2017 Colorado Revised Statutes
Title 10 - Insurance
Health Care Coverage
Article 16 - Health Care Coverage
Part 1 - General Provisions
§ 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 - repeal

(1) Any entity issuing excess loss insurance shall file all policy forms with the division and certify compliance with the provisions of this title.

(2) All excess loss insurance shall be issued to cover the employer's liability under the employer's self-insured obligation. Excess loss insurance shall meet the following requirements:

(a) The policy shall only be issued to insure an employer and not the employer's employees;

(b) Payment by the issuer of the insurance shall only be made to the employer and not the employees or providers;

(c) Commencing with policies issued or renewed on and after January 1, 2003, the minimum retention to the employer shall be no less than fifteen thousand dollars per person per plan year with a minimum one hundred twenty percent of expected claims aggregate.

(3) (a) For calendar years 2013 through 2018, an insurer that sells excess loss or stop-loss health insurance policies shall file with the commissioner annually, in the form and manner required by the commissioner by rule, information including the following:

(I) The total number and average group size of excess loss or stop-loss health insurance policies sold to employer groups with the following number of full-time equivalent employees:

(A) Ten or fewer;

(B) Eleven to twenty-five;

(C) Twenty-six to fifty; and

(D) Fifty-one to one hundred;

(II) The number of lives covered in Colorado for each group size specified in subparagraph (I) of this paragraph (a);

(III) The mean and median attachment points by the group sizes specified in subparagraph (I) of this paragraph (a);

(IV) The source of prior coverage for the groups specified in subparagraph (I) of this paragraph (a), including:

(A) Employers previously self-insured with excess loss or stop-loss health insurance coverage;

(B) Employers previously self-insured without excess loss or stop-loss health insurance coverage;

(C) Employers previously not offering coverage;

(D) Groups previously fully insured outside the Colorado health benefit exchange, created in article 22 of this title; and

(E) Groups previously fully insured inside the Colorado health benefit exchange, created in article 22 of this title; and

(V) The smallest group size covered and insurer minimum group size requirements.

(b) The commissioner shall collect the information identified in this subsection (3) annually for each calendar year from 2013 through 2018 and make the data available to the public.

(c) If an insurer that issues one or more stop-loss health insurance policies does not annually file the information required by paragraph (a) of this subsection (3) by the date specified by rules of the commissioner, the commissioner may assess a penalty of up to one hundred dollars per day for each day after the date the information is due that the insurer fails to submit the required information.

(d) This subsection (3) is repealed, effective September 1, 2019.