Section 3 CCR 702-4 Series 4-2 - LIFE, ACCIDENT AND HEALTH, Series 4-2 Accident and Health (General)
- Regulation Regulation 4-2-1 - REPLACEMENT OF INDIVIDUAL ACCIDENT AND SICKNESS INSURANCE (§§ 702-4-2-1-1 — 702-4-2-1-B)
- Regulation Regulation 4-2-2 - HOSPITAL INDEMNITY AND DISABILITY INCOME POLICIES (§§ 702-4-2-2-1 — 702-4-2-2-9)
- Regulation Regulation 4-2-3 - ADVERTISEMENTS OF ACCIDENT AND SICKNESS INSURANCE (§§ 702-4-2-3-1 — 702-4-2-3-24)
- Regulation Regulation 4-2-5 - [Repealed]
- Regulation Regulation 4-2-6 - CONCERNING THE DEFINITION OF THE TERM "COMPLICATIONS OF PREGNANCY" (§§ 702-4-2-6-1 — 702-4-2-6-9)
- Regulation Regulation 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 Regulation 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 (§§ 702-4-2-9-1 — 702-4-2-9-A)
- Regulation Regulation 4-2-10 - FILING REQUIREMENTS FOR MULTIPLE EMPLOYER WELFARE ARRANGEMENTS (MEWAS) (§§ 702-4-2-10-1 — 702-4-2-10-13)
- Regulation Regulation 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-M2)
- Regulation Regulation 4-2-13 - [Repealed]
- Regulation Regulation 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- Regulation Regulation 4-2-16 - [Repealed]
- Regulation Regulation 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- Regulation Regulation 4-2-18 - [Repealed]
- Regulation Regulation 4-2-19 - [Repealed]
- Regulation Regulation 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-B)
- Regulation Regulation 4-2-21 - External Review of Benefit Denials of Health Coverage Plans (§§ 702-4-2-21-1 — 702-4-2-21-18)
- Regulation Regulation 4-2-22 - [Repealed]
- Regulation Regulation 4-2-23 - PROCEDURE FOR PROVIDER-CARRIER DISPUTE RESOLUTION (§§ 702-4-2-23-1 — 702-4-2-23-9)
- Regulation Regulation 4-2-24 - CONCERNING CLEAN CLAIM REQUIREMENTS FOR HEALTH CARRIERS (§§ 702-4-2-24-1 — 702-4-2-24-11)
- Regulation Regulation 4-2-25 - [Repealed]
- Regulation Regulation 4-2-26 - [Repealed]
- Regulation Regulation 4-2-27 - PROCEDURES FOR REASONABLE MODIFICATIONS TO INDIVIDUAL AND SMALL GROUP HEALTH BENEFIT PLANS (§§ 702-4-2-27-1 — 702-4-2-27-C)
- Regulation Regulation 4-2-28 - CONCERNING THE PAYMENT OF EARLY INTERVENTION SERVICES FOR ELIGIBLE CHILDREN (§§ 702-4-2-28-1 — 702-4-2-28-10)
- Regulation Regulation 4-2-29 - CONCERNING THE RULES FOR STANDARDIZED CARDS ISSUED TO PERSONS COVERED BY HEALTH BENEFIT PLANS AND DENTAL COVERAGE PLANS (§§ 702-4-2-29-1 — 702-4-2-29-10)
- Regulation Regulation 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 Regulation 4-2-31 - ANNUAL HEALTH REPORTING AND DATA RETENTION REQUIREMENTS (§§ 702-4-2-31-1 — 702-4-2-31-11)
- Regulation Regulation 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 Regulation 4-2-33 - [Repealed]
- Regulation Regulation 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 Regulation 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 Regulation 4-2-36 - [Repealed]
- Regulation Regulation 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-B)
- Regulation Regulation 4-2-38 - CONTRACEPTIVE BENEFITS (§§ 702-4-2-38-1 — 702-4-2-38-9)
- Regulation Regulation 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 Regulation 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-E)
- Regulation Regulation 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-B)
- Regulation Regulation 4-2-42 - CONCERNING ESSENTIAL HEALTH BENEFITS (§§ 702-4-2-42-1 — 702-4-2-42-10)
- Regulation Regulation 4-2-43 - ENROLLMENT PERIODS RELATING TO INDIVIDUAL AND GROUP HEALTH BENEFIT PLANS (§§ 702-4-2-43-1 — 702-4-2-43-11)
- Regulation Regulation 4-2-44 - [Repealed]
- Regulation Regulation 4-2-45 - UNIFORM INDIVIDUAL AND SMALL GROUP HEALTH BENEFIT PLAN APPLICATIONS (§§ 702-4-2-45-1 — 702-4-2-45-B)
- Regulation Regulation 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 Regulation 4-2-47 - CONCERNING THE REQUIRED BENEFIT FOR APPLIED BEHAVIOR ANALYSIS THERAPY FOR THE TREATMENT OF AUTISM SPECTRUM DISORDERS FOR A CHILD (§§ 702-4-2-47-1 — 702-4-2-47-9)
- Regulation Regulation 4-2-48 - CONCERNING GRACE PERIODS FOR POLICYHOLDERS RECEIVING ADVANCE PAYMENT TAX CREDITS (§§ 702-4-2-48-1 — 702-4-2-48-9)
- Regulation Regulation 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-A)
- Regulation Regulation 4-2-50 - CONCERNING PEDIATRIC DENTAL COVERAGE REQUIREMENTS (§§ 702-4-2-50-1 — 702-4-2-50-10)
- Regulation Regulation 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-B)
- Regulation Regulation 4-2-52 - [Repealed]
- Regulation Regulation 4-2-53 - NETWORK ADEQUACY STANDARDS AND REPORTING REQUIREMENTS FOR ACA-COMPLIANT HEALTH BENEFIT PLANS (§§ 702-4-2-53-1 — 702-4-2-53-B)
- Regulation Regulation 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 Regulation 4-2-55 - STANDARDS AND REPORTING REQUIREMENTS FOR ACA-COMPLIANT HEALTH BENEFIT PLAN PROVIDER DIRECTORIES (§§ 702-4-2-55-1 — 702-4-2-55-A)
- Regulation Regulation 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 Regulation 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-D)
- Regulation Regulation 4-2-58 - NON-DISCRIMINATORY COST-SHARING AND TIERING REQUIREMENTS FOR PRESCRIPTION DRUGS (§§ 702-4-2-58-1 — 702-4-2-58-11)
- Regulation Regulation 4-2-59 - CONCERNING PREMIUM RATE SETTING FOR SHORT-TERM LIMITED DURATION HEALTH INSURANCE POLICIES (§§ 702-4-2-59-1 — 702-4-2-59-J)
- Regulation Regulation 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-E)
- Regulation Regulation 4-2-61 - CONCERNING THE PAYMENT PARAMETERS FOR THE COLORADO REINSURANCE PROGRAM (§§ 702-4-2-61-1 — 702-4-2-61-9)
- Regulation Regulation 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 Regulation 4-2-63 - CONCERNING MEANINGFUL DIFFERENCE STANDARDS FOR HEALTH BENEFIT PLANS (§§ 702-4-2-63-1 — 702-4-2-63-9)
- Regulation Regulation 4-2-64 - CONCERNING MENTAL HEALTH PARITY IN HEALTH BENEFIT PLANS (§§ 702-4-2-64-1 — 702-4-2-64-16)
- Regulation Regulation 4-2-65 - CONCERNING THE ESTABLISHMENT OF A CARRIER PAYMENT ARBITRATION PROGRAM FOR OUT-OF-NETWORK PROVIDERS S (§§ 702-4-2-65-1 — 702-4-2-65-B)
- Regulation Regulation 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-A)
- Regulation Regulation 4-2-67 - CONCERNING CARRIER DISCLOSURES FOR EMERGENCY AND NON-EMERGENCY OUT-OF-NETWORK SERVICES (§§ 702-4-2-67-1 — 702-4-2-67-A)
- Regulation Regulation 4-2-68 - CONCERNING PRESCRIPTION INSULIN DRUG COST SHARING AND LIMITATIONS (§§ 702-4-2-68-1 — 702-4-2-68-10)
- Regulation Regulation 4-2-69 - [Repealed]
- Regulation Regulation 4-2-71 - CONCERNING CARRIER CARE MANAGEMENT PROTOCOLS FOR THE COLORADO REINSURANCE PROGRAM (§§ 702-4-2-71-1 — 702-4-2-71-9)
- Regulation Regulation 4-2-72 - CONCERNING STRATEGIES TO ENHANCE HEALTH INSURANCE AFFORDABILITY (§§ 702-4-2-72-1 — 702-4-2-72-C)
- Regulation Regulation 4-2-73 - CONCERNING HUMAN IMMUNODEFICIENCY VIRUS PRE-EXPOSURE PROPHYLAXIS PRESCRIPTION DRUGS AND BASELINE AND MONITORING SERVICES (§§ 702-4-2-73-1 — 702-4-2-73-9)
- Regulation Regulation 4-2-74 - CONCERNING DATA REPORTING REQUIREMENTS FOR CARRIERS' OUT-OF- NETWORK REIMBURSEMENTS (§§ 702-4-2-74-1 — 702-4-2-74-9)
- Regulation Regulation 4-2-75 - CONCERNING REQUIREMENTS FOR REPORTING MEDICATION-ASSISTED TREATMENT COVERAGE (§§ 702-4-2-75-1 — 702-4-2-75-A)
- Regulation Regulation 4-2-76 - CONCERNING THE HEALTH INSURANCE AFFORDABILITY FEE ASSESSMENT AND COLLECTION PROCESS (§§ 702-4-2-76-1 — 702-4-2-76-9)
- Regulation Regulation 4-2-77 - CONCERNING PAYMENTS TO CARRIERS FOR THE COLORADO REINSURANCE PROGRAM (§§ 702-4-2-77-1 — 702-4-2-77-9)
- Regulation Regulation 4-2-78 - CONCERNING COST SHARING REDUCTION ENHANCEMENTS (§§ 702-4-2-78-1 — 702-4-2-78-A)
- Regulation Regulation 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-A)
- Regulation Regulation 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 Regulation 4-2-81 - CONCERNING COLORADO OPTION STANDARDIZED HEALTH BENEFIT PLAN (§§ 702-4-2-81-1 — 702-4-2-81-A)
- Regulation Regulation 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-F)
- Regulation Regulation 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 — 702-4-2-83-14)
- Regulation Regulation 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 Regulation 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-A)
- Regulation Regulation 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 Regulation 4-2-87 - CONCERNING OCCUPATIONAL ACCIDENT INSURANCE COVERAGE (§§ 702-4-2-87-1 — 702-4-2-87-10)
- Regulation Regulation 4-2-88 - CONCERNING GAG CLAUSES IN INDIVIDUAL AND GROUP HEALTH BENEFIT PLANS (§§ 702-4-2-88-1 — 702-4-2-88-12)
- Regulation Regulation 4-2-89 - COMPENSATION DISCLOSURES FOR HEALTH INSURANCE CARRIERS (§§ 702-4-2-89-1 — 702-4-2-89-10)
- Regulation Regulation 4-2-90 - CONCERNING COVERAGE FOR COVID-19 VACCINES (§§ 702-4-2-90-1 — 702-4-2-90-10)
- Regulation Regulation 4-2-91 - CONCERNING THE METHODOLOGY FOR CALCULATING REIMBURSEMENT RATES TO SUPPORT PREMIUM RATE REDUCTIONS FOR COLORADO OPTION STANDARDIZED HEALTH BENEFIT PLANS (§§ 702-4-2-91-1 — 702-4-2-91-11)
- Regulation Regulation 4-2-92 - CONCERNING COLORADO OPTION PUBLIC HEARINGS (§§ 702-4-2-92-1 — 702-4-2-92-30)
- Regulation Regulation 4-2-95 - CONTRACEPTIVE BENEFIT REQUIREMENTS FOR HEALTH BENEFIT PLANS (§§ 702-4-2-95-1 — 702-4-2-95-A)
- Regulation Regulation 4-2-96 - CONCERNING PRIMARY CARE ALTERNATIVE PAYMENT MODEL PARAMETERS (§§ 702-4-2-96-1 — 702-4-2-96-C)
- Regulation Regulation 4-2-97 - CONCERNING THE REQUIREMENTS FOR PHARMACY BENEFIT MANAGERS TO REGISTER IN COLORADO (§§ 702-4-2-97-1 — 702-4-2-97-A)
- Regulation Regulation 4-2-98 - CONCERNING COVERAGE OF THE RESPIRATORY SYNCYTIAL VIRUS IMMUNIZATIONS AS A PREVENTIVE SERVICE (§§ 702-4-2-98-1 — 702-4-2-98-10)
- Regulation Regulation 22-E-20 - HEALTH-CARE SHARING PLAN OR ARRANGEMENT REQUIRED REPORTING (§§ 702-4-22-E-20-1 — 702-4-22-E-20-C)
- Regulation Regulation 23-E-01 - CONCERNING COLORADO OPTION STANDARDIZED HEALTH BENEFIT PLAN (§§ 702-4-23-E-01-1 — 702-4-23-E-01-A)
- Regulation Regulation 22-E-02 - CONCERNING THE METHODOLOGY FOR CALCULATING PREMIUM RATE REDUCTIONS FOR COLORADO OPTION STANDARDIZED HEALTH BENEFIT PLANS (§§ 702-4-22-E-02-1 — 702-4-22-E-02-11)
- Regulation Regulation 23-E-08 - [Effective until 2/13/2024] CONCERNING COVERAGE OF THE RESPIRATORY SYNCYTIAL VIRUS IMMUNIZATIONS AS A PREVENTIVE SERVICE (§§ 702-4-23-E-08-1 — 702-4-23-E-08-10)
- Regulation Regulation 24-E-01 - [Effective until 6/7/2024] CONCERNING COVERAGE OF THE RESPIRATORY SYNCYTIAL VIRUS IMMUNIZATIONS AS A PREVENTIVE SERVICE (§§ 702-4-24-E-01-1 — 702-4-24-E-01-10)
- Regulation Regulation 24-E-02 - [Effective until 6/14/2024] CONCERNING COLORADO OPTION STANDARDIZED HEALTH BENEFIT PLANS (§§ 702-4-24-E-02-1 — 702-4-24-E-02-A)
- Regulation Regulation 24-E-03 - [Effective until 6/14/2024] CONCERNING THE METHODOLOGY FOR CALCULATING PREMIUM RATE REDUCTIONS FOR COLORADO OPTION STANDARDIZED HEALTH BENEFIT PLANS (§§ 702-4-24-E-03-1 — 702-4-24-E-03-11)