UT| The Utah Insurance Departments Bulletin 2026-1 informs health insurers of the inflation-adjusted insulin prescription caps applicable to policies issued or renewed in calendar year 2027 under Utah Code § 31A-22-626 and Utah Admin. Code R590-200. For 30-day prescription supplies, insurers must offer at least one insulin in each therapy category, with caps of 5 dollars under § 31A-22-626(4)(a) and 30 dollars under § 31A-22-626(6)(b), calculated using Public Employees Health Plan (PEHP) data on average wholesale price per milliliter (AWP/mL) for insulin from 2019 through 2025.
The bulletin explains that PEHPs AWP/mL series is used to adjust the prior 2021 base caps of 30 and 100 dollars, shows the AWP/mL trend and percentage changes over those years in a graph and table, and illustrates the formula for deriving the 2027 low and high caps, which round down to 5 and 30 dollars respectively. It also references the separate Utah Insulin Savings Program website for program pricing.