OFFICE OF FISCAL ANALYSIS
Legislative Office Building, Room 5200
Hartford, CT 06106 (860) 240-0200
http://www.cga.ct.gov/ofa
SB-1003
AN ACT PROHIBITING CERTAIN HEALTH CARRIERS AND
PHARMACY BENEFITS MANAGERS FROM EMPLOYING COPAY
ACCUMULATOR PROGRAMS.
Primary Analyst: AN 4/5/21
Contributing Analyst(s):
OFA Fiscal Note
State Impact:
Agency Affected Fund-Effect FY 22 $ FY 23 $
State Comptroller - Fringe
Benefits
GF - Potential
Cost
Minimal Minimal
Note: GF=General Fund
Municipal Impact:
Municipalities Effect FY 22 $ FY 23 $
Various Municipalities Potential
Cost
Minimal Minimal
Explanation
The bill prohibits health carriers and pharmacy benefits managers
from using copay accumulator programs, thereby potentially
increasing the cost of providing benefits to the state employee and
retiree health plan and municipalities.
Copay accumulator programs prohibit manufacturer coupons that
are provided to enrollees by prescription manufacturers from being
applied to the out of pocket cost for the brand name drug. By
prohibiting such programs, the bill may increase costs depending on
the negotiation of contracts between the state and municipalities and
their respective pharmacy benefit managers
1
. Any increased cost will
be reflected in premiums for plan years starting on and after January 1,
1
There is evidence that the price of couponed drugs rises at a faster rate than non-
couponed drugs. Medicare does not permit manufacturer coupons. 2021SB-01003-R000363-FN.DOCX Page 2 of 2
2022. It is anticipated that the net impact to premiums as a result of the
bill will be minimal relative to the overall employer share of the
premium.
The Out Years
The annualized ongoing fiscal impact identified above would
continue into the future subject to the utilization of coupons used for
brand name drugs by state and municipal enrollees.