This 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. The bill defines "cost-sharing requirement" to include copayments, coinsurance, deductibles, and annual limitations on cost-sharing for specific health care services. It mandates that insurers include all cost-sharing amounts paid by or on behalf of an enrollee when calculating their contribution for covered prescription drugs. Additionally, it outlines the responsibilities of drug manufacturers in providing financial assistance to enrollees, including requirements for reporting assistance data to the Department of Insurance annually.

The provisions of this new section will apply to health benefit plans entered into, amended, extended, or renewed on or after January 1, 2027, and will only apply to qualified high-deductible health plans after the enrollee meets the deductible. 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. The Department of Insurance is authorized to create rules to implement these provisions, which will take effect on January 1, 2027.