This bill amends RSA 420-J:7-b to restrict health carriers from modifying prescription drug coverage under health benefit plans to only occur at the time of coverage renewal. Specifically, it introduces new provisions that allow modifications to drug coverage only if they are applied uniformly across all group or individual health benefit plans that are identical or substantially identical. Additionally, the bill mandates that health carriers must continue to provide coverage for any prescription drug that was previously approved or covered under the plan until the enrollee's renewal date, even if that drug is removed from the formulary before the renewal.

The bill aims to protect enrollees from midyear changes to their prescription drug coverage, which could lead to increased costs for health carriers. These costs may be passed on to policyholders through higher premiums, potentially resulting in increased insurance premium tax revenue for the state. However, the bill may also create challenges for health carriers in managing drug expenses and complying with existing state and federal regulations regarding prescription drug coverage. Overall, the bill seeks to enhance stability and predictability in prescription drug coverage for enrollees while balancing the financial implications for health carriers and policyholders.

Statutes affected:
Introduced: 420-J:7-b
SB544 text: 420-J:7-b