Sec. 9. (a) At the time of contracting, an insurer shall only offer to plan sponsors the following plans:

(1) A plan that applies one hundred percent (100%) of the rebates to reduce premiums for all covered individuals equally.

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Terms Used In Indiana Code 27-1-50-9

  • defined cost sharing: means a deductible payment or coinsurance amount imposed on a covered individual for a covered prescription drug under the covered individual's health insurance coverage. See Indiana Code 27-1-50-2
  • insurer: means an insurer that provides health insurance coverage to a covered individual. See Indiana Code 27-1-50-4
  • plan sponsor: means an employer or organization that offers health insurance coverage to its employees or members through an insurer. See Indiana Code 27-1-50-5
(2) A plan that calculates defined cost sharing for covered individuals of the plan sponsor at the point of sale based on a price that is reduced by an amount equal to at least eighty-five percent (85%) of all of the rebates received or estimated to be received by the insurer concerning the dispensing or administration of the prescription drug.

     (b) A plan sponsor may choose one (1) of the plans offered under subsection (a).

As added by P.L.166-2023, SEC.3. Amended by P.L.158-2024, SEC.15.