The general assembly hereby recognizes that, through the sunset review for the division of insurance within the department of regulatory agencies in October 2001, the general assembly adopted a recommendation to consolidate and relocate the regulatory functions concerning health-care cooperatives. The provisions of parts 1, 2, and 4 of article 18 of title 6, C.R.S., […]
As used in this part 10, unless the context otherwise requires: Repealed. “Cooperative” or “health-care coverage cooperative” means a health-care coverage cooperative created pursuant to this part 10 as an entity that provides to its members health coverage and health-care purchasing services, including but not limited to detailed information on comparative prices, usage, outcomes, quality, […]
Individually identifiable health information collected for or by a cooperative is subject to HIPAA. All disclosures of individually identifiable health information shall be restricted to the minimum amount of information necessary to accomplish the purpose for which the information is being disclosed. Any cooperative shall implement administrative, technical, and physical safeguards for the security of […]
There is hereby authorized the creation of entities to be known as health- care coverage cooperatives. A health-care coverage cooperative may be created as any lawful entity under articles 55, 56, 58, 101 to 117, or 121 to 137 of title 7, C.R.S., so long as such entity operates for the mutual benefit of its […]
On and after August 4, 2004, an unlicensed cooperative conducting business pursuant to this part 10 shall file an application with the commissioner for issuance of a certificate of authority to purchase health-care coverage for members and their eligible employees. An application shall include the following information: The name of the cooperative and any agent […]
On and after August 4, 2004, the commissioner may deny an application for a certificate of authority pursuant to section 10-16-1005 or revoke or suspend a certificate of authority of any cooperative found to be in violation of this part 10. Any party may request a hearing pursuant to article 4 of title 24, C.R.S., […]
A cooperative shall not perform any activity included in the definition of transacting insurance business in this state, as provided in section 10-3-903, except as otherwise authorized in the powers, duties, and responsibilities of cooperatives as set forth in section 10-16-1009. A cooperative shall not establish or engage in the activities of a health maintenance […]
The affairs of the cooperative shall be managed in accordance with the legal structure required of the entity and, except as provided in subsection (1)(a)(II) of this section, governed by persons elected by the members from their own number. The governing body of the cooperative shall adopt bylaws and rules for the cooperative. (1) (a) […]
Each cooperative organized pursuant to this part 10 shall: Establish the conditions of cooperative membership; Provide to cooperative members and their eligible employees clear, standardized information about each provider network, licensed provider network, carrier, or other provider contracted with by the cooperative, including, but not limited to, information on price, benefits, costs, quality, patient satisfaction, […]
A cooperative shall use appropriate, efficient, and standardized means to notify members and prospective members and their eligible employees of the availability of sponsored health-care coverage from the cooperative. A cooperative shall make available to members and prospective members and their eligible employees marketing materials that accurately summarize the health benefit plans that are offered […]
As used in this section, unless the context otherwise requires, “responsible party” means a member of the governing body or an executive officer of a cooperative. After notice and the opportunity for a hearing pursuant to article 4 of title 24, C.R.S., the commissioner may enforce the provisions of this part 10 by issuing orders […]
Subject to available appropriations, the commissioner may provide technical assistance to any cooperative that: Repealed. Repealed. Repealed. Establishes rules that specify that employer members shall take no action to limit their employees’ choice of plans offered through the cooperative or to encourage or discourage employees from making particular choices of plans offered through the cooperative; […]
The commissioner may promulgate rules consistent with this part 10 for purposes of carrying out the commissioner’s duties under this part 10. Source: L. 2004: Entire part added, p. 1009, § 14, effective August 4. L. 2019: Entire section amended, (SB 19-004), ch. 205, p. 2197, § 12, effective August 2. Cross references: For the […]
As necessary to implement this part 10, the commissioner may apply to the secretary of the United States department of health and human services for a five-year state innovation waiver in accordance with section 1332 of the federal act, codified at 42 U.S.C. sec. 18052, and 45 CFR 155.1300. The commissioner shall ensure that a […]
