CO| Colorado Division of Insurance Notice of Adoption of Amended Regulation 4-2-27 outlines procedures for reasonable modifications to individual and small group health benefit plans in Colorado, governed by the Division of Insurance. The regulation provides guidelines for carriers on submitting modifications to both grandfathered and non-grandfathered plans, ensuring compliance with federal and state requirements while maintaining fairness and consistency.
Key points:
- Modification Rules: Carriers can make reasonable modifications, such as adding benefits or adjusting deductibles, provided changes are uniformly applied across plans and meet specific criteria. Unreasonable modifications, like removing benefits or altering cost-share structures, may result in loss of grandfathered status.
- Submission Requirements: Carriers must submit modification requests electronically via SERFF by specified deadlines, including detailed documentation such as cover letters, HIOS plan ID listings, side-by-side comparisons, and policyholder notices.
- Enforcement and Compliance: Noncompliance may lead to penalties, cease-and-desist orders, or license revocation. The regulation becomes effective May 30, 2025, with severability ensuring unaffected provisions remain valid if any part is deemed invalid.
Click here to review CO Adoption of Amended Regulation 4-2-27