Connecticut General Statutes 38a-477gg – Contracts between health carriers and pharmacy benefits managers. Credit required for third-party discounts and payments for covered prescription drug benefits
(a) On and after January 1, 2022, each contract entered into between a health carrier, as defined in § 38a-591a, and a pharmacy benefits manager, as defined in § 38a-479aaa, for the administration of the pharmacy benefit portion of a health benefit plan in this state on behalf of plan sponsors shall require that the pharmacy benefits manager, when calculating an insured‘s or enrollee’s liability for a coinsurance, copayment, deductible or other out-of-pocket expense for a covered prescription drug benefit, give credit for any discount provided or payment made by a third party for the amount of, or any portion of the amount of, the coinsurance, copayment, deductible or other out-of-pocket expense for the covered prescription drug benefit.
Terms Used In Connecticut General Statutes 38a-477gg
- Contract: A legal written agreement that becomes binding when signed.
- Insured: means a person to whom or for whose benefit an insurer makes a promise in an insurance policy. See Connecticut General Statutes 38a-1
- State: means any state, district, or territory of the United States. See Connecticut General Statutes 38a-1
- United States: means the United States of America, its territories and possessions, the Commonwealth of Puerto Rico and the District of Columbia. See Connecticut General Statutes 38a-1
(b) The provisions of subsection (a) of this section shall apply to a high deductible health plan, as that term is used in subsection (f) of § 38a-493 or subsection (f) of § 38a-520, as applicable, to the maximum extent permitted by federal law, except if such plan is used to establish a medical savings account or an Archer MSA pursuant to Section 220 of the Internal Revenue Code of 1986, or any subsequent corresponding internal revenue code of the United States, as amended from time to time, or a health savings account pursuant to Section 223 of said Internal Revenue Code, as amended from time to time, the provisions of said subsection (a) shall apply to such plan to the maximum extent that (1) is permitted by federal law, and (2) does not disqualify such account for the deduction allowed under said Section 220 or 223, as applicable.