(1) As used in this section:

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(a) ‘Health benefit plan’ has the meaning given that term in ORS § 743B.005.

(b) ‘Insulin’ has the meaning given that term in ORS § 689.696.

(2) A health benefit plan offered in this state may not require an enrollee in the plan to incur cost-sharing or other out-of-pocket costs, as adjusted under subsection (3) of this section, that exceed $75 for each 30-day supply of a type of insulin prescribed for the treatment of diabetes or $225 for each 90-day supply.

(3) The Department of Consumer and Business Services shall, by rule, annually adjust the maximum cost specified in subsection (2) of this section by the percentage increase, if any, in the cost of living for the previous calendar year, based on changes in the Consumer Price Index for All Urban Consumers, West Region (All Items), as published by the Bureau of Labor Statistics of the United States Department of Labor.

(4) The coverage under this section may not be subject to a deductible imposed by a health benefit plan.

(5) This section does not prohibit a health benefit plan from using a drug formulary or other utilization review protocol applicable to prescription drug coverage under the plan.

(6) This section is not subject to ORS § 743A.001. [2021 c.160 § 2]

743A.069 was added to and made a part of the Insurance Code by legislative action but was not added to ORS Chapter 743A or any series therein. See Preface to Oregon Revised Statutes for further explanation.