Indiana 2025 Regular Session

Indiana House Bill HB1594 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. 1594
4	4	_____
5	5	DIGEST OF INTRODUCED BILL
6	6	Citations Affected: IC 5-10-8-27; IC 27-1-3-36; IC 27-8-40;
7	7	IC 27-13-7-29.
8	8	Synopsis: Coverage for preventative health services. Requires a state
9	9	employee health plan, a policy of accident and sickness insurance, and
10	10	a health maintenance organization contract to provide coverage for
11	11	preventative health services as determined by the insurance
12	12	commissioner. Prohibits a state employee health plan, a policy of
13	13	accident and sickness insurance, and a health maintenance organization
14	14	contract from imposing a cost sharing requirement for a preventative
15	15	health service that is provided by an in network health care provider.
16	16	Effective: July 1, 2025.
17	17	Barrett
18	18	January 21, 2025, read first time and referred to Committee on Insurance.
19	19	2025 IN 1594—LS 7588/DI 141 Introduced
20	20	First Regular Session of the 124th General Assembly (2025)
21	21	PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
22	22	Constitution) is being amended, the text of the existing provision will appear in this style type,
23	23	additions will appear in this style type, and deletions will appear in this style type.
24	24	Additions: Whenever a new statutory provision is being enacted (or a new constitutional
25	25	provision adopted), the text of the new provision will appear in this style type. Also, the
26	26	word NEW will appear in that style type in the introductory clause of each SECTION that adds
27	27	a new provision to the Indiana Code or the Indiana Constitution.
28	28	Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
29	29	between statutes enacted by the 2024 Regular Session of the General Assembly.
30	30	HOUSE BILL No. 1594
31	31	A BILL FOR AN ACT to amend the Indiana Code concerning
32	32	insurance.
33	33	Be it enacted by the General Assembly of the State of Indiana:
34	34	1 SECTION 1. IC 5-10-8-27 IS ADDED TO THE INDIANA CODE
35	35	2 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
36	36	3 1, 2025]: Sec. 27. (a) This section applies to a state employee health
37	37	4 plan that is established, entered into, amended, or renewed after
38	38	5 December 31, 2025.
39	39	6 (b) As used in this section, "cost sharing" means one (1) or more
40	40	7 of the following paid by or on behalf of a covered individual for
41	41	8 health services:
42	42	9 (1) Coinsurance.
43	43	10 (2) A copayment.
44	44	11 (3) A deductible.
45	45	12 (4) Any other payment of part of the cost of covered health
46	46	13 services that is made by the covered individual or by another
47	47	14 individual on behalf of the covered individual.
48	48	15 (c) As used in this section, "covered individual" means an
49	49	16 individual who is entitled to coverage under a state employee
50	50	17 health plan.
51	51	2025 IN 1594—LS 7588/DI 141 2
52	52	1 (d) As used in this section, "state employee health plan" means
53	53	2 the following:
54	54	3 (1) A self-insurance program established under section 7(b) of
55	55	4 this chapter.
56	56	5 (2) A contract for prepaid health care services entered into
57	57	6 under section 7(c) of this chapter.
58	58	7 (e) A state employee health plan shall provide coverage for the
59	59	8 preventative health services as determined by the insurance
60	60	9 commissioner under IC 27-1-3-36.
61	61	10 (f) A state employee health plan may not impose a cost sharing
62	62	11 requirement for a preventative health service described in
63	63	12 subsection (e) that is provided by an in network health care
64	64	13 provider.
65	65	14 (g) Nothing in this section shall be construed to:
66	66	15 (1) prohibit a state employee health plan from providing
67	67	16 coverage for health services in addition to the preventative
68	68	17 health services described in subsection (e); or
69	69	18 (2) require a state employee health plan to deny coverage for
70	70	19 health services that are not described in subsection (e).
71	71	20 SECTION 2. IC 27-1-3-36 IS ADDED TO THE INDIANA CODE
72	72	21 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
73	73	22 1, 2025]: Sec. 36. (a) The commissioner shall, in consultation with
74	74	23 other appropriate state agencies, determine the preventative health
75	75	24 services that are subject to the coverage requirements under the
76	76	25 following provisions:
77	77	26 (1) IC 5-10-8-27.
78	78	27 (2) IC 27-8-40-5.
79	79	28 (3) IC 27-13-7-29.
80	80	29 (b) The commissioner shall adopt rules under IC 4-22-2 to
81	81	30 implement this section.
82	82	31 SECTION 3. IC 27-8-40 IS ADDED TO THE INDIANA CODE AS
83	83	32 A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE JULY
84	84	33 1, 2025]:
85	85	34 Chapter 40. Coverage for Preventative Health Services
86	86	35 Sec. 1. This chapter applies to a policy of accident and sickness
87	87	36 insurance that is issued, delivered, amended, or renewed after
88	88	37 December 31, 2025.
89	89	38 Sec. 2. As used in this chapter, "cost sharing" means one (1) or
90	90	39 more of the following paid by or on behalf of an insured for health
91	91	40 services:
92	92	41 (1) Coinsurance.
93	93	42 (2) A copayment.
94	94	2025 IN 1594—LS 7588/DI 141 3
95	95	1 (3) A deductible.
96	96	2 (4) Any other payment of part of the cost of covered health
97	97	3 services that is made by the insured or by another individual
98	98	4 on behalf of the insured.
99	99	5 Sec. 3. As used in this chapter, "insured" means an individual
100	100	6 entitled to coverage under a policy of accident and sickness
101	101	7 insurance.
102	102	8 Sec. 4. As used in this chapter, "policy of accident and sickness
103	103	9 insurance" has the meaning set forth in IC 27-8-5-1. The term does
104	104	10 not include a policy, plan, or coverage set forth in IC 27-8-5-2.5(a).
105	105	11 Sec. 5. A policy of accident and sickness insurance shall provide
106	106	12 coverage for the preventative health services as determined by the
107	107	13 commissioner under IC 27-1-3-36.
108	108	14 Sec. 6. A policy of accident and sickness insurance may not
109	109	15 impose a cost sharing requirement for a preventative health service
110	110	16 described in section 5 of this chapter that is provided by an in
111	111	17 network health care provider.
112	112	18 Sec. 7. Nothing in this chapter shall be construed to:
113	113	19 (1) prohibit a policy of accident and sickness insurance from
114	114	20 providing coverage for preventative health services described
115	115	21 in section 5 of this chapter; or
116	116	22 (2) require a policy of accident and sickness insurance to deny
117	117	23 coverage for preventative health services that are not
118	118	24 described in section 5 of this chapter.
119	119	25 SECTION 4. IC 27-13-7-29 IS ADDED TO THE INDIANA CODE
120	120	26 AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
121	121	27 1, 2025]: Sec. 29. (a) This section applies to an individual contract
122	122	28 and a group contract that is entered into, delivered, amended, or
123	123	29 renewed after December 31, 2025.
124	124	30 (b) As used in this section, "cost sharing" means one (1) or more
125	125	31 of the following paid by or on behalf of an enrollee for health
126	126	32 services:
127	127	33 (1) Coinsurance.
128	128	34 (2) A copayment.
129	129	35 (3) A deductible.
130	130	36 (4) Any other payment of part of the cost of covered health
131	131	37 services that is made by the enrollee or by another individual
132	132	38 on behalf of the enrollee.
133	133	39 (c) An individual contract or a group contract shall provide
134	134	40 coverage for the preventative health services as determined by the
135	135	41 commissioner under IC 27-1-3-36.
136	136	42 (d) An individual contract or a group contract may not impose
137	137	2025 IN 1594—LS 7588/DI 141 4
138	138	1 a cost sharing requirement for a preventative health service
139	139	2 described in subsection (c) that is provided by an in network health
140	140	3 care provider.
141	141	4 (e) Nothing in this section shall be construed to:
142	142	5 (1) prohibit an individual contract or a group contract from
143	143	6 providing coverage for health services in addition to the
144	144	7 preventative health services described in subsection (c); or
145	145	8 (2) require an individual contract or a group contract to deny
146	146	9 coverage for health services that are not described in
147	147	10 subsection (c).
148	148	2025 IN 1594—LS 7588/DI 141