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Axiom
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Colorado
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Statutes
Colorado Revised Statutes 2025 Title 10 Insurance
10-16-101
Short title
10-16-102
Definitions
10-16-103
Proposal of mandatory health-care coverage provisions
10-16-103.3
Commission on mandated health insurance benefits - cash fund - purpose - creation - duties - repeal. (Repealed)
10-16-103.4
Essential health benefits - requirements - rules
10-16-103.5
Payment of premiums - required term in contract - rules - definition
10-16-103.6
Copayment-only prescription payment structures - required inclusion in health benefit plans - rules
10-16-104
Mandatory coverage provisions - applicability - rules - definitions
10-16-104.1
Prohibition on discrimination for organ transplants based solely on disability - definition
10-16-104.2
Coverage for contraception - rules - definitions
10-16-104.3
Health coverage for persons under twenty-six years of age - coverage for students who take medical leave of absence
10-16-104.4
Child-only plans - legislative declaration - open enrollment - reporting requirements - repeal. (Repealed)
10-16-104.5
Autism - treatment - not mental illness - repeal. (Repealed)
10-16-104.6
Off-label use of cancer drugs
10-16-104.7
Substance use disorders - court-ordered treatment coverage
10-16-104.8
Behavioral, mental health, or substance use disorder services coverage - court-ordered
10-16-104.9
Geographic areas for small employers
10-16-105
Guaranteed issuance of health insurance coverage - individual and small employer health benefit plans
10-16-105.1
Guaranteed renewability - exceptions - individual and small employer health benefit plans - rules - notice to revisor of statutes
10-16-105.2
Small employer health insurance availability program
10-16-105.3
Health benefit plans - not prohibited
10-16-105.5
Individual health plans - federally eligible individual - limited guarantee issue. (Repealed)
10-16-105.6
Rate usage
10-16-105.7
Health benefit plan open enrollment periods - special enrollment periods - rules
10-16-105.9
Health benefit plan - carrier insolvency - covered persons - deductible amounts - rules - definition
10-16-106
Group replacement - extension of benefits
10-16-106.3
Uniform claims - billing codes - electronic claim forms
10-16-106.5
Prompt payment of claims - legislative declaration - rules
10-16-106.7
Assignment of health insurance benefits
10-16-107
Rate filing regulation - benefits ratio - rules
10-16-107.1
False or misleading information - penalties
10-16-107.2
Filing of health policies - rules
10-16-107.3
Health insurance policies - plain language required - rules
10-16-107.4
Health-care sharing plan or arrangement - required reporting and certification - noncompliance - information posted on division website - rules
10-16-107.5
Uniform application form - use by all carriers - rules
10-16-107.7
Nondiscrimination against providers
10-16-108
Continuation privileges
10-16-108.3
Continuation privileges - special election period - notice requirements - definitions - repeal. (Repealed)
10-16-108.5
Fair marketing standards - rules
10-16-109
Rules
10-16-110
Fees paid by health coverage entities
10-16-111
Annual statements and reports - rules
10-16-112
Private utilization review - health-care coverage entity responsibility - definitions
10-16-112.5
Prior authorization for health-care services - disclosures and notice - determination deadlines - criteria - limits and exceptions - enforcement - definitions - rules
10-16-113
Procedure for denial of benefits - internal review - rules - definitions
10-16-113.5
Independent external review of adverse determinations - legislative declaration - definitions - rules
10-16-113.7
Reporting the denial of benefits to division
10-16-114
Short title. (Repealed)
10-16-115
Definitions. (Repealed)
10-16-116
Catastrophic health insurance - coverage - premium payments - reporting requirements - definitions - short title - rules - repeal
10-16-116.5
State innovation waiver for nonemployer catastrophic health plans - notice of decision by secretary - effect of secretary's decision - notice to revisor of statutes - definitions - rules - state measurement for accountable, responsive, and transparent (SMART) government act report - repeal. (Repealed)
10-16-117
Premium payments - pre-tax - election - reporting requirements. (Repealed)
10-16-118
Prohibition against preexisting condition exclusions
10-16-119
Requirements for excess loss or stop-loss health insurance used in conjunction with self-insured employer benefit plans under the federal Employee Retirement Income Security Act - data collection 2013-18 - rules
10-16-119.5
Stop-loss health insurance for small employers of not more than fifty employees - requirements - definitions - rules
10-16-120
Legislative review of requirements for guaranteed issue of basic and standard health benefit plans. (Repealed)
10-16-121
Required contract provisions in contracts between carriers and providers - definitions
10-16-121.3
Limitations on provisions in contracts between carriers and licensed health-care providers - methods of payment - fees - definitions
10-16-121.5
Prohibited contract provisions in contracts between carriers and providers for dental services - definition
10-16-121.7
Prohibited contract provisions in contracts between carriers and eye care providers - definitions
10-16-122
Access to prescription drugs
10-16-122.1
Contracts between PBMs and pharmacies - carrier submit list of PBMs - PBM registration - fees - prohibited practices - exception - rules - enforcement - short title - definitions
10-16-122.3
Pharmacy benefit management firm payments - retroactive reduction prohibited - enforcement - rules - dispensing fees - definitions
10-16-122.4
Pharmacy benefits - formulary change prohibition - exceptions - enforcement - definition - rules
10-16-122.5
Pharmacy benefit manager - audit of pharmacies - time limits on on-site audits - enforcement - rules
10-16-122.6
Pharmacy benefit managers - contracts with pharmacies - maximum allowable cost pricing - enforcement - rules
10-16-122.7
Disclosures between pharmacists and patients - carrier and PBM prohibitions - enforcement - short title - legislative declaration - preemption by federal law - rules
10-16-122.8
Pharmacy benefit manager practices - agreements - fees - documentation - rules. [Editor's note: This section is effective January 1, 2027.]
10-16-122.9
Prescription drug benefits - real-time access to benefit information - enforcement - definitions - rules
10-16-123
Telehealth - definitions
10-16-124
Prescription information cards - legislative declaration
10-16-124.5
Prior authorization form - drug benefits - program - chronic maintenance drugs - rules of commissioner - definitions - repeal
10-16-124.6
Drugs used for substance use disorder - prior authorization prohibited
10-16-124.7
Opioid analgesics with abuse-deterrent properties - study - definitions
10-16-124.8
Colorado consortium for prescription drug abuse prevention - create process for recovery - report
10-16-125
Reimbursement to nurses
10-16-126
Fee-for-service dental plans
10-16-127
Coinsurance and deductibles
10-16-128
Annual report to general assembly
10-16-129
Health savings accounts
10-16-130
Disclosure of rate increases to public entities - legislative declaration - definitions
10-16-131
Health care reform project - blue ribbon commission for health care reform - repeal. (Repealed)
10-16-132
Study of factors driving health care costs in Pueblo county - repeal. (Repealed)
10-16-133
Health carrier information disclosure - website - insurance producer fees and disclosure requirements - legislative declaration - rules
10-16-134
Health-care transparency - information required - website - definition. (Repealed)
10-16-135
Health coverage plan information cards - rules - standardization - contents
10-16-136
Wellness and prevention programs - individual and small group health coverage plans - voluntary participation - incentives or rewards - rules - definitions - legislative declaration - repeal. (Repealed)
10-16-137
Policy forms - explanation of benefits - standardization of forms - rules
10-16-138
Pathology services - direct billing required
10-16-139
Access to care - rules - definitions
10-16-140
Grace periods - premium payments - rules
10-16-141
Medication synchronization services - cost sharing for partial refills - dispensing fees
10-16-142
Physical rehabilitation services - copayments and coinsurance - research
10-16-143
Single geographic rating area - individual plans - study - report - repeal. (Repealed)
10-16-143.5
Pharmacy reimbursement - substance use disorders - injections - patient counseling
10-16-144
Health-care services provided by pharmacists
10-16-145
Step therapy - limitations - exceptions - definitions - rules
10-16-145.5
Step therapy - prior authorization - prohibited - stage four advanced metastatic cancer - opioid prescription - definitions
10-16-146
Periodic updates to provider directory
10-16-147
Parity reporting - commissioner - carriers - rules - examination of complaints
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