BIP Summer 2025

NABIP in Action

1 Who really pays? don’t pay our medical bills — employers and employees do,” Kuhni writes. Banning copay accumulators shifts more financial burden onto them. 2 Coupons break the pricing model By bypassing deductibles, coupons distort actuarial assumptions. Plans priced for higher member cost sharing end up behaving like richer plans, forcing insurers to raise premiums. 3 Premiums aren’t arbitrary Health plans are priced based on expected medical utilization, not insurer whims. Banning accumulators undermines the accuracy of this pricing structure. 4 Artificial demand & gaming risk Coupons eliminate price sensitivity, discourage biosimilar usage and can incentivize members and brokers to “game the system” by leveraging low-premium plans with coupon-backed care. 5 Wider economic harm As lower-cost plans become more expensive, small businesses may drop coverage entirely, pushing more people into the uninsured pool. THE PROBLEM WITH COPAY ACCUMULATOR BANS “Insurance companies

A growing fight against accumulator bills Utah member’s white paper is helping reshape the national conversation on copay accumulator bans.

What started as a local policy tool to improve understanding of a complicated healthcare and insurance issue has rippled across the country. In Utah, NABIP member Erick Kuhni’s white paper on pharmacy copay accumulator programs has helped stall legislation that many believe could fundamentally distort the

insurance market — and it’s now being used in NABIP advocacy efforts in at least 10 other states. The document, initially written with the purpose of educating Utah legislators and NABIP-Utah members, offers an explanation of why accumulator restrictions — often framed as patient protections — can ultimately increase costs,

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10 bip magazine Summer 2025