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Legislative Year: 2021 Change
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Bill Detail: HB21-1232

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Title Standardized Health Benefit Plan Colorado Option
Status Governor Signed (06/16/2021)
Bill Subjects
  • Health Care & Health Insurance
House Sponsors D. Roberts (D)
I. Jodeh (D)
Senate Sponsors K. Donovan (D)
House Committee Health and Insurance
Senate Committee Health and Human Services
Date Introduced 03/18/2021
Summary

The bill requires the commissioner of insurance (commissioner)
in the department of regulatory agencies to establish a standardized health
benefit plan (standardized plan) by rule to be offered by health insurance
carriers (carriers) in the individual and small group markets. The
standardized plan must:
  • Offer health-care coverage at the bronze, silver, and gold

levels;
  • Be offered through the Colorado health benefit exchange;
  • Be a standardized benefit design created through a
stakeholder engagement process;
  • Provide first-dollar, predictable coverage for certain high
value services; and
  • Comply with state and federal law.
Beginning January 1, 2023, and each year thereafter, the bill
encourages carriers that offer:
  • An individual health benefit plan in Colorado to offer the
standardized plan in the individual market; and
  • A small group health benefit plan in Colorado to offer the
standardized plan in the small group market.
For 2023, each carrier shall set a goal of offering a standardized
plan premium that is at least 10% less than the premium rate for health
benefit plans offered by that carrier in the 2021 calendar year in the
individual and small group market. For 2024, each carrier shall set a goal
of offering a standardized plan premium that is at least 20% less than the
premium rate for health benefit plans offered by that carrier in the 2021
calendar year in the individual and small group market. For 2025 and
each year thereafter, carriers are encouraged to limit annual premium rate
increases for the standardized plan to no more than the consumer price
index plus one percent, relative to the previous year.
The Colorado option authority (authority) is created for the
purpose of operating as a carrier to offer the standardized plan as the
Colorado option if the carriers do not meet the established premium rate
goals. The authority shall operate as a nonprofit, unincorporated public
entity. The authority is required to implement a provider fee schedule as
established by the commissioner in consultation with the executive
director of the department of health care policy and financing.
Health-care providers and health facilities are required to accept
consumers who are enrolled in any health benefit plan offered by the
authority.
The bill creates an advisory committee to make recommendations
to the authority concerning the development, implementation, and
operation of the authority.
The commissioner is required to apply to the secretary of the
United States department of health and human services for a waiver and
include a request for a pass-through of federal funding to capture savings
as a result of the implementation of the standardized plan. The
commissioner is required to disapprove of a rate filing submitted by a
carrier if the rate filing reflects a cost shift between the standardized plan
and the health benefit plan for which rate approval is being sought.
The bill makes the failure to accept consumers who are covered
through the Colorado option or the balance billing of a patient in violation
of this bill grounds for discipline under specified practice acts.
The bill repeals the authority and its functions if the United States
congress establishes a national public option program that meets or
exceeds the premium rate goals set forth in and health-care coverage
pursuant to this bill.

Committee Reports
with Amendments
Full Text
Full Text of Bill (pdf) (most recent)
Fiscal Notes Fiscal Notes (05/17/2021) (most recent)  
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  • Past fiscal notes
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