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.
AMENDMENT
LCO No.: 7656
File Copy No.: 363
Senate Calendar No.: 230
Primary Analyst: AN 4/28/21
Contributing Analyst(s): ()
OFA Fiscal Note
State Impact:
Agency Affected Fund-Effect FY 22 $ FY 23 $ FY 24 $
State
Comptroller -
Fringe Benefits
1
GF - Potential
Cost
None None See Below
Note: GF=General Fund
Municipal Impact:
Municipalities Effect FY 22 $ FY 23 $ FY 24 $
Various
Municipalities
Potential
Cost
None None Minimal
Explanation
The amendment strikes the underlying bill and its associated fiscal
impact.
For plan years starting on and after January 1, 2024, the amendment
prohibits health carriers and pharmacy benefits managers from using
1
The fringe benefit costs for most state employees are budgeted centrally in accounts
administered by the Comptroller. The estimated active employee fringe benefit cost
associated with most personnel changes is 41.3% of payroll in FY 22 and FY 23. 2021SB-01003-R00LCO07656-FNA.DOCX Page 2 of 2
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
2
. Any increased cost will be reflected in
premiums for plan years starting on and after January 1, 2024. 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 preceding Fiscal Impact statement is prepared for the benefit of the members of the General Assembly, solely
for the purposes of information, summarization and explanation and does not represent the intent of the General
Assembly or either chamber thereof for any purpose. In general, fiscal impacts are based upon a variety of
informational sources, including the analyst’s professional knowledge. Whenever applicable, agency data is
consulted as part of the analysis, however final products do not necessarily reflect an assessment from any
specific department.
2
There is evidence that the price of couponed drugs rises at a faster rate than non-
couponed drugs. Medicare does not permit manufacturer coupons.