Bill Text: IL HB1054 | 2023-2024 | 103rd General Assembly | Introduced

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Bill Title: Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance amended, delivered, issued, or renewed on or after January 1, 2024 that provides coverage for prescription drugs shall require that a covered individual's defined cost sharing for each prescription drug shall be calculated at the point of sale based on a price that is reduced by an amount equal to at least 100% of all rebates received in connection with the dispensation or administration of the prescription drug. Provides that an insurer shall apply any rebate amount in excess of the defined cost sharing amount to the health plan to reduce premiums. Provides that the provisions shall not preclude an insurer from decreasing a covered individual's defined cost sharing by an amount greater than the stated amount at the point of sale. Provides that the Department of Insurance may adopt rules to implement the provisions.

Spectrum: Partisan Bill (Democrat 4-0)

Status: (Introduced) 2024-02-09 - Added Co-Sponsor Rep. Jenn Ladisch Douglass [HB1054 Detail]

Download: Illinois-2023-HB1054-Introduced.html

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103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 HB1054 Introduced , by Rep. Rita Mayfield SYNOPSIS AS INTRODUCED:
215 ILCS 5/356z.60 new
Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance amended, delivered, issued, or renewed on or after January 1, 2024 that provides coverage for prescription drugs shall require that a covered individual's defined cost sharing for each prescription drug shall be calculated at the point of sale based on a price that is reduced by an amount equal to at least 100% of all rebates received in connection with the dispensation or administration of the prescription drug. Provides that an insurer shall apply any rebate amount in excess of the defined cost sharing amount to the health plan to reduce premiums. Provides that the provisions shall not preclude an insurer from decreasing a covered individual's defined cost sharing by an amount greater than the stated amount at the point of sale. Provides that the Department of Insurance may adopt rules to implement the provisions.
LRB103 00023 BMS 45023 b
A BILL FOR
HB1054 LRB103 00023 BMS 45023 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The Illinois Insurance Code is amended by
adding Section 356z.60 as follows:
(215 ILCS 5/356z.60 new)
Sec. 356z.60. Cost sharing; prescription rebates.
(a) A group or individual policy of accident and health
insurance amended, delivered, issued, or renewed on or after
January 1, 2024 that provides coverage for prescription drugs
shall require that a covered individual's defined cost sharing
for each prescription drug shall be calculated at the point of
sale based on a price that is reduced by an amount equal to at
least 100% of all rebates received in connection with the
dispensation or administration of the prescription drug.
(b) An insurer shall apply any rebate amount in excess of
the defined cost sharing amount to the health plan to reduce
premiums.
(c) Nothing in this Section shall preclude an insurer from
decreasing a covered individual's defined cost sharing by an
amount greater than the stated amount at the point of sale.
(d) The Department may adopt rules to implement this
Section.