IL HB1745

Beginning January 1, 2023, health insurance carriers offering individual health plans must ensure at least 10% of plans in each service area and coverage level use flat-dollar copayments for the entire drug benefit; increases to 25% starting January 1, 2024.

Beginning January 1, 2023, health insurance carriers offering group health plans must offer at least one plan per service area and coverage level with flat-dollar copayments for prescription drugs; increases to at least 2 plans starting January 1, 2024.

Flat-dollar copayment structures must be applied pre-deductible and be reasonably graduated across tier levels to avoid discriminating against or discouraging enrollment of individuals with significant health care needs.

Health insurance carriers must clearly name and market the flat-dollar copayment plans in the same manner as other plans to aid selection process.

The Department of Insurance shall adopt rules to implement and enforce these provisions, effective January 1, 2023.