ARIZONA HOUSE OF REPRESENTATIVES

HB 2166: unfair claims practices; cost sharing

NOW: health plans; cost sharing; calculation

PRIME SPONSOR: Representative Barto, LD 15

BILL STATUS: House Engrossed

Overview

Requires a health plan to include any cost sharing amount paid by either the enrollee or another person on behalf of the enrollee when calculating an enrollee's contribution to any out-of-pocket maximum, deductible, copayment, coinsurance or other applicable cost sharing requirements.

History

A.R.S. § 20-3111 defines cost sharing requirements as an enrollees' applicable coinsurance, copayment and deductible requirements under a health plan.

Provisions

1. Requires a health care insurer that provides pharmacy benefits, or a pharmacy benefits manager that administers pharmacy benefits for a health care insurer, to include any cost sharing amount paid by either the enrollee or another person on behalf of the enrollee when calculating an enrollee's contribution to any out-of-pocket maximum, deductible, copayment, coinsurance or other applicable cost sharing requirements.  (Sec. 1)

2. Defines health care insurer. (Sec. 1)

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6. Fifty-fourth Legislature                       HB 2166

7. First Regular Session                            Version 3: House Engrossed

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