Colorado Option

Page Updated: Nov. 30, 2023

CHA Advocacy Principle: All rates must ensure payment adequacy and efficiency to provide care, and any rate-setting determination should include a fair, transparent process that provides due consideration to cost-drivers, such as pharmaceutical and labor costs, and recognizes good-faith efforts to negotiate.

What Has Been Completed:

Origin: House Bill (HB) 21-1232 established the Standardized Health Benefit Plan Colorado Option.

Background: The regulatory process began to operationalize the Colorado Option in July 2021, and included the development of the standardized plan, cultural competency requirements, the federal 1332 waiver to provide pass-through funding, and the rate-setting process. 2023 would have been the first year rate hearings were held; however, all of the scheduled rate hearings were canceled due to hospitals and insurers coming to agreements prior to when the hearings would have occurred.

Outstanding Items: Consumers will shop for 2024 plans in the Fall of 2023.

During the 2023 legislative session, the DOI finalized legislative updates to the Colorado Option through HB 23-1224. This legislation updates the preference process for plan selection, grant the Commissioner 120 days to review the rate filings, increase the Commissioner’s discretion to bring a provider to a hearing once identified by a carrier, make all appeals subject only to the court of appeals. 

Resources: 

Meetings/Dates of Note:

    • November – January 2024 – Colorado Option plans for 2024 plan year available for purchase
    • Dec. 4 – DOI Rulemaking Hearing on Proposed Rule Changes – register here

CHA Staff Contact: Megan Axelrod, CHA director of regulatory policy and federal affairs, [email protected]