Workers' compensation insurance - deductibles - definition

Colo. Rev. Stat. § 8-44-111, under Labor and Industry.

Colo. Rev. Stat. § 8-44-111

(1) (a) Any employer may agree, as a condition of any contract for the insurance of compensation and benefits as provided in articles 40 to 47 of this title or against liability therefor, to pay an amount not to exceed the split point approved by the commissioner of insurance per claim toward the total amount of any claim payable under articles 40 to 47 of this title. The amount of premium to be paid by an employer who agrees to pay such deductible shall be reduced based upon such deductible in an amount determined by the insurance carrier.

(b) As used in this subsection (1), split point means the amount of each loss approved by the commissioner of insurance that an insurer may apply as the primary loss in each workers' compensation claim. The full amount of primary losses counts in each employer's experience modification calculation that determines the employer's percentage credit or surcharge on workers' compensation coverage. The loss amount above the split point is excess loss and constitutes part of each employer's experience modification calculation.

(c) Nothing in this section abrogates an employer's responsibility to pay the full amount of any compensation and benefits due under articles 40 to 47 of this title. It is a violation of this title for an employer or, if insured, the insurer to require any employee to pay any part of the compensation and benefits due under articles 40 to 47 of this title.

(d) It is a violation of this title for an employer or, if insured, the insurer to require an employee to use any other type of insurance, regardless of whether it is provided as a benefit of employment, or any other employment benefit, to pay any portion of any compensation and benefits due under articles 40 to 47 of this title.

(e) Nothing in this subsection (1) allows a carrier to stop offering no-deductible policies.

(1.5) Whenever any insurer, including Pinnacol Assurance created in section 8-45-101, issues a workers' compensation policy in this state, and annually thereafter, the insurer must issue a policy including the deductible provision if requested by the insured employer; except that the commissioner shall promulgate rules establishing criteria to allow the insurer to deny a deductible policy to an employer based on financial inability to reimburse the insurer for the deductible plan selected.

(2) The existence of an insurance contract with a deductible or the fact of payment as a result of a deductible shall not affect the requirement of an employer to report an injury or death to the division as required in section 8-43-103 (1).

(3) The deductible amounts paid by any employer under the provisions of this section shall be excluded from consideration by insurance carriers authorized to transact business in Colorado, including Pinnacol Assurance, which insures employers against liability for compensation under the provisions of articles 40 to 47 of this title, in establishing the modification factors based upon experience used by such insurance carriers to determine premiums. For purposes of experience modifications, medical only claims shall be calculated in the same manner as claims with indemnity payments.

(4) Every insurance carrier authorized to transact business in Colorado, including Pinnacol Assurance, which insures employers against liability for compensation under the provisions of articles 40 to 47 of this title, shall clearly and conspicuously inform policyholders of the availability of the deductible option specified in subsection (1) of this section.

Source: L. 90: Entire article R&RE, p. 523, � 1, effective July 1. L. 91: (3) added, p. 1331, � 44, effective July 1. L. 92: Entire section amended, p. 1816, � 1, effective July 1. L. 93: (1.5) added, p. 2085, � 4, effective July 1. L. 2002: (1.5), (3), and (4) amended, p. 1886, � 40, effective July 1. L. 2010: (3) amended, (SB 10-112), ch. 52, p. 196, � 1, effective January 1, 2011. L. 2013: (1) amended, (HB 13-1025), ch. 140, p. 455, � 1, effective July 1.

Editor's note: This section is similar to former � 8-44-116 as it existed prior to 1990.

8-44-112. Surcharge on workers' compensation insurance premiums - workers' compensation cash fund - repeal. (1) (a) Notwithstanding the provisions of sections 10-3-209 (1)(c) and 10-6-128 (3), C.R.S., for the purpose of offsetting the direct and indirect costs of the administration of the workers' compensation system, every person, partnership, association, and corporation, whether organized under the laws of this state or of any other state or country, every mutual company or association, every captive insurance company, and every other insurance carrier, including Pinnacol Assurance, insuring employers in this state against liability for personal injury to their employees or death caused thereby under the provisions of the Workers' Compensation Act of Colorado shall, as provided in this section, pay a surcharge upon the premiums received, whether in cash or not, in this state, or on account of business done in this state, for such insurance in this state, at a rate established by the director by rule, which surcharge shall be reviewed and adjusted annually based upon appropriations made for the direct and indirect costs of the administration of the workers' compensation system, as provided in subsection (7) of this section. Such insurance carriers shall be credited with all canceled or returned premiums actually refunded during the year of such insurance.

(b) (I) For the purpose of funding the direct and indirect costs of the activities of the division related to the Workers' Compensation Cost Containment Act, article 14.5 of this title, there shall be added to the surcharge imposed pursuant to paragraph (a) of this subsection (1) an increment not to exceed three-hundredths of one percent upon the premiums received, said surcharge to be reviewed and adjusted annually and paid over to the division in the same manner as specified in this section for the surcharge.

(II) Notwithstanding any other provisions of this section, no employer acting as a self-insurer under the provisions of the Workers' Compensation Act of Colorado shall be subject to the increment added to the surcharge pursuant to subparagraph (I) of this paragraph (b).

(III) All moneys collected pursuant to subparagraph (I) of this paragraph (b) shall be transmitted to the state treasurer, who shall credit the same to the cost containment fund, created in section 8-14.5-108.

(2) Every such insurance carrier shall, on July 1, 1987, and semiannually thereafter, make a return, verified by affidavits of its president and secretary, or other chief officers or agents, to the division of workers' compensation, stating the amount of all such premiums received and credits granted during the period covered by such return. Every insurance carrier required to make such return shall file the same with the division within thirty days after the close of the period covered thereby and shall, at the same time, pay to the division of workers' compensation a surcharge ascertained as provided in subsection (1) of this section, less return premiums on canceled policies.

(3) Every employer acting as a self-insurer under the provisions of the Workers' Compensation Act of Colorado shall, under oath, report to the division of workers' compensation the business payroll in such form as may be prescribed by the director and at the times in this section provided for premium reports by insurance companies in subsection (2) of this section. The division shall assess against such payroll a surcharge for the purposes of this section ascertained as provided in subsection (2) of this section on the basic premiums chargeable against the same or most similar industry or business taken from the manual insurance rates, including any discount or experience modification allowed, chargeable by the Pinnacol Assurance fund, and, upon receipt of notice from the division of workers' compensation of the surcharge so assessed, every such self-insurer shall, within thirty days after the receipt of such notice, pay to the division of workers' compensation the surcharge so assessed.

(4) If any such insurance carrier or self-insurer fails or refuses to make the return required by this article, the director shall assess the surcharge against such insurance carrier or self-insurer at the rate provided for in this section on such amount of premium as the director may deem just, and the proceedings thereof shall be the same as if the return had been made.

(5) If any such insurance carrier or self-insurer withdraws from business in this state before the surcharge falls due as provided in this section, or fails or neglects to pay such surcharge, the director shall at once proceed to collect the same; and the director is authorized to employ such legal processes as may be necessary for that purpose. Suit shall be brought by the director in any of the courts of this state having jurisdiction.

(6) The director, in the enforcement of this section, shall have all of the powers granted to said director in the Workers' Compensation Act of Colorado, and any insurance carrier or self-insurer violating any of the provisions of this section, or failing to pay the surcharge imposed in this section, is guilty of violation of said act and subject to the penalties therein prescribed.

(7) (a) All money collected pursuant to this section shall be transmitted to the state treasurer, who shall credit the same to the workers' compensation cash fund, which fund is created. The money in the workers' compensation cash fund is subject to annual appropriation by the general assembly for the direct and indirect costs of the administration of the Workers' Compensation Act of Colorado, articles 40 to 47 of this title 8.

(a.5) (I) For state fiscal years commencing on or before July 1, 2024, and on or after July 1, 2026, the state treasurer shall credit all interest and income derived from the deposit and investment of money in the workers' compensation cash fund to the workers' compensation cash fund.

(II) For the state fiscal year commencing on July 1, 2025, in accordance with section 24-36-114 (1), the state treasurer shall credit all interest and income derived from the deposit and investment of money in the workers' compensation cash fund to the general fund.

(III) (A) On June 30, 2025, the state treasurer shall transfer seven hundred thirty-three thousand one hundred forty-seven dollars from the workers' compensation cash fund to the general fund.

(B) This subsection (7)(a.5)(III) is repealed, effective July 1, 2026.

(b) and (c) Repealed.

(d) The workers' compensation cash fund is exempt from the limitations set forth in section 24-75-402.

(e) Repealed.

Source: L. 90: Entire article R&RE, p. 524, � 1, effective July 1. L. 92: (7) amended, p. 1828, � 2, effective May 19. L. 93: (1)(b) RC&RE, p. 1459, � 1, effective June 6; (1)(b) RC&RE, p. 1723, � 2, effective June 6. L. 99: (7) amended, p. 617, �4, effective August 4. L. 2002: (1)(a) and (3) amended, p. 1886, � 41, effective July 1. L. 2003: (7) amended, p. 454, � 2, effective March 5. L. 2009: (7)(c) added, (SB 09-208), ch. 149, p. 618, � 1, effective April 20. L. 2018: (7)(d) added, (HB 18-1429), ch. 398, p. 2362, � 1, effective June 6. L. 2020: (7)(e) added, (HB 20-1406), ch. 178, p. 811, � 2, effective June 29. L. 2021: (7)(b), (7)(c), and (7)(e) repealed, (SB 21-266), ch. 423, p. 2794, � 3, effective July 2. L. 2025: (7)(a) amended and (7)(a.5) added, (SB 25-317), ch. 385, p. 2140, � 3, effective June 3.

Editor's note: (1) This section is similar to former � 8-44-111 as it existed prior to 1990.

(2) Subsection (1)(b)(IV) provided for the repeal of subsection (1)(b), effective July 1, 1992. (See L. 90, p. 524.) Subsection (1)(b) has subsequently been reenacted.

(3) Subsection (7)(c) required the state treasurer to transfer $15,700,000 from the workers' compensation cash fund to the general fund on March 30, 2009; however, Senate Bill 09-208, which enacted the provision, did not take effect until April 20, 2009.

Cross references: For the legislative declaration in SB 25-317, see section 1 of chapter 385, Session Laws of Colorado 2025.

8-44-113. Data from insurance carriers and self-insured employers related to workers' compensation - studies related to workers' compensation system. (Repealed)

Source: L. 91: Entire section added, p. 1331, � 45, effective July 1. L. 93: (1), (2), (3), and (4) amended, p. 1276, � 1, effective June 6. L. 97: (4) RC&RE p. 529, � 1, effective April 24; (1)(b) repealed, p. 1475, � 10, effective June 3. L. 2002: (1)(a) amended, p. 1887, � 42, effective July 1; (1)(a) amended, p. 1467, � 21, effective October 1. L. 2003: (1)(a), (1)(c), and IP(4)(b) amended, p. 1556, � 1, effective May 1. L. 2005: Entire section repealed, p. 1248, � 1, effective July 1.