Section 3 CCR 702-4-2 - LIFE, ACCIDENT AND HEALTH, Series 4-2
- Regulation 3 CCR 702-4-2-1 - REPLACEMENT OF INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE (§§ 702-4-2-1-1 — 702-4-2-1)
- Regulation 3 CCR 702-4-2-2 - HOSPITAL INDEMNITY AND DISABILITY INCOME POLICIES (§§ 702-4-2-2-1 — 702-4-2-2-9)
- Regulation 3 CCR 702-4-2-3 - ADVERTISEMENTS OF ACCIDENT AND SICKNESS INSURANCE (§§ 702-4-2-3-1 — 702-4-2-3)
- Regulation 3 CCR 702-4-2-5 - Repealed (§§ 702-4-2-5-1 — 702-4-2-5-8)
- Regulation 3 CCR 702-4-2-6 - CONCERNING THE DEFINITION OF THE TERM "COMPLICATIONS OF PREGNANCY" (§§ 702-4-2-6-1 — 702-4-2-6-9)
- Regulation 3 CCR 702-4-2-8 - CONCERNING REQUIRED HEALTH INSURANCE BENEFITS FOR HOME HEALTH SERVICES AND HOSPICE CARE (§§ 702-4-2-8-1 — 702-4-2-8-11)
- Regulation 3 CCR 702-4-2-9 - CONCERNING NON-DISCRIMINATORY TREATMENT OF ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS) AND HUMAN IMMUNODEFICIENCY VIRUS (HIV) RELATED ILLNESS BY LIFE AND HEALTH CARRIERS (§§ 702-4-2-8 — 702-4-2-9-10)
- Regulation 3 CCR 702-4-2-10 - REPORTING REQUIREMENTS FOR MULTIPLE EMPLOYER WELFARE ARRANGEMENTS (MEWAS) (§§ 702-4-2-10-1 — 702-4-2-10-13)
- Regulation 3 CCR 702-4-2-11 - RATE FILING SUBMISSIONS FOR HEALTH INSURANCE, LIMITED BENEFIT PLANS, EXCESS/STOP LOSS INSURANCE, LONG-TERM CARE INSURANCE, MEDICARE SUPPLEMENT INSURANCE, SICKNESS AND ACCIDENT INSURANCE, DISABILITY INCOME, OTHER THAN HEALTH BENEFIT PLANS (§§ 702-4-2-11-1 — 702-4-2-11)
- Regulation 3 CCR 702-4-2-15 - REQUIRED PROVISIONS IN CARRIER CONTRACTS WITH PROVIDERS,CARRIER CONTRACTS WITH INTERMEDIARIES NEGOTIATING ON BEHALF OF PROVIDERS, AND CARRIER CONTRACTS WITH INTERMEDIARIES CONDUCTING UTILIZATION REVIEWS (§§ 702-4-2-15-1 — 702-4-2-15-9)
- Regulation 3 CCR 702-4-2-17 - PROMPT INVESTIGATION OF HEALTH CLAIMS INVOLVING UTILIZATION REVIEW AND DENIAL OF BENEFITS AND RULES RELATED TO INTERNAL CLAIMS AND APPEALS PROCESSES (§§ 702-4-2-17-1 — 702-4-2-17-18)
- Regulation 3 CCR 702-4-2-18 - CONCERNING THE METHOD OF CREDITING AND CERTIFYING CREDITABLE COVERAGE FOR PRE-EXISTING CONDITIONS (Repealed) (§§ 702-4-2-18-1 — 702-4-2-18-10)
- Regulation 3 CCR 702-4-2-20 - CONCERNING THE SUMMARY OF BENEFITS AND COVERAGE FORM AND THE COLORADO SUPPLEMENT TO THE SUMMARY OF BENEFITS AND COVERAGE FORM (§§ 702-4-2-20-1 — 702-4-2-20)
- Regulation 3 CCR 702-4-2-21 - External Review of Benefit Denials of Health Coverage Plans (§§ 702-4-2-21-1 — 702-4-2-21-18)
- Regulation 3 CCR 702-4-2-23 - PROCEDURE FOR PROVIDER-CARRIER DISPUTE RESOLUTION (§§ 702-4-2-23-1 — 702-4-2-23-9)
- Regulation 3 CCR 702-4-2-24 - CONCERNING CLEAN CLAIM REQUIREMENTS FOR HEALTH CARRIERS (§§ 702-4-2-24-1 — 702-4-2-24-11)
- Regulation 3 CCR 702-4-2-27 - PROCEDURES FOR REASONABLE MODIFICATIONS TO INDIVIDUAL AND SMALL GROUP HEALTH BENEFIT PLANS AND PEDIATRIC STAND ALONE DENTAL PLANS COMPLIANT WITH THE AFFORDABLE CARE ACT (§§ 702-4-2-27-1 — 702-4-2-27)
- Regulation 3 CCR 702-4-2-28 - CONCERNING THE PAYMENT OF EARLY INTERVENTION SERVICES FOR ELIGIBLE CHILDREN (§§ 702-4-2-28-1 — 702-4-2-28)
- Regulation 3 CCR 702-4-2-29 - CONCERNING THE RULES FOR STANDARDIZED CARDS ISSUED TO PERSONS COVERED BY HEALTH BENEFIT PLANS (§§ 702-4-2-29-1 — 702-4-2-29-9)
- Regulation 3 CCR 702-4-2-30 - CONCERNING THE RULES FOR COMPLYING WITH MANDATED COVERAGE OF HEARING AIDS AND PROSTHETICS (§§ 702-4-2-30-1 — 702-4-2-30-9)
- Regulation 3 CCR 702-4-2-31 - ANNUAL HEALTH REPORTING AND DATA RETENTION REQUIREMENTS (§§ 702-4-2-31-1 — 702-4-2-31-12)
- Regulation 3 CCR 702-4-2-32 - STANDARDIZED ELECTRONIC IDENTIFICATION AND COMMUNICATION SYSTEMS GUIDELINES FOR HEALTH BENEFIT PLANS (§§ 702-4-2-32-1 — 702-4-2-32-10)
- Regulation 3 CCR 702-4-2-34 - SECTION NAMES AND THE PLACEMENT OF THOSE SECTIONS IN POLICY FORMS BY CARRIERS (§§ 702-4-2-34-1 — 702-4-2-34-9)
- Regulation 3 CCR 702-4-2-35 - REQUIRED INFORMATION FOR CARRIERS TO PROVIDE ON EXPLANATION OF BENEFITS FORMS (§§ 702-4-2-35-1 — 702-4-2-35-10)
- Regulation 3 CCR 702-4-2-37 - REQUIRED INFORMATION FOR CARRIERS TO OBTAIN ON ALL FULL-LENGTH APPLICATIONS FOR INDIVIDUAL HEALTH BENEFIT PLANS (§§ 702-4-2-37-1 — 702-4-2-37)
- Regulation 3 CCR 702-4-2-38 - CONTRACEPTIVE BENEFITS (§§ 702-4-2-38-1 — 702-4-2-38-9)
- Regulation 3 CCR 702-4-2-39 - CONCERNING PREMIUM RATE SETTING FOR NON-GRANDFATHERED INDIVIDUAL, SMALL AND LARGE GROUP HEALTH BENEFIT PLANS (§§ 702-4-2-39-1 — 702-4-2-39-14)
- Regulation 3 CCR 702-4-2-40 - CONCERNING THE ELEMENTS OF CERTIFICATION FOR CERTAIN LIMITED BENEFIT HEALTH PLANS, CREDIT LIFE AND HEALTH, PRENEED FUNERAL CONTRACTS, EXCESS/STOP-LOSS INSURANCE FORMS, SICKNESS AND ACCIDENT INSURANCE, AND OTHER LIMITED BENEFIT HEALTH PLANS (§§ 702-4-2-40-1 — 702-4-2-40)
- Regulation 3 CCR 702-4-2-41 - CONCERNING THE ELEMENTS FOR FORM FILINGS FOR HEALTH BENEFIT PLANS, ACA-COMPLIANT STAND-ALONE DENTAL PLANS, STUDENT HEALTH INSURANCE COVERAGE, AND SHORT-TERM LIMITED DURATION HEALTH INSURANCE POLICIES (§§ 702-4-2-41-1 — 702-4-2-41)
- Regulation 3 CCR 702-4-2-42 - CONCERNING ESSENTIAL HEALTH BENEFITS (§§ 702-4-2-42-1 — 702-4-2-42-11)
- Regulation 3 CCR 702-4-2-43 - ENROLLMENT PERIODS RELATING TO INDIVIDUAL AND GROUP HEALTH BENEFIT PLANS (§§ 702-4-2-43-1 — 702-4-2-43)
- Regulation 3 CCR 702-4-2-44 - TRANSITION OF INDIVIDUAL HEALTH BENEFIT PLANS, BASIC AND STANDARD HEALTH BENEFIT PLANS, BUSINESS GROUP OF ONE PLANS, AND CONVERSION PLANS (§§ 702-4-2-44-1 — 702-4-2-44-A-7)
- Regulation 3 CCR 702-4-2-45 - UNIFORM INDIVIDUAL AND SMALL GROUP HEALTH BENEFIT PLAN APPLICATIONS (§§ 702-4-2-45-1 — 702-4-2-45)
- Regulation 3 CCR 702-4-2-46 - CONCERNING PREMIUM RATE SETTING FOR GRANDFATHERED INDIVIDUAL, SMALL GROUP, AND LARGE GROUP HEALTH BENEFIT PLANS AND STUDENT HEALTH COVERAGE (§§ 702-4-2-46-1 — 702-4-2-46-17)
- Regulation 3 CCR 702-4-2-49 - CONCERNING THE DEVELOPMENT AND IMPLEMENTATION OF A UNIFORM DRUG BENEFIT PRIOR AUTHORIZATION PROCESS, THE REQUIRED DRUG APPEALS PROCESS, AND THE COVERAGE OF CERTAIN OPIOID DEPENDENCE AND OTHER SUBSTANCE USE DISORDER TREATMENT DRUGS (§§ 702-4-2-49-1 — 702-4-2-49)
- Regulation 3 CCR 702-4-2-50 - CONCERNING PEDIATRIC DENTAL COVERAGE REQUIREMENTS (§§ 702-4-2-50-1 — 702-4-2-50-10)
- Regulation 3 CCR 702-4-2-51 - CARRIER DISCONTINUANCE OR MARKET EXIT OF HEALTH BENEFIT PLANS OR STUDENT HEALTH INSURANCE COVERAGE POLICIES (§§ 702-4-2-51-1 — 702-4-2-51)
- Regulation 3 CCR 702-4-2-52 - INSURER SPECIAL FEE ASSESSMENTS FOR THE COLORADO HEALTH BENEFIT EXCHANGE (Repealed) (§§ 702-4-2-52-1 — 702-4-2-52)
- Regulation 3 CCR 702-4-2-53 - NETWORK ADEQUACY STANDARDS AND REPORTING REQUIREMENTS FOR ACA-COMPLIANT HEALTH BENEFIT PLANS (§§ 702-4-2-53-1 — 702-4-2-53)
- Regulation 3 CCR 702-4-2-54 - NETWORK ACCESS PLAN STANDARDS AND REPORTING REQUIREMENTS FOR ACA-COMPLIANT HEALTH BENEFIT PLANS (§§ 702-4-2-54-1 — 702-4-2-54-15)
- Regulation 3 CCR 702-4-2-55 - STANDARDS AND REPORTING REQUIREMENTS FOR ACA-COMPLIANT HEALTH BENEFIT PLAN PROVIDER DIRECTORIES (§§ 702-4-2-55-1 — 702-4-2-55)
- Regulation 3 CCR 702-4-2-56 - CONCERNING NETWORK ADEQUACY AND CONTINUITY OF CARE REQUIREMENTS FOR ACA-COMPLIANT HEALTH BENEFIT PLANS (§§ 702-4-2-56-1 — 702-4-2-56-9)
- Regulation 3 CCR 702-4-2-57 - NETWORK ADEQUACY STANDARDS AND REPORTING REQUIREMENTS FOR ACA-COMPLIANT STAND-ALONE DENTAL MANAGED CARE PLANS (§§ 702-4-2-57-1 — 702-4-2-57)
- Regulation 3 CCR 702-4-2-58 - NON-DISCRIMINATORY COST-SHARING AND TIERING REQUIREMENTS FOR PRESCRIPTION DRUGS (§§ 702-4-2-58-1 — 702-4-2-58-11)
- Regulation 3 CCR 702-4-2-59 - CONCERNING PREMIUM RATE SETTING FOR SHORT-TERM LIMITED DURATION HEALTH INSURANCE POLICIES (§§ 702-4-2-59-1 — 702-4-2-59)
- Regulation 3 CCR 702-4-2-60 - CONCERNING NETWORK ADEQUACY FILINGS FOR DENTAL PLANS, VISION PLANS, PHARMACY PLANS, SHORT-TERM LIMITED DURATION HEALTH INSURANCE POLICIES AND OTHER NON-AFFORDABLE CARE ACT MANAGED CARE PLANS (§§ 702-4-2-60-1 — 702-4-2-60)
- Regulation 3 CCR 702-4-2-61 - CONCERNING THE PAYMENT PARAMETERS FOR THE COLORADO REINSURANCE PROGRAM (§§ 702-4-2-61-1 — 702-4-2-61-9)
- Regulation 3 CCR 702-4-2-62 - CONCERNING INSURANCE UNFAIR PRACTICES ACT PROHIBITIONS ON DISCRIMINATION BASED UPON SEXUAL ORIENTATION OR GENDER IDENTITY (§§ 702-4-2-62-1 — 702-4-2-62-9)
- Regulation 3 CCR 702-4-2-63 - CONCERNING MEANINGFUL DIFFERENCE STANDARDS FOR HEALTH BENEFIT PLANS (§§ 702-4-2-63-1 — 702-4-2-63-9)
- Regulation 3 CCR 702-4-2-64 - CONCERNING MENTAL HEALTH PARITY IN HEALTH BENEFIT PLANS (§§ 702-4-2-64-1 — 702-4-2-64)
- Regulation 3 CCR 702-4-2-65 - CONCERNING THE ESTABLISHMENT OF A CARRIER PAYMENT ARBITRATION PROGRAM FOR OUT-OF-NETWORK PROVIDERS (§§ 702-4-2-65-1 — 702-4-2-65)
- Regulation 3 CCR 702-4-2-66 - CONCERNING THE PAYMENT METHODOLOGY FOR NON-CONTRACTED SERVICE AGENCIES THAT PROVIDE EMERGENCY AMBULANCE SERVICES (§§ 702-4-2-66-1 — 702-4-2-66)
- Regulation 3 CCR 702-4-2-67 - CONCERNING CARRIER DISCLOSURES FOR EMERGENCY AND NON-EMERGENCY OUT-OF-NETWORK SERVICES (§§ 702-4-2-67-1 — 702-4-2-67)
- Regulation 3 CCR 702-4-2-68 - CONCERNING PRESCRIPTION INSULIN DRUG COST SHARING AND LIMITATIONS (§§ 702-4-2-68-1 — 702-4-2-68-10)
- Regulation 3 CCR 702-4-2-69 - CONCERNING HOSPITAL SPECIAL FEE COLLECTION FOR THE COLORADO REINSURANCE PROGRAM (REPEALED) (§§ 702-4-2-69-1 — 702-4-2-69-10)
- Regulation 3 CCR 702-4-2-71 - CONCERNING CARRIER CARE MANAGEMENT PROTOCOLS FOR THE COLORADO REINSURANCE PROGRAM (§§ 702-4-2-71-1 — 702-4-2-71)
- Regulation 3 CCR 702-4-2-72 - CONCERNING STRATEGIES TO ENHANCE HEALTH INSURANCE AFFORDABILITY (§§ 702-4-2-72-1 — 702-4-2-72)
- Regulation 3 CCR 702-4-2-73 - CONCERNING HUMAN IMMUNODEFICIENCY VIRUS PRE-EXPOSURE PROPHYLAXIS PRESCRIPTION DRUGS AND BASELINE AND MONITORING SERVICES (§§ 702-4-2-73-1 — 702-4-2-73-10)
- Regulation 3 CCR 702-4-2-74 - CONCERNING DATA REPORTING REQUIREMENTS FOR CARRIERS' OUT-OF NETWORK REIMBURSEMENTS (§§ 702-4-2-74-1 — 702-4-2-74-9)
- Regulation 3 CCR 702-4-2-75 - CONCERNING REQUIREMENTS FOR REPORTING MEDICATION-ASSISTED TREATMENT COVERAGE (§§ 702-4-2-75-1 — 702-4-2-75-9)
- Regulation 3 CCR 702-4-2-76 - CONCERNING THE HEALTH INSURANCE AFFORDABILITY FEE ASSESSMENT AND COLLECTION PROCESS (§§ 702-4-2-76-1 — 702-4-2-76-9)
- Regulation 3 CCR 702-4-2-77 - CONCERNING PAYMENTS TO CARRIERS FOR THE COLORADO REINSURANCE PROGRAM (§§ 702-4-2-77-1 — 702-4-2-77-9)
- Regulation 3 CCR 702-4-2-78 - CONCERNING COST SHARING REDUCTION ENHANCEMENTS (§§ 702-4-2-78-1 — 702-4-2-78)
- Regulation 3 CCR 702-4-2-79 - CONCERNING THE REQUIREMENTS FOR PROVIDER DATA REQUESTS AND CARRIER RESPONSES CONFIRMING OUT-OF-NETWORK PAYMENT METHODOLOGY UTILIZATION (§§ 702-4-2-79-1 — 702-4-2-79)
- Regulation 3 CCR 702-4-2-80 - CONCERNING NETWORK ADEQUACY STANDARDS AND REPORTING REQUIREMENTS FOR COLORADO OPTION STANDARDIZED HEALTH BENEFIT PLANS (§§ 702-4-2-80-1 — 702-4-2-80-14)
- Regulation 3 CCR 702-4-2-81 - [Effective6/30/2022]CONCERNING COLORADO OPTION STANDARDIZED HEALTH BENEFIT PLAN (§§ 702-4-2-81-1 — 702-4-2-81)
- Regulation 3 CCR 702-4-2-82 - CONCERNING CARRIER NOTICES TO POLICYHOLDERS FOR REASONABLE MODIFICATIONS, DISCONTINUANCES, MARKET EXITS AND CARRIER RENEWAL FOR OFF-EXCHANGE PLANS (§§ 702-4-2-82-1 — 702-4-2-82)
- Regulation 3 CCR 702-4-2-83 - CONCERNING HEALTH INSURANCE AFFORDABILITY ENTERPRISE SUBSIDIES FOR QUALIFIED INDIVIDUALS THROUGH PREMIUM WRAP AND COST SHARING REDUCTION ENHANCEMENTS ON THE COLORADO OPTION SILVER PLAN (§§ 702-4-2-83-1 — 702-4-2-83-13)
- Regulation 3 CCR 702-4-2-84 - CONCERNING THE SPECIAL ASSESSMENT ON HOSPITALS FOR THE COLORADO HEALTH INSURANCE AFFORDABILITY ENTERPRISE (§§ 702-4-2-84-1 — 702-4-2-84-10)
- Regulation 3 CCR 702-4-2-85 - CONCERNING THE METHODOLOGY FOR CALCULATING PREMIUM RATE REDUCTIONS FOR COLORADO OPTION STANDARDIZED HEALTH BENEFIT PLANS (§§ 702-4-2-85-1 — 702-4-2-85)
- Regulation 3 CCR 702-4-2-86 - CONCERNING THE METHODOLOGY FOR CALCULATING THE HEALTHCARE COVERAGE COOPERATIVE EXEMPTION FOR THE COLORADO OPTION STANDARDIZED HEALTH BENEFIT PLANS AND PREMIUM RATE REDUCTION REQUIREMENT (§§ 702-4-2-86-1 — 702-4-2-86-10)
- Regulation 3 CCR 702-4-19-E-04 - CONCERNING MENTAL HEALTH PARITY IN HEALTH BENEFIT PLANS (§§ 702-4-19-E-04-1 — 702-4-19-E-04)
- Regulation 3 CCR 702-4-19-E-05 - CONCERNING THE ESTABLISHMENT OF A CARRIER PAYMENT ARBITRATION PROGRAM FOR OUT-OF-NETWORK PROVIDERS (§§ 702-4-19-E-05-1 — 702-4-19-E-05)
- Regulation 3 CCR 702-4-19-E-06 - CONCERNING THE PAYMENT METHODOLOGY FOR NON-CONTRACTED SERVICE AGENCIES THAT PROVIDE EMERGENCY AMBULANCE SERVICES (§§ 702-4-19-E-06-1 — 702-4-19-E-06)
- Regulation 3 CCR 702-4-19-E-07 - CONCERNING CARRIER DISCLOSURES FOR EMERGENCY AND NON-EMERGENCY OUT-OF-NETWORK SERVICES (§§ 702-4-19-E-07-1 — 702-4-19-E-07)
- Regulation 3 CCR 702-4-19-E-08 - CONCERNING PRESCRIPTION INSULIN DRUG COST SHARING AND LIMITATIONS (§§ 702-4-19-E-08-1 — 702-4-19-E-08-10)
- Regulation 3 CCR 702-4-22-E-05 - [Effective until6/28/2022]CONCERNING THE METHODOLOGY FOR CALCULATING PREMIUM RATE REDUCTIONS FOR COLORADO OPTION STANDARDIZED HEALTH BENEFIT PLANS (§§ 702-4-22-E-05-1 — 702-4-22-E-05)
- Regulation 3 CCR 702-4-22-E-06 - [Effective until6/28/2022]CONCERNING THE METHODOLOGY FOR CALCULATING THE HEALTHCARE COVERAGE COOPERATIVE EXEMPTION FOR THE COLORADO OPTION STANDARDIZED HEALTH BENEFIT PLANS AND PREMIUM RATE REDUCTION REQUIREMENT (§§ 702-4-22-E-06-1 — 702-4-22-E-06-10)
- Regulation 3 CCR 702-4-22-E-07 - [Effective until7/15/2022]CONCERNING ESTABLISHING A SPECIAL ENROLLMENT PERIOD FOR INDIVIDUALS CURRENTLY ENROLLED IN PLANS OFFERED BY SALVASEN HEALTH (§§ 702-4-22-E-07-1 — 702-4-22-E-07-9)
- Regulation 3 CCR 702-4-22-E-08 - [Effective until7/29/2022]CONCERNING COLORADO OPTION STANDARDIZED HEALTH BENEFIT PLAN (§§ 702-4-22-E-08-1 — 702-4-22-E-08)