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California Legislative Updates for Group Health Plan Sponsors
Sequoia
[Guidance Overview] Dec. 3, 2025 "AB 260, effective September 26, 2025, requires California regulated health plans with prescription drug benefits to cover mifepristone even when [FDA] labeling or federal risk evaluation strategies would otherwise limit its use.... AB 144 requires California regulated health plans to cover preventive services without cost-sharing or prior authorization ... as [federal] recommendations existed on January 1, 2025.... California is 'locking in' the federal and professional standards that were in place on that date, regardless of any future changes or litigation at the federal level.... SB 41, effective January 1, 2026 ... bans spread pricing and requires PBMs to use pass-through pricing models so plans pay pharmacies what PBMs reimburse them, plus a transparent administrative fee." MORE >> |
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