Affordability of insulin directly impacts the adherence and health status of those living with diabetes that require insulin. Many states have implemented legislation for maximum copays on the cost of insulin to address this issue. State legislation only impacts state-regulated health plans. Self-insured employers can set their own coverage limits to make this life-saving medicine affordable. This action brief offers best practices for High Deductible Health Plans (HDHP), brings insight into what MBGH employers are saying and provides employer action steps.