SF 365

as introduced - 92nd Legislature (2021 - 2022) Posted on 04/04/2022 02:38pm

A bill for an act
relating to insurance; requiring individual and small group health plan offerings
to include a predeductible, flat co-pay on prescription drug option; amending
Minnesota Statutes 2020, section 62Q.81, by adding a subdivision.

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

Section 1.

Minnesota Statutes 2020, 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 ensure that no fewer than 25 percent of the individual health plans the
company offers in each geographic area that the health plan company services at each level
of coverage described in subdivision 1, paragraph (b), clause (3), 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 ensure that no fewer
than 25 percent of small group health plans the company offers in each geographic area that
the health plan company services at each level of coverage described in subdivision 1,
paragraph (b), clause (3), 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, 2022, and applies to individual
and small group health plans offered, issued, or renewed on or after that date.
new text end