An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in casualty insurance, providing for coverage for insulin.

PRINTER'S NO. 258
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 305
Session of
2025
INTRODUCED BY McNEILL, CERRATO, SAMUELSON, WAXMAN, PIELLI,
KENYATTA, KHAN, BOROWSKI, ISAACSON AND SANCHEZ,
JANUARY 23, 2025
REFERRED TO COMMITTEE ON HEALTH, JANUARY 23, 2025
AN ACT
Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An
act relating to insurance; amending, revising, and
consolidating the law providing for the incorporation of
insurance companies, and the regulation, supervision, and
protection of home and foreign insurance companies, Lloyds
associations, reciprocal and inter-insurance exchanges, and
fire insurance rating bureaus, and the regulation and
supervision of insurance carried by such companies,
associations, and exchanges, including insurance carried by
the State Workmen's Insurance Fund; providing penalties; and
repealing existing laws," in casualty insurance, providing
for coverage for insulin.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The act of May 17, 1921 (P.L.682, No.284), known
as The Insurance Company Law of 1921, is amended by adding a
section to read:
Section 635.11. Coverage for Insulin.--(a) A health
insurance policy providing prescription coverage of insulin may
not impose on a covered individual a copayment, coinsurance or
deductible of more than thirty-five dollars ($35) per thirty-day
supply of insulin, regardless of the amount or type of insulin
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needed to fill the covered individual's prescription.
(b) Nothing in this section shall prevent a health insurance
policy from offering a lesser monthly price for a thirty-day
supply of insulin than the price provided under subsection (a).
(c) The Insurance Department may promulgate regulations as
necessary to implement and enforce the maximum price established
under this section.
(d) This section shall not apply to the following types of
policies:
(1) Accident only.
(2) Fixed indemnity.
(3) Limited benefit.
(4) Credit.
(5) Dental.
(6) Vision.
(7) Specified disease.
(8) Medicare supplement.
(9) CHAMPUS (Civilian Health and Medical Program for the
Uniform Services) supplement.
(10) Long-term care or disability income.
(11) Workers' compensation.
(12) Automobile medical payment.
(e) The Attorney General shall investigate pricing of
prescription insulin drugs to ensure that adequate pricing is
achieved and to determine if additional consumer protections are
necessary. As part of this investigation, the Attorney General
shall gather, compile and analyze information concerning
business practices, pricing, data and other information
regarding insulin prescription drug manufacturers' roles in the
current prices of insulin prescription drugs.
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(f) The Attorney General shall submit the findings of the
investigation under subsection (e) in a report to the General
Assembly, which shall be made accessible to the public no later
than one year after the effective date of this subsection. The
report must include:
(1) A summary of insulin pricing practices and factors that
contribute to the pricing of health insurance plans.
(2) Public policy recommendations to control and prevent
overpricing of prescription insulin drugs made available to
consumers in this Commonwealth.
(3) Any other information the Attorney General finds
necessary to complete the report.
Section 2. This act shall take effect in 60 days.
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