Prohibition on copay accumulator adjustments.
Summary
Provides that under certain circumstances, the administrator of the state employee health plan shall include any amount paid by a covered individual or another person on behalf of the covered individual for a prescription drug when calculating a covered individual's overall contribution to an out-of-pocket maximum or cost sharing requirement under the covered individual's state employee health plan. Provides that under certain circumstances, a pharmacy benefit manager shall include any amount paid by a covered individual or another person on behalf of the covered individual for a prescription drug when calculating a covered individual's overall contribution to an out-of-pocket maximum or cost sharing requirement under the covered individual's health plan. Provides that under certain circumstances, an insurer who issues a policy of accident and sickness insurance shall include any amount paid by an insured or another person on behalf of the insured for a prescription drug when calculating an insured's overall contribution to an out-of-pocket maximum or cost sharing requirement under the insured's policy of accident and sickness insurance. Provides that under certain circumstances, a health maintenance organization shall include any amount paid by an enrollee or another person on behalf of the enrollee for a prescription drug when calculating an enrollee's overall contribution to an out-of-pocket maximum or cost sharing requirement under the enrollee's individual or group contract.
Bill status
in committee
1 of 4 stages cleared
Introduction
Jan 2025
Committee Review
Floor Vote
Governor
Introduced Jan 13, 2025
Last action Jan 14, 2025
Floor votes
How they voted
No floor votes recorded yet.
Full legislative history
Actions timeline
Total actions
3
Key actions
0
Committee
0
1 primary · 2 co-sponsors
Sponsors
Role
Legislator
Party
State
District
P
Andrea Hunley
DDemocratic
Co
J.D. Ford
DDemocratic
Co
Shelli Yoder
DDemocratic
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