IA HF735

Requires health carriers and pharmacy benefits managers to count payments made by third parties on behalf of covered persons toward their cost-sharing requirements (deductibles, copays, coinsurance, out-of-pocket maximums)

Includes an exception for health savings account (HSA) eligible plans, where the standard cost-sharing calculation applies only after the minimum HSA deductible is met, except for preventive care services which count immediately

Applies to individual and group accident/sickness insurance, hospital/medical service contracts, HMO contracts, and public employee health plans delivered, issued, continued, or renewed on or after January 1, 2026

Excludes specialized coverage types including accident-only, dental, vision, Medicare supplement, long-term care, disability income, workers' compensation, and automobile medical payment insurance

Authorizes the Commissioner of Insurance to adopt administrative rules to implement the new requirements