HB249 Summary

• Health benefit plans providing prescription insulin coverage must cap total cost-sharing and co-pay amounts at $100 per 30-day supply, regardless of insulin type or deductible status.

• Annual cost-sharing caps increase each January 1 by the percentage change in the prescription drug component of the Consumer Price Index.

• Plans may not apply this cap if doing so would require increasing cost-sharing for other services to meet federal actuarial value requirements for non-grandfathered individual and small group plans.

• Applies to health insurance policies, HMOs, PPOs, and other health benefit plans covering hospital, medical, or surgical expenses issued or delivered in Alabama.

• Becomes effective October 1, 2021 and applies to contracts entered into after that date.