DOI Request for Information - Costs and Benefits of Requiring Health Insurance Coverage of Annual Mental Health Wellness Exam


The Division of Insurance (Division) is issuing a Request for Information (RFI) on the costs and benefits associated with requiring health insurance coverage for an annual mental health wellness examination of up to sixty (60) minutes in length with a qualified mental health provider without consumer cost-sharing. The examination may include services such as a behavioral health screening; education and consultation on healthy lifestyle changes; referrals to ongoing treatment, mental health services and other supports; and discussion of potential options for medication. 

This coverage proposal derives from HB20-1086, concerning an annual mental health wellness examination. Please refer to the legislation for additional information.

Responses to this RFI should be provided to the Division no later than close of business on Wednesday, September 30, 2020. The Division will hold a virtual public meeting from 9:00 am to 11:00 am on Wednesday, October 21, 2020, to take additional comments from the public for consideration in evaluating the impacts of requiring carriers to provide coverage for a mental health wellness examination. Information on how to attend the virtual public meeting will be sent out in a later communication.

Based on the information received in response to this RFI, and the information gathered at the public meeting, the Division will prepare a report on the costs and benefits of a mental health wellness examination as described above. 

Request for Information:

The Division requests information on the financial impact, the health benefits of the services, and the medical efficacy of the services proposed. Specifically, the Division seeks the following information: 

  1. The anticipated impact on premiums in the fully insured individual, small group, and large group markets and the underlying assumptions on which the impact is based; 
  2. The anticipated impact on consumer out of pocket costs and the underlying assumptions on which the impact is based; 
  3. The anticipated impact on the total cost of health care services, including potential benefits or savings to insurers, consumers, and employers resulting from prevention or early detection of the health condition related to such coverage, and the underlying assumptions for that determination;
  4. The potential health benefits of the proposed coverage and the extent to which scientific evidence exists regarding the potential health benefits;
  5. The extent to which the proposed coverage would be a substitute for more expensive or less safe treatment;
  6. The estimated change in utilization as a result of providing the coverage;
  7. The extent to which insurance coverage for the proposed coverage already exists or, if no coverage exists, the extent to which the lack of coverage results in inadequate health care or financial hardship for Coloradans; 
  8. The extent to which the proposed benefit would result in changes to existing benefits and/or reduce access to other health benefits; and 
  9. Any other data responsive to Colorado Revised Statute Section 10-16-103 or other information that the respondent believes relevant to the analysis. 

Responses to this RFI should be submitted to [email protected].  

For questions regarding this RFI, please contact Debra Judy at [email protected].