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General Assembly Substitute Bill No. 6436
January Session, 2025
AN ACT CONCERNING REVISIONS TO THE HEALTH INSURANCE
STATUTES.
Be it enacted by the Senate and House of Representatives in General
Assembly convened:
Section 1. Subsection (b) of section 38a-21 of the general statutes is 1
repealed and the following is substituted in lieu thereof (Effective October 2
1, 2025): 3
(b) (1) There is established within the Insurance Department a health 4
benefit review program for the review and evaluation of any mandated 5
health benefit that is requested by the joint standing committee of the 6
General Assembly having cognizance of matters relating to insurance. 7
Such program shall be funded by the Insurance Fund established under 8
section 38a-52a. The commissioner shall be authorized to make 9
assessments in a manner consistent with the provisions of chapter 698 10
for the costs of carrying out the requirements of this section. Such 11
assessments shall be in addition to any other taxes, fees and moneys 12
otherwise payable to the state. The commissioner shall deposit all 13
payments made under this section with the State Treasurer. The moneys 14
deposited shall be credited to the Insurance Fund and shall be accounted 15
for as expenses recovered from insurance companies. Such moneys shall 16
be expended by the commissioner to carry out the provisions of this 17
section and section 2 of public act 09-179. 18
(2) The commissioner [shall contract with The University of 19 Substitute Bill No. 6436
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Connecticut Center for Public Health and Health Policy to conduct] may 20
engage the services of any actuary, actuarial firm, quality improvement 21
clearinghouse, health policy research organization or any other 22
independent expert as the commissioner deems necessary to assist the 23
commissioner in the review and evaluation of any mandated health 24
benefit review requested pursuant to subsection (c) of this section. [The 25
director of said center may engage the services of an actuary, quality 26
improvement clearinghouse, health policy research organization or any 27
other independent expert, and may engage or consult with any dean, 28
faculty or other personnel said director deems appropriate within The 29
University of Connecticut schools and colleges, including, but not 30
limited to, The University of Connecticut (A) School of Business, (B) 31
School of Dental Medicine, (C) School of Law, (D) School of Medicine, 32
and (E) School of Pharmacy.] 33
Sec. 2. Section 38a-479ppp of the general statutes is repealed and the 34
following is substituted in lieu thereof (Effective from passage): 35
(a) Not later than [February 1, 2025] March 1, 2026, and annually 36
thereafter, each pharmacy benefits manager shall file a report with the 37
commissioner for the immediately preceding calendar year. The report 38
shall contain the following information for health carriers that 39
delivered, issued for delivery, renewed, amended or continued health 40
care plans that included a pharmacy benefit managed by the pharmacy 41
benefits manager during such calendar year: 42
(1) The aggregate dollar amount of all rebates concerning drug 43
formularies used by such health carriers that such manager collected 44
from pharmaceutical manufacturers that manufactured outpatient 45
prescription drugs that (A) were covered by such health carriers during 46
such calendar year, and (B) are attributable to patient utilization of such 47
drugs during such calendar year; and 48
(2) The aggregate dollar amount of all rebates, excluding any portion 49
of the rebates received by such health carriers, concerning drug 50
formularies that such manager collected from pharmaceutical 51 Substitute Bill No. 6436
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manufacturers that manufactured outpatient prescription drugs that (A) 52
were covered by such health carriers during such calendar year, and (B) 53
are attributable to patient utilization of such drugs by covered persons 54
under such health care plans during such calendar year. 55
(b) The commissioner shall establish a standardized form for 56
reporting information pursuant to subsection (a) of this section after 57
consultation with pharmacy benefits managers. The form shall be 58
designed to minimize the administrative burden and cost of reporting 59
on the department and pharmacy benefits managers. 60
(c) All information submitted to the commissioner pursuant to 61
subsection (a) of this section shall be exempt from disclosure under the 62
Freedom of Information Act, as defined in section 1-200, except to the 63
extent such information is included on an aggregated basis in the report 64
required by subsection (d) of this section. The commissioner shall not 65
disclose information submitted pursuant to subdivision (1) of 66
subsection (a) of this section, or information submitted pursuant to 67
subdivision (2) of said subsection in a manner that (1) is likely to 68
compromise the financial, competitive or proprietary nature of such 69
information, or (2) would enable a third party to identify a health care 70
plan, health carrier, pharmacy benefits manager, pharmaceutical 71
manufacturer, or the value of a rebate provided for a particular 72
outpatient prescription drug or therapeutic class of outpatient 73
prescription drugs. 74
(d) Not later than [March 1, 2025] April 1, 2026, and annually 75
thereafter, the commissioner shall submit a report, in accordance with 76
section 11-4a, to the joint standing committee of the General Assembly 77
having cognizance of matters relating to insurance. The report shall 78
contain (1) an aggregation of the information submitted to the 79
commissioner pursuant to subsection (a) of this section for the 80
immediately preceding calendar year, and (2) such other information as 81
the commissioner, in the commissioner's discretion, deems relevant for 82
the purposes of this section. Not later than ten days prior to the 83
submission of the annual report pursuant to the provisions of this 84 Substitute Bill No. 6436
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subsection, the commissioner shall provide each pharmacy benefits 85
manager and any third party affected by submission of such report 86
required by this subsection with a written notice describing the content 87
of the report. 88
(e) The commissioner may impose a penalty of not more than seven 89
thousand five hundred dollars on a pharmacy benefits manager for each 90
violation of this section. 91
(f) The commissioner may adopt regulations, in accordance with the 92
provisions of chapter 54, to implement the provisions of this section. 93
Sec. 3. Subsection (c) of section 38a-492w of the general statutes is 94
repealed and the following is substituted in lieu thereof (Effective from 95
passage): 96
(c) The Insurance Commissioner [shall] may adopt regulations, in 97
accordance with chapter 54, to implement the provisions of this section. 98
Sec. 4. Subsection (c) of section 38a-518w of the general statutes is 99
repealed and the following is substituted in lieu thereof (Effective from 100
passage): 101
(c) The Insurance Commissioner [shall] may adopt regulations, in 102
accordance with chapter 54, to implement the provisions of this section. 103
This act shall take effect as follows and shall amend the following
sections:
Section 1 October 1, 2025 38a-21(b)
Sec. 2 from passage 38a-479ppp
Sec. 3 from passage 38a-492w(c)
Sec. 4 from passage 38a-518w(c)
Statement of Legislative Commissioners:
In Section 1(b)(2), "said commissioner" was changed to "the
commissioner", for accuracy.
INS Joint Favorable Subst. -LCO Substitute Bill No. 6436
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