Indiana Code 27-1-50-11. Disclosure of information to plan sponsor
(1) The approximate amount of rebates expected to be received by the insurer concerning the dispensing or administration of prescription drugs to the covered individuals of the plan sponsor.
Terms Used In Indiana Code 27-1-50-11
- covered individual: means an individual who is entitled to health insurance coverage. See Indiana Code 27-1-50-1
- defined cost sharing: means a deductible payment or coinsurance amount imposed on a covered individual for a covered prescription drug under the covered individual's health insurance coverage. See Indiana Code 27-1-50-2
- insurer: means an insurer that provides health insurance coverage to a covered individual. See Indiana Code 27-1-50-4
- plan sponsor: means an employer or organization that offers health insurance coverage to its employees or members through an insurer. See Indiana Code 27-1-50-5
(A) apply the rebates to reduce premiums for all covered individuals; or
(B) calculate defined cost sharing for a covered individual at the point of sale based on a price that is reduced by rebates received or estimated to be received by the insurer concerning the dispensing or administration of the covered individual’s prescription drugs.
(3) An explanation that, in the individual market, IC 27-1-49 requires that covered individual defined cost sharing be calculated at the point of sale based on a price that is reduced by at least eighty-five percent (85%) of the rebates concerning the dispensing or administration of the covered individual’s prescription drugs.
As added by P.L.166-2023, SEC.3.