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

This bill establishes how health insurance companies and pharmacy benefit managers must calculate an enrollee's contribution toward cost-sharing and out-of-pocket maximums in Minnesota. It requires these entities to include all amounts paid by enrollees or on their behalf when determining these limits, regardless of whether the prescription drugs are covered under medical or pharmacy benefits. The legislation also specifies that these calculations only apply after an enrollee has met their plan deductible if doing so earlier would affect eligibility for health savings accounts or catastrophic health plans. The changes will take effect on January 1, 2027, for health plans offered, issued, or renewed on or after that date.