Requiring certain cost-sharing assistance be applied toward a covered individual's deductible or annual out-of-pocket limit under the individual's health benefit plan.

SB 423 requires health insurers to count certain prescription drug payments toward a patient's deductible or out-of-pocket limit under their health insurance plan. It applies specifically to brand-name drugs without generic equivalents (or biosimilar options) or when a patient has met prior authorization, step therapy, or appeal requirements. This means patients’ payments for these drugs reduce the amount they must pay before full insurance coverage applies. The bill directly affects individuals enrolled in health benefit plans who use such prescription drugs.