Colorado Legislative Council Staff

NO FISCAL IMPACT

TITLE:            CONCERNING THE SALE OF AN INDIVIDUAL HEALTH BENEFIT PLAN TO A BUSINESS GROUP OF ONE SELF-EMPLOYED APPLICANT.

Summary of Assessment

            This bill makes changes to the "Small Employer Health Insurance Availability Program Act" by amending certain conditions required for an individual health benefit plan to be exempt from the statutory provisions concerning small employer carriers and small group plans provided under the Act. The bill makes the following changes:

            •   requires any carrier doing business in both the individual and small group markets, who rejects an application for a business group of one self-employed person, to notify the applicant of the availability of coverage through the small group market and of the availability of small group coverage through the carrier;

            •   requires any individual insurance carrier to make available in the disclosure forms that must be provided to a business group of one self-employed person purchasing an individual health benefit plan to briefly describe the factors used to set the rates for the individual policy being purchased, as well as a description of the standard plan together with the individual plan being marketed, and to compare the individual rate factors with the factors used to set rates for a business group of one small group policy;

            •   requires the Division of Insurance, Department of Regulatory Agencies, to make available a standard plan description form to carriers upon request; and

            •   repeals the requirement that every application by a business group of one self- employed person include a statement certifying that the marketing and sale of the individual health benefit plan complies with the business group of one statute governing the sale of individual coverage.

            The bill will become effective ninety days after the General Assembly adjourns, unless a referendum petition is filed and approved by the voters.

            This bill will affect health insurers who offer individual health insurance to business groups of one self-employed individuals. The bill will have a minimal impact on the workload of the Division of Insurance that can be absorbed within their existing appropriation. The bill will not affect any other state agency or unit of local government. Therefore, this bill is assessed as having no fiscal impact.

Departments Contacted

            Regulatory Agencies