Senate Bill 703 establishes new regulations regarding the access and ownership of claims data for plan sponsors, such as employers, in relation to employee benefit plans. The bill mandates that contracts between plan administrators, insurers, or pharmacy benefit managers and plan sponsors must explicitly state that the plan sponsor owns the claims data associated with the contract. Additionally, it prohibits the sale of claims data without the consent of both the plan sponsor and the individual to whom the data pertains. The bill requires that certain information be provided to the plan sponsor or their designee within seven business days upon request, including details about claims, payments, and itemized billing statements. It allows plan sponsors to request this information up to three times per plan year, covering a maximum of 24 months of data.

Furthermore, the bill outlines specific duties for administrators, insurers, and pharmacy benefit managers regarding the provision of claims data. For high-cost claims, defined as those exceeding $25,000 for non-pharmacy claims and $10,000 for pharmacy claims, the relevant parties must provide itemized billing statements and medical records prior to payment. The bill also stipulates that no fees can be charged for accessing this information that exceed the reasonable costs incurred. Overall, Senate Bill 703 aims to enhance transparency and control for plan sponsors over their claims data, ensuring they have timely access to critical information necessary for managing health benefits effectively.