MA S698

Requires health insurers to count third-party payments (such as manufacturer copay assistance programs) toward an enrollee's deductible and out-of-pocket maximum, not just payments made directly by the enrollee.

Mandates that any cost sharing reductions made on behalf of an enrollee must be applied in full and immediately toward the enrollee's deductible, copayment, coinsurance, or similar obligations.

Applies to health insurance issuers subject to state law and state/local governmental employer plans, covering all cost sharing requirements including annual out-of-pocket limits under federal ACA provisions.

Takes effect for health plans entered into, amended, extended, or renewed on or after January 1, 2026.

Authorizes the Commission to promulgate rules and regulations for implementation.