HB13-1290 Summary

• Requires insurers selling stop-loss health insurance to small employers (1-50 employees) to maintain minimum annual attachment points of $20,000 per individual and the greater of 120% of expected claims or $20,000 in aggregate starting January 1, 2014.

• Prohibits stop-loss policies for small employers that provide direct coverage of health care expenses, vary attachment points by individual within a group, or exclude any employee or dependent from coverage.

• Mandates insurers file annual actuarial certifications with the commissioner confirming compliance with attachment point requirements and provide insureds with detailed policy exhibits disclosing costs, coverage terms, attachment points, and terminal liability funding information.

• Requires data collection from all stop-loss insurers for calendar years 2013-2018 on policy numbers, group sizes, lives covered, attachment points, and prior coverage sources, with penalties up to $100 per day for late filings.

• Allows the commissioner to adjust dollar thresholds by rule based on changes in medical components of the Consumer Price Index for the Denver-Boulder-Greeley area, with at least six months' notice before implementation.