SB 133 IN
Restriction on co-pay accumulators.
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Summary
Provides that under certain circumstances, the administrator of a state employee health plan shall include any amount paid by a covered individual or another person on behalf of the covered individual for a prescription drug when calculating a covered individual's overall contribution to an out-of-pocket maximum or cost sharing requirement under the covered individual's state employee health plan. Provides that under certain circumstances, a pharmacy benefit manager shall include any amount paid by a covered individual or another person on behalf of the covered individual for a prescription drug when calculating a covered individual's overall contribution to an out-of-pocket maximum or cost sharing requirement under the covered individual's health plan. Provides that under certain circumstances, an insurer that issues a policy of accident and sickness insurance shall include any amount paid by an insured or another person on behalf of the insured for a prescription drug when calculating an insured's overall contribution to an out-of-pocket maximum or cost sharing requirement under the insured's policy of accident and sickness insurance. Provides that under certain circumstances, a health maintenance organization shall include any amount paid by an enrollee or another person on behalf of the enrollee for a prescription drug when calculating an enrollee's overall contribution to an out-of-pocket maximum or cost sharing requirement under the enrollee's individual or group contract.
Sponsor (1)
- J.D. Ford Democratic · author
Action history (2)
- Jan 8, 2025 Authored by Senator Ford J.D. · upper
- Jan 8, 2025 First reading: referred to Committee on Health and Provider Services · upper
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