Second Regular Session
Seventy-third General Assembly
STATE OF COLORADO
INTRODUCED
LLS NO. 22-0288.01 Christy Chase x2008
HOUSE BILL 22-1269
House Committees Senate Committees
Health & Insurance
A BILL FOR AN ACT
C
ONCERNING REQUIREMENTS IMPOSED ON UNAUTHORIZED PERSONS101
OFFERING COVERAGE OF HEALTH -CARE COSTS FOR COLORADO102
RESIDENTS.103
Bill Summary
(Note: This summary applies to this bill as introduced and does
not reflect any amendments that may be subsequently adopted. If this bill
passes third reading in the house of introduction, a bill summary that
applies to the reengrossed version of this bill will be available at
http://leg.colorado.gov
.)
Starting October 1, 2022, and by each March 1 thereafter, the bill
requires any person that is not authorized to engage in the business of
insurance in this state but that offers or intends to offer a plan or
arrangement to facilitate payment of or to cover health-care costs or
services for Colorado residents to annually submit to the commissioner
HOUSE SPONSORSHIP
Lontine,
SENATE SPONSORSHIP
Hansen,
Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
Capital letters or bold & italic numbers indicate new material to be added to existing statute.
Dashes through the words indicate deletions from existing statute. of insurance (commissioner) specified information and a certification that
the information is accurate and complies with the requirements of the bill.
The submission must include information about the operation of the plan
or arrangement in the immediately preceding calendar year, including:
! The number of participants in the plan or arrangement;
! The total amount of fees, dues, or other payments collected
from participants and the percentage of fees, dues, or other
payments that the person retained;
! The total amount of payments made to providers or to
reimburse participants for health-care services provided or
received;
! The estimated number of participants the person anticipates
in the next calendar year;
! The counties in which the person offers or intends to offer
a plan or arrangement and any other states in which the
person offers a plan or arrangement;
! A list of third parties associated with, or offering or
enrolling participants in a plan or arrangement on behalf of,
the person and a detailed accounting of commissions or
other remuneration paid to a third party for services
provided in promoting or administering the plan or
arrangement;
! The person's reserve balance; and
! Contact information for an individual serving as the
person's contact person in this state, a list of the person's
officers and directors, and the person's organizational chart.
Within 45 days after receipt, the commissioner is to determine
whether a submission by a person is complete. Each year, the
commissioner is to compile a report summarizing the information
submitted by persons, post the report on the division of insurance website,
and submit the report to specified legislative committees. The
commissioner is authorized to adopt rules to implement the bill and to
issue an emergency cease-and-desist order against a person that fails to
comply with the requirements of the bill.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, add 10-16-107.4 as2
follows:3
10-16-107.4. Health-care sharing plan or arrangement -4
required reporting and certification - noncompliance - information5
HB22-1269-2- posted on division website - reports to general assembly - rules. (1) A1
PERSON NOT AUTHORIZED BY THE COMMISSIONER PURSUANT TO ARTICLE2
3
OF THIS TITLE 10 TO OFFER INSURANCE IN THIS STATE THAT OFFERS OR3
INTENDS TO OFFER A PLAN OR ARRANGEMENT TO FACILITATE PAYMENT OF4
OR TO COVER HEALTH-CARE COSTS OR SERVICES FOR RESIDENTS OF THIS5
STATE, REGARDLESS OF WHETHER THE PERSON IS DOMICILED IN THIS STATE6
OR ANOTHER STATE, SHALL SUBMIT TO THE COMMISSIONER BY OCTOBER7
1,
2022, AND BY MARCH 1 EACH YEAR THEREAFTER:8
(a) T
HE FOLLOWING INFORMATION :9
(I) T
HE TOTAL NUMBER OF INDIVIDUALS AND HOUSEHOLDS THAT10
PARTICIPATED IN THE PLAN OR ARRANGEMENT IN THIS STATE IN THE11
IMMEDIATELY PRECEDING CALENDAR YEAR ;12
(II) T
HE TOTAL NUMBER OF EMPLOYER GROUPS THAT13
PARTICIPATED IN THE PLAN OR ARRANGEMENT IN THIS STATE IN THE14
IMMEDIATELY PRECEDING CALENDAR YEAR , SPECIFYING THE TOTAL15
NUMBER OF PARTICIPATING INDIVIDUALS IN EACH PARTICIPATING16
EMPLOYER GROUP;17
(III) T
HE TOTAL AMOUNT OF FEES , DUES, OR OTHER PAYMENTS18
COLLECTED BY THE PERSON IN THE IMMEDIATELY PRECEDING CALENDAR19
YEAR FROM INDIVIDUALS , EMPLOYER GROUPS , OR OTHERS WHO20
PARTICIPATED IN THE PLAN OR ARRANGEMENT IN THIS STATE , SPECIFYING21
THE PERCENTAGE OF FEES, DUES, OR OTHER PAYMENTS RETAINED BY THE22
PERSON FOR ADMINISTRATIVE EXPENSES ;23
(IV) T
HE TOTAL AMOUNT OF PAYMENTS MADE TO PROVIDERS IN24
THE IMMEDIATELY PRECEDING CALENDAR YEAR FOR HEALTH -CARE25
SERVICES PROVIDED TO OR RECEIVED BY A PLAN OR ARRANGEMENT26
PARTICIPANT;27
HB22-1269
-3- (V) THE TOTAL AMOUNT OF REIMBURSEMENTS MADE TO PLAN OR1
ARRANGEMENT PARTICIPANTS IN THE IMMEDIATELY PRECEDING CALE NDAR2
YEAR FOR HEALTH-CARE SERVICES PROVIDED TO OR RECEIVED BY A PLAN3
OR ARRANGEMENT PARTICIPANT ;4
(VI) T
HE ESTIMATED NUMBER OF PLAN OR ARRANGEMENT5
PARTICIPANTS THE PERSON IS ANTICIPATING IN THE NEXT CALENDAR YEAR ,6
SPECIFYING THE ESTIMATED NUMBER OF INDIVIDUALS , HOUSEHOLDS,7
EMPLOYER GROUPS, AND EMPLOYEES;8
(VII) T
HE SPECIFIC COUNTIES IN THIS STATE IN WHICH THE PERSON:9
(A) O
FFERED A PLAN OR ARRANGEMENT IN THE IMMEDIATELY10
PRECEDING CALENDAR YEAR ; AND11
(B) I
NTENDS TO OFFER A PLAN OR ARRANGEMENT IN THE NEXT12
CALENDAR YEAR;13
(VIII) O
THER STATES IN WHICH THE PERSON OFFERS A PLAN OR14
ARRANGEMENT;15
(IX) A
LIST OF ANY THIRD PARTY, INCLUDING A PRODUCER, THAT16
IS ASSOCIATED WITH THE PERSON OR ASSISTS THE PERSON IN OFFERING OR17
ENROLLING PARTICIPANTS IN THE PLAN OR ARRANGEMENT , COPIES OF ANY18
TRAINING MATERIALS PROVIDED TO A THIRD PARTY , INCLUDING A19
PRODUCER, AND A DETAILED ACCOUNTING OF ANY COMMISSIONS OR20
OTHER FEES OR REMUNERATION PAID TO A THIRD PARTY , INCLUDING A21
PRODUCER, IN THE IMMEDIATELY PRECEDING CALENDAR YEAR FOR :22
(A) M
ARKETING, PROMOTING, OR ENROLLING PARTICIPANTS IN A23
PLAN OR ARRANGEMENT OFFERED BY THE PERSON IN THIS STATE ; OR24
(B) O
PERATING, MANAGING, OR ADMINISTERING A PLAN OR25
ARRANGEMENT OFFERED BY THE PERSON IN THIS STATE ;26
(X) C
OPIES OF ANY CONSUMER -FACING AND MARKETING27
HB22-1269
-4- MATERIALS USED IN PROMOTING THE PERSON 'S PLAN OR ARRANGEMENT,1
INCLUDING PLAN OR ARRANGEMENT AND BENEFIT DESCRIPTIONS AND2
OTHER MATERIALS THAT EXPLAIN THE PLAN OR ARRANGEMENT ;3
(XI) T
HE NAME, MAILING ADDRESS, E-MAIL ADDRESS, AND4
TELEPHONE NUMBER OF AN INDIVIDUAL SERVING AS A CONTACT PERSON5
FOR THE PERSON IN THIS STATE;6
(XII) A
LIST OF ANY PARENT COMPANIES , SUBSIDIARIES, AND7
OTHER NAMES THAT THE PERSON HAS OPERATED UNDER AT ANY TIME8
WITHIN THE IMMEDIATELY PRECEDING FIVE CALENDAR YEARS ;9
(XIII) A
N ORGANIZATIONAL CHART FOR THE PERSON AND A LIST10
OF THE OFFICERS AND DIRECTORS OF THE PERSON ;11
(XIV) T
HE BALANCE OF RESERVES THE PERSON HAS AT THE TIME12
OF SUBMITTAL; AND13
(XV) A
NY OTHER INFORMATION REGARDING THE PERSON THAT14
THE COMMISSIONER DEEMS RELEVANT TO CONSUMER PROTECTION AND15
THAT THE COMMISSIONER SPECIFIES BY RULE ;16
(b) A
CERTIFICATION BY AN OFFICER OF THE PERSON THAT, TO THE17
BEST OF THE PERSON'S GOOD-FAITH KNOWLEDGE AND BELIEF , THE18
INFORMATION SUBMITTED IS ACCURATE AND SATISFIES THE19
REQUIREMENTS OF THIS SUBSECTION (1).20
(2) (a) I
F THE PERSON SUBJECT TO THE REQUIREMENTS OF21
SUBSECTION (1) OF THIS SECTION FAILS TO SUBMIT THE INFORMATION OR22
CERTIFICATION REQUIRED BY SAID SUBSECTION , THE SUBMISSION IS23
INCOMPLETE. THE COMMISSIONER SHALL MAKE A DETERMINATION OF24
COMPLETENESS NO LATER THAN FORTY -FIVE DAYS AFTER THE SUBMISSION.25
I
F THE COMMISSIONER HAS NOT INFORMED THE PERSON OF ANY26
DEFICIENCIES IN THE SUBMISSION WITHIN FORTY -FIVE DAYS AFTER27
HB22-1269
-5- RECEIVING THE SUBMISSION, THE SUBMISSION IS CONSIDERED COMPLETE .1
(b) I
F A PERSON FAILS TO COMPLY WITH THE REQUIREMENTS OF2
SUBSECTION (1) OF THIS SECTION, THE COMMISSIONER MAY ISSUE AN3
EMERGENCY CEASE-AND-DESIST ORDER IN ACCORDANCE WITH SECTION4
10-3-904.5.5
(3) O
N OR BEFORE APRIL 1, 2023, AND ON OR BEFORE EACH6
O
CTOBER 1 THEREAFTER, THE COMMISSIONER SHALL:7
(a) P
REPARE A WRITTEN REPORT SUMMARIZING THE INFORMATION8
SUBMITTED BY PERSONS PURSUANT TO SUBSECTION (1) OF THIS SECTION;9
(b) P
OST ON THE DIVISION 'S WEBSITE THE REPORT AND10
INFORMATION ABOUT HOW CONSUMERS MAY FILE COMPLAINTS ABOUT11
UNAUTHORIZED PERSONS ; AND12
(c) S
UBMIT THE REPORT TO THE SENATE HEALTH AND HUMAN13
SERVICES COMMITTEE AND THE HOUSE OF REPRESENTATIVES HEALTH AND14
INSURANCE COMMITTEE OR ANY SUCCESSOR COMMIT TEES .15
N
OTWITHSTANDING SECTION 24-1-136 (11)(a)(I), THE REQUIREMENT TO16
REPORT TO THE LEGISLATIVE COMMITTEES CONTINUES INDEFINITELY .17
(4) T
HE COMMISSIONER MAY ADOPT RULES AS NECESSARY TO18
IMPLEMENT THIS SECTION.19
SECTION 2. In Colorado Revised Statutes, 10-3-904.5, amend20
(1)(a) as follows:21
10-3-904.5. Emergency cease-and-desist orders - issuance.22
(1) The commissioner may issue an emergency cease-and-desist order ex23
parte if:24
(a) The commissioner believes that:25
(I) An unauthorized person is engaging in the business of26
insurance in violation of the provisions
of section 10-3-105 or 10-3-90327
HB22-1269
-6- or is in violation of a rule promulgated by the commissioner; and OR1
(II) A
PERSON IS FAILING TO COMPLY WITH SECTION 10-16-107.4;2
AND3
SECTION 3. Applicability. This act applies to conduct occurring4
on or after the effective date of this act.5
SECTION 4. Safety clause. The general assembly hereby finds,6
determines, and declares that this act is necessary for the immediate7
preservation of the public peace, health, or safety.8
HB22-1269
-7-