Please note that prior to May 6, 2013, Connect for Health Colorado was known as the Colorado Health Benefit Exchange (COHBE), the legal name created by SB 11-200.
Certification, Recertification and Decertification of Health Issuers and Qualified Health Plans
Presentation on Certification, Recertification and Decertification of Health Issuers and Qualified Health Plans
Comment Letter from Colorado Community Health Network
Certification of Insurers & Qualified Health Plans (Part 1)
Certification of Insurers & Qualified Health Plans (Part 2)
Carrier Participation Requirements Recommendations
- The Board voted June 25, 2012 on an approach for addressing plan certification requirements in the areas of accreditation (2-year transition period for accreditation), developing a process for addressing complaints, collecting claims payment data and financial data and providing that information on our website, including formulary and provider information for shoppers, working with the Co. Division of Insurance and partners to validate licensure, gather Medical Loss Ratio information, assist with network adequacy issues, out-of-network payment disclosures, rate review, and solvency requirements.
- The Board voted on August 27, 2012 to acknowledge the Exchange cannot duplicate the role of the Co. Division of Insurance, which will define the requirements for validation of essential health benefits, discriminatory benefit design and plan differentiation, to require qualified health plan marketing materials to include any connection with the Exchange, to protect Exchange logos, and to expand the federal provider list for Medicaid to include essential community providers and to include the evaluation of essential community provider coverage in existing network adequacy requirements validation through the Division of Insurance.
- The Board voted on Nov. 26, 2012 to instate a 1-year waiting period for plans that choose not to sell on Exchange in 2014 and a 2-year wait for plans that participate in the Exchange and then voluntarily leave.