Pennsylvania 2025_0 Regular Session Status: In Committee Bipartisan · 9 D · 5 R cosponsors

SB 268 — 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 cost-sharing calculation.

Last action — Referred to BANKING AND INSURANCE, Feb. 20, 2025

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  1. ✓
    Introduced
  2. 2
    In Committee
  3. 3
    Passed Senate
  4. 4
    Passed House
  5. 5
    To Executive
  6. 6
    Enacted

This bill is in committee in the Senate. Introduced February 20, 2025. It must pass committee before a floor vote.

Next likely step: a committee vote, then a floor vote in the Senate.

Prognosis

Advancing 42% · moderate confidence

Where this bill stands today.

Odds of enactment

Low

How often bills like it became law.

  • In Committee

    Current position in the legislative process.

  • 14 sponsors

    1 primary, 13 co-sponsors signed on.

  • Bipartisan support

    Sponsored across 2 parties (9 D · 5 R) — cross-party backing.

Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.

Summary

Co-pay Accumulator Legislation

Bill Text

How this bill changes current law

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AI-generated reading aid from the bill's amendatory text — verify against the official bill.

The bill adds a new section to the Insurance Company Law of 1921 that mandates the inclusion of certain cost-sharing amounts when calculating an insured's contribution under health insurance policies.

  • Section 631.2

    Cost-Sharing Calculation.--(a) When calculating an insured's contribution to an applicable cost-sharing requirement under a health insurance policy: (1) The insurer shall include any cost-sharing amounts paid by the insured or on behalf of the insured by another person. (2) A pharmacy benefits manager that administers pharmacy benefits for the insurer shall include any cost-sharing amounts paid by the insured or on behalf of the insured by another person. (b) This section shall apply to a health insurance policy issued or entered into or renewed on or after the effective date of this section. (c) As used in this section: "Cost-sharing" means the cost to an individual insured under a health insurance policy according to a coverage limit, copayment, coinsurance, deductible or other out-of-pocket expense requirements imposed by the policy, contract or agreement. "Covered entity" means a contract holder or policy holder providing pharmacy benefits to a covered individual under a health insurance policy pursuant to a contract administered by a pharmacy benefits manager. "Health insurance policy" means: (1) An individual or group health, sickness or accident policy, or subscriber contract or certificate offered, issued or renewed by an entity subject to one of the following: (i) This act. (ii) The act of December 29, 1972 (P.L.1701, No.364), known as the "Health Maintenance Organization Act." (iii) 40 Pa.C.S. Ch. 61 (relating to hospital plan corporations) or 63 (relating to professional health services plan corporations). (2) The term does not include accident only, fixed indemnity, hospital indemnity, limited benefit, credit, dental, vision, specified disease, Medicare supplement, Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) supplement, long-term care or disability income, workers' compensation or automobile medical payment insurance. "Pharmacy benefits manager" means a person, business or other entity that performs pharmacy benefits management for covered entities.

    This addition establishes guidelines for how cost-sharing amounts are calculated for health insurance policies.

Action History

  1. Referred to BANKING AND INSURANCE, Feb. 20, 2025

Sponsors

Sponsorship breakdown

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1 sponsors · 13 co-sponsors · 239 not signed on

Sponsors (1)

Co-sponsors (13)

Not signed on (239)

239 members have not signed on to this bill.

Show all 239 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Subjects

healthcare health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

What does SB 268 do?
Co-pay Accumulator Legislation
Who sponsors SB 268?
SB 268 is sponsored by Carolyn T. Comitta (Democratic), Camera Bartolotta (Republican), Judy Ward (Republican), Lindsey M. Williams (Democratic), Maria Collett (Democratic), Michele Brooks (Republican), Tracy Pennycuick (Republican), Wayne D. Fontana (Democratic), Timothy P. Kearney (Democratic), Christine M. Tartaglione (Democratic), Judith L. Schwank (Democratic), Steven J. Santarsiero (Democratic), Frank A. Farry (Republican), and Amanda M. Cappelletti (Democratic).
What is the current status of SB 268?
This bill is in committee in the Senate. Introduced February 20, 2025. It must pass committee before a floor vote.
Where can I track SB 268?
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Last checked for changes 4 months ago · updated continuously

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