On Apr. 11, 2025, COL INS posted adoption of Rule 4-2-104, effective May 30, 2025.
On Feb. 6, COL INS proposed rule on prescription contract disclosures.
COL INS proposed new Regulation 4-2-XX concerning disclosures of prescription drug contract terms to policyholders by carriers and pharmacy benefit managers (PBMs).
Establishes process for carriers, PBMs to provide policy disclosures on contract terms.
Drug Contract Disclosures
Applies to all health insurance carriers offering group health benefit plans in Colorado.
For health plans beginning in calendar year 2025 and each calendar year thereafter.
The carriers may satisfy obligations under this regulation by requiring pharmacy benefit managers to make required contract terms disclosures on the carriers' behalf.
However the carriers maintain ultimate responsibility in demonstrating compliance.
The proposed rule covers definitions, contract terms disclosure requirements, contract terms attestation, carrier exemption, severability, and enforcement compliance.
Effectiveness
This regulation is proposed to become effective on May 31, 2025.
Consultation
Comments on the proposed regulation are due on or before 5:00 pm on Feb. 13, 2025.
Mar. 3, 2025 COL INS Notice of Hearing
On Mar. 3, 2025, COL INS issued notice of hearing for draft proposed new Regulation 4-2-104 on prescription drug contract terms, with hearing scheduled for Mar. 31, 2025.
Mar. 10, 2025 COL INS State Reg
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 posted adoption of Rule 4-2-104, effective May 30, 2025.
Regulators
COL INS
Entity Types
IB; Ins
Reference
Nt, 4/11/2025; COL SR Vol. 48 No. 5, 3/10/2025; Nt, RF Reg 4-2-104, 3/3/2025; PR, RF, 2/6/2025
