BY REPRESENTATIVES Swenson, Arrington, Veiga, T. Williams, Bacon, Dyer, Mace, McPherson, Morrison, Nichol, Owen, Reeser, and S. Williams;
also SENATORS J. Johnson, Lacy, Perlmutter,
Powers, Tebedo, and Hernandez.
CONCERNING REQUIREMENTS FOR PERSONAL INJURY PROTECTION
COVERAGE POLICIES.
Be it enacted by the General Assembly of the State
of Colorado:
SECTION 1. 104706
(1), Colorado Revised Statutes, is amended BY THE ADDITION OF
A NEW PARAGRAPH to read:
104706. Required coverages
complying policies PIP examination program.
(1) Subject to the limitations and exclusions authorized
by this part 7, the minimum coverages required for compliance
with this part 7 are as follows:
(f) (I) WITH RESPECT TO THE MEDICAL
AND REHABILITATION EXPENSE PROVISIONS IN PARAGRAPHS (b) AND (c)
OF THIS SUBSECTION (1), AN INSURER SHALL MAKE AVAILABLE AND PROVIDE
AT THE OPTION OF THE NAMED INSURED, DEDUCTIBLES AND COINSURANCE
ARRANGEMENTS. PURSUANT TO SUCH DEDUCTIBLES AND COINSURANCE ARRANGEMENTS,
THE RECIPIENT OF THE CARE, TREATMENT, SERVICES, PRODUCTS, EXPENSES,
OR ACCOMMODATIONS SHALL SHARE IN THE PAYMENT OBLIGATIONS FOR SUCH
CARE, TREATMENT, SERVICES, PRODUCTS, EXPENSES, OR ACCOMMODATIONS.
(II) ANY DEDUCTIBLES AND COINSURANCE ARRANGEMENTS
PROVIDED PURSUANT TO SUBPARAGRAPH (I) OF THIS PARAGRAPH (f) SHALL
APPLY ONLY TO THE NAMED INSURED, RESIDENT SPOUSE, RESIDENT RELATIVE,
AND PERSONS OPERATING THE COVERED MOTOR VEHICLE WITH THE PERMISSION
OF THE NAMED INSURED OR RESIDENT SPOUSE; EXCEPT THAT ANY POLICY
OF SUCH PERMISSIVE OPERATOR SHALL BE PRIMARY.
(III) FOR PURPOSES OF THIS PARAGRAPH (f),
"RESIDENT RELATIVE" HAS THE SAME MEANING AS SET FORTH
IN SUBPARAGRAPH (II) OF PARAGRAPH (d) OF SUBSECTION (2) OF THIS
SECTION.
SECTION 2. 104706
(2) (a), (2) (b), and (2) (f), Colorado Revised Statutes, are
amended to read:
104706. Required coverages
complying policies PIP examination program.
(2) (a) (I) An insurer may offer, and provide
at the option of the named insured, the benefits described in
subsection (1) (b) and (1) (c) of this section through managed
care arrangements such as a health maintenance organization (HMO)
or a preferred provider organization. INSURERS SHALL MAKE DEDUCTIBLES
AND COINSURANCE OPTIONS AVAILABLE IN such policy option
may include AND MAY MAKE OTHER conditions
and limitations to coverage AVAILABLE. including,
but not limited to, deductibles and coinsurance requirements,
as approved by the commissioner.
The commissioner shall approve such DEDUCTIBLES, COINSURANCE
OPTIONS, conditions, and limitations unless a finding is made
by the commissioner that such DEDUCTIBLES, COINSURANCE OPTIONS,
conditions, and limitations are unreasonable when compared with
benefits provided.
(II) WHEN A PERSON MAKES AN INITIAL APPLICATION
FOR INSURANCE COVERAGE UNDER THIS PART 7, IN ADDITION TO ANY OTHER
REQUIREMENTS ESTABLISHED BY LAW, THE INSURER SHALL DISCLOSE IN
THE SAME MEDIUM AS THAT IN WHICH THE APPLICATION WAS TAKEN, OR
IN WRITTEN FORM, THE FOLLOWING INFORMATION REGARDING MANAGED CARE
OPTIONS:
(A) THAT MOTOR VEHICLE INSURANCE POLICIES
IN COLORADO MAY INCLUDE OPTIONAL MANAGED CARE ARRANGEMENTS, INCLUDING,
BUT NOT LIMITED TO, HEALTH MAINTENANCE ORGANIZATIONS AND PREFERRED
PROVIDER ORGANIZATIONS;
(B) WHAT MANAGED CARE IS AND HOW IT AFFECTS
THE CONSUMER; AND
(C) WHETHER THE INSURER OFFERS SUCH A
MANAGED CARE OPTION AND, IF SO, THE DISCLOSURE SHALL INDICATE
THAT POTENTIAL COST SAVINGS MAY BE OBTAINED IF AN INSURED CHOOSES
TO ACCEPT A MANAGED CARE OPTION.
(b) An insurer may
offer SHALL MAKE AVAILABLE, and provide
at the option of the named insured, deductible and coinsurance
arrangements whereby the recipient of care, treatment, services,
products, expenses, or accommodations shares in the payment obligation
for such care, treatment, services, products, expenses, or accommodations.
(f) An insurer offering the coverages
authorized in paragraphs (a) and (b) of this subsection (2) shall
demonstrate in rate filings submitted to the commissioner the
savings to the insured to be realized under the plan and shall
further submit to the commissioner, for preapproval, any disclosure
form to be used to record an insured's election for any coverage
authorized in paragraphs (a) and (b) of this subsection (2).
A DISCLOSURE FORM FOR A MANAGED CARE ARRANGEMENT SHALL INCLUDE
THE FOLLOWING INFORMATION IN TYPE OF AT LEAST TWELVEPOINT
SIZE:
(I) THAT A POLICY CONTAINING A MANAGED
CARE OPTION MAY BE ACCEPTED OR REJECTED BY THE NAMED INSURED
AT ANY TIME UPON NOTICE TO THE INSURER OR ITS AGENT; EXCEPT THAT
SUCH CHANGE SHALL NOT AFFECT ANY CLAIM ARISING OUT OF AN ACCIDENT
THAT OCCURRED PRIOR TO THE DATE OF SUCH NOTICE;
(II) THAT OBTAINING OR RENEWING THE INSURANCE
POLICY IS NOT DEPENDENT UPON ACCEPTING A MANAGED CARE OPTION;
AND
(III) WHAT THE APPROXIMATE COST SAVINGS
WILL BE IF THE MANAGED CARE OPTION IS ACCEPTED.
SECTION 3. Effective
date applicability. This act shall take
effect January 1, 1999, and shall apply to policy options offered
and policies issued and renewed on or after said date.
SECTION 4. Safety
clause. The general assembly hereby finds, determines, and
declares that this act is necessary for the immediate preservation
of the public peace, health, and safety.
____________________________ ____________________________
Charles E. Berry Tom Norton
SPEAKER OF THE HOUSE PRESIDENT OF
OF REPRESENTATIVES THE SENATE
____________________________ ____________________________
Judith M. Rodrigue Patricia K. Dicks
CHIEF CLERK OF THE HOUSE ASSISTANT SECRETARY OF
OF REPRESENTATIVES THE SENATE
APPROVED________________________________________
_________________________________________
Roy Romer
GOVERNOR OF THE STATE
OF COLORADO