AN ACT to create and enact a new section to chapter 26.1-36 of the North Dakota Century Code, relating to out-of-pocket expenses for prescription drugs; to amend and reenact section 26.1-36.6-03 of the North Dakota Century Code, relating to self-insurance health care plans; to provide for application; and to provide an effective date.

New definitions for 'cost-sharing', 'enrollee', 'health benefit plan', and 'prescription drug' to clarify coverage requirements.

Health plans must include all amounts paid by enrollees or on their behalf when calculating out-of-pocket maximums and cost-sharing requirements.

Plans cannot vary out-of-pocket maximums or design benefits based on the availability of cost-sharing assistance programs.

Self-insurance health plan requirements in section 26.1-36.6-03 are amended and reenacted with updated effective dates.

New section applies to self-insurance plans effective through July 31, 2025, with different provisions applying after that date.

Full application to public employee retirement system and general health benefit plans begins January 1, 2026.