A bill for an act relating to health carriers, pharmacy benefits managers, and the calculation of cost-sharing contributions by covered persons.

HF 735 requires health insurers and pharmacy benefits managers in Iowa to include all payments made by a plan participant (or others on their behalf) when calculating their total out-of-pocket cost-sharing under health plans. It specifically protects Health Savings Account (HSA) eligibility by delaying HSA contribution calculations until after a participant meets the federal minimum deductible, except for preventive care services. The bill applies to most health benefit plans issued or renewed in Iowa on or after January 1, 2026, but excludes accident-only, Medicare supplement, dental, vision, and other specialized coverage. It directs Iowa’s insurance commissioner to create implementing rules under Chapter 17A.