CO| The Colorado Division of Insurance Emergency Regulation 26-E-01 sets the required 2027 Colorado Option standardized bronze, silver (including CSR variants), and gold health benefit plan designs for all carriers in the individual and small group markets, specifying detailed coverage, cost-sharing, filing, and consumer-facing requirements, and making them effective April 6, 2026.
Key Points:
- Imposes naming conventions, logo/co-branding rules, filing requirements using Federal and Colorado plan & benefits templates, EHB limits with narrow reproductive health additions, MHPAEA financial compliance with Division-driven adjustments if needed, and authorizes enforcement through penalties, cease and desist orders, and license actions.
- Defines standardized plan structures (gold, silver, CSR 73/87/94, silver off-exchange, bronze) with fixed actuarial values, combined medical/Rx deductibles, out-of-pocket maximums, embedded deductibles/OOPMs, and $0 cost-sharing for preventive services, primary care, prenatal/postnatal visits, and MH/SUD office visits.
- Requires five-tier copay-only drug formularies, $0 cost-sharing for diabetes supplies (including CGMs) with a detailed, plan-specific public web list and clear benefit-channel indicators, and prohibits tiered in-network cost-sharing while tying all in-network cost sharing to the OOP maximum.