HB 305 — 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
 1   Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An
 2      act relating to insurance; amending, revising, and
 3      consolidating the law providing for the incorporation of
 4      insurance companies, and the regulation, supervision, and
 5      protection of home and foreign insurance companies, Lloyds
 6      associations, reciprocal and inter-insurance exchanges, and
 7      fire insurance rating bureaus, and the regulation and
 8      supervision of insurance carried by such companies,
 9      associations, and exchanges, including insurance carried by
10      the State Workmen's Insurance Fund; providing penalties; and
11      repealing existing laws," in casualty insurance, providing
12      for coverage for insulin.
13      The General Assembly of the Commonwealth of Pennsylvania
14   hereby enacts as follows:
15      Section 1.    The act of May 17, 1921 (P.L.682, No.284), known
16   as The Insurance Company Law of 1921, is amended by adding a
17   section to read:
18      Section 635.11.    Coverage for Insulin.--(a)   A health
19   insurance policy providing prescription coverage of insulin may
20   not impose on a covered individual a copayment, coinsurance or
21   deductible of more than thirty-five dollars ($35) per thirty-day
22   supply of insulin, regardless of the amount or type of insulin
 1   needed to fill the covered individual's prescription.
 2      (b)    Nothing in this section shall prevent a health insurance
 3   policy from offering a lesser monthly price for a thirty-day
 4   supply of insulin than the price provided under subsection (a).
 5      (c)    The Insurance Department may promulgate regulations as
 6   necessary to implement and enforce the maximum price established
 7   under this section.
 8      (d)    This section shall not apply to the following types of
 9   policies:
10      (1)    Accident only.
11      (2)    Fixed indemnity.
12      (3)    Limited benefit.
13      (4)    Credit.
14      (5)    Dental.
15      (6)    Vision.
16      (7)    Specified disease.
17      (8)    Medicare supplement.
18      (9)    CHAMPUS (Civilian Health and Medical Program for the
19   Uniform Services) supplement.
20      (10)     Long-term care or disability income.
21      (11)     Workers' compensation.
22      (12)     Automobile medical payment.
23      (e)    The Attorney General shall investigate pricing of
24   prescription insulin drugs to ensure that adequate pricing is
25   achieved and to determine if additional consumer protections are
26   necessary. As part of this investigation, the Attorney General
27   shall gather, compile and analyze information concerning
28   business practices, pricing, data and other information
29   regarding insulin prescription drug manufacturers' roles in the
30   current prices of insulin prescription drugs.

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 1      (f)   The Attorney General shall submit the findings of the
 2   investigation under subsection (e) in a report to the General
 3   Assembly, which shall be made accessible to the public no later
 4   than one year after the effective date of this subsection. The
 5   report must include:
 6      (1)   A summary of insulin pricing practices and factors that
 7   contribute to the pricing of health insurance plans.
 8      (2)   Public policy recommendations to control and prevent
 9   overpricing of prescription insulin drugs made available to
10   consumers in this Commonwealth.
11      (3)   Any other information the Attorney General finds
12   necessary to complete the report.
13      Section 2.   This act shall take effect in 60 days.




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