(1)(a) The
specifications drawn by the director for any group benefit plans include those
benefits as determined by the director or as otherwise specifically provided in this
part 6. Such specifications shall include provisions for noncancellation for reasons
of health of any individual employee by the carrier and transferability to other
group benefit coverages or individual policies with the same carrier by the
employee.
(b)At any time the director seeks to contract with any carriers under this
section, the director shall first give notice of such intent in a manner determined by
the director.
(c)Specifications and related data shall be prepared by the director for
submission to carriers which indicate their interest in preparing proposals for any
group benefit plans.
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(1) (a) The
specifications drawn by the director for any group benefit plans include those
benefits as determined by the director or as otherwise specifically provided in this
part 6. Such specifications shall include provisions for noncancellation for reasons
of health of any individual employee by the carrier and transferability to other
group benefit coverages or individual policies with the same carrier by the
employee.
(b) At any time the director seeks to contract with any carriers under this
section, the director shall first give notice of such intent in a manner determined by
the director.
(c) Specifications and related data shall be prepared by the director for
submission to carriers which indicate their interest in preparing proposals for any
group benefit plans.
(d) Contracts awarded under this section by the director shall be to the
lowest, most responsive offerors, according to criteria predetermined by the
director, subject to the provisions of subsection (2) of this section and articles 101 to
111 of this title. The director may accept a responsive proposal for combined group
benefit plans.
(e) The director shall review the group benefit plans at least once each year
and shall solicit and receive proposals on the group benefit plans at least once
every five years.
(f) The specifications drawn by the director for any group benefit plans shall
include the mandated coverages required by section 10-16-104, C.R.S.
(2) (a) In order to permit each eligible employee individual selection of a
flexible benefits or cafeteria benefits package, the director may establish a variety
of group benefit plans.
(b) The director shall enter into contracts with the carriers selected to
provide group benefit plans. Such contracts shall include all policy provisions, the
premium rates to be charged during the term of the contract, specifications on the
method of claims administration, a grievance procedure provision, and such other
matters as the director deems necessary. In the director's discretion and based on
the plan's experience, the premium rates applying during the first contract term
may be adjusted during subsequent contract terms. Changes may also be
negotiated in the method of claims administration, the amount to be retained by the
carrier, and other matters.
(c) Each contract entered into with a carrier shall be available to be
inspected or copied by any employee at the offices of the director, except for
proprietary information of carriers as determined by the director.
(d) Every carrier shall prepare and provide the director with reports and
financial data as stated in the contract.
(e) Financial data will be available to be inspected or copied by any
employee at the offices of the director, except for proprietary and confidential
information of carriers and information regarding specific employees. The director
shall not enter into contracts with carriers that do not comply with paragraphs (c) to
(e) of this subsection (2).
(3) The director shall include the following statement in medical benefit
materials, in bold-faced type:
Warning: If you are insured under a separate group medical insurance policy, you
may be subject to coordination of benefits as explained in this booklet.
(4) and (5) Repealed.