Introduced Version
HOUSE BILL No. 1594
_____
DIGEST OF INTRODUCED BILL
Citations Affected: IC 5-10-8-27; IC 27-1-3-36; IC 27-8-40;
IC 27-13-7-29.
Synopsis: Coverage for preventative health services. Requires a state
employee health plan, a policy of accident and sickness insurance, and
a health maintenance organization contract to provide coverage for
preventative health services as determined by the insurance
commissioner. Prohibits a state employee health plan, a policy of
accident and sickness insurance, and a health maintenance organization
contract from imposing a cost sharing requirement for a preventative
health service that is provided by an in network health care provider.
Effective: July 1, 2025.
Barrett
January 21, 2025, read first time and referred to Committee on Insurance.
2025 IN 1594—LS 7588/DI 141 Introduced
First Regular Session of the 124th General Assembly (2025)
PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
Constitution) is being amended, the text of the existing provision will appear in this style type,
additions will appear in this style type, and deletions will appear in this style type.
Additions: Whenever a new statutory provision is being enacted (or a new constitutional
provision adopted), the text of the new provision will appear in this style type. Also, the
word NEW will appear in that style type in the introductory clause of each SECTION that adds
a new provision to the Indiana Code or the Indiana Constitution.
Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
between statutes enacted by the 2024 Regular Session of the General Assembly.
HOUSE BILL No. 1594
A BILL FOR AN ACT to amend the Indiana Code concerning
insurance.
Be it enacted by the General Assembly of the State of Indiana:
1 SECTION 1. IC 5-10-8-27 IS ADDED TO THE INDIANA CODE
2 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
3 1, 2025]: Sec. 27. (a) This section applies to a state employee health
4 plan that is established, entered into, amended, or renewed after
5 December 31, 2025.
6 (b) As used in this section, "cost sharing" means one (1) or more
7 of the following paid by or on behalf of a covered individual for
8 health services:
9 (1) Coinsurance.
10 (2) A copayment.
11 (3) A deductible.
12 (4) Any other payment of part of the cost of covered health
13 services that is made by the covered individual or by another
14 individual on behalf of the covered individual.
15 (c) As used in this section, "covered individual" means an
16 individual who is entitled to coverage under a state employee
17 health plan.
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1 (d) As used in this section, "state employee health plan" means
2 the following:
3 (1) A self-insurance program established under section 7(b) of
4 this chapter.
5 (2) A contract for prepaid health care services entered into
6 under section 7(c) of this chapter.
7 (e) A state employee health plan shall provide coverage for the
8 preventative health services as determined by the insurance
9 commissioner under IC 27-1-3-36.
10 (f) A state employee health plan may not impose a cost sharing
11 requirement for a preventative health service described in
12 subsection (e) that is provided by an in network health care
13 provider.
14 (g) Nothing in this section shall be construed to:
15 (1) prohibit a state employee health plan from providing
16 coverage for health services in addition to the preventative
17 health services described in subsection (e); or
18 (2) require a state employee health plan to deny coverage for
19 health services that are not described in subsection (e).
20 SECTION 2. IC 27-1-3-36 IS ADDED TO THE INDIANA CODE
21 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
22 1, 2025]: Sec. 36. (a) The commissioner shall, in consultation with
23 other appropriate state agencies, determine the preventative health
24 services that are subject to the coverage requirements under the
25 following provisions:
26 (1) IC 5-10-8-27.
27 (2) IC 27-8-40-5.
28 (3) IC 27-13-7-29.
29 (b) The commissioner shall adopt rules under IC 4-22-2 to
30 implement this section.
31 SECTION 3. IC 27-8-40 IS ADDED TO THE INDIANA CODE AS
32 A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE JULY
33 1, 2025]:
34 Chapter 40. Coverage for Preventative Health Services
35 Sec. 1. This chapter applies to a policy of accident and sickness
36 insurance that is issued, delivered, amended, or renewed after
37 December 31, 2025.
38 Sec. 2. As used in this chapter, "cost sharing" means one (1) or
39 more of the following paid by or on behalf of an insured for health
40 services:
41 (1) Coinsurance.
42 (2) A copayment.
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1 (3) A deductible.
2 (4) Any other payment of part of the cost of covered health
3 services that is made by the insured or by another individual
4 on behalf of the insured.
5 Sec. 3. As used in this chapter, "insured" means an individual
6 entitled to coverage under a policy of accident and sickness
7 insurance.
8 Sec. 4. As used in this chapter, "policy of accident and sickness
9 insurance" has the meaning set forth in IC 27-8-5-1. The term does
10 not include a policy, plan, or coverage set forth in IC 27-8-5-2.5(a).
11 Sec. 5. A policy of accident and sickness insurance shall provide
12 coverage for the preventative health services as determined by the
13 commissioner under IC 27-1-3-36.
14 Sec. 6. A policy of accident and sickness insurance may not
15 impose a cost sharing requirement for a preventative health service
16 described in section 5 of this chapter that is provided by an in
17 network health care provider.
18 Sec. 7. Nothing in this chapter shall be construed to:
19 (1) prohibit a policy of accident and sickness insurance from
20 providing coverage for preventative health services described
21 in section 5 of this chapter; or
22 (2) require a policy of accident and sickness insurance to deny
23 coverage for preventative health services that are not
24 described in section 5 of this chapter.
25 SECTION 4. IC 27-13-7-29 IS ADDED TO THE INDIANA CODE
26 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
27 1, 2025]: Sec. 29. (a) This section applies to an individual contract
28 and a group contract that is entered into, delivered, amended, or
29 renewed after December 31, 2025.
30 (b) As used in this section, "cost sharing" means one (1) or more
31 of the following paid by or on behalf of an enrollee for health
32 services:
33 (1) Coinsurance.
34 (2) A copayment.
35 (3) A deductible.
36 (4) Any other payment of part of the cost of covered health
37 services that is made by the enrollee or by another individual
38 on behalf of the enrollee.
39 (c) An individual contract or a group contract shall provide
40 coverage for the preventative health services as determined by the
41 commissioner under IC 27-1-3-36.
42 (d) An individual contract or a group contract may not impose
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1 a cost sharing requirement for a preventative health service
2 described in subsection (c) that is provided by an in network health
3 care provider.
4 (e) Nothing in this section shall be construed to:
5 (1) prohibit an individual contract or a group contract from
6 providing coverage for health services in addition to the
7 preventative health services described in subsection (c); or
8 (2) require an individual contract or a group contract to deny
9 coverage for health services that are not described in
10 subsection (c).
2025 IN 1594—LS 7588/DI 141