INSURANCE – Adds to existing law to establish cost-sharing requirements for health benefit plans.

This bill requires health insurers in Idaho to count all copays, deductibles, and coinsurance paid by or on behalf of plan members when calculating their total out-of-pocket costs for covered health services. It applies to all health benefit plans issued or renewed on or after January 1, 2027, directly affecting insurers and enrollees. Key provisions include excluding prescription drugs from the rule if a medically appropriate generic is available and prescribed, and giving Idaho's Department of Insurance authority to create implementing rules. The law takes effect July 1, 2026, with full application starting in 2027.