§ 10-16-103-6

(1)(a) In addition to the requirements in section 10-16-103.4(2), for health benefit plans issued or renewed on or after January 1, 2023, each carrier that offers an individual or small group health benefit plan shall offer at least twenty-five percent of its health benefit plans on the exchange and at least twenty-five percent of its plans not on the exchange in each bronze, silver, gold, and platinum benefit level in each service area as copayment-only payment structures for all prescription drug cost tiers.(b) For each copayment-only payment structure for prescription drugs: (I) The copayment amount for the highest prescription drug cost tier must not be greater than one-twelfth of the health benefit plan's out-of-pocket maximum amount;(II) The copayment amounts between the two highest prescription drug cost tiers must have a cost difference of at least ten percent;(III) No more than fifty percent of the drugs on the prescription drug formulary used to treat a specific condition may be placed on the highest prescription drug cost tier; and(IV) Each carrier shall use 'Rx Copay' at the end of the marketing names for each copayment-only payment structure.

t a specific condition may be placed on the highest prescription drug cost tier; and(IV) Each carrier shall use 'Rx Copay' at the end of the marketing names for each copayment-only payment structure. (2) The commissioner may promulgate rules to implement and enforce this section.Added by 2022 Ch. 184, § 1, eff. 8/10/2022, app. to health benefit plans issued or renewed on or after 1/1/2023 .. 2022 Ch. 184, was passed without a safety clause. See Colo. Const. art. V, § 1(3).