This bill introduces a new section to chapter 26.1-36 of the North Dakota Century Code, focusing on out-of-pocket expenses for prescription drugs. It defines key terms such as "cost-sharing," "enrollee," "health benefit plan," and "prescription drug." The bill stipulates that insurers cannot issue or renew health benefit plans providing prescription drug coverage unless they include all amounts paid by the enrollee towards the out-of-pocket maximum or cost-sharing requirements. Additionally, it clarifies that if the application of this section would make a high-deductible health plan ineligible for health savings accounts, the requirements will not apply until the enrollee meets the minimum deductible.

Furthermore, the bill amends section 26.1-36.6-03 regarding self-insurance health plans, specifying that certain policy provisions and health benefit provisions will apply to these plans and are subject to the jurisdiction of the commissioner. The new section created in this bill will also apply to self-insurance health plans. The provisions of this Act will take effect on January 1, 2026, and will apply to the public employees retirement system uniform group insurance program health insurance benefits coverage, as well as to health benefit plans upon their next renewal after this date.

Statutes affected:
INTRODUCED: 26.1-36.6-03
Adopted by the House Industry, Business and Labor Committee: 26.1-36.6-03
Adopted by the Senate Human Services Committee: 26.1-36.6-03
Prepared by the Legislative Council staff for Representative Karls: 26.1-36.6-03
Enrollment: 26.1-36.6-03
FIRST ENGROSSMENT: 26.1-36.6-03