Department of regulatory agencies 
DIVISION OF INSURANCE
3 CCR 702-4
LIFE, ACCIDENT AND HEALTH
Proposed New Regulation 4-2-29
CONCERNING THE RULES FOR STANDARDIZED CARDS ISSUED TO PERSONS COVERED BY HEALTH BENEFIT PLANS
Section 1	Authority
Section 2	Scope and Purpose
Section 3	Applicability
Section 4	Definitions
Section 5	Rules
Section 6	Severability
Section 7	Enforcement
Section 8	Effective Date
Section 9	History
Section 1	Authority
This regulation is being promulgated pursuant to the authority granted to the Commissioner of insurance in §10-1-109, C.R.S. and is adopted by the Commissioner of Insurance pursuant to the requirement in §10-16-135, C.R.S.
Section 2	Background and Purpose
The purpose of this regulation is to provide health carriers the guidance necessary to implement Senate Bill 135 enacted in 2008 by the Colorado General Assembly and effective on July 1, 2009.  
Section 3	Applicability and Scope
This regulation applies to all individual and group health benefit plans issued or renewed on or after July 1, 2009 by entities subject to Part 2, Part 3 and Part 4 of Article 16 of Title 10 of the Colorado Revised Statutes, and to any person enrolling in an existing plan on or after July 1, 2009. 
Section 4	Definitions
A.	“Carrier” shall have the same meaning as set forth in §10-16-102(8), C.R.S.
B.	“Health benefit plan” shall have the same meaning as set forth in §10-16-102(21), C.R.S.
C.	"Limited benefit health insurance" means a health policy, contract or certificate offered or marketed on an individual or group basis as supplemental health insurance that pays specified amounts according to a schedule of benefits to defray the costs of care, services, deductibles, copayments or coinsurance amounts not covered by a health benefit plan.  “Limited benefit health insurance” does not include short-term limited duration health insurance policies, contracts or certificates; high deductible plans; or catastrophic health policies, contracts or certificates.  Such non-supplemental plans are included under the term “health benefit plan”. 
Section 5	Rules
A.	The requirements of this regulation shall apply to identification cards issued to persons covered under health benefit plans.  These requirements do not apply to identification cards issued to persons covered by limited benefit health insurance plans.
B.	The card size shall be 2 and 1/8 inches by 3 and 3/8 inches, which is consistent with standard-sized credit cards, and shall be either made of plastic, or laminated.
C.	The colors used for the card and font shall be legible and conducive to black and white photocopying.
D.	The following information shall appear on the front side of the identification card, in no less than 9 point font:
1.	The name of the carrier underwriting the policy;
2.	The covered person’s first name, middle initial and last name;
3.	The covered person’s month and year of birth;
4.	All applicable policy, certificate, group and subscriber numbers;
5.	The specific plan number or name;
6.	The plan type (HMO, PPO, or Indemnity);
7.	Coverage levels for the following services.  If all services are subject to the plan’s deductible and applicable coinsurance, a notation of “Deductible and coinsurance” is sufficient unless the service requires a different deductible or coinsurance amount; otherwise, required copayments should be specified:
a.	Primary care;
b.	Specialty care;
c.	Preventive care;
d.	After hours/urgent care;
e.	Emergency room;
f.	Outpatient surgery;
g.	Inpatient hospital; and
h.	Prescription drugs.
8.	The covered person’s required deductible and coinsurance amounts.
9.	For group health benefit plans, a “Yes” or “No” for the following question:  “Is this policy a fully-insured?”
10.	Identification of the state where the policy contract is sitused.  State abbreviations may be used. 
E.	The following information shall appear on the reverse side of the identification card, in no less than 8 point font:
1.	Contact information for the carrier or plan administrator which includes:
a.	Name and address for claim submissions;
b.	Telephone number(s) for member/customer service;	
c.	Website address;
d.	Information related to hospital admissions, surgical procedures and other services that require preauthorization, including the telephone number to be used; and
e.	Information related to hospital admission notification requirements, if any, including the telephone number to be used.
Section 6	Severability
If any provision of this regulation or the application of it to any person or circumstance 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, after proper notice and hearing, 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 fines, issuance of cease and desist orders, and/or suspensions or revocation of certificates of authority.  Among others, the penalties provided for in §10-3-1108, C.R.S., may be applied.  
Section 8	Effective Date
This regulation shall become effective on October 1, 2008.
Section 9	History
New regulation is effective October 1, 2008.