A Bill for an Act
Page 1, Line 101Concerning limits on the amounts that certain health
Page 1, Line 102insurers may reimburse for the provision of certain
Page 1, Line 103health-care services, and, in connection therewith,
Page 1, Line 104creating the "Support Colorado's Health-Care Safety
Page 1, Line 105Net Act of 2025".
Bill Summary
(Note: This summary applies to this bill as introduced and does not reflect any amendments that may be subsequently adopted. If this bill passes third reading in the house of introduction, a bill summary that applies to the reengrossed version of this bill will be available at http://leg.colorado.gov.)
The bill sets the reimbursement rates that a health insurance carrier (carrier) may reimburse a health-care provider (provider) for covered services for the state employee group benefit plans (state group benefit plans) and for small employer group benefit plans (small group plans).
The bill prohibits a provider that is subject to the reimbursement limitations from billing or collecting payment from a person covered under a state group benefit plan or small group plan for any outstanding balance for covered services that is not reimbursed by the carrier, except for the applicable in-network coinsurance, copayment, or deductible amounts.
The bill requires a carrier to provide cost and quality of care information to the commissioner of insurance (commissioner) in the case of small group plans and to the director of the department of personnel (director) in the case of state group benefit plans, at the request of the commissioner or director, as applicable, and prohibits a carrier from entering into an agreement with a provider or third party that would restrict the carrier from providing the information.
By September 1, 2027, and by September 1 each year thereafter, the director is required to provide a report to the governor's office, the state treasurer's office, and the joint budget committee that states the amount of calculated savings in general fund expenditures (calculated savings), if any, for health plan reimbursement for the prior fiscal year as a result of the reimbursement limits for state group benefit plans. The director is also required to include in the report the cost to the department in determining the calculated savings. By September 15, 2027, and by September 15 each year thereafter, of the money from the calculated savings, the state treasurer is required to transfer an amount equal to the department's costs in determining the calculated savings to the group benefit plans expenditure savings cash fund (expenditure savings cash fund), which is created in the bill, and specified percentages of the calculated savings from the general fund to the primary care fund and to the expenditure savings cash fund.
The bill also requires the executive director of the department of health care policy and financing (state department) to conduct a study, in collaboration with specified state agencies, to determine the feasibility of establishing a similar reimbursement limit for group benefit plans offered to school district, higher education, and local government employees. The executive director is required to complete the study and report the findings to the general assembly on or before January 1, 2028. The bill allocates $500,000 from the calculated savings to a health care reimbursement feasibility study cash fund created in the bill and authorizes the state department to use the money to conduct the study.
Page 2, Line 1Be it enacted by the General Assembly of the State of Colorado:
Page 2, Line 2SECTION 1. In Colorado Revised Statutes, add 10-16-711 as follows:
Page 3, Line 110-16-711. Group health benefit plans - small employer
Page 3, Line 2carriers - reimbursement to providers and facilities - limitations -
Page 3, Line 3required participation in small group market - penalties - definitions.
Page 3, Line 4(1) As used in this section, unless the context otherwise requires:
Page 3, Line 5(a) "Affiliated health facility" means a health facility
Page 3, Line 6that is affiliated with a hospital or health system under a
Page 3, Line 7professional services agreement, faculty agreement, or
Page 3, Line 8management agreement that permits the hospital or health system to bill on behalf of the health facility.
Page 3, Line 9(b) (I) "Equivalent rate" means the payment or
Page 3, Line 10reimbursement rate determined by rule of the commissioner
Page 3, Line 11for a hospital that is part of a pediatric specialty hospital
Page 3, Line 12system where over ninety percent of the hospital system's
Page 3, Line 13population served is under eighteen years of age and that has a level I pediatric trauma center.
Page 3, Line 14(II) The "equivalent rate" is:
Page 3, Line 15(A) Calculated by multiplying the medicaid fee schedule
Page 3, Line 16for the hospital by a conversion factor equal to the ratio of the
Page 3, Line 17statewide payment-to-cost ratio for medicare to the hospital's specific payment-to-cost ratio, which is 1.52; and
Page 3, Line 18(B) Adjusted annually for cumulative inflation by a
Page 3, Line 19factor equal to the average percentage increase in the medicare
Page 3, Line 20inpatient and outpatient prospective payment systems over the previous three years.
Page 3, Line 21(c) "Essential access hospital" means a critical access
Page 4, Line 1hospital or a general hospital that is located in a rural area and that has twenty-five or fewer licensed beds.
Page 4, Line 2(d) "Health facility" means a facility licensed or certified
Page 4, Line 3pursuant to section 25-1.5-103 or established pursuant to part 5 of article 21 of title 23 or article 29 of title 25.
Page 4, Line 4(e) "Health system" means a corporation or other
Page 4, Line 5organization that owns, contains, or operates three or more hospitals.
Page 4, Line 6(f) (I) "Hospital" means a hospital that is licensed or
Page 4, Line 7certified by the department of public health and environment
Page 4, Line 8pursuant to the department's authority under section 25-1.5-103
Page 4, Line 9(1)(a) or that is established pursuant to part 5 of article 21 of title 23 or article 29 of title 25.
Page 4, Line 10(II) "Hospital" does not include a hospital or other
Page 4, Line 11medical facility created by and operated under the authority of section 25-29-101.
Page 4, Line 12(g) "Medicare reimbursement rate" means the
Page 4, Line 13facility-specific reimbursement rate for a particular
Page 4, Line 14health-care service provided under the "Health Insurance for
Page 4, Line 15the Aged Act", title XVIII of the federal "Social Security Act",
Page 4, Line 1642 U.S.C. sec. 1395 et seq. For hospitals that medicare reimburses
Page 4, Line 17under the hospital inpatient prospective payment system and the
Page 4, Line 18hospital outpatient prospective payment system, the "medicare
Page 4, Line 19reimbursement rate" means the rate based on the applicable
Page 4, Line 20prospective payment system fee schedule that is effective as of
Page 4, Line 21the quarter in which the carrier will file rates pursuant to
Page 4, Line 22section 10-16-107.
Page 5, Line 1(h) "Outpatient behavioral health services" means
Page 5, Line 2services provided to an individual regarding their behavioral
Page 5, Line 3health, as defined in section 27-50-101, in accordance with the
Page 5, Line 4individual's service plan, on a regular basis, and in a
Page 5, Line 5non-overnight setting. "Outpatient behavioral health services"
Page 5, Line 6may include individual, group, or family counseling; peer
Page 5, Line 7support professional services; case management; or medication management.
Page 5, Line 8(i) "Primary care provider" has the same meaning as set forth in section 10-16-157 (2)(e).
Page 5, Line 9(j) "Primary care services" has the same meaning as set forth in section 10-16-157 (2)(c).
Page 5, Line 10(k) "Small group market" means the market for small group health benefit plans.
Page 5, Line 11(l) "Small group health benefit plan" means a health benefit plan offered or issued to a small employer.
Page 5, Line 12(2) (a) Except as otherwise provided in subsection (2)(b) of
Page 5, Line 13this section, beginning January 1, 2027, each carrier offering
Page 5, Line 14coverage in the small group market shall reimburse providers in accordance with the following requirements:
Page 5, Line 15(I) (A) For inpatient and outpatient services received at
Page 5, Line 16an in-network hospital or at an in-network affiliated health
Page 5, Line 17facility, the reimbursement must not exceed, and the hospital or
Page 5, Line 18affiliated health facility shall not charge more than, the
Page 5, Line 19lesser of: The carrier's contracted rate for the service in the
Page 5, Line 202024 plan year; or one hundred sixty-five percent of the
Page 5, Line 21medicare reimbursement rate or one hundred sixty-five percent
Page 6, Line 1of the equivalent rate, whichever is applicable, for the same or similar services;
Page 6, Line 2(B) For inpatient and outpatient services received at an
Page 6, Line 3out-of-network hospital or at an out-of-network affiliated
Page 6, Line 4health facility, the reimbursement must not exceed, and the
Page 6, Line 5hospital or affiliated health facility shall not charge more
Page 6, Line 6than, one hundred fifty percent of the medicare reimbursement
Page 6, Line 7rate or one hundred fifty percent of the equivalent rate, whichever is applicable, for the same or similar services;
Page 6, Line 8(II) For primary care services provided by an in-network
Page 6, Line 9primary care provider, the reimbursement must not be less than
Page 6, Line 10one hundred thirty-five percent of the medicare reimbursement rate for the same or similar services; and
Page 6, Line 11(III) For outpatient behavioral health services, the
Page 6, Line 12reimbursement must not be less than one hundred thirty-five
Page 6, Line 13percent of the medicare reimbursement rate for the same or similar services.
Page 6, Line 14(b) Subsection (2)(a) of this section does not apply to an essential access hospital.
Page 6, Line 15(3) This section does not prohibit a carrier offering
Page 6, Line 16coverage in the small group market from reimbursing a hospital
Page 6, Line 17or an affiliated health facility through an alternative
Page 6, Line 18payment model that is not paid on a fee-for-services or per-claim
Page 6, Line 19basis so long as the payments incentivize the hospital or
Page 6, Line 20affiliated health facility to achieve higher quality or improved
Page 6, Line 21health outcomes and the carrier continues to comply with the
Page 6, Line 22reimbursement requirements of this section.
Page 7, Line 1(4) A hospital or an affiliated health facility that is
Page 7, Line 2reimbursed in accordance with subsection (2)(a)(I) of this section
Page 7, Line 3shall not bill or collect payment from a covered person for any
Page 7, Line 4outstanding balance for covered services not paid by the
Page 7, Line 5carrier, except for the applicable in-network coinsurance,
Page 7, Line 6deductible, or copayment amount required, pursuant to the
Page 7, Line 7small group health benefit plan, to be paid by the covered person.
Page 7, Line 8(5) At the request of the commissioner, a carrier offering
Page 7, Line 9coverage in the small group market shall provide cost and
Page 7, Line 10quality of care information to the commissioner, including
Page 7, Line 11negotiated reimbursement rate data. A carrier shall not enter
Page 7, Line 12into an agreement with a hospital, health facility, provider, or
Page 7, Line 13third party that would restrict the carrier from providing cost and quality of care information to the commissioner.
Page 7, Line 14(6) (a) In establishing and filing rates for small group
Page 7, Line 15plans pursuant to section 10-16-107, a carrier must take into
Page 7, Line 16account any anticipated reduction in the cost of services
Page 7, Line 17provided at a hospital or affiliated health facility that may result from the application of this section.
Page 7, Line 18(b) (I) The commissioner may require a hospital or
Page 7, Line 19affiliated health facility to participate in a small group health
Page 7, Line 20benefit plan offered in the small group market and to accept the
Page 7, Line 21reimbursement rate specified in this section. If the commissioner
Page 7, Line 22requires a hospital or affiliated health facility to participate
Page 7, Line 23in a small group health benefit plan and to accept the
Page 7, Line 24reimbursement rate specified in this section and receives notice
Page 8, Line 1that a hospital or affiliated health facility refuses to
Page 8, Line 2participate in a small group market health benefit plan and
Page 8, Line 3accept the reimbursement rate specified in this section, the
Page 8, Line 4commissioner shall issue a warning to the hospital or affiliated
Page 8, Line 5health facility. If the hospital or affiliated health facility
Page 8, Line 6refuses to participate in a small group market health benefit
Page 8, Line 7plan and accept the reimbursement rate specified in this section
Page 8, Line 8after receipt of the warning, the commissioner shall fine the
Page 8, Line 9hospital or affiliated health facility up to ten thousand
Page 8, Line 10dollars per day for the first thirty days that the hospital or
Page 8, Line 11affiliated health facility refuses to participate and accept the
Page 8, Line 12reimbursement rate specified in this section and up to forty
Page 8, Line 13thousand dollars per day for each day beyond the first thirty
Page 8, Line 14days that the hospital or affiliated health facility refuses to
Page 8, Line 15participate and accept the reimbursement rate specified in this section.
Page 8, Line 16(II) In determining the appropriate fine pursuant to
Page 8, Line 17subsection (6)(b)(I) of this section, the commissioner shall
Page 8, Line 18consider any recommendations from the department of public
Page 8, Line 19health and environment, the hospital's financial circumstances, and other circumstances the commissioner deems relevant.
Page 8, Line 20(7) The commissioner may adopt rules in accordance with article 4 of title 24 to implement this section.
Page 8, Line 21SECTION 2. In Colorado Revised Statutes, 10-16-704, amend (5.5)(b)(I) introductory portion; and add (5.5)(b)(IV) as follows:
Page 8, Line 2210-16-704. Network adequacy - required disclosures - balance
Page 8, Line 23billing - rules - legislative declaration - definitions. (5.5) (b) (I) If a
Page 9, Line 1covered person receives emergency services at an out-of-network facility,
Page 9, Line 2other than any out-of-network facility operated by the Denver health and
Page 9, Line 3hospital authority pursuant to article 29 of title 25,
thePage 9, Line 4provided in subsection (5.5)(b)(IV) of this section, a carrier shall
Page 9, Line 5reimburse the out-of-network provider in accordance with subsection
Page 9, Line 6(3)(d)(II) of this section and reimburse the out-of-network facility directly in accordance with section 10-16-106.5 the greater of:
Page 9, Line 7(IV) For a covered person enrolled in a small group plan
Page 9, Line 8who receives emergency services at an out-of-network facility
Page 9, Line 9other than an essential access hospital, as defined in section
Page 9, Line 1010-16-711 (1)(c), the carrier shall reimburse the out-of-network
Page 9, Line 11facility directly in accordance with sections 10-16-106.5 and 10-16-711 (2)(a)(II).
Page 9, Line 12SECTION 3. In Colorado Revised Statutes, 25-3-122, amend (3)(a) as follows:
Page 9, Line 1325-3-122. Out-of-network facilities - emergency medical
Page 9, Line 14services - billing - payment - deceptive trade practice. (3) (a) (I) An
Page 9, Line 15out-of-network facility, other than any out-of-network facility operated
Page 9, Line 16by the Denver health and hospital authority pursuant to article 29 of title
Page 9, Line 1725, must send a claim for emergency services to the carrier within one
Page 9, Line 18hundred eighty days after the receipt of insurance information in order to receive reimbursement as specified in this subsection (3)(a).
Page 9, Line 19(II) Except as provided in subsection (3)(a)(III) of this section, the reimbursement rate is the greater of:
Page 9, Line 20(A) One hundred five percent of the carrier's median in-network
Page 9, Line 21rate of reimbursement for that service provided in a similar facility or
Page 9, Line 22setting in the same geographic area; or
Page 10, Line 1(B) The median in-network rate of reimbursement for the same
Page 10, Line 2service provided in a similar facility or setting in the same geographic
Page 10, Line 3area for the prior year based on claims data from the all-payer health claims database created in section 25.5-1-204.
Page 10, Line 4(III) For emergency services provided by an
Page 10, Line 5out-of-network facility, other than an essential access
Page 10, Line 6hospital, as defined in section 10-16-711 (1)(c), to a covered
Page 10, Line 7person enrolled in a small group plan, as defined in section
Page 10, Line 810-16-102 (63), the reimbursement rate is determined in accordance with section 10-16-711 (2)(a)(II).
Page 10, Line 9SECTION 4. In Colorado Revised Statutes, 24-50-605, add (1)(g) as follows:
Page 10, Line 1024-50-605. Group benefit plans - specifications - contracts.
Page 10, Line 11(1) (g) The specifications drawn by the director for any group
Page 10, Line 12benefit plans shall include the parameters for provider reimbursements specified in section 24-50-621.
Page 10, Line 13SECTION 5. In Colorado Revised Statutes, add 24-50-621 as follows:
Page 10, Line 1424-50-621. Group benefit plans - reimbursement limits for
Page 10, Line 15health plans - hospital services - health plan expenditure savings
Page 10, Line 16distribution - group benefit plans expenditure savings cash fund -
Page 10, Line 17report - short title - rules - definitions. (1) The short title of this
Page 10, Line 18section is the "Support Colorado's Health-Care Safety Net Act of 2025".
Page 10, Line 19(2) As used in this section, unless the context otherwise requires:
Page 10, Line 20(a) "Affiliated health facility" means a health facility
Page 11, Line 1that is affiliated with a hospital or health system under a
Page 11, Line 2professional services agreement, faculty agreement, or
Page 11, Line 3management agreement that permits the hospital or health system to bill on behalf of the health facility.
Page 11, Line 4(b) (I) "Equivalent rate" means the payment or
Page 11, Line 5reimbursement rate determined by rule of the commissioner of
Page 11, Line 6insurance for a hospital that is part of a pediatric specialty
Page 11, Line 7hospital system where over ninety percent of the hospital
Page 11, Line 8system's population served is under eighteen years of age and that has a level I pediatric trauma center.
Page 11, Line 9(II) The "equivalent rate" is:
Page 11, Line 10(A) Calculated by multiplying the medicaid fee schedule
Page 11, Line 11for the hospital by a conversion factor equal to the ratio of the
Page 11, Line 12statewide payment-to-cost ratio for medicare to the hospital's specific payment-to-cost ratio, which is 1.52; and
Page 11, Line 13(B) Adjusted annually for cumulative inflation by a
Page 11, Line 14factor equal to the average percentage increase in the medicare
Page 11, Line 15inpatient and outpatient prospective payment systems over the previous three years.
Page 11, Line 16(c) "Essential access hospital" means a critical access
Page 11, Line 17hospital or a general hospital that is located in a rural area and that has twenty-five or fewer licensed beds.
Page 11, Line 18(d) "Health facility" means a facility licensed or certified
Page 11, Line 19pursuant to section 25-1.5-103 or established pursuant to part 5 of article 21 of title 23 or article 29 of title 25.
Page 11, Line 20(e) "Health system" means a corporation or other
Page 11, Line 21organization that owns, contains, or operates three or more hospitals.
Page 12, Line 1(f) "Hospital" means a hospital that is licensed or
Page 12, Line 2certified by the department of public health and environment
Page 12, Line 3pursuant to the department's authority under section 25-1.5-103
Page 12, Line 4(1)(a) or that is established pursuant to part 5 of article 21 of title 23 or article 29 of title 25.
Page 12, Line 5(g) "Medicare reimbursement rate" means the
Page 12, Line 6facility-specific reimbursement rate for a particular
Page 12, Line 7health-care service provided under the "Health Insurance for
Page 12, Line 8the Aged Act", title XVIII of the federal "Social Security Act",
Page 12, Line 942 U.S.C., sec. 1395 et seq. For hospitals that medicare reimburses
Page 12, Line 10under the hospital inpatient prospective payment system and the
Page 12, Line 11hospital outpatient prospective payment system, the "medicare
Page 12, Line 12reimbursement rate" means the rate based on the applicable
Page 12, Line 13prospective payment system fee schedule that is effective as of each January of the applicable plan year.
Page 12, Line 14 (h) "Outpatient behavioral health services" means
Page 12, Line 15services provided to an individual regarding their behavioral
Page 12, Line 16health, as defined in section 27-50-101, in accordance with the
Page 12, Line 17individual's service plan, on a regular basis, and in a
Page 12, Line 18non-overnight setting. "Outpatient behavioral health services"
Page 12, Line 19may include individual, group, or family counseling; peer
Page 12, Line 20support professional services; case management; or medication management.
Page 12, Line 21(i) "Primary care provider" has the same meaning as set forth in section 10-16-157 (2)(e).
Page 12, Line 22(j) "Primary care services" has the same meaning as set forth in section 10-16-157 (2)(c).
Page 13, Line 1(3) (a) Except as otherwise provided in subsection (3)(b) of
Page 13, Line 2this section, beginning July 1, 2026, each carrier that provides or
Page 13, Line 3administers a group benefit plan pursuant to this part 6 shall
Page 13, Line 4reimburse providers in accordance with the following
Page 13, Line 5requirements for the following services provided to an employee or dependent enrolled in the group benefit plan:
Page 13, Line 6(I) (A) For inpatient and outpatient services received at
Page 13, Line 7an in-network hospital or at an in-network affiliated health
Page 13, Line 8facility, the reimbursement must not exceed, and the hospital or
Page 13, Line 9affiliated health facility shall not charge more than, the
Page 13, Line 10lesser of: The carrier's contracted rate for the service in the
Page 13, Line 11annual group benefit plan year that commences in the 2024-25
Page 13, Line 12state fiscal year; or one hundred sixty-five percent of the
Page 13, Line 13medicare reimbursement rate or one hundred sixty-five percent
Page 13, Line 14of the equivalent rate, whichever is applicable, for the same or similar services; and
Page 13, Line 15(B) For inpatient and outpatient services received at an
Page 13, Line 16out-of-network hospital or at an out-of-network affiliated
Page 13, Line 17health facility, the reimbursement must not exceed, and the
Page 13, Line 18hospital or affiliated health facility shall not charge more
Page 13, Line 19than, one hundred fifty percent of the medicare reimbursement
Page 13, Line 20rate or one hundred fifty percent of the equivalent rate, whichever is applicable, for the same or similar services.
Page 13, Line 21(II) For primary care services provided by a primary care
Page 13, Line 22provider, the reimbursement must not be less than one hundred
Page 13, Line 23thirty-five percent of the medicare reimbursement rate for the same or similar services; and
Page 14, Line 1(III) For outpatient behavioral health services, the
Page 14, Line 2reimbursement must not be less than one hundred thirty-five
Page 14, Line 3percent of the medicare reimbursement rate for the same or similar services.
Page 14, Line 4(b) Subsection (3)(a) of this section does not apply to an essential access hospital.
Page 14, Line 5(4) This section does not prohibit a carrier from reimbursing a hospital or affiliated health facility through an
Page 14, Line 6alternative payment model that is not paid on a fee-for-services
Page 14, Line 7or per-claim basis so long as the payments incentivize the
Page 14, Line 8hospital or affiliated health facility to achieve higher quality
Page 14, Line 9or improved health outcomes and the carrier continues to comply with the reimbursement requirements of this section.
Page 14, Line 10(5) A hospital or an affiliated health facility that is
Page 14, Line 11reimbursed in accordance with subsection (3)(a)(I) of this section
Page 14, Line 12shall not bill or collect payment from a plan enrollee for any
Page 14, Line 13outstanding balance for covered services not paid by the
Page 14, Line 14carrier, except for the applicable in-network coinsurance,
Page 14, Line 15deductible, or copayment amount required, pursuant to the group benefit plan, to be paid by the plan enrollee.
Page 14, Line 16(6) At the request of the director, a carrier shall provide
Page 14, Line 17cost and quality of care information to the director, including
Page 14, Line 18negotiated reimbursement rate data. A carrier shall not enter
Page 14, Line 19into an agreement with a hospital, health facility, provider, or
Page 14, Line 20third party that would restrict the carrier from providing cost
Page 14, Line 21and quality of care information to the director.
Page 15, Line 1(7) (a) By September 1, 2027, and by September 1 each year
Page 15, Line 2thereafter, the director shall provide a report to the
Page 15, Line 3governor's office, the office of the state treasurer, and the
Page 15, Line 4joint budget committee of the general assembly that specifies
Page 15, Line 5the calculated savings, if any, in general fund expenditures
Page 15, Line 6that result from reduced provider reimbursements under group
Page 15, Line 7benefit plans in the immediately preceding fiscal year pursuant
Page 15, Line 8to this section. The director shall include in the report the cost
Page 15, Line 9to the department to determine the calculated savings, if any,
Page 15, Line 10in general fund expenditures that result from reduced provider
Page 15, Line 11reimbursements under group benefit plans in the immediately
Page 15, Line 12preceding state fiscal year as pursuant to this section, as reported pursuant to this subsection (7)(a).
Page 15, Line 13(b) By September 15, 2027, of the calculated general fund
Page 15, Line 14expenditure savings identified in the report required by
Page 15, Line 15subsection (7)(a) of this section, the state treasurer shall transfer from the general fund:
Page 15, Line 16(I) To the group benefit plans expenditure savings cash
Page 15, Line 17fund created in subsection (8) of this section, an amount, as
Page 15, Line 18specified in the report required by subsection (7)(a) of this
Page 15, Line 19section, equal to the department's cost to calculate and report
Page 15, Line 20general fund expenditure savings as required by subsection
Page 15, Line 21(7)(a) of this section, which amount is to be used by the
Page 15, Line 22department in accordance with subsection (8)(c)(I) of this section;
Page 15, Line 23(II) Five hundred thousand dollars to the health care
Page 15, Line 24reimbursement feasibility study cash fund, created in section
Page 16, Line 125.5-1-135 (5), to be used by the department of health care policy
Page 16, Line 2and financing for the feasibility study required in section 25.5-1-135; and
Page 16, Line 3(III) Of the amount specified in the report submitted for
Page 16, Line 4the 2026-27 state fiscal year pursuant to subsection (7)(a) of this
Page 16, Line 5section that is remaining after the state treasurer transfers
Page 16, Line 6the amounts required by subsections (7)(b)(I) and (7)(b)(II) of this section:
Page 16, Line 7(A) An amount equal to twenty percent of the remaining
Page 16, Line 8amount to the group benefit plans expenditure savings cash fund
Page 16, Line 9created in subsection (8) of this section to be used by the department as specified in subsection (8)(c)(II) of this section; and
Page 16, Line 10(B) An amount equal to eighty percent of the remaining
Page 16, Line 11amount to the primary care fund created in section 24-22-117
Page 16, Line 12(2)(b) to be used by the department of health care policy and financing for the purposes specified in that section.
Page 16, Line 13(c) By September 15, 2028, and by September 10 each year
Page 16, Line 14thereafter, of the calculated general fund expenditure savings
Page 16, Line 15identified in the report required by subsection (7)(a) of this
Page 16, Line 16section, the state treasurer shall transfer from the general fund:
Page 16, Line 17(I) To the group benefit plans expenditure savings cash
Page 16, Line 18fund created in subsection (8) of this section, an amount, as
Page 16, Line 19specified in the report required by subsection (7)(a) of this
Page 16, Line 20section, equal to the department's cost to calculate and report
Page 16, Line 21general fund expenditure savings as required by subsection
Page 16, Line 22(7)(a) of this section, which amount is to be used by the
Page 17, Line 1department in accordance with subsection (8)(c)(I) of this section; and
Page 17, Line 2(II) Of the amount specified in the report submitted for the
Page 17, Line 3applicable state fiscal year pursuant to subsection (7)(a) of this
Page 17, Line 4section that is remaining after the state treasurer transfers the amount required by subsection (7)(c)(I) of this section:
Page 17, Line 5(A) An amount equal to twenty percent of the remaining
Page 17, Line 6amount to the group benefit plans expenditure savings cash fund
Page 17, Line 7created in subsection (8) of this section to be used by the
Page 17, Line 8department as specified in subsection (8)(c)(III) of this section; and
Page 17, Line 9(B) An amount equal to eighty percent of the remaining
Page 17, Line 10amount to the primary care fund created in section 24-22-117
Page 17, Line 11(2)(b) to be used by the department of health care policy and financing for the purposes specified in that section.
Page 17, Line 12(8) (a) The group benefit plans expenditure savings cash
Page 17, Line 13fund is created in the state treasury. The fund consists of money
Page 17, Line 14transferred to the fund pursuant to subsections (7)(b)(I),
Page 17, Line 15(7)(b)(III)(A), (7)(c)(I), and (7)(c)(II)(A) of this section and any
Page 17, Line 16other money that the general assembly may appropriate or transfer to the fund.
Page 17, Line 17(b) The state treasurer shall credit all interest and
Page 17, Line 18income derived from the deposit and investment of money in the group benefit plans expenditure savings cash fund to the fund.
Page 17, Line 19(c) The money in the fund is continuously appropriated to the department to be used as follows:
Page 17, Line 20(I) For the 2027-28 state fiscal year and each state fiscal
Page 18, Line 1year thereafter, first to reimburse the department for its costs
Page 18, Line 2in determining the calculated savings, if any, in general fund
Page 18, Line 3expenditures that result from reduced provider reimbursements
Page 18, Line 4under group benefit plans in the immediately preceding state
Page 18, Line 5fiscal year pursuant to this section, and then for the purposes specified in subsections (8)(c)(II) and (8)(c)(III) of this section;
Page 18, Line 6(II) For the 2027-28 state fiscal year, of the amount
Page 18, Line 7remaining after the requirements of subsection (8)(c)(I) of this
Page 18, Line 8section have been satisfied, to reduce group benefit plan premium
Page 18, Line 9costs for state employees for the remainder of that state fiscal year; and
Page 18, Line 10(III) For the 2028-29 state fiscal year and each state
Page 18, Line 11fiscal year thereafter, of the amount remaining after the
Page 18, Line 12requirements of subsection (8)(c)(I) of this section have been
Page 18, Line 13satisfied, for the benefit of state employees as negotiated in the
Page 18, Line 14partnership agreement between the state and Colorado
Page 18, Line 15Workers for Innovative and New Solutions pursuant to the
Page 18, Line 16"Colorado Partnership for Quality Jobs and Services Act", part 11 of this article 50.
Page 18, Line 17(9) The director may adopt rules in accordance with
Page 18, Line 18article 4 of this title 24 to implement this section, including
Page 18, Line 19rules for levying fines and taking other contract actions deemed necessary to enforce compliance with this section.
Page 18, Line 20SECTION 6. In Colorado Revised Statutes, add 25.5-1-135 as follows:
Page 18, Line 2125.5-1-135. Feasibility study - requirements for health plan
Page 18, Line 22reimbursement for public employee group benefit plans - school
Page 19, Line 1districts - higher education institutions - local governments - health
Page 19, Line 2plan reimbursement feasibility study cash fund - repeal. (1) The
Page 19, Line 3executive director shall conduct a study to determine the
Page 19, Line 4feasibility of establishing specifications for health plan
Page 19, Line 5reimbursements, similar to the requirements established for
Page 19, Line 6state employee group benefit plans pursuant to section
Page 19, Line 724-50-621, in collaboration with the following state agencies for benefit plans offered to the following public employees:
Page 19, Line 8(a) In collaboration with the department of education, for employees of school districts;
Page 19, Line 9(b) In collaboration with the Colorado commission on
Page 19, Line 10higher education, for employees of institutions of higher education; and
Page 19, Line 11(c) In collaboration with the department of local affairs, for employees of local governments.
Page 19, Line 12(2) School districts, institutions of higher education, and
Page 19, Line 13local governments shall submit the data and information
Page 19, Line 14requested of them by the executive director, in the format and
Page 19, Line 15timeline requested, as necessary to complete the feasibility study.
Page 19, Line 16(3) The executive director shall complete the study
Page 19, Line 17required by subsection (1) of this section and submit the report to the general assembly on or before January 1, 2028.
Page 19, Line 18(4) The state department shall use the money in the
Page 19, Line 19health care reimbursement feasibility study cash fund, created
Page 19, Line 20in subsection (5) of this section, to conduct the study and
Page 19, Line 21prepare the report required in this section.
Page 20, Line 1(5) (a) The health care reimbursement feasibility study
Page 20, Line 2cash fund is created in the state treasury. The fund consists of
Page 20, Line 3money transferred to the fund pursuant to section 24-51-621
Page 20, Line 4(7)(b)(II) and any other money that the general assembly may appropriate or transfer to the fund.
Page 20, Line 5(b) The state treasurer shall credit all interest and
Page 20, Line 6income derived from the deposit and investment of money in the
Page 20, Line 7health care reimbursement feasibility study cash fund to the fund.
Page 20, Line 8(c) The money in the health care reimbursement feasibility
Page 20, Line 9study cash fund is continuously appropriated to the state
Page 20, Line 10department to be used to conduct the study and prepare the report required in this section.
Page 20, Line 11(d) The state treasurer shall transfer all unexpended
Page 20, Line 12and unencumbered money in the health care reimbursement feasibility study cash fund on June 30, 2027, to the general fund.
Page 20, Line 13(6) This section is repealed, effective July 1, 2027.
Page 20, Line 14SECTION 7. In Colorado Revised Statutes, 24-22-117, amend (2)(b)(I) as follows:
Page 20, Line 1524-22-117. Tobacco tax cash fund - accounts - creation -
Page 20, Line 16legislative declaration. (2) There are hereby created in the state treasury the following funds:
Page 20, Line 17(b) (I) The primary care fund to be administered by the department
Page 20, Line 18of health care policy and financing. The state treasurer and the controller
Page 20, Line 19shall transfer an amount equal to nineteen percent of the
moneysPage 20, Line 20deposited into the cash fund, plus nineteen percent of the interest and
Page 20, Line 21income earned on the deposit and investment of
those moneysPage 21, Line 1money, to the primary care fund; except that, for the 2008-09, 2009-10,
Page 21, Line 22010-11, and 2011-12 fiscal years, the state treasurer and the controller
Page 21, Line 3shall transfer to the primary care fund only an amount equal to nineteen
Page 21, Line 4percent of the
moneysPage 21, Line 5in the 2027-28 state fiscal year, the primary care fund also
Page 21, Line 6consists of money transferred to the primary care fund
Page 21, Line 7pursuant to section 24-50-621 (6)(b)(I) and (6)(c). All interest and
Page 21, Line 8income derived from the deposit and investment of
moneysPage 21, Line 9primary care fund shall be credited to the primary care fund; except that
Page 21, Line 10all interest and income derived from the deposit and investment of
Page 21, Line 11
moneysPage 21, Line 122010-11, and 2011-12 fiscal years shall be credited to the general fund.
Page 21, Line 13Any unexpended and unencumbered
moneysPage 21, Line 14primary care fund at the end of a fiscal year
shall remainPage 21, Line 15fund and shall not be credited or transferred to the general fund or any other fund.
Page 21, Line 16SECTION 8. Safety clause. The general assembly finds,
Page 21, Line 17determines, and declares that this act is necessary for the immediate
Page 21, Line 18preservation of the public peace, health, or safety or for appropriations for
Page 21, Line 19the support and maintenance of the departments of the state and state institutions.