1.1 	A bill for an act
1.2 	relating to health insurance; setting requirements for the calculation of an enrollee's 
1.3 	contribution toward cost-sharing and out-of-pocket maximum requirements;
1.4 	proposing coding for new law in Minnesota Statutes, chapter 62Q.
1.5 	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

1.6 	Section 1. [62Q.491] COST-SHARING OR OUT-OF-POCKET MAXIMUM 
1.7 	REQUIREMENTS; ENROLLEE CONTRIBUTION.
1.8 		Subdivision 1.Definitions. (a) For purposes of this section, the following terms have 
1.9 	the meanings given.
1.10 	(b) "Cost-sharing" means co-pays, coinsurance, and deductibles.
1.11 	(c) "Pharmacy benefit manager" has the meaning given in section 62W.02, subdivision 
1.12 	15.
1.13 		Subd. 2.Calculation. (a) When calculating an enrollee's overall contribution to a 
1.14 	cost-sharing or out-of-pocket maximum requirement, a health plan company or pharmacy 
1.15 	benefit manager must include any amount paid by an enrollee or paid on behalf of an enrollee 
1.16 	by another person. The requirement under this paragraph applies to prescription drugs 
1.17 	approved for coverage by the health plan company, regardless of whether the prescription 
1.18 	drugs are covered under a medical or pharmacy benefit.
1.19 	(b) If application of this section before an enrollee has met the enrollee's plan deductible 
1.20 	results in (1) health savings account ineligibility under United States Code, title 26, section 
1.21 	223, or (2) catastrophic health plan ineligibility under United States Code, title 42, section 
2.1 	18022(e), this section applies to calculations only after the enrollee has met the enrollee's 
2.2 	plan deductible.

2.3 	EFFECTIVE DATE. This section is effective January 1, 2027, and applies to health 
2.4 	plans offered, issued, or renewed on or after that date.