Colorado § 10-16-116 - Catastrophic health insurance - coverage - premium payments - reporting requirements - definitions - short title - rules - repeal.

§ 10-16-116. Catastrophic health insurance - coverage - premium payments - reporting requirements - definitions - short title - rules - repeal.

(1) This section shall be known and may be cited as the "Colorado Catastrophic Health Insurance Coverage Act".

(2) (a) An employer may offer catastrophic health insurance to its employees pursuant to this section.

(b) Prior to January 1, 2025, employees who elect the coverage shall pay the cost of the insurance pursuant to subsection (5) of this section.

(c) This subsection (2)(c) and subsection (2)(b) of this section are repealed, effective December 31, 2028.

(3) Each catastrophic health insurance policy issued pursuant to this section must:

(a) Be issued to the employer unless issued as an individual plan pursuant to section 10-16-105.2 (1)(d);

(b) In order to be considered a qualified higher deductible plan for purposes of a medical savings account pursuant to section 39-22-504.7, C.R.S., or other provisions of state law, meet the requirements for a qualifying plan for a health savings account under federal law and have a minimum deductible of at least one thousand five hundred dollars but no more than two thousand two hundred fifty dollars for individual coverage or at least three thousand dollars but no more than four thousand five hundred dollars for family coverage;

(c) Offer coverage for the spouse or partner in a civil union and dependent children of the insured employee;

(d) Cover all employees who elect coverage and are not otherwise covered by medicare or another health insurance policy;

(e) For group coverage, cover an employee and eligible dependents regardless of health status;

(f) Be priced according to appropriate rating requirements for health benefit plans as specified by law;

(g) Provide a clearly written contract of coverage, including a list of procedures covered under the policy;

(h) Comply with requirements for health benefit plans specified in this article.

(4) When catastrophic health insurance is purchased pursuant to this section, the employer, at its option, may pay all or a part of the cost of the insurance.

(5) (a) Prior to January 1, 2025, if claiming an exclusion of premium payments for state income tax purposes pursuant to section 39-22-104.5, an employee shall elect to purchase catastrophic health insurance by signing a written election, which must be in the form prescribed by the executive director of the department of revenue and signed by the employee prior to the date the employer withholds the first contribution.

(b) Prior to January 1, 2025, an employer shall withhold the premium payments for catastrophic health insurance from the wages of an employee who has elected coverage pursuant to subsection (5)(a) of this section and shall remit the premiums to the insuring entity on the employee's behalf. All premiums collected by an employer are withheld from the employee's wages on a pretax basis pursuant to section 39-22-104.5.

(c) Prior to January 1, 2025, an employer withholding premium payments from an employee's wages pursuant to subsection (5)(b) of this section shall report the amount withheld to the department of revenue, pursuant to rules promulgated by the executive director of the department.

(d) This subsection (5) is repealed, effective December 31, 2028.

(6) As used in this section, unless the context otherwise requires:

(a) "Catastrophic health insurance" means insurance meeting the requirements set forth in subsection (3) of this section. The term does not include a catastrophic plan as defined in section 10-16-102 (10).

(b) "Dependent child" means an adopted or natural child of an employee who is:

(I) Under twenty-one years of age;

(II) Legally entitled to or the subject of a court order for the provision of proper or necessary subsistence, education, medical care, or any other care necessary for the individual's health, guidance, or well-being and who is not otherwise emancipated, self-supporting, married, or a member of the armed forces of the United States; or

(III) So mentally or physically incapacitated that the individual cannot provide for himself or herself.

(c) "Employee" means an individual who resides in this state and is employed by an employer.

(d) "Employer" means a person or entity employing one or more individuals in this state, excluding the federal government or businesses providing health insurance coverage through a self-insured plan that has benefits equal to or greater than a catastrophic health insurance plan set forth in this section.

Source: L. 94: Entire section added, p. 742, § 1, effective January 1, 1995; (2) amended, p. 1917, § 10, effective July 1. L. 2000: (2)(a), (2)(b), (2)(e), (2)(f), IP(2)(h), and (2)(h)(II) amended and (2)(i) added, p. 171, § 1, effective January 1, 2001. L. 2002: (3) added, p. 1293, § 4, effective January 1, 2003. L. 2004: (1), (2)(a), (2)(b), (2)(d), (2)(g), (2)(h)(II), and (3) amended, p. 989, § 8, effective August 4. L. 2007: (3) amended, p. 451, § 4, effective January 1, 2008. L. 2009: (3) amended, (HB 09-1204), ch. 344, p. 1808, § 5, effective January 1, 2010. L. 2013: Entire section amended with relocations, (HB 13-1266), ch. 217, p. 970, § 21, effective May 13. L. 2024: (2) and (5) amended, (HB 24-1036), ch. 373, p. 2524, § 2, effective August 7.

Editor's note: Subsection (1) is similar to former § 10-16-114; subsection (4) is similar to former § 10-16-117 (1); subsection (5) is similar to former § 10-16-117 (2), (3), and (4); and subsection (6) is similar to former § 10-16-115, as those sections existed prior to 2013.

Cross references: For the legislative declaration contained in the 2009 act amending subsection (3), see section 1 of chapter 344, Session Laws of Colorado 2009. For the legislative declaration in HB 24-1036, see section 1 of chapter 373, Session Laws of Colorado 2024.