SB 420 FISCAL NOTE Fiscal Review Committee Tennessee General Assembly January 31, 2025 Fiscal Analyst: Chris Higgins | Email: chris.higgins@capitol.tn.gov | Phone: 615-741-2564 SB 420 SUMMARY OF BILL: Establishes that if the calculation of an enrollee's contribution to an applicable cost sharing requirement by an insurer would result in health savings account (HSA) ineligibility under federal law, then the requirement for such calculation applies for HSA-qualified high deductible health plans with respect to the deductible of such a plan only after the enrollee has satisfied the minimum deductible, except for items or services that are preventive care. Specifies this does not apply to a prescription drug for which there is a generic alternative, unless the enrollee has obtained access to the brand name prescription drug through prior authorization, a step therapy protocol, the insurer's exceptions and appeals process, or the determination of a prescriber. Prohibits an insurer, pharmacy benefits manager, or third-party administrator from setting, altering, implementing, or conditioning the terms of health plan coverage based on information about the availability or amount of financial or product assistance available for a prescription drug. Effective upon becoming a law, and applies only to health plans entered into, amended, extended, or renewed on or after January 1, 2026. FISCAL IMPACT: NOT SIGNIFICANT Assumptions: • Based on information provided by the Department of Finance and Administration, Division of Benefits Administration, the proposed legislation will not have a significant impact on the State Group Insurance Program. • The Department of Commerce and Insurance can monitor insurers, pharmacy benefit managers, and third-party administrators for compliance utilizing existing resources; therefore, any fiscal impact is estimated to be not significant. IMPACT TO COMMERCE: NOT SIGNIFICANT Assumption: • Any impact to commerce or jobs in Tennessee will not be significant. SB 420 2 CERTIFICATION: The information contained herein is true and correct to the best of my knowledge. Bojan Savic, Executive Director