Colorado Revised Statutes Title 10. Insurance § 10-16-1002. Definitions

(1) Repealed by Laws 2019, Ch. 205 (S.B. 19-004), § 3, eff. Aug. 2, 2019.

(2) “Cooperative” or “health-care coverage cooperative” means a health-care coverage cooperative created pursuant to this part 10 as an entity that provides to its members health coverage and health-care purchasing services, including but not limited to detailed information on comparative prices, usage, outcomes, quality, and member satisfaction with provider networks. “Cooperative” does not include a cooperative association organized without capital stock in accordance with article 55 of title 7, C.R.S., that is subject to articles 121 to 137 of title 7, C.R.S., and that had filed articles of incorporation with the secretary of state on or before March 15, 1991.

(3) “Health information” has the same meaning as “medical information”, as set forth in section 18-4-412(2)(b), C.R.S. “Health information” also includes information that relates to the past, present, or future physical or mental health of the member and its eligible employees and to payment for the provision of health care to the member and its eligible employees.

(4) “Licensed provider network” shall have the same meaning as in section 6-18-301.5(1), C.R.S.

(5) “Managed care” has the same meaning as “managed care plan”, as defined in section 10-16-102(43).

(6.5) “Member class” means the class of member based on whether the member would qualify for coverage in the individual market, the small employer fully insured market, the large employer fully insured market, or the employer self-insured market.

(7) “Person with financial interest in the cooperative's business” means one of the following or an immediate family member of one of the following:

(8) “Provider network” means a group of health-care providers formed to provide health-care services to individuals.

(9) “Purchaser” means an individual, an organization, or a governmental entity that makes health benefit purchasing decisions on behalf of a group of individuals.

(10) “Utilization management” means programs designed to assure appropriate utilization of health services relative to established standards or norms.

(11) Repealed by Laws 2019, Ch. 205 (S.B. 19-004), § 3, eff. Aug. 2, 2019.