Health insurance; limit on cost-sharing payments for prescription drugs under certain plans.

The effective date for the new cost-sharing limits was changed from January 1, 2028, to January 1, 2027, allowing the law to take effect one year earlier.

A new provision was added stating that the act will not become effective unless it is reenacted by the 2027 Session of the General Assembly.

Minor formatting changes were made to section headers, including updating the bill status from 'Senate Substitute' to 'Engrossed' and adjusting the patron attribution.

The definition of 'Health plan' was updated to include a space after the section number symbol (§) for consistency.

Subsection C was slightly modified to clarify that plans must be marketed in the same manner as other plans offered by the 'health insurance carrier' instead of just the 'carrier'.

The requirement for health plans to be marketed was changed from being offered by the 'plan sponsor' to being offered by the 'carrier' to ensure consistency with industry terminology.

The definition of covered documents was expanded to include any individual or group accident and sickness insurance policy, any subscription contract, and any health care plan.

The effective date for the new provisions was changed from January 1, 2027, to January 1, 2028.

Cost-sharing limits were increased for all metal tiers: Bronze ($300), Silver ($250), Gold ($200), and Platinum ($150), replacing the previous limits that only applied to Silver, Gold, and Platinum plans.

The requirement to offer compliant plans was changed from 'at least 50 percent' of plans to 'at least one health plan' in each metal level.

A new subsection (D) was added stating that plans meeting these requirements cannot count against limits on the number of plan options established by state regulators.

The effective date was changed from a placeholder to January 1, 2028, and the requirement for the bill to be reenacted in the 2027 session was removed.

The mandate to cap drug costs now applies to bronze-level plans in addition to silver, gold, and platinum plans.