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* 1. Company Name:

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* 2. NAIC#:

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* 3. Respondent Name

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* 4. Respondent Phone Number

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* 5. Respondent Email

This survey applies to Comprehensive Major Medical, Dental, Vision, Limited Benefit Plans, Accident Only, and Long Term Care insurance and all questions below should be answered keeping in mind all of those categories.

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* 6. Did your company have Colorado covered lives in 2024

For companies that had Colorado Covered lives please fill out the remaining questions. If there is no activity in Colorado for a given field, please enter 0.

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* 7. Calendar year 2024 Estimated Written Health Premium

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* 8. Does your company follow both regulation 4-2-17 Prompt Investigation of Health Claims involving Utilization Review and Denial of Benefits and Rules related to internal Claims and Appeals Process and Regulation 4-2-21 External Review of Benefit Denials of Health Coverage Plans?

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* 9. If you answered "No" to the question above, please provide an explanation for why your company does not comply with these regulations. 

Individual Coverage

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* 10. Total Number of First-Level appeals requested and completed in the 2024 Calendar year:

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* 11. Number of those appeals where carrier's position was upheld:

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* 12. Number of those appeals decided in favor of consumer:

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* 13. Number of those appeals with a mixed disposition:

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* 14. Number of those appeals withdrawn prior to completion:

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* 15. Total Number of Independent external review appeals requested and completed in the 2024 Calendar year:

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* 16. Number of those appeals where carrier’s position was upheld:

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* 17. Number of those appeals decided in favor of consumer:

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* 18. Number of those appeals with a mixed disposition:

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* 19. Number of those appeals withdrawn prior to completion:

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* 20. Comments on Individual Coverage:

Group Coverage

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* 21. Total Number of First-Level appeals requested and completed in the 2024 Calendar year:

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* 22. Number of those appeals where carrier's position was upheld:

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* 23. Number of those appeals decided in favor of consumer:

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* 24. Number of those appeals with a mixed disposition:

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* 25. Number of those appeals withdrawn prior to completion:

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* 26. Total Number of Second-Level appeals requested and completed in the 2024 Calendar year:

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* 27. Number of those appeals where carrier’s position was upheld:

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* 28. Number of those appeals decided in favor of consumer:

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* 29. Number of those appeals with a mixed disposition:

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* 30. Number of those appeals withdrawn prior to completion:

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* 31. Total Number of Independent external review appeals requested and completed in the 2024 Calendar year:

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* 32. Number of those appeals where carrier’s position was upheld:

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* 33. Number of those appeals decided in favor of consumer:

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* 34. Number of those appeals with a mixed disposition:

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* 35. Number of those appeals withdrawn prior to completion:

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* 36. Comments on Group Coverage:

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