wa-law.org > bill > 2023-24 > SB 5775 > Original Bill

SB 5775 - Concerning cost-sharing requirements for prescription epinephrine autoinjectors.


Section 1

  1. Except as required in subsection (2) of this section, a health plan issued or renewed on or after January 1, 2025, that provides coverage for prescription epinephrine autoinjectors must cap the total amount that an enrollee is required to pay for all covered prescription epinephrine autoinjectors at an amount not to exceed $60 for a two-pack of epinephrine autoinjectors, regardless of the amount or type of epinephrine needed to fill the covered person's prescription. Prescription epinephrine autoinjectors must be covered without being subject to a deductible, and any cost sharing paid by an enrollee must be applied toward the enrollee's deductible obligation.

  2. For a health plan that provides coverage for prescription epinephrine autoinjectors and is offered as a qualifying health plan for a health savings account, the health carrier shall establish the plan's cost sharing for the coverage required by this section at the minimum level necessary to preserve the enrollee's ability to claim tax exempt contributions and withdrawals from the enrollee's health savings account under internal revenue service laws and regulations.

Section 2

Each health plan that provides medical insurance offered under this chapter, including plans created by insuring entities, plans not subject to the provisions of Title 48 RCW, and plans created under RCW 41.05.140, are subject to the provisions of RCW 48.43.500, 70.02.045, 48.43.505 through 48.43.535, 48.43.537, 48.43.545, 48.43.550, 70.02.110, 70.02.900, 48.43.190, 48.43.083, 48.43.0128, 48.43.780, 48.43.435, 48.43.815, section 1 of this act, and chapter 48.49 RCW.

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