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State RegulationsCO specificDifficulty 2/5

Which statement best describes 'essential health benefits' for health benefit plans regulated in Colorado?

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Answer & full 3-part explanation (select an option above, or peek)

Why C is correct

C.R.S. § 10-16-102(22) defines essential health benefits, and C.R.S. § 10-16-103.4 together with Colorado Insurance Regulation 4-2-42 implements the required benefit package for applicable individual and small-group health plans. The requirement ensures a baseline of coverage regardless of carrier, so a plan sold in the individual or small-group market cannot omit an essential health benefit category.

Why the other options are wrong

  • A) The essential health benefits framework targets the individual and small-group markets, not large-employer plans.
  • B) Essential health benefits are defined by Colorado law and Division of Insurance regulation, not by whatever an insurer advertises.
  • D) Medicare supplement policies are governed by C.R.S. § 10-18-107 and related rules, not by the essential health benefits package.

Memory hook

EHB = the floor for individual and small group — big plans and Med supp stand elsewhere.

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