# C.R.S. § 10-16-104.2: 10-16-104.2. Coverage for contraception - rules - definitions > Colorado · Statutes · In force URL: https://www.frixlaw.com/law-library/statutes/STATE_CO_T10_A16_P1_S10-16-104.2 ## Section - **Citation:** C.R.S. § 10-16-104.2 - **Heading:** 10-16-104.2. Coverage for contraception - rules - definitions - **Jurisdiction:** Colorado - **Kind:** Statutes - **Status:** In force - **Text as of:** August 14, 2026 - **Source:** Compiled text - **Location:** CO Code / Title 10 / Article 16 / Part 1 / Section 10-16-104.2 ## Text 10-16-104.2. Coverage for contraception - rules - definitions. (1) As used in this section, unless the context otherwise requires: (a) "Carrier" means a carrier offering a health benefit plan. (b) "Contraception" has the same meaning as "contraceptive" or "contraception" set forth in section 2-4-401 (1.5). (c) "Dispensing entity" means a pharmacy, other outlet, or other facility registered by the state board of pharmacy under part 1 of article 280 of title 12 that dispenses or furnishes contraception. (2) As part of the coverage required for contraception pursuant to section 10-16-104 (3)(a)(I), (18), or (18.1), as applicable, a carrier or a pharmacy benefit management firm acting on behalf of the carrier shall provide coverage for, and shall reimburse a provider or an in-network dispensing entity for, the single dispensing or furnishing of contraception intended to last the covered person for a duration of twelve months, as permitted by the covered person's prescription, dispensed or furnished at one time, unless requested otherwise by the covered person. (3) A carrier or pharmacy benefit management firm acting on behalf of the carrier shall: (a) Allow for the continuous use of clinically appropriate contraception as determined by the prescribing provider; (b) Reimburse a provider or an in-network dispensing entity per unit for dispensing or furnishing contraception; (c) Not implement step therapy, prior authorization, or other utilization management practices, including quantity or fill limits, for contraception coverage if the practice would result in a covered person receiving less than a twelve-months' duration of contraception dispensed or furnished either at one time or, if requested by the covered person at the point of dispensing or furnishing, over a twelve-month period; (d) Include an alternative prescribed contraception without prior authorization, step therapy, or cost sharing if, in the determination and judgment of the prescribing provider, the alternative prescribed contraception is medically necessary; (e) Make available an easily accessible, timely, and transparent exceptions process for a covered person to obtain coverage, without cost sharing, for medically necessary contraception that is not otherwise included in the formulary or available without cost sharing; (f) Not require a prescription for coverage of FDA-approved, -cleared, or -granted over-the-counter contraception; and (g) Include point-of-sale coverage for over-the-counter contraception at in-network dispensing entities without prior authorization, step therapy, utilization management, or cost sharing. (4) (a) Carriers shall report annually to the commissioner regarding the coverage of contraception required pursuant to section 10-16-104 (3)(a)(I), (18), or (18.1). At a minimum, the reporting requirements must include annual reporting of data relating to contraception coverage provided in the previous calendar year. (b) For purposes of the carrier's required reporting to the commissioner pursuant to subsection (4)(a) of this section, a pharmacy benefit management firm acting on behalf of a carrier shall annually provide data to the carrier relating to contraception coverage in the previous calendar year, and the carrier shall include the data provided by a pharmacy benefit management firm in its annual report required by subsection (4)(a) of this section. (5) The commissioner may promulgate rules to implement this section. ## Nearby sections - [C.R.S. § 10-16-101 10-16-101. Short title](https://www.frixlaw.com/law-library/statutes/STATE_CO_T10_A16_P1_S10-16-101.md) - [C.R.S. § 10-16-102 10-16-102. Definitions](https://www.frixlaw.com/law-library/statutes/STATE_CO_T10_A16_P1_S10-16-102.md) - [C.R.S. § 10-16-103 10-16-103. Proposal of mandatory health-care coverage provisions](https://www.frixlaw.com/law-library/statutes/STATE_CO_T10_A16_P1_S10-16-103.md) - [C.R.S. § 10-16-103.3 10-16-103.3. Commission on mandated health insurance benefits - cash fund - purpose - creatio](https://www.frixlaw.com/law-library/statutes/STATE_CO_T10_A16_P1_S10-16-103.3.md) - [C.R.S. § 10-16-103.4 10-16-103.4. Essential health benefits - requirements - rules](https://www.frixlaw.com/law-library/statutes/STATE_CO_T10_A16_P1_S10-16-103.4.md) - [C.R.S. § 10-16-103.5 10-16-103.5. Payment of premiums - required term in contract - rules - definition](https://www.frixlaw.com/law-library/statutes/STATE_CO_T10_A16_P1_S10-16-103.5.md) - [C.R.S. § 10-16-103.6 10-16-103.6. Copayment-only prescription payment structures - required inclusion in health be](https://www.frixlaw.com/law-library/statutes/STATE_CO_T10_A16_P1_S10-16-103.6.md) - [C.R.S. § 10-16-104 10-16-104. Mandatory coverage provisions - definitions - rules - applicability](https://www.frixlaw.com/law-library/statutes/STATE_CO_T10_A16_P1_S10-16-104.md) - [C.R.S. § 10-16-104.1 10-16-104.1. Prohibition on discrimination for organ transplants based solely on disability -](https://www.frixlaw.com/law-library/statutes/STATE_CO_T10_A16_P1_S10-16-104.1.md) - [C.R.S. § 10-16-104.2 10-16-104.2. Coverage for contraception - rules - definitions](https://www.frixlaw.com/law-library/statutes/STATE_CO_T10_A16_P1_S10-16-104.2.md) - [C.R.S. § 10-16-104.3 10-16-104.3. Health coverage for persons under twenty-six years of age - coverage for student](https://www.frixlaw.com/law-library/statutes/STATE_CO_T10_A16_P1_S10-16-104.3.md) - [C.R.S. § 10-16-104.4 10-16-104.4. Child-only plans - legislative declaration - open enrollment - reporting require](https://www.frixlaw.com/law-library/statutes/STATE_CO_T10_A16_P1_S10-16-104.4.md) - [C.R.S. § 10-16-104.5 10-16-104.5. Autism - treatment - not mental illness - repeal](https://www.frixlaw.com/law-library/statutes/STATE_CO_T10_A16_P1_S10-16-104.5.md) - [C.R.S. § 10-16-104.6 10-16-104.6. Off-label use of cancer drugs](https://www.frixlaw.com/law-library/statutes/STATE_CO_T10_A16_P1_S10-16-104.6.md) --- Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_CO_T10_A16_P1_S10-16-104.2. Check the current official text before relying on it. Not legal advice.