HB 1111 - Health Insurance Cost Sharing Summary

• Requires individual and group health insurers and pharmacy benefit managers to apply all payments (including manufacturer copay cards, financial assistance, and product vouchers) toward an insured's total cost-sharing requirements, effective January 1, 2022.

• Mandates health insurers disclose on their websites and in policies that payments by or on behalf of policyholders will be applied toward total cost-sharing requirements for prescription drug coverage.

• Applies to pharmacy benefits manager contracts with health insurers and health maintenance organizations, requiring them to apply payments toward cost-sharing and disclose this practice to insureds and subscribers.

• Requires small employer carriers to comply with cost-sharing contribution requirements and applies provisions to group health insurance policies and HMO contracts issued on or after January 1, 2022.

• Effective date: July 1, 2021.