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Colorado - Compensation & Benefit Legislation

COLORADO - AASHOWME

Demonstrates www.BenefitsReview.com™. Illustrates insurance carriers' coverages within the State.

 

COLORADO - ADOPTED CHILD HEALTH CARE MANDATE

OBRA 1993 (Federal) requires group health plans to honor medical and child support orders. Also, plans must treat adopted children like biological children covered by the plan, and plans are precluded from applying pre-existing condition exclusions to an adopted child where no such exclusion applies to a newborn biological child. Health plans that covered the cost of pediatric vaccines as of May 1, 1993, and fail to continue that level of coverage, will be subject to an excise tax penalty applicable to plans that fail to meet the health care continuation coverage requirements under OBRA 1993.

 

Mandatory coverage of birth of adopted children is included in state's newborn health care mandate. State statute does not provide for minimum levels of coverage or preventive care. (Colorado Rev. Stat. Sections 10-16-104(l), 10-16-104(1,5), 10-16-104(2), 10-16-104(3), 10-16-104(6.5))

 

COLORADO - ALCOHOLISM & DRUG ABUSE

Employer option (alcoholism only).

 

Minimum yearly inpatient coverage: 45 days.

 

Minimum yearly outpatient coverage: $500.

 

Minimum lifetime coverage: no statutory requirements.

 

(Colorado Rev. Stat. Section 10-16-104(9))

 

COLORADO - CAFETERIA PLAN TAX LAWS

State income tax, unemployment insurance tax on salary reduction: No. Follows FUTA.

 

COLORADO - CONTINUATION OF COVERAGE CONVERSIONS

Events Triggering Continuation of Coverage:

 

Death: Yes. (18 months.)

 

Job Termination: Yes. (18 months minimum continuation of coverage.)

 

Reduction of Hours: No.

 

Divorce or Legal Separation: Yes. (18 months minimum continuation of coverage.)

 

Medicare Eligibility: No.

 

Other Provisions: Early Termination of Continuation of Coverage: Becoming eligible for Medicare; becoming eligible for similar health coverage. (Colorado Rev. Stat. Section 10-16-108)

 

COLORADO - COORDINATION OF BENEFITS

Requires use of the birthday rule if coordinating benefits. (effective January 1, 1987). Also see Reg. 86-1 regarding rule if coordinating benefits coordination with no-fault (effective January 1, 1987). Based on 1985 automobile insurance and National Association of Insurance Commissioner Rules model. (Colorado Admin. Ins. Reg. 4-6-2.)

 

COLORADO - COST-OF-LIVING

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian cost-of-living data and U.S. Automobile Cost Survey.

 

COLORADO - DRUG TESTING AND EMPLOYEE ASSISTANCE BENEFITS

State has no statutory requirements.

 

COLORADO - GROUP HEALTH CODE ADDITIONS (MANDATED)

Alcoholism Treatment: Insurers must offer to group hospital and medical policyholders coverage for 45 days of inpatient treatment per year. Each day used shall reduce by 1 day the total days available for all other illnesses and shall reduce by 1 day available days for treatment of mental illness. Outpatient benefits must equal $500 per year. Co-payments for treatment must be the same as for other illnesses except that they cannot exceed 50 percent. Deductibles must be the same. Benefits will not be payable if patient does not complete detoxification and rehabilitation treatment. (Colorado Rev. Stat. Section 10-16-104(9).)

 

Autism: Any health policy that provides coverage for autism may not classify autism as a mental illness. Coverage for autism must be provided in the same manner as coverage for any other illness covered under the policy. However, health insurance policies are not required to provide coverage for autism. (Colorado Rev. Stat. Section 10-16-104.5.)

 

Catastrophic Health Coverage: The Colorado Catastrophic Health Insurance Coverage Act of 1994 allows employers that do not offer other health insurance to offer catastrophic health coverage to its employees. Employees electing the coverage must pay the cost, but may do so on a pretax basis. Each policy must do the following: be in the name of the insured employee, have a minimum deductible of $2,500, offer coverage for the spouse and dependent children of the employee, cover all employees who elect coverage and are not otherwise covered by Medicare or other catastrophic health plans, cover an employee who would be eligible except for underwriting considerations that relate to health, be priced using a modified form of community rating (using age, sex, health status, and geographic area as underwriting factors), provide a clearly written contract of coverage and procedures covered under the policy, and allow conversion to individual policies priced at 135 percent of the premium. (Colorado Rev. Stat. Sections 10-16-114 to -117.)

 

 Coverage Continuation and Conversion: Group accident and sickness policies must provide continuation rights of up to 90 days to employees whose employment is terminated for themselves and their dependents. Group accident and sickness policies must provide conversion rights to employees whose coverage ceases for reasons other than termination of the policy or nonpayment of premiums for themselves and their dependents. Conversion rights also must be provided for spouses and dependents whose coverage ceases due to death of the insured, age, or dissolution of marriage. (Colorado Rev. Stat. Section 10-16-108.)

 

Home Health and Hospice Care: Insurers must offer coverage for such care. (Colorado Rev. Stat. Section 10-16-104(8).)

 

Managed Care Plans: Effective January 1, 1997, patients must be allowed direct access to a participating and available obstetrician or gynecologist for reproductive health care; requests from individuals for timely referrals to such doctors must not be unreasonably withheld. (H1082, 1996) (Colorado Rev. Stat. Section 10-16-102, 10-16-107.)

 

Mammography Screening: Accident and sickness policies must provide single base line mammogram for women 35 to 40 years of age, screening once every two years between 40 and 50 years of age (once a year for women with risk factors for breast cancer), and annual screenings for women between 50 and 65 years of age. (Colorado Rev. Stat. Section 10-16-104(4).)

 

Maternity: Group accident and sickness policies must cover normal pregnancy and childbirth. Exception for employers of fewer than 15 employees or any number of employees for not more than 6 consecutive months if the employer self-insures the benefit. (Colorado Rev. Stat. Section 10-16-104(3)(a).)

 

Mental Health: Group policies providing hospital or medical benefits must cover 45 days of inpatient care or 90 days of partial hospitalization (three to 12 hours per day) per year. Two days of partial hospitalization is equivalent to one benefit day. Providers which may not be denied reimbursement include licensed registered nurse professionals and licensed clinical social workers. Outpatient benefits shall include services provided by comprehensive health care service corporations, hospitals, community mental health centers or those furnished under the supervision of a licensed physician or psychologist. Copayments for treatment must be the same as for other illnesses except that they cannot exceed 50 percent. Deductibles must be the same. Aggregate benefits may be limited to $1,000 per year. (Colorado Rev. Stat. Section 10-16-104(5).)

 

Newborns: Group policies providing family coverage must cover newborn children from the moment of birth for injury or sickness including treatment for congenital defects and birth abnormalities and necessary treatment, as defined, for cleft palate and cleft lip. (Colorado Rev. Stat. Section 10-16-104(1).) Effective January 1, 1997, dependent newborn children of insured individuals must be covered from the time of birth. (H1241, 1996) (Colorado Rev. Stat. Section 10-16-104(1).)

 

Policies for Small Employers: Policies for employers of fewer than 25 employees are exempted from providing mental health benefits under some circumstances and can elect to not cover other mandatory benefits provided written notice is given. (Colorado Rev. Stat. Section 10-16-105.) A 1994 law requires small employer health insurance carriers to offer a small employer the choice of a basic or standard health benefit plan if the employer has been denied coverage on the basis of health status or claims experience. The law also prohibits such insurance carriers from discouraging small employers from applying for a health benefit plan because of claims experience, industry occupation, or location, or from inducing an employer to exclude an employee from health coverage, or practice other unfair and deceptive business practices. Also, continued health benefit plan coverage for terminated, widowed, or divorced eligible employees or their eligible dependents now is extended to 18 months under an amendment to the law. (Colorado Rev. Stat. Section 10-16-601.) Another 1994 law authorizes the creation of health care coverage cooperatives and provider networks. Cooperatives must offer the same premiums to all member classes of small employers and must offer at least a basic and a standard health benefit plan to all employees. No small employers may be excluded from membership in the cooperative if they agree to pay applicable fees and abide by the rules and bylaws of the cooperative. Small employers for this purpose are defined as businesses that employ 50 eligible employees on at least 50 percent of its working days during the preceding calendar quarter, the majority of whom are employed within the state. (Colorado Rev. Stat. Section 10-16-101.)

 

Pregnancy: Accident and sickness policies covering disability must cover complications of pregnancy and childbirth on the same basis as other illnesses and accidents. (Colorado Rev. Stat. Section 10-16-104(2).)

 

Prostate Cancer: Health policies must provide coverage for annual screening for the early detection of prostate cancer in men over the age of 50 years and in men 40 to 50 years old who are in high risk categories as determined by their physician. The coverage shall be the lesser of $65 per prostate cancer screening, or the actual charge for the screening. The benefit shall not diminish or limit other diagnostic benefits allowable under a policy. The screening shall be performed by a qualified medical professional and, at a minimum, consist of a prostate-specific antigen ('PSA') blood test and a digital rectal exam. (Colorado Rev. Stat. Section 10-16-104(10).)

 

Providers: Osteopaths, dentists, optometrists, psychologists, chiropractors, podiatrists, and registered nurses: Costs for services must be covered if the provider is licensed, the service is within the provider's scope of services, and the service is covered by the policy. (Colorado Rev. Stat. Section 10-8-103(3).) Providers defined as physicians, dentists, optometrists, anesthesiologists, hospitals, x-ray, laboratory, and ambulance services, or other person licensed or otherwise authorized in the state to provide health care services. (Colorado Rev. Stat. Section 10-16-103(15).)

 

COLORADO - GROUP HEALTH FOR SMALL EMPLOYERS

For insurance plans offered to small employers:

 

Eligibility Criteria: 2-50 employees, the majority within the state.

 

Restrictions on premiums: Yes.

 

Restrictions on cancellation: Yes.

 

Pre-existing Conditions: No provisions especially for small employers.

 

Other: Exemption from mandatory coverage of mental health benefits. Children's preventive care must be covered.

 

(Colorado Rev. Stat. Sections 10-26-102, 10-16-104, 10-16-105)

 

COLORADO - GROUP LIFE CODE ADDITIONS

Employer required to pay part of premium: No.

 

Percent of employees who must elect coverage (if employees pay part of premium): No statutory requirements.

 

Percent of employees who must be covered if employer pays all of premium: No statutory requirements.

 

Minimum number of employees in group plan: 3.

 

Employer prohibited as beneficiary: No.

 

Grace period (days): 31.

 

Mandatory conversion: Yes.

 

Other provisions: none. (Colorado Rev. Stat. Sections 10-7-202)

 

COLORADO - HOLIDAYS

January 1, Washington's Birthday (or 3rd Monday in February), Memorial Day (or last Monday in May), July 4, Labor Day (or 1st Monday in September), Veterans Day, and December 25 are state holidays in all 50 states and in the District of Columbia. Other holidays under State law include: Martin Luther King's birthday (or 3rd Monday in January), Thanksgiving. Other: Any day appointed by the Governor or the President. If any holiday falls on a Sunday, the following Monday is a holiday. (Colorado Rev. Stat. Sections 24-11-101, 24-11-103 through 24-11-109, 24-11-111)

 

COLORADO - IMMIGRATION (PREVAILING WAGE POLICY)

See U.S. Federal General Administrative Letter 1-2000

 

COLORADO - JURY DUTY & WITNESS TIME OFF

Employer Restriction For Discharging Employee For Taking Leave For Jury Service: Yes.

Remedies and Penalties: Discrimination against an employee for taking leave is a misdemeanor. Employee can bring civil action for lost wages, other damages, and reinstatement.

 

Other Requirements: Employees are entitled to paid leave for first 3 days of service; pay not to exceed $50 per day unless by mutual agreement. (Colorado Rev. Stat. Sections 13-71-126 et seq.)

 

Employer Restriction For Discharging Employee For Taking Leave to be a Witness: Yes, in criminal cases if the employee was the crime victim.

 

Remedies and Penalties: Employee may notify the victims' compensation and assistance coordinating committee. If noncompliance cannot be resolved, committee will refer employee's report to the governor, who will ask the attorney general to file suit to enforce compliance with this provision.

 

Other Requirements: Employee who is a crime victim has right to be provided appropriate employer intercession services to encourage victim's employer to cooperate with criminal justice system and minimize loss of employment, wages, and benefits. (Colorado Rev. Stat. Sections 24-4.1-302(n), 24-4.1 303(8))

 

COLORADO - LEAVES OF ABSENCE

Employers Subject to Leave Laws: Employers with full or part time classified employees in the Colorado state personnel system.

 

Criteria for Eligibility: Employed for more than 1 year.

 

Maximum length of leave: 520 hours in a fiscal year.

 

Paid Leave: State requires paid sick leave. State does not require paid family leave unless paid time-off benefits are used.

 

Acceptable Reasons for Leave: Birth/adoption of a child, care of a family member.

 

Employment Guarantees After Leave: Entitled to reinstatement in position with the same classification held prior to the leave or equivalent classification.

 

Use of Vacation or other Time-off Benefits: Employer may require employee to use vacation and sick benefits before receiving leave benefits.

 

Certification Required: Employer may require certification of illness if leave is taken to care for an ill family member or for employee's illness.

 

Effect Of Leave on Other Benefits: Employee pays for health benefits for any unpaid portion of leave.

 

Effect of Seniority Accrual During Leave: Seniority for retirement stops accruing while on leave.

 

Minimum Requirements for Notification to Employer: Prior notice is required for more than 5 days sick leave; 1 month's notice, if possible, is required for family leave.

 

Conditions for Denial of a Request For Leave: Sick leave may be denied for failure to notify or certify; family leave may be denied if business will be harmed or if no certification is given. (Colorado Rev. Stat. Section 19-5-211.)

 

See U.S. Federal Family and Medical Leave Act

 

COLORADO - LONG TERM DISABILITY CODE ADDITIONS

State does not require employer to provide long term disability benefits; although many employers do in order to remain competitive in hiring/retention of employees.

 

See LEAVES OF ABSENCE (above), WORKERS' COMPENSATION (below) and U.S. Federal Americans With Disabilities Act

 

COLORADO - MANDATED PROVIDERS

Optometrists, chiropractors, dentists, psychologists, podiatrists, and social workers. Mandatory coverage for osteopaths, registered professional nurses, licensed family therapists, and licensed family counselors. (Colorado Rev. Stat. Section 10-16-104(5), 10-16-104(7))

 

COLORADO - MENTAL HEALTH CARE

Mandatory coverage.

 

Minimum yearly inpatient coverage: 45 days inpatient or 90 days partial hospitalization.

 

Minimum yearly outpatient coverage: $1,000.

 

Minimum lifetime coverage: No statutory requirements. (Colorado Rev. Stat. Section 10-16-104(5))

 

COLORADO - MINIMUM WAGE

Refer to the Federal minimum wage: $5.15 per hour (effective September 1, 1997).

 

Exemptions: Some handicapped in special environments (sub-minimum wage of 85%). (Colorado Rev. Stat. Sections 8-6-106, 8-6-108.5, 8-6-112); Colorado Code of Regulations (Order No. 19)

 

See U.S. Minimum Wage

 

COLORADO - NEW HIRE REPORTING

Who is required to report: All employers.

 

Who must be reported: All new employees and rehires.

 

Exempt from reporting: Employees hired for fewer than 30 days.

 

Form(s) to file: Copy of W-4 or an employer developed form. Report may be transmitted by first class mail, magnetically, or electronically.

 

Filing deadline: Within 20 days of hire.

 

Employer information to be included: Name, address, and federal EIN.

 

Employee information to be included: Name, address, and SSN.

 

Penalty for failure to report: -

 

(Colorado Rev. Stat. Section 26-13-125)

 

COLORADO - NEWBORN CARE MANDATE

Mandated coverage. State statute does not provide for minimum levels of coverage or preventive care. (Colorado Rev. Stat. Sections 10-16-104(l), 10-16-104(1,5), 10-16-104(2), 10-16-104(3), 10-16-104(6.5))

 

COLORADO - PARENTAL LEAVE

See U.S. Federal Family and Medical Leave Act

 

COLORADO - PRE-EXISTING CONDITIONS

For insurance plans offered to small employers, no provision relating specifically to small employer health plans. (Colorado Revised Statute Sections 10-16-102, 10-16-104, 10-16-105.)

 

See U.S. Federal Health Insurance Portability & Accountability Act

 

COLORADO - PROTECTED CLASSIFICATIONS

Age:   Yes.

 

Race:  Yes.

 

Color:  Yes.

 

National Origin:   Yes.

 

Ancestry:   Yes.

 

Religion:  Yes.

 

Sex:  Yes.

 

Pregnancy:   No specific law. State has expressed policy against discrimination.

 

Sexual Harassment:  No specific law. State has expressed policy against discrimination.

 

(Colo. Rev. Stat. Section 24-34-402.)

 

COLORADO - SALARY SURVEY

ERI's Relocation Assessor™ is a recommended source for U.S./Canadian wages & salaries (covering 3,000 positions).

 

COLORADO - SHORT TERM DISABILITY CODE ADDITIONS

State does not require employer or employee participation in short term disability plans.

 

COLORADO - TERMINATION & SEVERANCE PAY

Date pay is due if employee is discharged: Immediately.

 

Date due if employee resigns: Payday.

 

Wages: Yes.

 

Vacation Pay: Yes, based on case law.

 

Holiday: No.

 

Sick leave: No.

 

Severance: No. (Colorado Rev. Stat. Section 8-4-104. See Lee v. Great Empire Broadcasting, Inc., 794 P .2d 1032 (Colorado Court App. 1989); Jet Courier Serv., v. Mulei, 771 P .2d 486 (Colorado ))

 

COLORADO - UNEMPLOYMENT TAX

Employer Contributions:

 

 

Voluntary Contribution Provision: Yes. Before March 15 of rate year.

 

(Colorado Rev. Stat. Sections 8-72-107, 8-76-102, 8-76-103, 8-76-104).

 

COLORADO - VACATION PAY

See TERMINATION & SEVERANCE PAY (above).

 

COLORADO - VOTING TIME OFF

2 hours unless employee has 3 consecutive hours outside working hours while polls are open. (Colorado Rev. Stat. Sections 1-7-102, 1-13-719)

 

COLORADO - WORKERS' COMPENSATION

Private Employers: Mandatory as to all employments. Corporate officer or member of a limited liability company who is a 10% shareholder may reject coverage. Elective coverage for active employee or partner.

 

Public Employers: Mandatory as to all salaried public employments. Job trainees deemed employees of training institution.

 

Exceptions: Part-time domestic servants, (Note: Part-time is equal to less than 40 hours per week.), casual employees who earn less than $2,000 per year, volunteer ski patrol and instructors, independent real estate salespersons and brokers, and independent truckers.

 

Special Coverage Provisions: All farm labor covered in 1977 Officers of farm corporation may reject coverage. (U.S. Chamber of Commerce, 1994 Analysis of Workers' Compensation Laws.)