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.
As Amended by Senate "A" (LCO 7236)
Senate Calendar No.: 230
Primary Analyst: AN 4/29/21
Contributing Analyst(s):
OFA Fiscal Note
State Impact:
Agency Affected Fund-Effect FY 22 $ FY 23 $
State Comptroller - Fringe
Benefits
1
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 as amended 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 as amended may increase costs
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-R01-FN.DOCX Page 2 of 2
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, 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.
Senate "A" specifies that any discounts provided by manufacturers
shall be included in the calculations used to determine the out of
pocket cost for prescription drugs and does not result in a fiscal
impact.
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.
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.