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Current as of January 01, 2025 | Updated by FindLaw Staff
(a) Each health carrier that delivers, issues for delivery, renews, amends or continues a health care plan on or after January 1, 2021, shall submit the following information and data to the commissioner, for such health care plan for the immediately preceding calendar year, at the time that such health carrier submits a rate filing for such health care plan pursuant to sections 38a-183, 38a-481, or 38a-513, as applicable:
(1) For covered outpatient prescription drugs that were prescribed to insureds under such health care plan during such calendar year, the names of:
(A) The twenty-five most frequently prescribed outpatient prescription drugs;
(B) The twenty-five outpatient prescription drugs that the health care plan covered at the greatest cost, calculated by using the total annual plan spending by such health care plan for each outpatient prescription drug; and
(C) The twenty-five outpatient prescription drugs that experienced the greatest year-over-year increase in cost, calculated by using the total annual plan spending by such health care plan for each outpatient prescription drug.
(2) The portion of the premium for such health care plan that is attributable to each of the following categories of covered outpatient prescription drugs that were prescribed to insureds under such health care plan during such calendar year:
(A) Brand name drugs;
(B) Generic drugs; and
(C) Specialty drugs.
(3) The year-over-year increase, calculated on a per member, per month basis and expressed as a percentage, in the total annual cost of each category of covered outpatient prescription drugs set forth in subdivision (2) of this subsection.
(4) A comparison, calculated on a per member, per month basis, of the year-over-year increase in the cost of covered outpatient prescription drugs to the year-over-year increase in the costs of other contributors to the premium cost of such health care plan.
(5) The name of each specialty drug covered during such calendar year.
(6) The names of the twenty-five most frequently prescribed outpatient prescription drugs for which the health carrier received rebates from pharmaceutical manufacturers during such calendar year.
(b) The commissioner may adopt regulations, in accordance with the provisions of chapter 54, 1 to implement the provisions of this section.
Cite this article: FindLaw.com - Connecticut General Statutes Title 38A. Insurance § 38a-479qqq. Annual report by health carriers. Regulations - last updated January 01, 2025 | https://codes.findlaw.com/ct/title-38a-insurance/ct-gen-st-sect-38a-479qqq/
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