Indiana 2025 Regular Session

Indiana House Bill HB1298 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1
2	2	Introduced Version
3	3	HOUSE BILL No. 1298
4	4	_____
5	5	DIGEST OF INTRODUCED BILL
6	6	Citations Affected: IC 5-10-8-27; IC 27-8-40; IC 27-13-7-29.
7	7	Synopsis: Contraceptive coverage. Requires a state employee health
8	8	plan, a policy of accident and sickness insurance, and a health
9	9	maintenance organization contract to provide coverage, without cost
10	10	sharing, for: (1) contraceptive products and services; (2) counseling
11	11	and screening for certain sexually transmitted infections; and (3)
12	12	pre-exposure prophylaxis, post-exposure prophylaxis, and human
13	13	papillomavirus vaccination.
14	14	Effective: July 1, 2025.
15	15	Errington
16	16	January 13, 2025, read first time and referred to Committee on Insurance.
17	17	2025 IN 1298—LS 6283/DI 154 Introduced
18	18	First Regular Session of the 124th General Assembly (2025)
19	19	PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
20	20	Constitution) is being amended, the text of the existing provision will appear in this style type,
21	21	additions will appear in this style type, and deletions will appear in this style type.
22	22	Additions: Whenever a new statutory provision is being enacted (or a new constitutional
23	23	provision adopted), the text of the new provision will appear in this style type. Also, the
24	24	word NEW will appear in that style type in the introductory clause of each SECTION that adds
25	25	a new provision to the Indiana Code or the Indiana Constitution.
26	26	Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
27	27	between statutes enacted by the 2024 Regular Session of the General Assembly.
28	28	HOUSE BILL No. 1298
29	29	A BILL FOR AN ACT to amend the Indiana Code concerning
30	30	insurance.
31	31	Be it enacted by the General Assembly of the State of Indiana:
32	32	1 SECTION 1. IC 5-10-8-27 IS ADDED TO THE INDIANA CODE
33	33	2 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
34	34	3 1, 2025]: Sec. 27. (a) This section applies to a state employee health
35	35	4 plan that is established, entered into, amended, or renewed after
36	36	5 June 30, 2025.
37	37	6 (b) As used in this section, "contraceptive products and
38	38	7 services" means the following:
39	39	8 (1) All contraceptive drugs, devices, products, and procedures
40	40	9 that are approved by the federal Food and Drug
41	41	10 Administration, including over-the-counter contraceptive
42	42	11 drugs, devices, and products as prescribed by the covered
43	43	12 individual's health care provider or as otherwise authorized
44	44	13 under state or federal law.
45	45	14 (2) All emergency contraception that is approved by the
46	46	15 federal Food and Drug Administration.
47	47	16 (3) Voluntary sterilization procedures.
48	48	17 (4) Patient education and counseling concerning
49	49	2025 IN 1298—LS 6283/DI 154 2
50	50	1 contraception.
51	51	2 (5) Follow-up services related to the drugs, devices, products,
52	52	3 and procedures covered under this section, including:
53	53	4 (A) management of side effects;
54	54	5 (B) counseling for continued adherence; and
55	55	6 (C) device insertion and removal.
56	56	7 (c) As used in this section, "cost sharing" means payment of a
57	57	8 deductible, coinsurance, copayment, or other out-of-pocket cost
58	58	9 required under a state employee health plan.
59	59	10 (d) As used in this section, "covered individual" means an
60	60	11 individual entitled to coverage under a state employee health plan.
61	61	12 (e) As used in this section, "state employee health plan" means
62	62	13 the following:
63	63	14 (1) A self-insurance program established under section 7(b) of
64	64	15 this chapter.
65	65	16 (2) A contract for prepaid health care services entered into
66	66	17 under section 7(c) of this chapter.
67	67	18 (f) As used in this section, "therapeutic equivalent" means a
68	68	19 drug, device, or product that is designated as therapeutically
69	69	20 equivalent by the federal Food and Drug Administration in the
70	70	21 Approved Drug Products with Therapeutic Equivalence
71	71	22 Evaluations.
72	72	23 (g) Except as provided in subsection (i), a state employee health
73	73	24 plan shall provide coverage for contraceptive products and
74	74	25 services without cost sharing, subject to the following:
75	75	26 (1) If the federal Food and Drug Administration has
76	76	27 designated a therapeutic equivalent of a contraceptive
77	77	28 product or service, the state employee health plan must
78	78	29 include either the original contraceptive product or service or
79	79	30 a therapeutic equivalent of the contraceptive product or
80	80	31 service. If there is no therapeutic equivalent for the
81	81	32 contraceptive product or service, the state employee health
82	82	33 plan must include the original contraceptive product or
83	83	34 service.
84	84	35 (2) If the contraceptive product or service is deemed
85	85	36 medically inadvisable by the covered individual's health care
86	86	37 provider, the state employee health plan shall:
87	87	38 (A) defer to the determination and judgment of the
88	88	39 attending health care provider; and
89	89	40 (B) provide coverage for the alternate prescribed
90	90	41 contraceptive product or service.
91	91	42 (3) The coverage must provide for the single dispensing of a
92	92	2025 IN 1298—LS 6283/DI 154 3
93	93	1 thirteen (13) unit supply of contraceptive products and
94	94	2 services intended to last over a twelve (12) month duration,
95	95	3 which may be furnished or dispensed all at once or over the
96	96	4 course of the twelve (12) months at the discretion of the health
97	97	5 care provider regardless of whether the covered individual
98	98	6 was entitled to coverage under the state employee health plan
99	99	7 at the time of the first dispensing. The state employee health
100	100	8 plan shall reimburse a health care provider or dispensing
101	101	9 entity per unit for furnishing or dispensing an extended
102	102	10 supply of contraceptive products and services.
103	103	11 (4) Except as otherwise provided in this subsection, the state
104	104	12 employee health plan may not impose any restrictions or
105	105	13 delays on the coverage required under this subsection.
106	106	14 (5) Nothing in this subsection shall be construed to exclude
107	107	15 coverage for contraceptive products and services as
108	108	16 prescribed by a health care provider acting within the health
109	109	17 care provider's scope of practice for:
110	110	18 (A) reasons other than contraceptive purposes, such as
111	111	19 decreasing the risk of ovarian cancer or eliminating
112	112	20 symptoms of menopause; or
113	113	21 (B) contraception that is necessary to preserve the life or
114	114	22 health of a covered individual.
115	115	23 (h) Except as provided in subsection (i), a state employee health
116	116	24 plan shall provide coverage without cost sharing for the following:
117	117	25 (1) Counseling for sexually transmitted infections, including
118	118	26 human immunodeficiency virus and acquired immune
119	119	27 deficiency syndrome.
120	120	28 (2) Screening for:
121	121	29 (A) chlamydia;
122	122	30 (B) gonorrhea;
123	123	31 (C) hepatitis B;
124	124	32 (D) hepatitis C;
125	125	33 (E) human immunodeficiency virus;
126	126	34 (F) acquired immune deficiency syndrome;
127	127	35 (G) human papillomavirus; and
128	128	36 (H) syphilis.
129	129	37 (3) Pre-exposure prophylaxis, post-exposure prophylaxis, and
130	130	38 human papillomavirus vaccination.
131	131	39 (i) If a state employee health plan is offered as a qualifying high
132	132	40 deductible health plan for a health savings account, the state
133	133	41 employee health plan shall establish cost sharing for the coverage
134	134	42 under this section at the minimum level necessary to preserve the
135	135	2025 IN 1298—LS 6283/DI 154 4
136	136	1 covered individual's ability to claim tax exempt contributions and
137	137	2 withdrawal from the covered individual's health savings account
138	138	3 under 26 U.S.C. 223.
139	139	4 SECTION 2. IC 27-8-40 IS ADDED TO THE INDIANA CODE AS
140	140	5 A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE JULY
141	141	6 1, 2025]:
142	142	7 Chapter 40. Coverage for Contraceptive Products and Services
143	143	8 Sec. 1. This chapter applies to a policy of accident and sickness
144	144	9 insurance that is issued, delivered, amended, or renewed after June
145	145	10 30, 2025.
146	146	11 Sec. 2. As used in this chapter, "contraceptive products and
147	147	12 services" means the following:
148	148	13 (1) All contraceptive drugs, devices, products, and procedures
149	149	14 that are approved by the federal Food and Drug
150	150	15 Administration, including over-the-counter contraceptive
151	151	16 drugs, devices, and products as prescribed by the insured's
152	152	17 health care provider or as otherwise authorized under state or
153	153	18 federal law.
154	154	19 (2) All emergency contraception that is approved by the
155	155	20 federal Food and Drug Administration.
156	156	21 (3) Voluntary sterilization procedures.
157	157	22 (4) Patient education and counseling concerning
158	158	23 contraception.
159	159	24 (5) Follow-up services related to the drugs, devices, products,
160	160	25 and procedures covered under this chapter, including:
161	161	26 (A) management of side effects;
162	162	27 (B) counseling for continued adherence; and
163	163	28 (C) device insertion and removal.
164	164	29 Sec. 3. As used in this chapter, "cost sharing" means payment
165	165	30 of a deductible, coinsurance, copayment, or other out-of-pocket
166	166	31 cost required under a policy of accident and sickness insurance.
167	167	32 Sec. 4. As used in this chapter, "insured" means an individual
168	168	33 entitled to coverage under a policy of accident and sickness
169	169	34 insurance.
170	170	35 Sec. 5. As used in this chapter, "policy of accident and sickness
171	171	36 insurance" has the meaning set forth in IC 27-8-5-1.
172	172	37 Sec. 6. As used in this chapter, "therapeutic equivalent" means
173	173	38 a drug, device, or product that is designated as therapeutically
174	174	39 equivalent by the federal Food and Drug Administration in the
175	175	40 Approved Drug Products with Therapeutic Equivalence
176	176	41 Evaluations.
177	177	42 Sec. 7. Except as provided in section 9 of this chapter, a policy
178	178	2025 IN 1298—LS 6283/DI 154 5
179	179	1 of accident and sickness insurance shall provide coverage for
180	180	2 contraceptive products and services without cost sharing, subject
181	181	3 to the following:
182	182	4 (1) If the federal Food and Drug Administration has
183	183	5 designated a therapeutic equivalent of a contraceptive
184	184	6 product or service, the policy of accident and sickness
185	185	7 insurance must include either the original contraceptive
186	186	8 product or service or a therapeutic equivalent of the
187	187	9 contraceptive product or service. If there is no therapeutic
188	188	10 equivalent for the contraceptive product or service, the policy
189	189	11 of accident and sickness insurance must include the original
190	190	12 contraceptive product or service.
191	191	13 (2) If the contraceptive product or service is deemed
192	192	14 medically inadvisable by the insured's health care provider,
193	193	15 the policy of accident and sickness insurance shall:
194	194	16 (A) defer to the determination and judgment of the
195	195	17 attending health care provider; and
196	196	18 (B) provide coverage for the alternate prescribed
197	197	19 contraceptive product or service.
198	198	20 (3) The coverage must provide for the single dispensing of a
199	199	21 thirteen (13) unit supply of contraceptive products and
200	200	22 services intended to last over a twelve (12) month duration,
201	201	23 which may be furnished or dispensed all at once or over the
202	202	24 course of the twelve (12) months at the discretion of the health
203	203	25 care provider regardless of whether the insured was entitled
204	204	26 to coverage under the policy of accident and sickness
205	205	27 insurance at the time of the first dispensing. The policy of
206	206	28 accident and sickness insurance shall reimburse a health care
207	207	29 provider or dispensing entity per unit for furnishing or
208	208	30 dispensing an extended supply of contraceptive products and
209	209	31 services.
210	210	32 (4) Except as otherwise provided in this section, the policy of
211	211	33 accident and sickness insurance may not impose any
212	212	34 restrictions or delays on the coverage required under this
213	213	35 section.
214	214	36 (5) Nothing in this section shall be construed to exclude
215	215	37 coverage for contraceptive products and services as
216	216	38 prescribed by a health care provider acting within the health
217	217	39 care provider's scope of practice for:
218	218	40 (A) reasons other than contraceptive purposes, such as
219	219	41 decreasing the risk of ovarian cancer or eliminating
220	220	42 symptoms of menopause; or
221	221	2025 IN 1298—LS 6283/DI 154 6
222	222	1 (B) contraception that is necessary to preserve the life or
223	223	2 health of an insured.
224	224	3 Sec. 8. Except as provided in section 9 of this chapter, a policy
225	225	4 of accident and sickness insurance shall provide coverage without
226	226	5 cost sharing for the following:
227	227	6 (1) Counseling for sexually transmitted infections, including
228	228	7 human immunodeficiency virus and acquired immune
229	229	8 deficiency syndrome.
230	230	9 (2) Screening for:
231	231	10 (A) chlamydia;
232	232	11 (B) gonorrhea;
233	233	12 (C) hepatitis B;
234	234	13 (D) hepatitis C;
235	235	14 (E) human immunodeficiency virus;
236	236	15 (F) acquired immune deficiency syndrome;
237	237	16 (G) human papillomavirus; and
238	238	17 (H) syphilis.
239	239	18 (3) Pre-exposure prophylaxis, post-exposure prophylaxis, and
240	240	19 human papillomavirus vaccination.
241	241	20 Sec. 9. If a policy of accident and sickness insurance is offered
242	242	21 as a qualifying high deductible health plan for a health savings
243	243	22 account, the policy of accident and sickness insurance shall
244	244	23 establish cost sharing for the coverage under this chapter at the
245	245	24 minimum level necessary to preserve the insured's ability to claim
246	246	25 tax exempt contributions and withdrawal from the insured's health
247	247	26 savings account under 26 U.S.C. 223.
248	248	27 SECTION 3. IC 27-13-7-29 IS ADDED TO THE INDIANA CODE
249	249	28 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
250	250	29 1, 2025]: Sec. 29. (a) This section applies to an individual contract
251	251	30 and a group contract that is entered into, delivered, amended, or
252	252	31 renewed after June 30, 2025.
253	253	32 (b) As used in this section, "contraceptive products and
254	254	33 services" means the following:
255	255	34 (1) All contraceptive drugs, devices, products, and procedures
256	256	35 that are approved by the federal Food and Drug
257	257	36 Administration, including over-the-counter contraceptive
258	258	37 drugs, devices, and products as prescribed by the enrollee's
259	259	38 health care provider or as otherwise authorized under state or
260	260	39 federal law.
261	261	40 (2) All emergency contraception that is approved by the
262	262	41 federal Food and Drug Administration.
263	263	42 (3) Voluntary sterilization procedures.
264	264	2025 IN 1298—LS 6283/DI 154 7
265	265	1 (4) Patient education and counseling concerning
266	266	2 contraception.
267	267	3 (5) Follow-up services related to the drugs, devices, products,
268	268	4 and procedures covered under this section, including:
269	269	5 (A) management of side effects;
270	270	6 (B) counseling for continued adherence; and
271	271	7 (C) device insertion and removal.
272	272	8 (c) As used in this section, "cost sharing" means payment of a
273	273	9 deductible, coinsurance, copayment, or other out-of-pocket cost
274	274	10 required under an individual contract or a group contract.
275	275	11 (d) As used in this chapter, "therapeutic equivalent" means a
276	276	12 drug, device, or product that is designated as therapeutically
277	277	13 equivalent by the federal Food and Drug Administration in the
278	278	14 Approved Drug Products with Therapeutic Equivalence
279	279	15 Evaluations.
280	280	16 (e) An individual contract or a group contract shall provide
281	281	17 coverage for contraceptive products and services without cost
282	282	18 sharing, subject to the following:
283	283	19 (1) If the federal Food and Drug Administration has
284	284	20 designated a therapeutic equivalent of a contraceptive
285	285	21 product or service, the individual contract or group contract
286	286	22 must include either the original contraceptive product or
287	287	23 service or a therapeutic equivalent of the contraceptive
288	288	24 product or service. If there is no therapeutic equivalent for
289	289	25 the contraceptive product or service, the individual contract
290	290	26 or group contract must include the original contraceptive
291	291	27 product or service.
292	292	28 (2) If the contraceptive product or service is deemed
293	293	29 medically inadvisable by the enrollee's health care provider,
294	294	30 the individual contract or group contract shall:
295	295	31 (A) defer to the determination and judgment of the
296	296	32 attending health care provider; and
297	297	33 (B) provide coverage for the alternate prescribed
298	298	34 contraceptive product or service.
299	299	35 (3) The coverage must provide for the single dispensing of a
300	300	36 thirteen (13) unit supply of contraceptive products and
301	301	37 services intended to last over a twelve (12) month duration,
302	302	38 which may be furnished or dispensed all at once or over the
303	303	39 course of the twelve (12) months at the discretion of the health
304	304	40 care provider regardless of whether the enrollee was entitled
305	305	41 to coverage under the individual contract or group contract
306	306	42 at the time of the first dispensing. The individual contract or
307	307	2025 IN 1298—LS 6283/DI 154 8
308	308	1 a group contract shall reimburse a health care provider or
309	309	2 dispensing entity per unit for furnishing or dispensing an
310	310	3 extended supply of contraceptive products and services.
311	311	4 (4) Except as otherwise provided in this subsection, the
312	312	5 individual contract or group contract may not impose any
313	313	6 restrictions or delays on the coverage required under this
314	314	7 subsection.
315	315	8 (5) Nothing in this subsection shall be construed to exclude
316	316	9 coverage for contraceptive products and services as
317	317	10 prescribed by a health care provider acting within the health
318	318	11 care provider's scope of practice for:
319	319	12 (A) reasons other than contraceptive purposes, such as
320	320	13 decreasing the risk of ovarian cancer or eliminating
321	321	14 symptoms of menopause; or
322	322	15 (B) contraception that is necessary to preserve the life or
323	323	16 health of an enrollee.
324	324	17 (f) An individual contract or a group contract shall provide
325	325	18 coverage without cost sharing for the following:
326	326	19 (1) Counseling for sexually transmitted infections, including
327	327	20 human immunodeficiency virus and acquired immune
328	328	21 deficiency syndrome.
329	329	22 (2) Screening for:
330	330	23 (A) chlamydia;
331	331	24 (B) gonorrhea;
332	332	25 (C) hepatitis B;
333	333	26 (D) hepatitis C;
334	334	27 (E) human immunodeficiency virus;
335	335	28 (F) acquired immune deficiency syndrome;
336	336	29 (G) human papillomavirus; and
337	337	30 (H) syphilis.
338	338	31 (3) Pre-exposure prophylaxis, post-exposure prophylaxis, and
339	339	32 human papillomavirus vaccination.
340	340	2025 IN 1298—LS 6283/DI 154