Reinsurance Program

HB19-1168 and 1332 State Innovation Waiver Application

Draft Reinsurance Program Timeline

  • October 1, 2019: Permanent regulation containing the payment parameters for the 2020 plan year will become effective.
  • Late November 2019: The Division expects to issue draft regulations for reinsurance implementation
  • Early December 2019: Stakeholder meetings for draft regulations 
  • Late December 2019: Regulations finalized 
  • January 1, 2020: Division submits payment schedule to CMS
  • January 2020: First provider payments collected (monthly thereafter)
  • February 28th, 2020: Division submits first quarterly report 
  • March 15, 2020: Payment parameters for the 2021 plan year will be established by the Commissioner via rule.
  • April 2020: The federal pass-through money is provided to the Division 
     

HB19-1168, The State Innovation Waiver Reinsurance Program was passed by the Colorado Legislature in 2019 and signed into law by Governor Polis on May 17, 2019. In addition to establishing a two-year reinsurance program for 2020 and 2021, the law requires the Division to submit an application to the Federal Government for a 1332 State Innovation Waiver for a reinsurance program.

HHS Approval Letter for Colorado's 1332 Waiver for Reinsurance (includes specific terms and conditions) - Issued July 31, 2019

Colorado's 1332 State Innovation Waiver Application for a Reinsurance Program (includes final actuarial analysis) - submitted on May 20, 2019 to the Centers for Medicare & Medicaid Services (CMS)

Addendum to Colorado 1332 State Innovaction Waiver Application: Responding to Federal Comments - July 31, 2019

June 5, 2019 Letter from CMS: Preliminary determination that Colorado application is complete - This marks the beginning of 180-day full review of the application, and the 30-day Federal public notice and comment period (comment period will end on July 5, 2019).

Public Meetings and Preliminary Actuarial Analysis 

SB17-300 - High-Risk Health Care Coverage Program 

In 2017, the Colorado Legislature passed SB17-300, which directed the Division of Insurance to "explore the feasibility of maintaining healthcare coverage for high-risk individuals and reducing premiums through a reinsurance program or other high-risk programs." The information below contains the actuarial studies and reports that were the outcome of that bill, as well as information and materials from the numerous stakeholder meetings that were convened on this topic throughout 2017. 

Actuarial Studies / Reports 

SB17-300 Stakeholder Meetings and Materials

 


Contact Information
Division of Insurance, Colorado Department of Regulatory Agencies
1560 Broadway, Suite 850
Denver, CO 80202