Requirements for the calculation of an enrollee's contribution toward cost-sharing and out-of-pocket maximum requirements set.

HF 3123 requires Minnesota health insurance companies and pharmacy benefit managers to include all payments made by an enrollee (or on their behalf) for covered prescription drugs toward the enrollee's cost-sharing and out-of-pocket maximum. This includes payments for drugs covered under either medical or pharmacy benefits, regardless of how the drug is billed. However, if counting these payments before meeting the plan deductible would make an enrollee ineligible for a health savings account or catastrophic health plan, the rule only applies after the deductible is met. The law takes effect January 1, 2026, for new or renewed health plans.