LEGISLATIVE SERVICES AGENCY
OFFICE OF FISCAL AND MANAGEMENT ANALYSIS
FISCAL IMPACT STATEMENT
LS 7588 NOTE PREPARED: Jan 14, 2025
BILL NUMBER: HB 1594 BILL AMENDED:
SUBJECT: Coverage for Preventative Health Services.
FIRST AUTHOR: Rep. Barrett BILL STATUS: As Introduced
FIRST SPONSOR:
FUNDS AFFECTED:XGENERAL IMPACT: State & Local
XDEDICATED
FEDERAL
Summary of Legislation: This bill requires a state employee health plan (SEHP), 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. It prohibits a SEHP, 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 Date: July 1, 2025.
Explanation of State Expenditures: The bill will increase state expenditures for the SEHP to pay the cost
sharing amount for any service or drug determined to be preventative by the Department of Insurance (DOI)
that is not currently considered to be preventative under the SEHP. The increase in state expenditures will
depend on decisions of the DOI in identifying preventative services and the utilization of newly-considered
preventative services.
The bill’s requirements will increase workload for the DOI but should be able to be implemented using
existing staffing and resources. [The DOI is funded through a dedicated agency fund.]
Additional Information: Under the SEHP, preventive care is covered at 100% with in-network providers.
Preventive care services include an annual physical, yearly eye exam, yearly dental exams and cleanings,
cancer screenings, and some vaccines. Non-preventative SEHP services have coinsurance requirements of
10% and 30% depending on the tier of the in-network provider, while the copay amounts for
non-preventative drug coverage range from $10 to a maximum of $210.
Explanation of State Revenues:
Explanation of Local Expenditures: Local entities providing health plans may have increased expenditures
to pay the cost sharing amount for any service or drug determined to be preventative by the DOI that is not
currently considered to be preventative under the plan.
HB 1594 1 Explanation of Local Revenues:
State Agencies Affected: Department of Insurance; State Personnel Department; all state agencies.
Local Agencies Affected: Local units offering health plans.
Information Sources: https://www.in.gov/investinyourhealth/preventive-care;
https://www.in.gov/spd/benefits/health-plan-options.
Fiscal Analyst: Jason Barrett, 317-232-9809.
HB 1594 2