CA SB1199

Requires health care service plans and health insurers to count drug manufacturer discounts, copay assistance, and other direct support toward an enrollee's out-of-pocket maximum and deductible

Applies to nongrandfathered health plans subject to essential health benefits requirements; excludes grandfathered plans, Medicare supplements, and accident-only or hospital indemnity policies

Authorizes the Insurance Commissioner to assess administrative penalties of up to $5,000 per violation, or $10,000 per willful violation, against health insurers who fail to comply

Introduced by Senator Weber Pierson on February 19, 2026, adding new sections to the Health and Safety Code and Insurance Code