Colorado Code § 10-16-1207

Health insurance affordability board - creation - membership - powers and duties - subject to open meetings and public records laws - commissioner rules
Open in Lexace · Ask the AI about this section
(1) (a) 
There is hereby created the health insurance affordability board, which board is responsible for
governance of the enterprise established in this part 12. The board consists of the following
eleven voting members:
(I) The executive director of the exchange or the executive director's designee;
(II) The commissioner or the commissioner's designee; and
(III) Nine members appointed by the governor, with the consent of the senate, as
follows:
(A) One member who is employed by a carrier;
(B) One member who is a representative of a statewide association of health benefit
plans;
(C) One member representing primary care health care providers who does not represent
a carrier;
(D) Three members who are consumers of health care who are not representatives or
employees of a hospital, carrier, or other health care industry entity. To the extent possible, the
governor shall ensure that the consumer members of the board are individuals who lack
affordable offers of coverage from their employers and otherwise struggle to afford to purchase
health insurance.
(E) One member who represents a health care advocacy organization;
(F) One member who is a representative of a business that purchases or otherwise
provides health insurance for its employees; and
(G) One member who represents a rural, critical access, or independent hospital.
(b) To the extent possible, the governor shall attempt to appoint board members who
reflect the diversity of the state with regard to race, ethnicity, immigration status, income,
wealth, ability, and geography. In considering geographic diversity, the governor shall ensure at
least one member resides on the eastern plains and one member resides on the western slope and,
to the extent possible, shall attempt to appoint members from each congressional district in the
state.
(c) The governor shall make initial appointments to the board by October 1, 2020.
(2) (a) (I) Except as provided in subsection (2)(a)(II) of this section, the term of office of
the members of the board appointed by the governor is four years, and those members may serve
no more than two four-year terms.
(II) In order to ensure staggered terms of office, the initial term of office of the members
of the board is:
(A) Two years for the members appointed pursuant to subsections (1)(a)(III)(A),
(1)(a)(III)(C), and (1)(a)(III)(F) of this section and for two of the members appointed pursuant to
subsection (1)(a)(III)(D) of this section; and
(B) Four years for the members appointed pursuant to subsections (1)(a)(III)(B),
(1)(a)(III)(E), and (1)(a)(III)(G) of this section and for one of the members appointed pursuant to
subsection (1)(a)(III)(D) of this section.
(b) Members of the board appointed by the governor serve at the pleasure of the
governor and may be removed by the governor.
(c) A member who is appointed to fill a vacancy shall serve the remainder of the
unexpired term of the member whose vacancy is being filled.
(d) Members of the board may be reimbursed for actual and necessary expenses,
including any required dependent care and dependent or attendant travel, food, and lodging,
while engaged in the performance of official duties of the board.
(3) The board shall meet as often as necessary to carry out its duties pursuant to this part
12.
(4) The board is authorized to:
(a) Implement and administer the enterprise;
(b) Establish administrative and accounting procedures for the operation of the
enterprise;
(c) Recommend, for approval and establishment by the commissioner by rule:
(I) The timing and methodology for assessing and collecting the fee and special
assessment, subject to section 10-16-1205 (1)(a);
(II) The distribution of enterprise revenues allocated for carrier payments and subsidies
in a manner that improves affordability for subsidized populations and individuals not eligible
for the premium tax credit, medicaid, medicare, or the children's basic health plan;
(III) The payments authorized by this part 12 to be made to carriers to reduce the costs
of individual health plans for individuals who purchase an individual health benefit plan on the
exchange and receive the premium tax credit; and
(IV) The parameters for implementing the subsidies for state-subsidized individual
health coverage plans authorized by this part 12, including:
(A) Repealed.
(B) The criteria and procedures for determining whether an individual is a qualified
individual eligible to enroll in a state-subsidized individual health coverage plan;
(c.5) Further recommend, for approval and establishment by the commissioner by rule,
additional parameters for implementing the subsidies for state-subsidized individual health
coverage plans authorized by this part 12, including that the coverage required pursuant to state-
subsidized individual health coverage plans must:
(I) Maximize affordability for qualified individuals;
(II) Cover benefits equivalent to those in a qualified health plan; and
(III) For a person who, at the time the person applies for state-subsidized coverage,
meets the income requirements to qualify for emergency medical assistance pursuant to section
25.5-5-103 and who is a qualified individual who meets the eligibility criteria established in rule
pursuant to subsection (4)(c)(IV) of this section, include coverage that:
(A) Has no premium;
(B) Has an actuarial value of not less than ninety-four percent; and
(C) To the extent possible with available funding, includes cost sharing that is further
reduced from subsection (4)(c.5)(III)(B) of this section such that the plan has consumer cost-
sharing responsibilities for emergency services equivalent to cost-sharing responsibilities for
emergency medical assistance pursuant to section 25.5-5-103; and
(d) Establish bylaws, as appropriate and consistent with this part 12, for its effective
operation.
(5) The commissioner shall adopt rules necessary for the administration and
implementation of this part 12. In adopting the rules, the commissioner shall consider the
recommendations of the board and shall express in writing the reasons for any deviation from the
board recommendations.
(6) Meetings of the board are subject to the open meetings provisions of the "Colorado
Sunshine Act of 1972", contained in part 4 of article 6 of title 24. Except as otherwise provided
in the "Colorado Open Records Act", part 2 of article 72 of title 24, or other applicable state or
federal law, records of the board and the program are subject to the "Colorado Open Records
Act".

‹ Prev All Colorado sections Next ›


Lexace provides legal information, not legal advice, and no attorney–client relationship is created. Statute text is provided for general information and may not reflect the most recent amendments; verify against the official state code.