HB640 Summary

• Requires health benefit plans to apply identical coinsurance, copayment, deductible, and quantity limit factors to all drug prescriptions within the same employer group and plan-sponsored group, regardless of whether filled by retail or mail order pharmacies participating in the plan's network.

• Permits health benefit plans to apply different cost-sharing factors between generic and brand name drugs within the same employer group.

• Prohibits health benefit plans from setting quantity limits on prescriptions unless the limit is applied uniformly to all pharmacy providers in the plan's network.

• Prohibits health benefit plans from mandating a provider to change an enrollee's prescribed drug unless both the provider and enrollee agree to the change.

• Effective date: October 1, 2010.