Limits on Participant Payments for Prescription Drugs at the Point of Sale

On July 10, 2017, Gov. Malloy signed SB 445 into law, creating Public Act No. 17-241. This law states that health plan issuers cannot require plan participants to pay for prescription drugs at the point of sale in an amount that exceeds the applicable copayment, the allowable claim amount or the amount they must pay if they don’t have health plan coverage or other source of drug benefits or discounts (whichever of those is lowest). An “allowable claim amount” is generally defined to mean the amount the issuer pays the pharmacies for prescription medications.

This law is effective Jan. 1, 2018. Although the law doesn’t impose any new employer compliance obligations, employers may want to be aware of the new requirements in case questions should arise regarding prescription drug costs for employees.

Public Act No. 17-241 »