OFFICE OF FISCAL ANALYSIS
Legislative Office Building, Room 5200
Hartford, CT 06106 (860) 240-0200
http://www.cga.ct.gov/ofa
sHB-5386
AN ACT CONCERNING HEALTH INSURANCE COVERAGE FOR
EPINEPHRINE CARTRIDGE INJECTORS, HEALTH CARRIERS AND
PHARMACY BENEFIT MANAGERS.
Primary Analyst: RJW 4/4/22
Contributing Analyst(s): AS
Reviewer: AS
OFA Fiscal Note
State Impact: None
Municipal Impact:
Municipalities Effect FY 23 $ FY 24 $
Various Municipalities STATE
MANDATE
1
- Cost
See Below See Below
Explanation
There is no fiscal impact to the State resulting from the bill, which
requires that epinephrine cartridge injectors be covered under certain
health insurance policies at a total out of pocket cost of $25 or less. The
state employee and retiree health plans already provide coverage in
accordance with the bill. The bill may result in a potential cost to fully
insured municipalities, to the extent that providing coverage below the
out-of-pocket threshold may increase premiums reflected in plan years
beginning on and after January 1, 2023.
In addition, many municipal health plans are recognized as
“grandfathered” health plans under the Affordable Care Act (ACA). It
is unclear what effect the adoption of certain health mandates will have
1
State mandate is defined in Sec. 2-32b(2) of the Connecticut General Statutes, "state
mandate" means any state initiated constitutional, statutory or executive action that
requires a local government to establish, expand or modify its activities in such a way
as to necessitate additional expenditures from local revenues. 2022HB-05386-R000374-FN.DOCX Page 2 of 2
on the grandfathered status of certain municipal plans under ACA.
Pursuant to federal law, municipalities with self-insured plans are
exempt from state insurance mandates.
The Out Years
The annualized ongoing fiscal impact identified above would
continue into the future subject to inflation.