HF 4306

as introduced - 91st Legislature (2019 - 2020) Posted on 03/26/2020 01:13pm

A bill for an act
relating to insurance; health; requiring individual and small group health plan
offerings to include a predeductible, flat co-pay on prescription drug option;
amending Minnesota Statutes 2018, section 62Q.81, by adding a subdivision.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2018, section 62Q.81, is amended by adding a subdivision
to read:

new text begin Subd. 6. new text end

new text begin Prescription drug benefits. new text end

new text begin (a) A health plan company that offers individual
health plans must offer within each geographic area that they service at least one individual
health plan at each level of coverage described in subdivision 1, paragraph (b), clause (3),
which applies a predeductible, flat-dollar amount co-payment structure to the entire drug
benefit, including all tiers.
new text end

new text begin (b) A health plan company that offers small group health plans must offer within each
geographic area that they service at least one small group health plan at each level of coverage
described in subdivision 1, paragraph (b), clause (3), which applies a predeductible, flat-dollar
amount co-payment structure to the entire drug benefit, including all tiers.
new text end

new text begin (c) The highest allowable co-payment for the highest cost drug tier for health plans
offered pursuant to this subdivision must be no greater than 1/12 of the plan's out-of-pocket
maximum for an individual.
new text end

new text begin (d) The flat-dollar amount co-payment tier structure for prescription drugs under this
subdivision must be graduated and proportionate.
new text end

new text begin (e) All individual and small group health plans offered pursuant to this subdivision must
be:
new text end

new text begin (1) clearly and appropriately named to aid the purchaser in the selection process;
new text end

new text begin (2) marketed in the same manner as other health plans offered by the health plan company;
and
new text end

new text begin (3) offered for purchase to any individual or small group.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2021, and applies to individual
and small group health plans offered, issued, or renewed on or after that date.
new text end