tax credits available in any one year have not been fully allocated by the commissioner pursuant to statements of intent filed with insurance companies' quarterly tax payments due on or about July 31; or
(B) The total amount of tax credits has been claimed, but one or more insurance companies failed to timely make a contribution to the exchange.
(II) An insurance company that declares its intent to contribute to the exchange pursuant to this paragraph (c) shall make the contribution to the exchange as specified in the allocation notice on or before March 1 and may claim the tax credit on one or more subsequent quarterly or annual tax payments due on or about March 1.
(5) The board shall use money contributed to the exchange as follows:
(a) The amount of contributions from insurers to which the first five million dollars of tax credits is allocated pursuant to subsection (4)(b) of this section and the interest derived from the deposit and investment of the money, to operate and sustain the exchange and to build reserves; except that, on and after September 1, 2028, the total amount of contributions and interest derived from the deposit and investment of the money shall be used for the purposes specified in this subsection (5)(a).
s allocated pursuant to subsection (4)(b) of this section and the interest derived from the deposit and investment of the money, to operate and sustain the exchange and to build reserves; except that, on and after September 1, 2028, the total amount of contributions and interest derived from the deposit and investment of the money shall be used for the purposes specified in this subsection (5)(a).
(b) (I) Any amount of contributions from insurers to which any amount in excess of the first five million dollars of tax credits is allocated pursuant to subsection (4)(b) of this section and the interest derived from the deposit and investment of the money, for the public awareness and education campaign in section 10-22-115.
(II) This subsection (5)(b) is repealed, effective December 31, 2028.
C.R.S. § 10-22-111 Tax exemption
10-22-111. Tax exemption. The exchange is exempt from any tax levied by this state or any of its political subdivisions.
C.R.S. § 10-22-112 Health benefit exchange - referral to private insurance brokers - fees - rules
10-22-112. Health benefit exchange - referral to private insurance brokers - fees - rules. (1) The exchange shall include the following in its protocol for interacting with consumers in order to assist consumers in enrolling in health benefit plans: Upon a consumer's contact with the exchange when seeking assistance in selecting a qualified health plan, whether online or by telephone, the exchange shall inform the consumer that he or she has the option of selecting coverage online, with the assistance of a navigator, or with the assistance of a qualified insurance broker. The exchange shall inform the consumer that a navigator may assist with a health benefit plan selection but may not offer advice on a health benefit plan based on the consumer's individual situation, whereas a qualified broker may offer advice based on the consumer's personal and family situation.
(2) The exchange shall maintain online tools that allow insurance brokers to develop and maintain client relationships for customers who are eligible to enroll in private health benefit plans, when appropriate, if the client requests this option.
(3) (a) An insurance broker may charge a client a fee for advising the client on the selection of an individual health benefit plan offered on the exchange only if the broker:
(I) Will not receive a commission from the insurer offering the individual health benefit plan selected by the client; and
(II) Provides a written disclosure to the client if the broker will charge a fee for the service.
(b) The commissioner may promulgate rules regarding the form and manner by which an insurance broker must provide the disclosure required by this subsection (3). The rules shall include a prohibition on a broker charging a fee to assist a client to enroll in medicaid or the children's basic health plan, as defined in section 25.5-8-103 (2).
C.R.S. § 10-22-113 Colorado affordable health care coverage easy enrollment program - advisory committee - creation - appointments - duties - definitions - repeal
10-22-113. Colorado affordable health care coverage easy enrollment program - advisory committee - creation - appointments - duties - definitions - repeal. (1) There is hereby created the Colorado affordable health care coverage easy enrollment program for the purpose of leveraging the individual income tax filing process to maximize the enrollment of eligible uninsured individuals in a health-care coverage affordability program.
(2) (a) For the purpose of guiding the implementation and administration of the program, there is hereby created the affordable health care coverage easy enrollment advisory committee. The executive directors of the exchange and the department of revenue, or their designees, shall serve as co-chairs of the advisory committee. On or before September 1, 2020, the board shall appoint nine additional members, as specified in subsection (2)(b) of this section, to serve on the advisory committee. In making the appointments, the board shall consider the geographic, economic, ethnic, and other characteristics of the state.
(b) Members of the advisory committee must include:
(I) A representative of the department of health care policy and financing;
(II) A representative of the division;
(III) A representative of consumer advocacy groups;
(IV) A representative of small employers, as defined in section 10-16-102 (61);
(V) A representative of insurers;
(VI) A health-care consumer;
(VII) A health coverage guide or other person with expertise in the process of applying for federal insurance or assistance as provided by:
(A) Title XIX of the federal "Social Security Act", as amended, and the "Colorado Medical Assistance Act", articles 4, 5, and 6 of title 25.5; or
(B) The children's basic health plan, as defined in article 8 of title 25.5;
(VIII) An insurance producer, as defined in section 10-2-103 (6); and
(IX) A provider of income tax preparation services.
(c) Of the members first appointed, in order to ensure staggered terms, the initial term of office of five of the members is two years and the initial term of office of four of the members is four years. Thereafter, the term of office of all members is four years.
(d) Members of the advisory committee may be removed for cause by the board or by a majority vote of the advisory committee members.
(e) The advisory committee shall meet as often as necessary to carry out its duties pursuant to this section.
(f) Members of the advisory committee are not entitled to receive per diem or other compensation for performance of services for the advisory committee but may be reimbursed for actual and necessary expenses, including any required dependent care and dependent or attendant travel, food, and lodging, while engaged in the performance of official duties of the advisory committee.
nt to this section.
(f) Members of the advisory committee are not entitled to receive per diem or other compensation for performance of services for the advisory committee but may be reimbursed for actual and necessary expenses, including any required dependent care and dependent or attendant travel, food, and lodging, while engaged in the performance of official duties of the advisory committee.
(g) This subsection (2) is repealed, effective September 1, 2030.
(3) (a) The advisory committee shall:
(I) Determine the minimum information necessary to collect through the state individual income tax forms to identify uninsured individuals and allow the exchange to assess whether they are potentially eligible for enrollment in a health-care coverage affordability program or other creditable coverage;
(II) Determine the procedures that will be used to transfer tax filer information from the department of revenue to the exchange in order to facilitate the program;
(III) Recommend revisions to the state individual income tax form, supplemental schedules, or both to be implemented by the department of revenue pursuant to section 39-22-5202 that are needed to implement the program. The recommendations must include:
(A) A question asking if the tax filer wants the exchange to assess whether the uninsured individuals in the tax household are potentially eligible for a health-care coverage affordability program or other creditable coverage using information from the tax filer's state individual income tax return and other sources available to the exchange;
(B) For tax filers that want the exchange to assess potential eligibility, a request for: The identity of the uninsured individuals and any additional information, including the household size of the tax filer, that is not otherwise available to the exchange and that is deemed essential by the advisory committee for making assessments of potential eligibility; except that the request for additional information shall not include requests for citizenship, immigration, or health status;
(IV) Draft recommended instructions for the individual tax form instruction booklet that explain how to answer the questions added to the tax return form or schedules pursuant to section 39-22-5202 (1)(b) and the effects of indicating that the tax filer would like the exchange to assess the eligibility of uninsured household members;
(V) Determine the process that the exchange will use under the program to assess potential eligibility for and assist with enrollment in a health-care coverage affordability program or other creditable coverage including:
(A) A timeline for assessing each individual's potential eligibility for a health-care coverage affordability program or other creditable coverage;
(B) A process to notify individuals regarding the outcomes of assessments of potential eligibility, which process is designed to maximize health-care coverage enrollment levels; and
(C) A process for handling uninsured individuals whose status as United States citizens cannot be verified through information available to the exchange; and
(VI) Determine the feasibility of and, if feasible, recommend a process for automatic enrollment, through the program, of eligible uninsured individuals in a medical assistance program under the "Colorado Medical Assistance Act", articles 4, 5, and 6 of title 25.5, or other zero-net-premium creditable coverage.
(b) This subsection (3) is repealed, effective September 1, 2030.
(4) The exchange, through procedures determined by the advisory committee, shall:
(a) Assess whether uninsured individuals identified through the program are potentially eligible for a health-care coverage affordability program or other creditable coverage;
(b) Notify the uninsured individuals regarding their potential eligibility;
(c) Enroll or assist with enrolling the uninsured individuals in creditable coverage; and
procedures determined by the advisory committee, shall:
(a) Assess whether uninsured individuals identified through the program are potentially eligible for a health-care coverage affordability program or other creditable coverage;
(b) Notify the uninsured individuals regarding their potential eligibility;
(c) Enroll or assist with enrolling the uninsured individuals in creditable coverage; and
(d) Not take additional steps to determine eligibility for or enroll an uninsured individual identified through the program if the exchange cannot verify that the uninsured individual is a United States citizen until the individual provides affirmative consent using procedures developed by the advisory committee pursuant to subsection (3)(a)(V)(C) of this section.
(5) As used in this section:
(a) (I) "Advisory committee" means the affordable health care coverage easy enrollment advisory committee.
(II) This subsection (5)(a) is repealed, effective September 1, 2030.
(b) "Creditable coverage" has the same meaning as set forth in section 10-16-102 (16).
(c) "Program" means the Colorado affordable health care coverage easy enrollment program.
(d) "Uninsured individual" means an individual who does not have creditable coverage.
C.R.S. § 10-22-114 Standardized plan survey - repeal
10-22-114. Standardized plan survey - repeal. (1) The exchange shall conduct a survey in collaboration with the division that addresses the experience of consumers who purchased the standardized health benefit plan established pursuant to section 10-16-1304. The survey must be completed on or before January 1, 2026.
(2) This section is repealed, effective July 1, 2026.
C.R.S. § 10-22-115 Public awareness and education campaign - board - report - repeal
10-22-115. Public awareness and education campaign - board - report - repeal. (1) (a) On or before July 1, 2023, the board shall create and implement a public awareness and education campaign in order to educate consumers in Colorado regarding the options for obtaining health-care coverage.
(b) (I) On or before September 1, 2023, the board shall use the public awareness and education campaign to educate consumers in Colorado on how to attain and retain health-care coverage based on their health-care needs and financial circumstances so they can access the health care they need. The campaign must include efforts to:
(A) Improve health literacy among consumers in Colorado;
(B) Assist consumers in Colorado who lose minimum essential coverage; and
(C) Reduce the number of individuals eligible for health-care coverage who remain uninsured or without health-care coverage.
(II) The campaign must include information about eligibility and costs where practicable.
(c) The public awareness and education campaign must include marketing and outreach to help consumers in this state who, at the end of the COVID-19 public health emergency as declared and extended by the United States secretary of health and human services, are no longer eligible for benefits under the "Colorado Medical Assistance Act", articles 4, 5, and 6 of title 25.5, or the "Children's Basic Health Plan Act", article 8 of title 25.5, to understand coverage options and to transition to health-care coverage obtained through the exchange.
(d) The board may use print or electronic media, written material, social media, direct mail, or any effective means of outreach to create awareness and educate consumers throughout the campaign.
(2) The board shall annually report to the committee at the first scheduled meeting of the committee each calendar year starting in 2024. The board shall include in the report the following information:
(a) The public awareness and education campaign activities of the board in the prior calendar year;
(b) The amount of money spent on the campaign in the prior calendar year and a detailed accounting of how the money was spent; and
(c) Any recommendations of the board concerning changes to the public awareness and education campaign and the continuation or repeal of the duties of the board concerning the campaign.
(3) This section is repealed, effective December 31, 2028. The committee may report a bill to the legislative council of the general assembly pursuant to section 10-22-107 (5) to extend or eliminate the repeal date in this section.
Source: Open US Law by Vaquill AI (CC BY 4.0)URL: https://leg.colorado.gov/sites/default/files/images/olls/crs2024-title-10.docxFetched: 10/6/2026