CT SB00022

Caps out-of-pocket expenses for covered prescription drugs at $100 per 30-day supply for individual and group health insurance plans, with an exception for high deductible health plans until their minimum annual deductible is met.

Prohibits insurance companies from requiring insureds to use mail order pharmacies as a condition of obtaining prescription drug benefits.

Prevents insurers from placing all drugs within a given class in the highest cost-sharing tier of tiered formularies.

Limits step therapy requirements to a maximum of 60 days, after which treating health care providers may deem the regimen clinically ineffective and request coverage for an alternative drug.

Requires insurers to establish a convenient override process allowing health care providers to request step therapy exceptions at any time if the required regimen has been ineffective, is expected to be ineffective, causes adverse reactions, or is not in the patient's best interest.

Effective January 1, 2018 for both individual health insurance (Section 38a-510) and group health insurance (Section 38a-544).