Substitute House Bill No. 5375, also known as Public Act No. 26-47, mandates the Insurance Commissioner to study the feasibility of various insurance options for nonprofit entities that contract with the state. This includes allowing multiple nonprofit organizations to pool their liability insurance policies, establishing a captive insurance company or risk management agency, and creating other insurance programs tailored to their needs. The Commissioner is required to develop a proposed plan that assesses the structure, financial viability, and operational aspects of such programs, including data collection, actuarial analysis, and future premium cost estimates. A report detailing the findings, proposed plan, and any legislative recommendations must be submitted to relevant legislative committees by November 1, 2026.

Additionally, the bill introduces new provisions regarding health benefit plans, requiring health carriers, third-party administrators, and pharmacy benefits managers to include pharmacists in their reimbursement processes for covered clinical services. It prohibits the denial of reimbursement for services provided by pharmacists if those services would be reimbursable if performed by other licensed healthcare providers. The bill clarifies that it does not mandate coverage for services not already included in health benefit plans and allows the Insurance Commissioner to adopt regulations to implement these provisions.

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