*ES0140.2*
Reprinted
April 15, 2025
ENGROSSED
SENATE BILL No. 140
_____
DIGEST OF SB 140 (Updated April 14, 2025 3:55 pm - DI 141)
Citations Affected: IC 27-1; IC 27-2.
Synopsis: Pharmacy benefits. Requires an insurer, a pharmacy benefit
manager, or any other administrator of pharmacy benefits to ensure that
a network utilized by the insurer, pharmacy benefit manager, or other
administrator is reasonably adequate and accessible and file an annual
report regarding the network with the commissioner. Sets forth certain
(Continued next page)
Effective: June 30, 2025; January 1, 2026.
Charbonneau, Johnson T, Zay,
Randolph Lonnie M, Byrne, Becker
(HOUSE SPONSORS — MCGUIRE, CAMPBELL, SHACKLEFORD)
January 8, 2025, read first time and referred to Committee on Health and Provider
Services.
January 23, 2025, amended, reported favorably — Do Pass; reassigned to Committee on
Appropriations.
February 13, 2025, amended, reported favorably — Do Pass.
February 18, 2025, read second time, ordered engrossed. Engrossed. Returned to second
reading.
February 19, 2025, re-read second time, amended, ordered engrossed.
February 20, 2025, re-engrossed. Read third time, passed. Yeas 47, nays 2.
HOUSE ACTION
March 3, 2025, read first time and referred to Committee on Insurance.
April 8, 2025, amended, reported — Do Pass.
April 14, 2025, read second time, amended, ordered engrossed.
ES 140—LS 6503/DI 141 Digest Continued
limitations and requirements with respect to the provision of pharmacy
or pharmacist services under a health plan. Allows any insured,
pharmacy, or pharmacist impacted by an alleged violation to file a
complaint with the commissioner. Provides that the commissioner may
order reimbursement to any person who has incurred a monetary loss
as a result of a violation. Requires, if a pharmacy benefit manger is
used with regard to a state employee health plan, the state personnel
department to either create a pharmacy benefit manager or contract
with an insurer, a pharmacy benefit manager, or other administrator.
Prohibits a third party administrator from: (1) requiring, as a condition
of a plan sponsor entering into a contract with the third party
administrator, that the plan sponsor enter into a contract with a
particular pharmacy benefit manager; or (2) charging a different fee for
services provided by the third party administrator to a plan sponsor
based on the plan sponsor's selection of a particular pharmacy benefit
manager. Provides that certain provisions requiring a notice of material
change apply to personal automobile or homeowner's policies that are
issued, delivered, amended, or renewed after June 30, 2026.
ES 140—LS 6503/DI 141ES 140—LS 6503/DI 141 Reprinted
April 15, 2025
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.
ENGROSSED
SENATE BILL No. 140
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 27-1-24.6 IS ADDED TO THE INDIANA CODE
2 AS A NEW CHAPTER TO READ AS FOLLOWS [EFFECTIVE
3 JANUARY 1, 2026]:
4 Chapter 24.6. Pharmacy Benefits
5 Sec. 1. This chapter applies to a policy or contract that is issued,
6 delivered, entered into, renewed, or amended after December 31,
7 2025.
8 Sec. 2. As used in this chapter, "actual overpayment" means the
9 portion of any amount paid for pharmacy or pharmacist services
10 that:
11 (1) is duplicative because the pharmacy or pharmacist has
12 already been paid for the services; or
13 (2) was erroneously paid because the services were not
14 rendered in accordance with the prescriber's order, in which
15 case only the amount paid for the portion of the prescription
16 that was filled incorrectly or in excess of the prescriber's
17 order is deemed an actual overpayment.
ES 140—LS 6503/DI 141 2
1 Sec. 3. As used in this chapter, "ambulatory pharmacy" means
2 a pharmacy that:
3 (1) is open to the general public; and
4 (2) dispenses outpatient prescription drugs.
5 Sec. 4. As used in this chapter, "common control" includes:
6 (1) sharing common management or managers; and
7 (2) having common members on boards of directors.
8 Sec. 5. As used in this chapter, "cost sharing" means the cost to
9 an insured under a health plan according to any coverage limit,
10 copayment, coinsurance, deductible, or other out-of-pocket expense
11 requirements imposed by the health plan.
12 Sec. 6. (a) As used in this chapter, "health plan" means the
13 following:
14 (1) A state employee health plan (as defined in IC 5-10-8-6.7).
15 (2) A policy of accident and sickness insurance (as defined in
16 IC 27-8-5-1). However, the term does not include the
17 coverages described in IC 27-8-5-2.5(a).
18 (3) An individual contract (as defined in IC 27-13-1-21) or a
19 group contract (as defined in IC 27-13-1-16) that provides
20 coverage for basic health care services (as defined in
21 IC 27-13-1-4).
22 (4) Any other plan or program that provides payment,
23 reimbursement, or indemnification to a covered individual for
24 the cost of prescription drugs.
25 (b) The term does not include the following:
26 (1) A self-insured health plan provided by a hospital or health
27 system to its employees and dependents of employees if the
28 hospital or health system owns a pharmacy.
29 (2) A prescription drug plan established under Medicare Part
30 D.
31 Sec. 7. As used in this chapter, "insured" means an individual
32 covered under a health plan.
33 Sec. 8. (a) As used in this chapter, "insurer" means any of the
34 following that offer or issue a health plan:
35 (1) An insurance company.
36 (2) A health maintenance organization.
37 (3) A limited health service organization.
38 (4) A self-insurer, including a governmental plan, church
39 plan, or multiple employer welfare arrangement.
40 (5) A provider sponsored integrated health delivery network.
41 (6) A self-insured employer organized association.
42 (7) A nonprofit hospital, medical-surgical, dental, and health
ES 140—LS 6503/DI 141 3
1 service corporation.
2 (8) Any other third party payor that is:
3 (A) authorized to transact health insurance business in
4 Indiana; or
5 (B) not exempt by federal law from regulation under the
6 insurance laws of Indiana.
7 (b) The term includes any person or entity that has contracted
8 with a state or federal agency to provide coverage under a health
9 plan.
10 Sec. 9. As used in this chapter, "national drug code number"
11 means the unique national drug code number that identifies:
12 (1) a specific approved drug;
13 (2) the manufacturer of the drug; and
14 (3) the package presentation of the drug.
15 Sec. 10. As used in this chapter, "net amount" means the
16 amount paid to a pharmacy or pharmacist by the insurer,
17 pharmacy benefit manager, or other administrator minus:
18 (1) any fees;
19 (2) any price concessions; and
20 (3) all other revenue;
21 passing from the pharmacy or pharmacist to the insurer,
22 pharmacy benefit manager, or other administrator.
23 Sec. 11. As used in this chapter, "pharmacy" has the meaning
24 set forth in IC 25-26-13-2.
25 Sec. 12. As used in this chapter, "pharmacy affiliate" means a
26 pharmacy, including a specialty pharmacy, that directly or
27 indirectly, through one (1) or more intermediaries:
28 (1) owns or controls;
29 (2) is owned or controlled by; or
30 (3) is under common ownership or common control with;
31 an insurer, a pharmacy benefit manager, or other administrator of
32 pharmacy benefits.
33 Sec. 13. As used in this chapter, "pharmacy benefit manager"
34 has the meaning set forth in IC 27-1-24.5-12.
35 Sec. 14. (a) As used in this chapter, "pharmacy or pharmacist
36 services" means any:
37 (1) health care procedures or treatments within the scope of
38 practice of a pharmacist; or
39 (2) services provided by a pharmacy or pharmacist.
40 (b) The term includes the sale and provision of the following by
41 a pharmacy or pharmacist:
42 (1) Prescription drugs.
ES 140—LS 6503/DI 141 4
1 (2) Home medical equipment (as defined in IC 25-26-21-2).
2 Sec. 15. As used in this chapter, "wholesale acquisition cost":
3 (1) means the manufacturer's list price for a drug to
4 wholesalers or direct purchasers in the United States for the
5 most recent month for which the information is available, as
6 reported in wholesale price guides or other publications of
7 drug pricing data; and
8 (2) does not include prompt pay or other discounts, rebates,
9 or reductions in price.
10 Sec. 16. (a) An insurer, a pharmacy benefit manager, or any
11 other administrator of pharmacy benefits that utilizes a network
12 to provide pharmacy or pharmacist services under a health plan
13 shall ensure that the network is reasonably adequate and accessible
14 with respect to the provision of pharmacy or pharmacist services.
15 (b) A reasonably adequate and accessible network with respect
16 to the provision of pharmacy or pharmacist services must, at a
17 minimum:
18 (1) offer an adequate number of accessible pharmacies that
19 are not mail order pharmacies; and
20 (2) provide convenient access to pharmacies that are not mail
21 order pharmacies within a reasonable distance of not more
22 than thirty (30) miles from each insured's residence, to the
23 extent that pharmacy or pharmacist services are available.
24 (c) An insurer, a pharmacy benefit manager, and any other
25 administrator of pharmacy benefits shall file an annual report with
26 the commissioner in a manner and form prescribed by the
27 commissioner. The annual report must describe the networks of
28 the insurer, pharmacy benefit manager, or other administrator
29 that are utilized for the provision of pharmacy or pharmacist
30 services under a health plan.
31 (d) The commissioner shall review each network reported under
32 subsection (c) to ensure that the network complies with this section.
33 (e) All information and data acquired by the department under
34 this section that is generally recognized as confidential or
35 proprietary is confidential for the purposes of IC 5-14-3-4 and may
36 not be disclosed by the department. However, the department may
37 publicly disclose aggregated information that is not descriptive of
38 any readily identifiable person or entity.
39 Sec. 17. (a) A contract between a pharmacy or pharmacist and
40 an insurer, a pharmacy benefit manager, or any other
41 administrator of pharmacy benefits for the provision of pharmacy
42 or pharmacist services under a health plan, either directly or
ES 140—LS 6503/DI 141 5
1 through a pharmacy services administrative organization or group
2 purchasing organization, must include provisions that do the
3 following:
4 (1) Outline the terms and conditions for the provision of
5 pharmacy or pharmacist services.
6 (2) Subject to subsection (b), prohibit the insurer, pharmacy
7 benefit manager, or other administrator from retroactively
8 denying, reducing reimbursement for, or seeking any refunds
9 or recoupments for a claim for pharmacy or pharmacist
10 services, in whole or in part, from the pharmacy or
11 pharmacist after returning a paid claim response as part of
12 the adjudication of the claim, including claims for the cost of
13 a medication or dispensed product and claims for pharmacy
14 or pharmacist services that are deemed ineligible for
15 coverage, unless:
16 (A) the original claim was submitted fraudulently; or
17 (B) the pharmacy or pharmacist received an actual
18 overpayment.
19 (3) Prohibit the insurer, pharmacy benefit manager, or other
20 administrator from reimbursing the pharmacy or pharmacist
21 for a prescription drug or other service at a net amount that
22 is less than the greater of the following:
23 (A) The amount the insurer, pharmacy benefit manager, or
24 other administrator reimburses itself or a pharmacy
25 affiliate for the same prescription drug by national code
26 number or service.
27 (B) The following amount, as applicable:
28 (i) If the prescription drug or service is administered,
29 dispensed, or provided at a pharmacy that is a licensed
30 premises (as defined in IC 7.1-1-3-20), the pharmacy's
31 acquisition cost reported by the pharmacy or pharmacist
32 for the prescription drug by national code number or
33 service plus a professional dispensing fee equal to the
34 Medicaid fee for service dispensing fee under 405
35 IAC 5-24-6.
36 (ii) If the prescription drug or service is administered,
37 dispensed, or provided at a pharmacy not described in
38 item (i), the national average drug acquisition cost
39 (NADAC) for the prescription drug or service, as
40 determined by the federal Centers for Medicare and
41 Medicaid Services at the time the prescription drug or
42 service is administered, dispensed, or provided plus a
ES 140—LS 6503/DI 141 6
1 professional dispensing fee equal to the Medicaid fee for
2 service dispensing fee under 405 IAC 5-24-6.
3 (b) An insurer, a pharmacy benefit manager, or any other
4 administrator of pharmacy benefits may not request a refund or
5 make a recoupment of a dispensing fee paid to the pharmacy if the
6 correct medication was dispensed to the patient.
7 Sec. 18. (a) Except as provided in section 17 of this chapter, with
8 respect to the provision of pharmacy or pharmacist services under
9 a health plan, an insurer, a pharmacy benefit manager, or any
10 other administrator of pharmacy benefits may not:
11 (1) prohibit a pharmacy or pharmacist from, or impose a
12 penalty on a pharmacy or pharmacist for:
13 (A) selling a lower cost alternative to an insured, if a lower
14 cost alternative is available; or
15 (B) providing information to an insured under subsection
16 (b);
17 (2) discriminate against any pharmacy or pharmacist that is:
18 (A) located within the geographic coverage area of the
19 health plan; and
20 (B) willing to agree to, or accept, terms and conditions
21 established for participation in the insurer's, pharmacy
22 benefit manager's, other administrator's, or health plan's
23 network;
24 (3) impose limits, including quantity limits or refill frequency
25 limits, on an insured's access to medication from a pharmacy
26 that are more restrictive than those existing for a pharmacy
27 affiliate;
28 (4) require a pharmacy or pharmacist to enter into an
29 additional contract with an affiliate of the insurer, pharmacy
30 benefit manager, or other administrator of pharmacy benefits
31 as a condition of entering into a contract with this insurer,
32 pharmacy benefit manager, or administrator; or
33 (5) require a pharmacy or pharmacist to, as a condition of a
34 contract, agree to payment rates for any affiliate of the
35 insurer, pharmacy benefit manager, or other administrator of
36 pharmacy benefits that is not a party to the contract.
37 (b) A pharmacist shall have the right to provide an insured with
38 information regarding lower cost alternatives to assist the insured
39 in making informed decisions.
40 Sec. 19. (a) Any insured, pharmacy, or pharmacist impacted by
41 an alleged violation of this chapter may file a complaint with the
42 commissioner.
ES 140—LS 6503/DI 141 7
1 (b) The commissioner shall:
2 (1) review and investigate all complaints filed under this
3 section; and
4 (2) issue, in writing, a determination to the insured,
5 pharmacy, or pharmacist as to whether a violation occurred.
6 (c) An insurer, a pharmacy benefit manager, or any other
7 administrator of pharmacy benefits shall:
8 (1) respond to; and
9 (2) comply with;
10 any requests made by the commissioner under this section.
11 Sec. 20. (a) This section applies to a state employee health plan
12 (as defined in IC 5-10-8-6.7). If a pharmacy benefit manager is
13 used with regard to a state employee health plan, the state
14 personnel department shall either:
15 (1) create a pharmacy benefit manager within the state
16 personnel department; or
17 (2) contract with an insurer, a pharmacy benefit manager, or
18 any other administrator of pharmacy benefits.
19 (b) All data collected by a contractor while administering a
20 contract under subsection (a)(2) is the property of the state.
21 Sec. 21. (a) As used in this section, "plan sponsor" means an
22 employer or organization that:
23 (1) has more than one hundred (100) employees or members;
24 and
25 (2) offers health insurance coverage to its employees or
26 members through a self-funded health benefit plan.
27 (b) A third party administrator may not:
28 (1) require, as a condition of a plan sponsor entering into a
29 contract with the third party administrator, that the plan
30 sponsor enter into a contract with a particular pharmacy
31 benefit manager; or
32 (2) charge a different fee for services provided by the third
33 party administrator to a plan sponsor based on the plan
34 sponsor's selection of a particular pharmacy benefit manager.
35 Sec. 22. In addition to any other remedies, penalties, or damages
36 available under common law or statute, the commissioner may
37 order reimbursement to any person who has incurred a monetary
38 loss as a result of a violation of this chapter.
39 Sec. 23. This chapter applies to the extent that it is not in conflict
40 with federal law.
41 SECTION 2. IC 27-2-28-1, AS AMENDED BY P.L.158-2024,
42 SECTION 18, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
ES 140—LS 6503/DI 141 8
1 JUNE 30, 2025]: Sec. 1. (a) This chapter applies to a personal
2 automobile or homeowner's policy that is issued, delivered, amended,
3 or renewed after June 30, 2025. 2026.
4 (b) This chapter does not apply to notices required by the federal
5 Fair Credit Reporting Act (15 U.S.C. 1681 et seq.).
ES 140—LS 6503/DI 141 9
COMMITTEE REPORT
Mr. President: The Senate Committee on Health and Provider
Services, to which was referred Senate Bill No. 140, has had the same
under consideration and begs leave to report the same back to the
Senate with the recommendation that said bill be AMENDED as
follows:
Page 2, line 28, delete "and".
Page 2, line 30, delete "IC 27-1-24.5-12)." and insert "IC
27-1-24.5-12); and
(3) provides interoperability in the manner in which the data
is reported.".
Page 7, line 4, delete "administration" and insert "administrative".
Page 10, line 35, delete "or".
Page 11, line 1, delete "and".
Page 11, between lines 1 and 2, begin a new line double block
indented and insert:
"(G) require a pharmacy or pharmacist to enter into an
additional contract with an affiliate of the insurer,
pharmacy benefit manager, or other administrator of
pharmacy benefits as a condition of entering into a
contract with this insurer, pharmacy benefit manager, or
administrator; or
(H) require a pharmacy or pharmacist to, as a condition of
a contract, agree to payment rates for any affiliate of the
insurer, pharmacy benefit manager, or other
administrator of pharmacy benefits that is not a party to
the contract; and".
and when so amended that said bill do pass and be reassigned to the
Senate Committee on Appropriations.
(Reference is to SB 140 as introduced.)
CHARBONNEAU, Chairperson
Committee Vote: Yeas 10, Nays 1.
ES 140—LS 6503/DI 141 10
COMMITTEE REPORT
Mr. President: The Senate Committee on Appropriations, to which
was referred Senate Bill No. 140, has had the same under consideration
and begs leave to report the same back to the Senate with the
recommendation that said bill be AMENDED as follows:
Page 1, delete lines 1 through 17.
Page 2, delete lines 1 through 32.
Page 9, delete lines 14 through 31.
Page 9, line 32, delete "19." and insert "18.".
Page 11, line 41, delete "20." and insert "19.".
Page 12, between lines 15 and 16, begin a new paragraph and insert:
"Sec. 20. (a) This section applies to a state employee health plan
(as defined in IC 5-10-8-6.7). If a pharmacy benefit manager is
used with regard to a state employee health plan, the commissioner
shall either:
(1) create a pharmacy benefit manager within the
department; or
(2) contract with an insurer, a pharmacy benefit manager, or
any other administrator of pharmacy benefits.
(b) All data collected by a contractor while administering a
contract under subsection (a)(2) is the property of the state.".
Renumber all SECTIONS consecutively.
and when so amended that said bill do pass.
(Reference is to SB 140 as printed January 24, 2025.)
MISHLER, Chairperson
Committee Vote: Yeas 13, Nays 0.
_____
SENATE MOTION
Mr. President: I move that Engrossed Senate Bill 140, which is
eligible for third reading, be returned to second reading for purposes of
amendment.
CHARBONNEAU
ES 140—LS 6503/DI 141 11
SENATE MOTION
Mr. President: I move that Senate Bill 140 be amended to read as
follows:
Page 1, between the enacting clause and line 1, begin a new
paragraph and insert:
"SECTION 1. IC 27-1-7-2.5 IS ADDED TO THE INDIANA CODE
AS A NEW SECTION TO READ AS FOLLOWS [EFFECTIVE JULY
1, 2026]: Sec. 2.5. (a) This section applies to a policy of health
insurance coverage that is issued, delivered, amended, or renewed
after June 30, 2026.
(b) As used in this section, "health carrier" has the meaning set
forth in IC 27-1-46-3.
(c) A health carrier may not contract with, enter into an
agreement with, or use a pharmacy benefit manager to provide
services for a policy of health insurance coverage described in
subsection (a) if the health carrier has an ownership interest in the
pharmacy benefit manager.
(d) A person that willfully violates this section commits an
unfair and deceptive act or practice in the business of insurance
under IC 27-4-1-4 and is subject to the penalties and procedures set
forth in IC 27-4-1.
SECTION 2. IC 27-1-24.5-18.5 IS ADDED TO THE INDIANA
CODE AS A NEW SECTION TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2026]: Sec. 18.5. (a) This section applies to a
policy of health insurance coverage that is issued, delivered,
amended, or renewed after June 30, 2026.
(b) As used in this section, "health carrier" has the meaning set
forth in IC 27-1-46-3.
(c) A pharmacy benefit manager licensed under this chapter
may not provide services under a policy of health insurance
coverage for a health carrier that has an ownership interest in the
pharmacy benefit manager.
SECTION 3. IC 27-1-24.5-18.7 IS ADDED TO THE INDIANA
CODE AS A NEW SECTION TO READ AS FOLLOWS
[EFFECTIVE JULY 1, 2026]: Sec. 18.7. A pharmacy benefit
manager licensed under this chapter may not have an ownership
interest in a pharmacy.".
Page 6, between lines 34 and 35, begin a new line double block
indented and insert:
"(C) Reimbursing the pharmacy or pharmacist for a
prescription drug or other service at a net amount that is
ES 140—LS 6503/DI 141 12
less than the greater of:
(i) the amount the insurer, pharmacy benefit manager,
or other administrator reimburses itself or a pharmacy
affiliate for the same prescription drug by national code
number or service; or
(ii) the pharmacy's acquisition cost reported by the
pharmacy or pharmacist for the prescription drug by
national code number or service plus a professional
dispensing fee equal to the Medicaid fee for service
dispensing fee under 405 IAC 5-24-6.".
Page 6, delete lines 35 through 41.
Page 7, delete lines 9 through 42.
Page 8, delete lines 1 through 2.
Page 11, after line 6, begin a new paragraph and insert:
"SECTION 6. IC 27-4-1-4, AS AMENDED BY P.L.158-2024,
SECTION 19, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JULY 1, 2026]: Sec. 4. (a) The following are hereby defined as unfair
methods of competition and unfair and deceptive acts and practices in
the business of insurance:
(1) Making, issuing, circulating, or causing to be made, issued, or
circulated, any estimate, illustration, circular, or statement:
(A) misrepresenting the terms of any policy issued or to be
issued or the benefits or advantages promised thereby or the
dividends or share of the surplus to be received thereon;
(B) making any false or misleading statement as to the
dividends or share of surplus previously paid on similar
policies;
(C) making any misleading representation or any
misrepresentation as to the financial condition of any insurer,
or as to the legal reserve system upon which any life insurer
operates;
(D) using any name or title of any policy or class of policies
misrepresenting the true nature thereof; or
(E) making any misrepresentation to any policyholder insured
in any company for the purpose of inducing or tending to
induce such policyholder to lapse, forfeit, or surrender the
policyholder's insurance.
(2) Making, publishing, disseminating, circulating, or placing
before the public, or causing, directly or indirectly, to be made,
published, disseminated, circulated, or placed before the public,
in a newspaper, magazine, or other publication, or in the form of
a notice, circular, pamphlet, letter, or poster, or over any radio or
ES 140—LS 6503/DI 141 13
television station, or in any other way, an advertisement,
announcement, or statement containing any assertion,
representation, or statement with respect to any person in the
conduct of the person's insurance business, which is untrue,
deceptive, or misleading.
(3) Making, publishing, disseminating, or circulating, directly or
indirectly, or aiding, abetting, or encouraging the making,
publishing, disseminating, or circulating of any oral or written
statement or any pamphlet, circular, article, or literature which is
false, or maliciously critical of or derogatory to the financial
condition of an insurer, and which is calculated to injure any
person engaged in the business of insurance.
(4) Entering into any agreement to commit, or individually or by
a concerted action committing any act of boycott, coercion, or
intimidation resulting or tending to result in unreasonable
restraint of, or a monopoly in, the business of insurance.
(5) Filing with any supervisory or other public official, or making,
publishing, disseminating, circulating, or delivering to any person,
or placing before the public, or causing directly or indirectly, to
be made, published, disseminated, circulated, delivered to any
person, or placed before the public, any false statement of
financial condition of an insurer with intent to deceive. Making
any false entry in any book, report, or statement of any insurer
with intent to deceive any agent or examiner lawfully appointed
to examine into its condition or into any of its affairs, or any
public official to which such insurer is required by law to report,
or which has authority by law to examine into its condition or into
any of its affairs, or, with like intent, willfully omitting to make a
true entry of any material fact pertaining to the business of such
insurer in any book, report, or statement of such insurer.
(6) Issuing or delivering or permitting agents, officers, or
employees to issue or deliver, agency company stock or other
capital stock, or benefit certificates or shares in any common law
corporation, or securities or any special or advisory board
contracts or other contracts of any kind promising returns and
profits as an inducement to insurance.
(7) Making or permitting any of the following:
(A) Unfair discrimination between individuals of the same
class and equal expectation of life in the rates or assessments
charged for any contract of life insurance or of life annuity or
in the dividends or other benefits payable thereon, or in any
other of the terms and conditions of such contract. However,
ES 140—LS 6503/DI 141 14
in determining the class, consideration may be given to the
nature of the risk, plan of insurance, the actual or expected
expense of conducting the business, or any other relevant
factor.
(B) Unfair discrimination between individuals of the same
class involving essentially the same hazards in the amount of
premium, policy fees, assessments, or rates charged or made
for any policy or contract of accident or health insurance or in
the benefits payable thereunder, or in any of the terms or
conditions of such contract, or in any other manner whatever.
However, in determining the class, consideration may be given
to the nature of the risk, the plan of insurance, the actual or
expected expense of conducting the business, or any other
relevant factor.
(C) Excessive or inadequate charges for premiums, policy
fees, assessments, or rates, or making or permitting any unfair
discrimination between persons of the same class involving
essentially the same hazards, in the amount of premiums,
policy fees, assessments, or rates charged or made for:
(i) policies or contracts of reinsurance or joint reinsurance,
or abstract and title insurance;
(ii) policies or contracts of insurance against loss or damage
to aircraft, or against liability arising out of the ownership,
maintenance, or use of any aircraft, or of vessels or craft,
their cargoes, marine builders' risks, marine protection and
indemnity, or other risks commonly insured under marine,
as distinguished from inland marine, insurance; or
(iii) policies or contracts of any other kind or kinds of
insurance whatsoever.
However, nothing contained in clause (C) shall be construed to
apply to any of the kinds of insurance referred to in clauses (A)
and (B) nor to reinsurance in relation to such kinds of insurance.
Nothing in clause (A), (B), or (C) shall be construed as making or
permitting any excessive, inadequate, or unfairly discriminatory
charge or rate or any charge or rate determined by the department
or commissioner to meet the requirements of any other insurance
rate regulatory law of this state.
(8) Except as otherwise expressly provided by IC 27-1-47 or
another law, knowingly permitting or offering to make or making
any contract or policy of insurance of any kind or kinds
whatsoever, including but not in limitation, life annuities, or
agreement as to such contract or policy other than as plainly
ES 140—LS 6503/DI 141 15
expressed in such contract or policy issued thereon, or paying or
allowing, or giving or offering to pay, allow, or give, directly or
indirectly, as inducement to such insurance, or annuity, any rebate
of premiums payable on the contract, or any special favor or
advantage in the dividends, savings, or other benefits thereon, or
any valuable consideration or inducement whatever not specified
in the contract or policy; or giving, or selling, or purchasing or
offering to give, sell, or purchase as inducement to such insurance
or annuity or in connection therewith, any stocks, bonds, or other
securities of any insurance company or other corporation,
association, limited liability company, or partnership, or any
dividends, savings, or profits accrued thereon, or anything of
value whatsoever not specified in the contract. Nothing in this
subdivision and subdivision (7) shall be construed as including
within the definition of discrimination or rebates any of the
following practices:
(A) Paying bonuses to policyholders or otherwise abating their
premiums in whole or in part out of surplus accumulated from
nonparticipating insurance, so long as any such bonuses or
abatement of premiums are fair and equitable to policyholders
and for the best interests of the company and its policyholders.
(B) In the case of life insurance policies issued on the
industrial debit plan, making allowance to policyholders who
have continuously for a specified period made premium
payments directly to an office of the insurer in an amount
which fairly represents the saving in collection expense.
(C) Readjustment of the rate of premium for a group insurance
policy based on the loss or expense experience thereunder, at
the end of the first year or of any subsequent year of insurance
thereunder, which may be made retroactive only for such
policy year.
(D) Paying by an insurer or insurance producer thereof duly
licensed as such under the laws of this state of money,
commission, or brokerage, or giving or allowing by an insurer
or such licensed insurance producer thereof anything of value,
for or on account of the solicitation or negotiation of policies
or other contracts of any kind or kinds, to a broker, an
insurance producer, or a solicitor duly licensed under the laws
of this state, but such broker, insurance producer, or solicitor
receiving such consideration shall not pay, give, or allow
credit for such consideration as received in whole or in part,
directly or indirectly, to the insured by way of rebate.
ES 140—LS 6503/DI 141 16
(9) Requiring, as a condition precedent to loaning money upon the
security of a mortgage upon real property, that the owner of the
property to whom the money is to be loaned negotiate any policy
of insurance covering such real property through a particular
insurance producer or broker or brokers. However, this
subdivision shall not prevent the exercise by any lender of the
lender's right to approve or disapprove of the insurance company
selected by the borrower to underwrite the insurance.
(10) Entering into any contract, combination in the form of a trust
or otherwise, or conspiracy in restraint of commerce in the
business of insurance.
(11) Monopolizing or attempting to monopolize or combining or
conspiring with any other person or persons to monopolize any
part of commerce in the business of insurance. However,
participation as a member, director, or officer in the activities of
any nonprofit organization of insurance producers or other
workers in the insurance business shall not be interpreted, in
itself, to constitute a combination in restraint of trade or as
combining to create a monopoly as provided in this subdivision
and subdivision (10). The enumeration in this chapter of specific
unfair methods of competition and unfair or deceptive acts and
practices in the business of insurance is not exclusive or
restrictive or intended to limit the powers of the commissioner or
department or of any court of review under section 8 of this
chapter.
(12) Requiring as a condition precedent to the sale of real or
personal property under any contract of sale, conditional sales
contract, or other similar instrument or upon the security of a
chattel mortgage, that the buyer of such property negotiate any
policy of insurance covering such property through a particular
insurance company, insurance producer, or broker or brokers.
However, this subdivision shall not prevent the exercise by any
seller of such property or the one making a loan thereon of the
right to approve or disapprove of the insurance company selected
by the buyer to underwrite the insurance.
(13) Issuing, offering, or participating in a plan to issue or offer,
any policy or certificate of insurance of any kind or character as
an inducement to the purchase of any property, real, personal, or
mixed, or services of any kind, where a charge to the insured is
not made for and on account of such policy or certificate of
insurance. However, this subdivision shall not apply to any of the
following:
ES 140—LS 6503/DI 141 17
(A) Insurance issued to credit unions or members of credit
unions in connection with the purchase of shares in such credit
unions.
(B) Insurance employed as a means of guaranteeing the
performance of goods and designed to benefit the purchasers
or users of such goods.
(C) Title insurance.
(D) Insurance written in connection with an indebtedness and
intended as a means of repaying such indebtedness in the
event of the death or disability of the insured.
(E) Insurance provided by or through motorists service clubs
or associations.
(F) Insurance that is provided to the purchaser or holder of an
air transportation ticket and that:
(i) insures against death or nonfatal injury that occurs during
the flight to which the ticket relates;
(ii) insures against personal injury or property damage that
occurs during travel to or from the airport in a common
carrier immediately before or after the flight;
(iii) insures against baggage loss during the flight to which
the ticket relates; or
(iv) insures against a flight cancellation to which the ticket
relates.
(14) Refusing, because of the for-profit status of a hospital or
medical facility, to make payments otherwise required to be made
under a contract or policy of insurance for charges incurred by an
insured in such a for-profit hospital or other for-profit medical
facility licensed by the Indiana department of health.
(15) Refusing to insure an individual, refusing to continue to issue
insurance to an individual, limiting the amount, extent, or kind of
coverage available to an individual, or charging an individual a
different rate for the same coverage, solely because of that
individual's blindness or partial blindness, except where the
refusal, limitation, or rate differential is based on sound actuarial
principles or is related to actual or reasonably anticipated
experience.
(16) Committing or performing, with such frequency as to
indicate a general practice, unfair claim settlement practices (as
defined in section 4.5 of this chapter).
(17) Between policy renewal dates, unilaterally canceling an
individual's coverage under an individual or group health
insurance policy solely because of the individual's medical or
ES 140—LS 6503/DI 141 18
physical condition.
(18) Using a policy form or rider that would permit a cancellation
of coverage as described in subdivision (17).
(19) Violating IC 27-1-22-25, IC 27-1-22-26, or IC 27-1-22-26.1
concerning motor vehicle insurance rates.
(20) Violating IC 27-8-21-2 concerning advertisements referring
to interest rate guarantees.
(21) Violating IC 27-8-24.3 concerning insurance and health plan
coverage for victims of abuse.
(22) Violating IC 27-8-26 concerning genetic screening or testing.
(23) Violating IC 27-1-15.6-3(b) concerning licensure of
insurance producers.
(24) Violating IC 27-1-38 concerning depository institutions.
(25) Violating IC 27-8-28-17(c) or IC 27-13-10-8(c) concerning
the resolution of an appealed grievance decision.
(26) Violating IC 27-8-5-2.5(e) through IC 27-8-5-2.5(j) (expired
July 1, 2007, and removed) or IC 27-8-5-19.2 (expired July 1,
2007, and repealed).
(27) Violating IC 27-2-21 concerning use of credit information.
(28) Violating IC 27-4-9-3 concerning recommendations to
consumers.
(29) Engaging in dishonest or predatory insurance practices in
marketing or sales of insurance to members of the United States
Armed Forces as:
(A) described in the federal Military Personnel Financial
Services Protection Act, P.L.109-290; or
(B) defined in rules adopted under subsection (b).
(30) Violating IC 27-8-19.8-20.1 concerning stranger originated
life insurance.
(31) Violating IC 27-2-22 concerning retained asset accounts.
(32) Violating IC 27-8-5-29 concerning health plans offered
through a health benefit exchange (as defined in IC 27-19-2-8).
(33) Violating a requirement of the federal Patient Protection and
Affordable Care Act (P.L. 111-148), as amended by the federal
Health Care and Education Reconciliation Act of 2010 (P.L.
111-152), that is enforceable by the state.
(34) After June 30, 2015, violating IC 27-2-23 concerning
unclaimed life insurance, annuity, or retained asset account
benefits.
(35) Willfully violating IC 27-1-12-46 concerning a life insurance
policy or certificate described in IC 27-1-12-46(a).
(36) Violating IC 27-1-37-7 concerning prohibiting the disclosure
ES 140—LS 6503/DI 141 19
of health care service claims data.
(37) Violating IC 27-4-10-10 concerning virtual claims payments.
(38) Violating IC 27-1-24.5 concerning pharmacy benefit
managers.
(39) Violating IC 27-7-17-16 or IC 27-7-17-17 concerning the
marketing of travel insurance policies.
(40) Violating IC 27-1-49 concerning individual prescription drug
rebates.
(41) Violating IC 27-1-50 concerning group prescription drug
rebates.
(42) Violating IC 27-1-7-2.5 concerning a health carrier
contracting with a pharmacy benefit manager in which the
health carrier has an ownership interest.
(b) Except with respect to federal insurance programs under
Subchapter III of Chapter 19 of Title 38 of the United States Code, the
commissioner may, consistent with the federal Military Personnel
Financial Services Protection Act (10 U.S.C. 992 note), adopt rules
under IC 4-22-2 to:
(1) define; and
(2) while the members are on a United States military installation
or elsewhere in Indiana, protect members of the United States
Armed Forces from;
dishonest or predatory insurance practices.".
Renumber all SECTIONS consecutively.
(Reference is to SB 140 as printed February 14, 2025.)
JOHNSON T
_____
SENATE MOTION
Mr. President: I move that Senate Bill 140 be amended to read as
follows:
Page 10, line 35, delete "commissioner" and insert "state personnel
department".
Page 10, line 38, delete "department;" and insert "state personnel
department;".
(Reference is to SB 140 as printed February 14, 2025.)
CHARBONNEAU
ES 140—LS 6503/DI 141 20
COMMITTEE REPORT
Mr. Speaker: Your Committee on Insurance, to which was referred
Senate Bill 140, has had the same under consideration and begs leave
to report the same back to the House with the recommendation that said
bill be amended as follows:
Page 1, delete lines 1 through 17.
Delete page 2.
Page 3, delete lines 1 through 13.
Page 6, delete lines 36 through 42, begin a new line block indented
and insert:
"(2) Subject to subsection (b), prohibit the insurer, pharmacy
benefit manager, or other administrator from retroactively
denying, reducing reimbursement for, or seeking any refunds
or recoupments for a claim for pharmacy or pharmacist
services, in whole or in part, from the pharmacy or
pharmacist after returning a paid claim response as part of
the adjudication of the claim, including claims for the cost of
a medication or dispensed product and claims for pharmacy
or pharmacist services that are deemed ineligible for
coverage, unless:
(A) the original claim was submitted fraudulently; or
(B) the pharmacy or pharmacist received an actual
overpayment.
(3) Prohibit the insurer, pharmacy benefit manager, or other
administrator from reimbursing the pharmacy or pharmacist
for a prescription drug or other service at a net amount that
is less than the greater of the following:
(A) The amount the insurer, pharmacy benefit manager, or
other administrator reimburses itself or a pharmacy
affiliate for the same prescription drug by national code
number or service.
(B) The following amount, as applicable:
(i) If the prescription drug or service is administered,
dispensed, or provided at a drug store (as defined in
IC 7.1-1-3-15) that holds a permit under IC 7.1-3-5,
IC 7.1-3-10, or IC 7.1-3-15, the national average drug
acquisition cost (NADAC) for the prescription drug or
service, as determined by the federal Centers for
Medicare and Medicaid Services at the time the
prescription drug or service is administered, dispensed,
or provided.
(ii) If the prescription drug or service is administered,
ES 140—LS 6503/DI 141 21
dispensed, or provided at a pharmacy not described in
item (i), the national average drug acquisition cost
(NADAC) for the prescription drug or service, as
determined by the federal Centers for Medicare and
Medicaid Services at the time the prescription drug or
service is administered, dispensed, or provided plus a
professional dispensing fee equal to the Medicaid fee for
service dispensing fee under 405 IAC 5-24-6.".
Delete page 7.
Page 8, delete lines 1 through 3.
Page 8, delete lines 8 through 42, begin a new paragraph and insert:
"Sec. 18. (a) Except as provided in section 17 of this chapter,
with respect to the provision of pharmacy or pharmacist services
under a health plan, an insurer, a pharmacy benefit manager, or
any other administrator of pharmacy benefits may not:
(1) prohibit a pharmacy or pharmacist from, or impose a
penalty on a pharmacy or pharmacist for:
(A) selling a lower cost alternative to an insured, if a lower
cost alternative is available; or
(B) providing information to an insured under subsection
(b);
(2) discriminate against any pharmacy or pharmacist that is:
(A) located within the geographic coverage area of the
health plan; and
(B) willing to agree to, or accept, terms and conditions
established for participation in the insurer's, pharmacy
benefit manager's, other administrator's, or health plan's
network;
(3) impose limits, including quantity limits or refill frequency
limits, on an insured's access to medication from a pharmacy
that are more restrictive than those existing for a pharmacy
affiliate;
(4) require a pharmacy or pharmacist to enter into an
additional contract with an affiliate of the insurer, pharmacy
benefit manager, or other administrator of pharmacy benefits
as a condition of entering into a contract with this insurer,
pharmacy benefit manager, or administrator; or
(5) require a pharmacy or pharmacist to, as a condition of a
contract, agree to payment rates for any affiliate of the
insurer, pharmacy benefit manager, or other administrator of
pharmacy benefits that is not a party to the contract.
(b) A pharmacist shall have the right to provide an insured with
ES 140—LS 6503/DI 141 22
information regarding lower cost alternatives to assist the insured
in making informed decisions.".
Delete page 9.
Page 10, delete lines 1 through 16.
Page 10, line 22, after "section;" insert "and".
Page 10, line 24, delete "occurred;" and insert "occurred.".
Page 10, delete lines 25 through 28.
Page 11, between lines 1 and 2, begin a new paragraph and insert:
"Sec. 21. (a) As used in this section, "plan sponsor" means an
employer or organization that offers health insurance coverage to
its employees or members through a self-funded health benefit
plan.
(b) A third party administrator may not:
(1) require, as a condition of a plan sponsor entering into a
contract with the third party administrator, that the plan
sponsor enter into a contract with a particular pharmacy
benefit manager; or
(2) charge a different fee for services provided by the third
party administrator to a plan sponsor based on the plan
sponsor's selection of a particular pharmacy benefit
manager.".
Page 11, line 2, delete "21." and insert "22.".
Page 11, line 6, delete "22." and insert "23.".
Page 11, delete lines 8 through 42, begin a new paragraph and
insert:
"SECTION 6. IC 27-2-28-1, AS AMENDED BY P.L.158-2024,
SECTION 18, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
JUNE 30, 2025]: Sec. 1. (a) This chapter applies to a personal
automobile or homeowner's policy that is issued, delivered, amended,
or renewed after June 30, 2025. 2026.
(b) This chapter does not apply to notices required by the federal
Fair Credit Reporting Act (15 U.S.C. 1681 et seq.).".
Delete pages 12 through 18.
Renumber all SECTIONS consecutively.
and when so amended that said bill do pass.
(Reference is to SB 140 as reprinted February 20, 2025.)
CARBAUGH
Committee Vote: yeas 13, nays 0.
ES 140—LS 6503/DI 141 23
HOUSE MOTION
Mr. Speaker: I move that Engrossed Senate Bill 140 be amended to
read as follows:
Page 5, delete lines 28 through 36, begin a new line triple block
indented and insert:
"(i) If the prescription drug or service is administered,
dispensed, or provided at a pharmacy that is a licensed
premises (as defined in IC 7.1-1-3-20), the national
average drug acquisition cost (NADAC) for the
prescription drug or service, as determined by the
federal Centers for Medicare and Medicaid Services at
the time the prescription drug or service is administered,
dispensed, or provided.".
Page 7, line 23, delete "that offers health insurance coverage to" and
insert "that:
(1) has more than one hundred (100) employees or members;
and
(2) offers health insurance coverage to its employees or
members through a self-funded health benefit plan.".
Page 7, delete lines 24 through 25.
(Reference is to ESB 140 as printed April 8, 2025.)
CARBAUGH
_____
HOUSE MOTION
Mr. Speaker: I move that Engrossed Senate Bill 140 be amended to
read as follows:
Page 5, line 31, delete "national average drug" and insert
"pharmacy's acquisition cost reported by the pharmacy or
pharmacist for the prescription drug by national code number or
service plus a professional dispensing fee equal to the Medicaid fee
for service dispensing fee under 405 IAC 5-24-6.".
Page 5, delete lines 32 through 36.
(Reference is to ESB 140 as printed April 8, 2025.)
LEHMAN
ES 140—LS 6503/DI 141