HB 1219

Bill Subjects

Insurance Generally Public Officers And Employees

Abstract

Requires a state employee health plan, a policy of accident and sickness insurance, a health maintenance organization contract, an employee welfare benefit plan, or any other health plan that is compliant with federal law to only offer health plans that do not require a covered individual to: (1) pay a deductible; or (2) pay more than the amount of the copayment or coinsurance specified in the plan's summary of benefits and coverage; with respect to a prescription drug. Prohibits a state employee health plan, a policy of accident and sickness insurance, or a health maintenance organization contract from requiring an insured to pay a cost sharing requirement of more than $250 for a 30 day supply of an individual prescription drug. Requires a state employee health plan, a policy of accident and sickness insurance, and a health maintenance organization contract to include any amounts paid by a covered individual or on behalf of a covered individual when calculating the covered individual's cost sharing requirement. Provides that the cost sharing requirement for a prescription drug under a state employee health plan, a policy of accident and sickness insurance, or a health maintenance organization contract will be calculated at the point of sale and based on a price that is reduced by an amount equal to at least 75% of all rebates received by the insurer in connection with the dispensing or administration of the prescription drug.