COL INS proposed amended Regulation 4-2-58 and request for comments related to the non-discriminatory cost-sharing and tiering requirements for prescription drugs.
Extended the applicability to Affordable Care Act-compliant individual and small employer health benefit plans issued or renewed on or after Jan. 1, 2026.
Defined Colorado Option Standardized Plan or Standardized plan to have the meaning in Colorado revised statutes COL INS 10-16-1303(14), and defined lowest cost tier.
Carriers must use second tier of the formulary as lowest cost tier, offer at least one plan, other than COL Option Standardized Plan, that counts as part of 25% minimum.
Carriers must also not include in the calculations zip codes, counties or statewide counties that cross between service areas to account for the twenty-five percent.
Comment Request
Comments on proposed regulation must be submitted no later than Jan. 24, 2025.
Mar. 3, 2025 COL INS Notice of Hearing
On Mar. 3, 2025, COL INS issued notice of hearing, and scheduled for Mar. 31, 2025.
Mar. 10, 2025 COL INS State Register
On Mar. 10, 2025, COL INS published draft rule and hearing notice in State register.
Apr. 2025 COL INS Rule Adoption
On Apr. 11, 2025, COL INS issued notice of adoption for amended Regulation 4-2-58.
Rule related to non-discriminatory cost-sharing and tiering effective on May 30, 2025.
May 2025 COL INS Adoption Publication
On May 10, 2025, COL INS published rule adoption in State register, effective May 30.
Regulators
COL INS
Entity Types
IB; Ins
Reference
COL SR Vol. 48 No. 9, 5/10/2025; Nt, 4/11/2025; COL SR Vol. 48 No. 5, 3/10/2025; Nt, 3/3/2025; PR, RF 4-2-58, 1/16/2025; Citation: COL INS 10-16-1303;
