MI SB1083

Requires insurers and health maintenance organizations offering tiered formulary prescription drug coverage to cap out-of-pocket costs at $100 per single drug for up to a 30-day supply.

Limits annual out-of-pocket expenditures for prescription drugs to 50% of the dollar amounts specified in section 223(c)(2)(A)(ii) of the Internal Revenue Code for self-only or family coverage.

Mandates an exceptions process allowing covered individuals or their prescribers to request nonformulary drugs be covered like formulary drugs if the formulary drug would be less effective or cause adverse effects.

Treats denials of exception requests as adverse events subject to internal and external review processes.

Applies to policies, certificates, and contracts delivered, issued, or renewed by insurers and health maintenance organizations beginning 180 days after enactment.