Connecticut 2022 Regular Session

Connecticut Senate Bill SB00357 Compare Versions

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Version 2 (New)

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7	7		General Assembly Raised Bill No. 357
8	8		February Session, 2022
9	9		LCO No. 2234
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12	12		Referred to Committee on INSURANCE AND REAL ESTATE
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15	15		Introduced by:
16	16		(INS)
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20	21		AN ACT CONCERNING COPAY ACCUMULATOR PROGRAMS AND
21	22		HIGH DEDUCTIBLE HEALTH PLANS.
22	23		Be it enacted by the Senate and House of Representatives in General
23	24		Assembly convened:
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25	26		Section 1. Section 38a-477ff of the 2022 supplement to the general 1
26	27		statutes is repealed and the following is substituted in lieu thereof 2
27	28		(Effective from passage and applicable to policies delivered, issued for delivery, 3
28	29		renewed, amended or continued on or after January 1, 2022): 4
29	30		(a) Each insurer, health care center, hospital service corporation, 5
30	31		medical service corporation, fraternal benefit society or other entity that 6
31	32		delivers, issues for delivery, renews, amends or continues an individual 7
32	33		or group health insurance policy in this state on or after January 1, 2022, 8
33	34		providing coverage of the type specified in subdivisions (1), (2), (4), (11) 9
34	35		and (12) of section 38a-469 shall, when calculating an insured's liability 10
35	36		for a coinsurance, copayment, deductible or other out-of-pocket expense 11
36	37		for a covered benefit, give credit for any discount provided or payment 12
37	38		made by a third party for the amount of, or any portion of the amount 13
38	39		of, the coinsurance, copayment, deductible or other out-of-pocket 14
39	40		expense for the covered benefit. 15 Raised Bill No. 357
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46	46		(b) The provisions of subsection (a) of this section shall apply to a 16
47	47		high deductible health plan, as that term is used in subsection (f) of 17
48	48		section 38a-493 or subsection (f) of section 38a-520, as applicable, to the 18
49	49		maximum extent permitted by federal law, except if such plan is used 19
50	50		to establish a medical savings account or an Archer MSA pursuant to 20
51	51		Section 220 of the Internal Revenue Code of 1986, or any subsequent 21
52	52		corresponding internal revenue code of the United States, as amended 22
53	53		from time to time, or a health savings account pursuant to Section 223 23
54	54		of said Internal Revenue Code, as amended from time to time, the 24
55	55		provisions of said subsection (a) shall apply to such plan to the 25
56	56		maximum extent that (1) is permitted by federal law, and (2) does not 26
57	57		disqualify such account for the deduction allowed under said Section 27
58	58		220 or 223, as applicable. 28
59	59		Sec. 2. Section 38a-477gg of the 2022 supplement to the general 29
60	60		statutes is repealed and the following is substituted in lieu thereof 30
61	61		(Effective from passage and applicable to contracts entered into on or after 31
62	62		January 1, 2022): 32
63	63		(a) On and after January 1, 2022, each contract entered into between 33
64	64		a health carrier, as defined in section 38a-591a, and a pharmacy benefits 34
65	65		manager, as defined in section 38a-479aaa, for the administration of the 35
66	66		pharmacy benefit portion of a health benefit plan in this state on behalf 36
67	67		of plan sponsors shall require that the pharmacy benefits manager, 37
68	68		when calculating an insured's or enrollee's liability for a coinsurance, 38
69	69		copayment, deductible or other out-of-pocket expense for a covered 39
70	70		prescription drug benefit, give credit for any discount provided or 40
71	71		payment made by a third party for the amount of, or any portion of the 41
72	72		amount of, the coinsurance, copayment, deductible or other out-of-42
73	73		pocket expense for the covered prescription drug benefit. 43
74	74		(b) The provisions of subsection (a) of this section shall apply to a 44
75	75		high deductible health plan, as that term is used in subsection (f) of 45
76	76		section 38a-493 or subsection (f) of section 38a-520, as applicable, to the 46
77	77		maximum extent permitted by federal law, except if such plan is used 47
78	78		to establish a medical savings account or an Archer MSA pursuant to 48 Raised Bill No. 357
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85	84		Section 220 of the Internal Revenue Code of 1986, or any subsequent 49
86	85		corresponding internal revenue code of the United States, as amended 50
87	86		from time to time, or a health savings account pursuant to Section 223 51
88	87		of said Internal Revenue Code, as amended from time to time, the 52
89	88		provisions of said subsection (a) shall apply to such plan to the 53
90	89		maximum extent that (1) is permitted by federal law, and (2) does not 54
91	90		disqualify such account for the deduction allowed under said Section 55
92	91		220 or 223, as applicable. 56
93	92		Sec. 3. Section 38a-478w of the 2022 supplement to the general 57
94	93		statutes is repealed and the following is substituted in lieu thereof 58
95	94		(Effective from passage and applicable to contracts delivered, issued for 59
96	95		delivery, renewed, amended or continued on or after January 1, 2022): 60
97	96		(a) For any contract delivered, issued for delivery, renewed, amended 61
98	97		or continued in this state on or after January 1, 2022, each managed care 62
99	98		organization shall, when calculating an enrollee's liability for a 63
100	99		coinsurance, copayment, deductible or other out-of-pocket expense for 64
101	100		a covered benefit, give credit for any discount provided or payment 65
102	101		made by a third party for the amount of, or any portion of the amount 66
103	102		of, the coinsurance, copayment, deductible or other out-of-pocket 67
104	103		expense for the covered benefit. 68
105	104		(b) The provisions of subsection (a) of this section shall apply to a 69
106	105		high deductible health plan, as that term is used in subsection (f) of 70
107	106		section 38a-493 or subsection (f) of section 38a-520, as applicable, to the 71
108	107		maximum extent permitted by federal law, except if such plan is used 72
109	108		to establish a medical savings account or an Archer MSA pursuant to 73
110	109		Section 220 of the Internal Revenue Code of 1986, or any subsequent 74
111	110		corresponding internal revenue code of the United States, as amended 75
112	111		from time to time, or a health savings account pursuant to Section 223 76
113	112		of said Internal Revenue Code, as amended from time to time, the 77
114	113		provisions of said subsection (a) shall apply to such plan to the 78
115	114		maximum extent that (1) is permitted by federal law, and (2) does not 79
116	115		disqualify such account for the deduction allowed under said Section 80
117	116		220 or 223, as applicable. 81 Raised Bill No. 357
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124	122		This act shall take effect as follows and shall amend the following
125	123		sections:
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127	125		Section 1 from passage and
128	126		applicable to policies
129	127		delivered, issued for
130	128		delivery, renewed,
131	129		amended or continued on
132	130		or after January 1, 2022
133	131		38a-477ff
134	132		Sec. 2 from passage and
135	133		applicable to contracts
136	134		entered into on or after
137	135		January 1, 2022
138	136		38a-477gg
139	137		Sec. 3 from passage and
140	138		applicable to contracts
141	139		delivered, issued for
142	140		delivery, renewed,
143	141		amended or continued on
144	142		or after January 1, 2022
145	143		38a-478w
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147		-	INS Joint Favorable
	145	+	Statement of Purpose:
	146	+	To specify that certain cost-sharing requirements apply to high
	147	+	deductible health plans to the maximum extent that (1) is permitted by
	148	+	federal law, and (2) and does not disqualify corresponding health or
	149	+	medical savings accounts for federal tax deductions.
	150	+	[Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, except
	151	+	that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is not
	152	+	underlined.]
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