7 Colo. Code Regs. § 1107-5.13

Current through Register Vol. 47, No. 24, December 25, 2024

Section 7 CCR 1107-5.13 - Modification of a Private Plan

1. An employer shall notify the Division, in writing, of any material change to an approved private plan at least sixty (60) days before the change is to take effect. However, if an employer is changing from one approved private plan to another approved insurance carrier's private plan, the employer must notify the Division, in writing, of the change at least thirty-five (35) days before the change is to take effect. The notification shall include:

A. A detailed explanation of all material changes; and

B. For self-insured private plans, a statement describing how any material changes do not reduce benefits or impose new requirements on covered employees beyond what would be provided and required under the state plan.

2. The Division will review the material change to the approved private plan, and will determine whether the material change impacts private plan approval. The Division will make a good faith effort to confer with the employer regarding any impact to continued private plan approval, and to notify the employer of its determination within thirty (30) days of the employer's notification to the Division. In no event may an employer make a material change without first obtaining Division approval and providing at least thirty (30) days' notice to its employees.

3. Division review of material changes to a private plan may impact the calculation of an employer's annual maintenance fee.

4. Material changes to an approved private plan include, but are not limited to:

A. Changing from one private plan to another;

B. Changing the private plan to reduce benefits or leave types;

C. Changing the private plan to increase claims adjudication timeframes;

D. Changing the private plan to increase benefits payment timeframes; or

E. Changing the private plan to increase the information collected from employees to apply for or receive benefits.

5. Material changes to an approved private plan do not include:

A. Updating the private plan benefits application form in a way that does not make the form more onerous than the state's benefits application form;

B. Changing business or contact information;

C. Correcting typographical errors;

D. Increasing benefits or leave types; or

E. Updating the private plan to align with regulatory changes.

6. A change to an approved private plan will not extend the duration of its approval.

7. If the Division determines that an employer has not notified the Division of a material change in accordance with Section 5.13 of these rules, the Division may assess upon the employer a fine of up to $250.00. If the Division determines that an employer has not notified its employees of a material change in accordance with Section 5.13 of these rules, the Division may assess upon the employer a fine of up to $100 per employee per day.

7 CCR 1107-5.13

45 CR 23, December 10, 2022, effective 12/30/2022

46 CR 23, December 10, 2023, effective 1/1/2024

47 CR 23, December 10, 2024, effective 1/1/2025