On October 26, 2022, Gov. Carney signed SB 267 into law. The new law requires insurers to include any prescription cost-sharing amount paid by the participant or by another party on behalf of the participant toward the participant’s cost sharing limits under the policy. Cost-sharing requirements include deductible, copayment, coinsurance or out-of-pocket maximum. For example, an amount paid by a drug manufacturer toward a participant’s cost for a prescription would be counted toward the deductible and out-of-pocket maximums. Importantly, if the policy is a qualified high deductible health plan (HDHP), this requirement does not apply until the participant has met the annual statutory HDHP deductible.
The new law is effective for policies issued or renewed on or after January 1, 2024. Employers should work with their carrier to make sure the changes are implemented to the policy and plan documents are revised.
SB 267 »
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