This bill mandates that health carriers and pharmacy benefit managers must include any amounts paid by health benefit plan enrollees, or on their behalf by another person, when calculating the enrollee's overall contribution to out-of-pocket maximums or cost-sharing requirements under health benefit plans. This requirement applies to any health benefit plan that is entered into, amended, extended, or renewed on or after January 1, 2026.

Additionally, the bill specifies that if including these amounts would make a health savings account ineligible under the Internal Revenue Code, the requirement will only apply after the enrollee has met the minimum deductible for such accounts. However, for preventive care items or services, this requirement will apply regardless of whether the minimum deductible has been satisfied. The bill introduces new definitions for terms such as "cost-sharing requirement," "health benefit plan," "health carrier," "person," and "pharmacy benefit manager" to clarify its provisions.