(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.
At any time the director seeks to contract with any carriers under this section, thedirector shall first give notice of such intent in a manner determined by the director.
Specifications and related data shall be prepared by the director for submission tocarriers which indicate their interest in preparing proposals for any group benefit plans.
Contracts awarded under this section by the director shall be to the lowest, mostresponsive 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.
The director shall review the group benefit plans at least once each year and shallsolicit and receive proposals on the group benefit plans at least once every five years.
The specifications drawn by the director for any group benefit plans shall include themandated 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.
The director shall enter into contracts with the carriers selected to provide groupbenefit 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.
Each contract entered into with a carrier shall be available to be inspected or copiedby any employee at the offices of the director, except for proprietary information of carriers as determined by the director.
Every carrier shall prepare and provide the director with reports and financial data asstated in the contract.
Financial data will be available to be inspected or copied by any employee at theoffices 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).
The director shall include the following statement in medical benefit materials, inbold-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.
and (5) Repealed.
Source: L. 94: Entire part added with relocations, p. 1127, § 1, effective May 19. L. 98:
(1)(f) added, p. 229, § 1, effective April 10. L. 2003: (4) repealed, p. 1936, § 11, effective May
22. L. 2004: (5) added, p. 764, § 3, effective July 1. L. 2010: (1)(f) amended, (HB 10-1181), ch. 351, p. 1628, § 19, effective June 7. L. 2018: (1)(a) and (1)(b) amended and (5) repealed, (SB 18-131), ch. 100, p. 775, § 3, effective August 8.
Editor's note: This section was formerly numbered as 10-8-206.
Cross references: For the legislative declaration in SB 18-131, see section 1 of chapter 100, Session Laws of Colorado 2018.