Anthem | Action Needed: SB 10 Expected to Drastically Increase Costs in CT
Anthem | Action Needed: SB 10 Expected to Drastically Increase Costs in CT
5/9/2025
Current legislative proposals SB 10 and SB 11, if passed are expected to result in higher premiums and costs for you.
What is SB 10, SB 11
SB 10 would, among other things, require health insurers to bear the burden of proof for medical necessity; reduce step therapy requirements for certain treatments; mandate site-neutral payments; and add affordability as a factor in rate filings. We could also see language added in an amendment that would mandate attachment points and ACA benefits on stop-loss policies for self-funded plans. That language is included in SB 11, which also includes significant restrictions on pharmacy benefit managers.
A cost analysis prepared by Havarti Risk and Harmonic Consulting—provides a detailed cost analysis of Senate Bill 10 (SB 10). The results are alarming: SB 10 is projected to increase health coverage costs by up to 9.2% for fully insured plans and 7.8% for self-funded employers, with an estimated $14 billion to $22 billion in new costs over ten years. For families and employers already navigating rising premiums and economic uncertainty, this legislation could result in sharp cost hikes, increased administrative complexity, and reduced flexibility in managing benefits.
| Connecticut Market Segment | Annual Impact at Full Implementation | Percentage Impact at Full Implementation | Family of Four Per Year Impact at Full Implementation | 10-Year Impact |
| Fully Insured (Ind & Employers) | $697 to $907 million | 7.0% to 9.2% | $2,835 to $3,685 | $7.6 to $11.6 billion |
| Self-Funded Employers | $554 to $743 million | 5.8% to 7.8% | $2,337 to $3,132 | $6.3 to $9.7 billion |
| State Employee Health Plan | $43 to $64 million | 3.0% to 4.5% | $1,216 to $1,827 | $0.6 to $0.9 billion |
Now is the time to act. Review the cost analysis report. Reach out to your legislators to express your concerns and urge them to reconsider the bill’s most disruptive provisions. Share this information with colleagues, partners, and any professional associations you belong to.
Legislators are making decisions now, and it’s critical that they hear directly from stakeholders who will be impacted the most.
Click for more information on SB 10 | Take Action Against Legislation that Raises Healthcare Costs
