SB 1050 Summary

• Reduces refund request timeframe for claims paid to claimants from 12 months to 6 months after payment, and for health care providers from 18 months to 12 months after payment under the Unfair Claims Settlement Practices Act.

• Maintains existing exceptions allowing refund requests when payment resulted from fraud by the claimant or health care provider, or when the claimant/provider agreed to refund overpayments.

• Expands pharmacy benefits requirements to mandate that health insurers and pharmacy benefits managers include all amounts paid by enrollees or third parties when calculating out-of-pocket maximums, deductibles, copayments, and coinsurance, with exceptions for health savings account compliance under federal law.

• Preserves all other unfair claim settlement practices provisions including disclosure requirements, misrepresentation prohibitions, claim investigation standards, and good faith settlement obligations.

• Becomes effective November 1, 2025.