This bill establishes new regulations regarding the calculation of cost-sharing contributions for covered persons under health benefit plans in Iowa. It defines key terms such as "cost-sharing," "covered person," "health benefit plan," "health carrier," and "pharmacy benefits manager." The bill mandates that when calculating a covered person's overall contribution to any cost-sharing requirement, health carriers and pharmacy benefits managers must include amounts paid by the covered person or by others on their behalf. Additionally, it addresses the implications for health savings accounts (HSAs), stating that contribution calculations will only apply after the covered person meets the minimum deductible, except for preventive care services.

The provisions of this bill will apply to various health benefit plans that are delivered, issued, continued, or renewed in Iowa on or after January 1, 2026. However, it explicitly excludes certain types of insurance, such as accident-only, specified disease, and dental or vision coverage, among others. The bill also grants the commissioner of insurance the authority to adopt rules for its administration.