The bill amends Chapter 176O of the General Laws by adding a new section, Section 31, which outlines specific definitions and requirements related to consumer deductibles in health insurance. Key terms such as "Insurer," "Cost sharing requirement," "Enrollee," "Health plan," "Health care service," and "Person" are defined to clarify the scope of the legislation. The bill mandates that when calculating an enrollee's contribution to cost sharing requirements, insurers must include any amounts paid by the enrollee or on their behalf. Additionally, it specifies that any cost sharing reductions must be applied fully at the time of service towards the enrollee's out-of-pocket costs.

Furthermore, the bill stipulates that for health plans that are entered into, amended, extended, or renewed on or after January 1, 2026, insurers must also include expenditures for any health care service covered by the enrollee's health plan when calculating contributions to the annual limitation on cost sharing. The Commission is granted the authority to create rules and regulations necessary for the implementation of this section.