H.B. No. 177 Summary

• Amends health insurance regulations to require copayments, cost sharing, and deductibles to be reasonable and not barriers to necessary health care utilization.

• Caps annual cost-sharing charges at 40% of the total annual cost of providing all covered health care services, as demonstrated by a qualified actuary.

• Requires health insurers and pharmacy benefit managers to count third-party cost-sharing payments (from employers, nonprofits, etc.) toward an enrollee's cost-sharing obligations, except for brand-name drugs with generic alternatives unless medically necessary.

• Prohibits lifetime maximums on basic health care services while allowing benefit limits for supplemental health care services.

• Applies to health benefit plans delivered, issued for delivery, modified, or renewed on or after January 1, 2025.