Reminders on Plan Prescription Drug Formularies

On March 2, 2017, the Connecticut Insurance Department published Bulletin No. HC-113-17, which relates to information on plan formularies. The purpose of the bulletin is to set requirements and minimum standards for prescription drug formularies filed with the department. The bulletin reminds insurers of certain formulary requirements, including that the formulary must be easily electronically searchable, the medications within the formulary must be grouped in alphabetical order by therapeutic class, and the definition of each formulary tier must be clearly stated. In addition, definitions for utilization controls, such as quantity and dosage controls, prior authorization, step therapy and tier coverage must be clearly stated. The formulary must also include information on how to obtain drugs that are off formulary and how drugs might be obtained via mail order pharmacy. Lastly, the formulary must include customer service contact information.

The bulletin applies to insurers in connection with their annual filing requirements and contains no new employer obligations. However, the bulletin serves as a helpful resource for employers with fully insured plans in Connecticut.

Bulletin No. HC-113-17 »