MN SF4315

Health plan companies offering individual health plans must provide at least one plan at each coverage level in each geographic area with a predeductible, flat-dollar co-payment structure for all prescription drug tiers.

Health plan companies offering small group health plans must provide at least one plan at each coverage level in each geographic area with a predeductible, flat-dollar co-payment structure for all prescription drug tiers.

The highest co-payment allowed for the highest cost drug tier cannot exceed 1/12 of the plan's out-of-pocket maximum for an individual.

The flat-dollar co-payment tier structure must be graduated and proportionate, and plans must be clearly named, marketed the same as other company plans, and offered to any individual or small group.

The requirements become effective January 1, 2021, and apply to individual and small group health plans offered, issued, or renewed on or after that date.