CO| Emergency Regulation 25-E-02 from the Colorado Department of Regulatory Agencies, Division of Insurance establishes rules for the required premium reduction methodology for Colorado Option standardized health benefit plans to be offered by carriers in the individual and small group markets starting January 1, 2026. The regulation outlines the calculation methods for premium reductions, defines key terms, and sets filing requirements for carriers. This Emergency Regulation is effective February 14, 2025.
Key points:
- The regulation aims to ensure carriers comply with state law requiring specific premium reductions for standardized plans: 5% for 2023, 10% for 2024, and 15% for 2025 and beyond.
- It provides a detailed methodology for calculating the Maximum Colorado Option Standardized Plan Premium, which includes adjustments for various factors such as changes in member cost sharing, CSR loads, and medical inflation.
- Carriers must notify the Commissioner by March 1 of the preceding year whether their Colorado Option Standardized Plan will comply with the required premium rate reductions.
- The regulation applies to all carriers offering individual and small group health benefit plans subject to Colorado and federal laws.
- Non-compliance may result in sanctions, including civil penalties, cease and desist orders, and license suspensions or revocations.