3 CCR 702-4-2-58-4 - Definitions
A. "Carrier"
shall have the same meaning as found at §
10-16-102(8),
C.R.S.
B. "Catastrophic plan" shall
have the same meaning as found at §
10-16-102(10),
C.R.S.
C. "Colorado Option
Standardized Plan" or "Standardized plan" shall have the same meaning as found
at §
10-16-1303(14),
C.R.S.
D. "Exchange" shall have the
same meaning as found at §
10-16-102(26),
C.R.S.
E. "First tier" means, for
the purposes of this regulation, the prescription drug tier which consists of
drugs used for preventive purposes.
F. "Grandfathered health benefit plan" and
"grandfathered plan" shall have the same meaning as found at §
10-16-102(31),
C.R.S.
G. "Health benefit plan"
shall have the same meaning as found at §
10-16-102(32),
C.R.S.
H. "Limited benefit health
plans" means, for the purposes of this regulation, any type of health coverage
that is not provided by a health benefit plan, as defined in §
10-16-102(32)(a),
C.R.S.
I. "Lowest cost tier" means,
for the purposes of this regulation, the prescription drug tier which consists
of the lowest cost tier of prescription drugs and may include no-cost,
non-preventive care drugs.
J.
"Meaningful difference" means, for the purposes of this regulation, ten percent
(10%) or greater.
K. "Medical
service drugs" means, for the purposes of this regulation, prescription drugs
that are administered by a physician or other provider in the provider's office
or other outpatient setting and covered under the plan's medical benefits.
Medical Service Drugs are not generally covered under the plan's pharmacy
benefits.
L. "Preventive care
drugs" means, for the purposes of this regulation, drugs designated as
preventive under state or federal law.
M. "Service area" means, for the purposes of
this regulation, the geographic area a carrier offers a plan or plans. Service
areas may be limited to specific zip codes, counties or may be
statewide.
N. "Short-term limited
duration health insurance policy" and "short-term policy" shall have the same
meaning as found at §
10-16-102(60),
C.R.S.
O. "Small employer" shall
have the same meaning as found at §
10-16-102(61),
C.R.S.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
A. "Carrier " shall have the same meaning as found at § 10-16-102(8), C.R.S.
B. "Catastrophic plan " shall have the same meaning as found at § 10-16-102(10), C.R.S.
C. "Exchange " shall have the same meaning as found at § 10-16-102(26), C.R.S.
D. "Grandfathered health benefit plan " and "grandfathered plan " shall have the same meaning as found at § 10-16-102(31), C.R.S.
E. "Health benefit plan " shall have the same meaning as found at § 10-16-102(32), C.R.S.
F. "Limited benefit health plans " means, for the purposes of this regulation, any type of health coverage that is not provided by a health benefit plan , as defined in § 10-16-102(32)(a), C.R.S.
G. "Meaningful difference " means, for the purposes of this regulation, ten percent (10%) or greater.
H. "Medical service drugs " means, for the purposes of this regulation, prescription drugs that are administered by a physician or other provider in the provider 's office or other outpatient setting and covered under the plan 's medical benefits . Medical Service Drugs are not generally covered under the plan 's pharmacy benefits .
I. "Preventive care drugs " means, for the purposes of this regulation, drugs designated as preventive under state or federal law .
J. "Service area " means, for the purposes of this regulation, the geographic area a carrier offers a plan or plans. Service areas may be limited to specific zip codes, counties or may be statewide.
K. "Short-term limited duration health insurance policy " and "short-term policy " shall have the same meaning as found at § 10-16-102(60), C.R.S.
L. "Small employer " shall have the same meaning as found at § 10-16-102(61), C.R.S.