| Summary |
The bill imposes requirements on any organization that operates
a medical expense sharing program (program), which is defined as a
program, arrangement, or activity offered in Colorado that:
•
Facilitates the sharing and payment of medical expenses
among members using member-contributed funds; and
•
Does not transfer to members of an organization or to the
organization itself any risk or legal obligation to pay
medical expenses.
An organization that operates a program must:
•
Provide a notice to the public that the program is not an
insurance plan or policy, that the organization is not
engaged in the business of insurance, that payment of a
member's medical bills is voluntary, that some medical
expenses may be excluded despite requirements under
health insurance laws for health insurance plans to cover
such expenses, and that each person is personally
responsible for paying the person's own medical bills;
•
Before approving a membership application, obtain a
signed written, signed affirmation from the applicant
acknowledging that the applicant has received and
understands the notice, has received other program
materials, and understands that a third party may receive a
commission for enrolling the member;
•
Report specified financial and transactional information to
members monthly and annually, which may be
accomplished by sharing a link where the information is
posted on the organization's public website;
•
Submit to an annual, independent audit of the program's
financial information;
•
Post on its public-facing website and report to the attorney
general by providing a link to the website specified
information about the organization, including the name and
contact information, program materials, the annual
financial audit, and information about Colorado
membership in the program;
•
Operate only under the name or names reported on its
public-facing website, not make or circulate any statement
or publication representing that the program is insurance or
otherwise materially misrepresenting the program terms
and conditions, and not engage in an excess benefit
transaction, as defined in the federal Internal Revenue
Code of 1986 (tax code), if the organization identifies as
a nonprofit organization under the tax code; and
•
Indicate on membership cards and in communications to
providers that the program is not health insurance and that
members are personally responsible for paying their own
medical bills.
The attorney general is authorized to issue a notice of
noncompliance to an organization that is failing to comply with the
requirements specified in the bill, and if the organization's failure
continues for more than 45 days, to seek an injunction or an
administrative penalty in Denver district court.
The bill specifies that a program is exempt from state insurance
laws if the program facilitates the sharing of member medical expenses
by transferring member funds and the organization is a nonprofit
organization under the tax code and does not own the member funds.
Additionally, the bill states that the requirements imposed on
organizations that operate programs must be applied in a manner that
avoids excessive government entanglement with religion and that does
not limit protections of religious exercise rights of an organization
operating and members of a religious organization sharing program.
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