October 25, 2014

DORA Issues Emergency Regulation Prompted by New Child-Only Health Plans Law

As reported last week, Governor John Hickenlooper signed SB 11-128, which expands the amount child-only health insurance policies provided in Colorado.

Federal Healthcare Reform requires “insurers writing child-only policies to issue them without regard to the child’s health status or condition. As a result of this requirement, only two carriers in Colorado, Kaiser-Permanente and Rocky Mountain Health Plans, have been issuing child-only policies since fall of 2010.” The new Colorado law requires all insurance carriers selling individual health benefit plans in the state to provide at least one child-only health benefit plan for children.

As a result of the new law, DORA’s Division of Insurance has issued an Emergency Regulation, E-11-03: Mandatory Open Enrollment Periods for Carriers Issuing Child-Only Plans.

This year, the open enrollment period for child-only polices will begin August 1 and end August 31. The open enrollment periods for child-only policies in future years will occur in the months of January and July. Coverage obtained during an open enrollment period becomes effective thirty days after the end of the open enrollment period.

A child-only health policy means there is no adult on the individual policy. There can be many scenarios for this type of policy: the parents may be insured through an employer-sponsored plan which does not offer dependent coverage; or the family may not be able to afford coverage for all members, and is seeking coverage for the children only. Life events such as divorce or job loss may also affect insurance coverage.

Children who lose coverage due to a qualifying event can obtain child-only coverage by applying within 30 days of the event. Outside of a qualifying event, a child-only policy can be applied for only during an open enrollment period. Qualifying events include birth, adoption, marriage, dissolution of marriage, loss of employer-sponsored coverage, loss of Medicaid or Children’s Basic Health Plan coverage, entry of a court or administrative order mandating coverage, etc.

The Emergency Regulation can be found here.

For more information about child-only health policies, visit DORA’s information website.

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