CurrentSelectHealthPolicy N/A

Colorado state required benefits (index of mandated benefit categories)

Lists Colorado-required health insurance benefit categories and their market applicability and citation references; affects individual and group market plans in Colorado.

Policy Summary

PayerSelectHealth

PolicyColorado state required benefits (index of mandated benefit categories)

Policy CodePolicy N/A

Change TypeInformational / No material change

Effective DateN/A

Next Review DateN/A

Key ActionUse this index to confirm which benefit categories Colorado requires and their market applicability and cited statutes.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

~30distinct required benefit entries listed

Before 2012majority enactment year for listed benefits

Coloradostate governed

Colorado Required Benefit Categories

Colorado required benefits (selected entries)

Enumerated benefit categories (examples):

Congenital defects and birth abnormalities — Market applicability: (as listed). Citation: Section 10-16-104 (1.7), CRS.

Maternity coverage — Market applicability: Individual, group.

Biologically based mental illness — Market applicability: Individual, small group. Citation: Section 10-16-104 (5); Section 10-16-104 (5.5), CRS.

Applied behavior analysis–based therapies and other treatment services — Market applicability: Individual, group. Citation: Section 10-16-104 (1.3); Section 10-16-104 (1.4), CRS.

Prosthetic devices — Market applicability: Individual, group. Citation: Section 10-16-104 (14), CRS.

Policy Summary

PayerSelectHealth

PolicyColorado state required benefits (index of mandated benefit categories)

Policy CodePolicy N/A

Change TypeInformational / No material change

Effective DateN/A

Next Review DateN/A

Key ActionUse this index to confirm which benefit categories Colorado requires and their market applicability and cited statutes.

SourceLink

On This Page

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Statutory Citations and Code References

Statutory citations referenced (partial/varied)mixed

No codes listed

Referenced Colorado Statutes (extracted citations)mixed

Section 10-16-104 (1.7), CRS	Congenital defects and birth abnormalities
Section 10-16-104 (5), CRS	Biologically Based Mental Illness / Mental illness
Section 10-16-104 (5.5), CRS	Biologically Based Mental Illness / Mental illness
Section 10-16-104(1.3), CRS	Applied behavior analysis based therapies and other treatment services; rehabilitative therapies
Section 10-16-104(1.4), CRS	Applied behavior analysis based therapies and other treatment services
Section 10-16-104 (14), CRS	Prosthetic devices
Section 10-16-104 (19), CRS	Hearing aids for children
Section 10-16-104 (17), CRS	Cervical cancer vaccination
Section 10-16-104 (11), CRS	Preventative services (including immunizations for children up to age 13)
Section 10-16-104 (10), CRS	Prostate cancer screening

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Provider Impact Summary

Documentation Required

State benefit mandate listing — confirm market applicability and citations

This document is an index of Colorado-required benefit categories (for example: maternity coverage; prosthetic devices; applied behavior analysis–based therapies; hearing aids for children; preventative services including childhood immunizations) and indicates market applicability (individual, group, small group where noted) and statutory citation references when provided. Providers should use this listing to confirm whether a service category is a Colorado-mandated benefit for the member’s plan type and consult the cited Colorado Revised Statutes for specific coverage obligations.

Enumerates required benefit categories and, where available, market applicability (e.g., Individual, group, small group) — see entries such as Maternity coverage (Individual, group) and Applied behavior analysis based therapies (individual, group).
Includes statutory citation references for many entries (for example: Applied behavior analysis — Section 10-16-104(1.3); Prosthetic devices — Section 10-16-104 (14); Hearing aids for children — Section 10-16-104 (19)).
Does not provide benefit-level coverage criteria; providers must refer to the cited statutes or plan documents for specific coverage rules, limits, or documentation requirements.

Market Applicability and Enactment Details

Market Applicability (as used here)

DefinitionMarket Applicability indicates which insurance markets the Colorado-required benefit applies to (e.g., Individual, Group, Small Group).

Common values in this documentIndividual; Group; Small group; (some entries blank when not specified).

Source examplesMaternity coverage — Market Applicability = Individual, group; Biologically Based Mental Illness — Market Applicability = Individual, small group; Oral anticancer medication — Market Applicability = Individual, group.

Interpretation noteBlank or missing market applicability in an entry indicates the source did not specify the market for that benefit in this compilation.

Geographic scopeApplies to Colorado state required benefit listings in this document.

Year of Enactment

DefinitionYear of Enactment indicates the legislative enactment timeframe for the mandate as reported in this compilation.

Most entries' yearBefore 2012

Examples from sourceCongenital defects and birth abnormalities — Year of Enactment = Before 2012; Preventative services — Year of Enactment = Before 2012; Oral anticancer medication — Year of Enactment = Before 2012.

Usage noteThe listed year reflects the document's recorded enactment timeframe and may not be the precise statute adoption date; check the cited CRS sections for authoritative dates.