SB 447 Summary

• Large employer groups with 100+ full-time employees may request insurers to provide claims utilization and cost information by signing a nondisclosure agreement, with requests limited to once per calendar year and fulfilled within 30 days.

• Insurers must compile and provide data in electronic spreadsheet format including incurred/paid claims, inpatient/outpatient expenditures, prescription drug information (brand, generic, specialty), top 50 frequently paid and highest-cost drugs, and fees/administrative expenses.

• High-cost individual data must be reported for covered individuals with total claims exceeding $25,000 in any 12-month period, including their diagnoses, medical/prescription drug expenditures, and current coverage status.

• Large employer groups must disclose received claims data to any carrier or administrator they solicit for benefits or services, and data must be provided within 30 days of request.

• Insurers are granted immunity from civil liability for complying with information requests and subsequent use of the data; effective date September 22, 2022.