Connecticut 2022 2022 Regular Session

Connecticut Senate Bill SB00357 Comm Sub / Analysis

Filed 04/06/2022

                     
Researcher: JKL 	Page 1 	4/6/22 
 
 
 
OLR Bill Analysis 
SB 357  
 
AN ACT CONCERNING COPAY ACCUMULATOR PROGRAMS AND 
HIGH DEDUCTIBLE HEALTH PLANS.  
 
SUMMARY 
This bill applies the state’s copay accumulator program prohibition 
(see BACKGROUND) to high deductible health plans (HDHPs) to the 
maximum extent permitted by federal law. It applies it to HDHPs that 
are used to establish a health savings account (HSA), medical savings 
account (MSA), or Archer MSA to the maximum extent permitted by 
federal law and that does not disqualify the insured from receiving the 
associated federal tax benefits.  
Under federal law, an HDHP is a health plan that satisfies certain 
requirements, including those related to minimum deductibles and 
maximum out-of-pocket expenses. Individuals with eligible HDHPs 
may make pre-tax contributions to an HSA, MSA, or Archer MSA and 
use the account for qualified medical expenses.  
According to the Internal Revenue Service (IRS), an individual 
covered by an HDHP who also uses a discount card for health care 
services or products, may still contribute to an HSA as long as the 
individual must pay the costs of the covered health care until the 
HDHP’s minimum annual deductible is satisfied (IRS Notice 2021-0014). 
EFFECTIVE DATE: Upon passage, and applicable to policies or 
contracts delivered, issued, renewed, amended, or continued on or after 
January 1, 2022. 
BACKGROUND 
Copay Accumulator Program Prohibition 
PA 21-14, which took effect January 1, 2022, requires certain health 
carriers (e.g., insurers and HMOs) and pharmacy benefits managers,  2022SB-00357-R000355-BA.DOCX 
 
Researcher: JKL 	Page 2 	4/6/22 
 
when calculating a covered individual’s cost sharing liability (e.g., 
coinsurance, copayment, or deductible) for a covered benefit, to credit 
discounts provided and payments made by a third party for any portion 
of the cost sharing. Thus, it prohibits copay accumulator programs, 
under which drug manufacturer discount cards, coupons, and copay 
assistance generally do not apply toward a covered individual’s cost 
sharing responsibility.  
COMMITTEE ACTION 
Insurance and Real Estate Committee 
Joint Favorable 
Yea 17 Nay 0 (03/22/2022)