The proposed bill amends Chapter 3, Title 41 of the Idaho Code by adding a new section, 41-351, which establishes provisions regarding cost-sharing requirements for health benefit plans. It defines "cost-sharing requirement" to include copayments, coinsurance, deductibles, and annual limitations on cost-sharing for specific health care services. The bill mandates that when calculating an enrollee's contribution to cost-sharing for covered prescription drugs, insurers must include amounts paid by the enrollee or on their behalf. Additionally, it outlines the responsibilities of manufacturers providing financial assistance for prescription drugs, including requirements for reporting assistance data to the Department of Insurance annually.

The new provisions will take effect on January 1, 2027, and will apply to health benefit plans that are entered into, amended, extended, or renewed after that date. The bill also specifies that these provisions do not apply if a medically appropriate generic equivalent or biosimilar drug is available and deemed appropriate by the patient's doctor. Furthermore, the Department of Insurance is authorized to create rules to implement these provisions, subject to legislative approval.