Colo. Rev. Stat. § 10-22-103

Current through 11/5/2024 election

Section 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. § 10-22-103

Amended by 2020 Ch. 236, § 2, eff. 9/14/2020.

Amended by 2015 Ch. 284, § 1, eff. 6/5/2015.

Amended by 2013 Ch. 258, § 1, eff. 5/23/2013.

L. 2011: Entire article added, (SB 11-200), ch. 1074, p. 1074, § 1, effective June 1. L. 2013: (5) amended and (6) to (11) added, (HB 13-1245), ch. 1359, p. 1359, § 1, effective May 23. L. 2015: (2) amended, (SB 15-256), ch. 1166, p. 1166, § 1, effective June 5. L. 2020: IP amended and (6.5) added, (HB 20-1236), ch. 1144, p. 1144, § 2, effective September 14.