Colorado State Flexibility to Stabilize the Market Grant Award

Grant Application Summary

Colorado Grantee: Colorado Division of Insurance

Award Date: August 20, 2018

Total Award: $282,062.29

Baseline Award: $274,344.83

Workload Award: $7,717.46

Sections 2702 and 2703 - In addition to ensuring health insurance issuers are offering approved products for purchase and continue to offer coverage at the option of an individual or plan sponsor (unless an exception applies), the Colorado Division of Insurance will hire actuarial and provider network design consultants to conduct network design analysis and research related to possible State innovations to promote market stability, including but not limited to the expansion of catastrophic plan eligibility and implementation of a reinsurance program. The network design analysis will include optimization modeling of network providers to assess how the selection of particular providers within a network design in the highest cost regions may impact unit costs, utilization, and premiums. This will inform potential regulatory changes that support greater access to affordable health care coverage. The Colorado Division of Insurance is evaluating possible strategies to impact premiums through a State Innovation Waiver, including expanding access to catastrophic plans and a reinsurance program with tiered geographic application and partial funding through assessments on providers, carriers and/or the stop-loss market. Upon completion of these actuarial and network design analyses, the Colorado Division of Insurance will be well-positioned to take regulatory steps on networks and work towards a viable reinsurance program.