SB 376 Virginia Senate · 2025 Regular Session

Health insurance; limit on cost-sharing payments for prescription drugs under certain plans.

Summary
Health insurance; limit on cost-sharing payments for prescription drugs under certain plans. Requires each carrier that offers a health plan in either the individual or small group market to ensure that at least 50 percent of all health plans offered by the carrier, or at least one health plan if the carrier offers fewer than two health plans, in each rating area and in each of the bronze, silver, gold, and platinum levels of coverage in the individual and small group market conform with the following: (i) a plan that offers a silver, gold, or platinum level of coverage limits a person's cost-sharing payment for prescription drugs covered under the plan to an amount that does not exceed $100 per 30-day supply of the prescription drug and (ii) a plan that offers a bronze level of coverage limits a person's cost-sharing payment for prescription drugs covered under the plan to an amount that does not exceed $150 per 30-day supply of the prescription drug. The bill provides that such limits apply at any point in the benefit design, including before and after any applicable deductible is reached. The bill requires that any plans offered to meet its requirements are (a) clearly and appropriately named to aid the consumer or plan sponsor in the plan selection process and (b) marketed in the same manner as other plans offered by the health insurance carrier. The provisions of the bill apply with respect to health plans entered into, amended, extended, or renewed on or after January 1, 2025.
Bill status in committee 1 of 4 stages cleared
Introduction
Jan 2024
Committee Review
Floor Vote
Governor
Introduced Jan 9, 2024 Last action Nov 18, 2024
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Full legislative history

Actions timeline

Total actions
4
Key actions
0
Committee
1
Jan 9, 2024
Committee
Referred to Committee on Commerce and Labor
upper
1 primary · 0 co-sponsors

Sponsors

Role
Legislator
Party
State
District
P
Photo of Jennifer Boysko
Jennifer Boysko
DDemocratic
VA
38