Plain English Breakdown
The plain English breakdown is still being put together. The official documents below are already here.
HF4618 • 2026
Requirements for the calculation of an enrollee's contribution toward cost-sharing and out-of-pocket maximum set.
Requirements for the calculation of an enrollee's contribution toward cost-sharing and out-of-pocket maximum set.
Passed Legislature
This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.
Bill History
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2026-03-25
House
Introduction and first reading, referred to Commerce Finance and Policy
Official Summary Text
Requirements for the calculation of an enrollee's contribution toward cost-sharing and out-of-pocket maximum set.
Current Bill Text
Read the full stored bill text
A bill for an act relating to health insurance; setting requirements for the calculation of an enrollee's contribution toward cost-sharing and out-of-pocket maximum requirements; proposing coding for new law in Minnesota Statutes, chapter 62Q. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: Section 1. new text begin [62Q.491] COST-SHARING OR OUT-OF-POCKET MAXIMUM REQUIREMENTS; ENROLLEE CONTRIBUTION. new text end new text begin Subdivision 1. new text end new text begin Definitions. new text end new text begin (a) For purposes of this section, the following terms have the meanings given. new text end new text begin (b) "Cost-sharing" means co-pays, coinsurance, and deductibles. new text end new text begin (c) "Pharmacy benefit manager" has the meaning given in section 62W.02, subdivision 15. new text end new text begin Subd. 2. new text end new text begin Calculation. new text end new text begin (a) When calculating an enrollee's overall contribution to a cost-sharing or out-of-pocket maximum requirement, a health plan company or pharmacy benefit manager must include any amount paid by an enrollee or paid on behalf of an enrollee by another person. The requirement under this paragraph applies to prescription drugs approved for coverage by the health plan company, regardless of whether the prescription drugs are covered under a medical or pharmacy benefit. new text end new text begin (b) If application of this section before an enrollee has met the enrollee's plan deductible results in (1) health savings account ineligibility under United States Code, title 26, section 223, or (2) catastrophic health plan ineligibility under United States Code, title 42, section 18022(e), this section applies to calculations only after the enrollee has met the enrollee's plan deductible. new text end new text begin EFFECTIVE DATE. new text end new text begin This section is effective January 1, 2027, and applies to health plans offered, issued, or renewed on or after that date. new text end