DEPARTMENT OF REGULATORY AGENCIES Division of Insurance 3 CCR 702-4 LIFE, ACCIDENT AND HEALTH Emergency Regulation 20-E-02 CONCERNING ESTABLISHING A COVID-19 RELATED SPECIAL ENROLLMENT PERIOD FOR ENROLLMENT IN AN INDIVIDUAL HEALTH BENEFIT PLAN Section 1 Section 2 Section 3 Section 4 Section 5 Section 6 Section 7 Section 8 Section 9 Section 1 Authority Scope and Purpose Applicability Definitions Special Enrollment Period Requirements Severability Enforcement Effective Date History Authority This emergency regulation is promulgated and adopted by the Commissioner of Insurance under the authority of §§ 10-1-108(7)(a), (7)(b)(III), 10-1-109(1), 10-16-105(2)(b), 10-16-105.7(3)(a)(II)(G), 10-16105.7(3)(b)(II)(F),10-16-108.5(8), and 10-16-109, C.R.S. Section 2 Scope and Purpose The purpose of this emergency regulation is to allow for a special enrollment period (SEP) that allows enrollment in an individual health benefit plan for a period of fifteen (15) days beginning March 20, 2020 until April 3, 2020. The Division of Insurance finds, pursuant to § 24-4-103(6)(a), C.R.S., that immediate adoption of this regulation is imperatively necessary for the preservation of public health, safety, or welfare because allowing individuals not currently enrolled in health benefit plans in Colorado to enroll in a health benefit plan in order to receive coverage for COVID-19-related testing and care is imperative to preserve the health of the citizens of Colorado. Therefore, compliance with the requirements of § 24-4-103, C.R.S., would be contrary to the public interest. Section 3 Applicability This regulation shall apply to all carriers offering individual health benefit plans subject to the individual laws of Colorado and the requirements of the Patient Protection and Affordable Care Act. Section 4 Definitions A. “Carrier” shall have the same meaning as found at § 10-16-102(8), C.R.S. B. “Health benefit plan” shall have the same meaning as found at § 10-16-102(32), C.R.S. C. “Special enrollment period” or “SEP” shall mean, for purposes of this regulation only, a period during which an individual who meets the requirements under Section 5.B. may enroll in a health benefit plan outside the initial and annual open enrollment periods. Section 5 A. B. Special Enrollment Period Requirements A carrier offering a health benefit plan in this state shall establish a SEP that: 1. Begins on March 20, 2020 and extends through April 3, 2020; and 2. Ensures a coverage effective date for a plan selected by April 3, 2020 will be no later than April 1, 2020. Application and Verification requirements 1. To access this SEP, individuals must be otherwise eligible for enrollment in the individual health benefit plan for which they are applying and must not already be enrolled in an individual, group or other health benefit plan. Only individuals not currently enrolled in a health benefit plan are eligible for the SEP established under Section 5.A. 2. Individuals may apply for the SEP provided under Section 5.A. by contacting Connect for Health Colorado, a broker, an assister, or the carrier directly to determine eligibility and enrollment. 3. To verify eligibility for the SEP, individuals shall attest that they are currently not enrolled in an ACA-compliant health benefit plan. Verbal attestation is sufficient for purposes of determining eligibility for this SEP. Carriers shall not require additional verification or attestation beyond the eligibility and enrollment information provided by Connect for Health Colorado. Carriers shall not require written documentation for verification of this SEP. 4. The eligibility verification requirements of Colorado Insurance Regulation 4-2-43, 3 CCR 702-4, do not apply to this SEP. 5. This SEP is for qualified individuals applying for new coverage; it does not extend to those who, absent a separate triggering event, are currently enrolled in an ACAcompliant health benefit plan and are seeking to change their current coverage or change carriers. Section 6 Severability If any provision of this regulation or the application of it to any person or circumstances is for any reason held to be invalid, the remainder of this regulation shall not be affected. Section 7 Enforcement Noncompliance with this regulation may result in the imposition of any of the sanctions made available in the Colorado statutes pertaining to the business of insurance, or other laws, which include the imposition of civil penalties, issuance of cease and desist orders, and/or suspensions or revocation of license, subject to the requirements of due process. Section 8 Effective Date This emergency regulation shall be effective March 19, 2020. Section 9 History Emergency regulation effective March 19, 2020.