Colorado § 10-16-104.9 Geographic areas for small employers

Colorado Statutes

§ 10-16-104.9 — Geographic areas for small employers

Colorado § 10-16-104.9

Title 10Insurance

Art.Health-care Coverage

This text of Colorado § 10-16-104.9 (Geographic areas for small employers) is published on Counsel Stack Legal Research, covering Colorado primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook

Colo. Rev. Stat. § 10-16-104.9 (2026).

Text

(1)The commissioner shall promulgate a rule concerning geographic case characteristics, which may include metropolitan statistical areas for small employers. In promulgating such rule, the commissioner shall take testimony from all interested parties, including, but not limited to, consumer advocates and consumers, insurers, health-care providers, the state demographer, and producers. The rule shall include, without limitation, the following features:

(a)If the rule establishes separate geographic areas, in rate filings to the commissioner, a carrier shall be required to show that rates reflect a relativity to rates for other areas in the state and that rates and relativities are not excessive, inadequate, or unfairly discriminatory in such geographic areas;

(b)The rule shall

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(1) The commissioner
shall promulgate a rule concerning geographic case characteristics, which may
include metropolitan statistical areas for small employers. In promulgating such
rule, the commissioner shall take testimony from all interested parties, including,
but not limited to, consumer advocates and consumers, insurers, health-care
providers, the state demographer, and producers. The rule shall include, without
limitation, the following features:

(a) If the rule establishes separate geographic areas, in rate filings to the
commissioner, a carrier shall be required to show that rates reflect a relativity to
rates for other areas in the state and that rates and relativities are not excessive,
inadequate, or unfairly discriminatory in such geographic areas;

(b) The rule shall contain a determination of the appropriate population base
for statistical reliability in determining geographic areas or metropolitan statistical
areas;

(c) (I) The rule shall provide justifications of why any separate geographic
areas, which may include metropolitan statistical areas, serve the public interest in
regard to ensuring that premium rates for different geographic areas of the state
are not excessive, inadequate, or unfairly discriminatory;

(II) If the commissioner determines that metropolitan statistical areas are no
longer the best method for addressing geographic case characteristics, the
commissioner shall provide detailed justifications concerning the separate
geographic areas, in connection with which the commissioner shall make public the
impact the geographic case characteristics may have on insurance premiums for
the separate geographic areas; and

(d) In adopting such rule, the commissioner may consider the cost of health
care in a geographic area, experience of health care of any separate geographic
area, and information including actuarial opinions or certifications and set loss
ratios for loss ratio guarantees submitted by small employer carriers pursuant to
section 10-16-107 (1). The cost of health care and experience and the population
that may be served may be a consideration when determining whether separate
geographic case characteristics are necessary, but shall not be the sole factors of
separate geographic case characteristics, nor shall it compromise the public
interest of insureds and potential insureds of this state.