LEGISLATIVE SERVICES AGENCY
OFFICE OF FISCAL AND MANAGEMENT ANALYSIS
FISCAL IMPACT STATEMENT
LS 6503 NOTE PREPARED: Apr 14, 2025
BILL NUMBER: SB 140 BILL AMENDED: Apr 14, 2025
SUBJECT: Pharmacy Benefits.
FIRST AUTHOR: Sen. Charbonneau BILL STATUS: 2
nd
Reading - 2
nd
House
FIRST SPONSOR: Rep. McGuire
FUNDS AFFECTED:XGENERAL IMPACT: State
XDEDICATED
FEDERAL
Summary of Legislation: Pharmacy Benefits: This bill requires an insurer, a pharmacy benefit manager
(PBM), or any other administrator of pharmacy benefits to ensure that a network utilized by the insurer,
PBM, or other administrator is reasonably adequate and accessible and file an annual report regarding the
network with the Commissioner. It sets forth certain limitations and requirements with respect to the
provision of pharmacy or pharmacist services under a health plan.
This bill allows any insured, pharmacy, or pharmacist impacted by an alleged violation to file a complaint
with the Commissioner. It provides that the Commissioner may order reimbursement to any person who has
incurred a monetary loss as a result of a violation.
This bill requires, if a PBM is used with regard to a state employee health plan, the State Personnel
Department to either create a PBM or contract with an insurer, a PBM, or other administrator.
This bill 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
PBM; 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 PBM.
Notice of Material Change: This bill 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.
Effective Date: June 30, 2025; January 1, 2026.
Explanation of State Expenditures: Pharmacy Benefits: The bill’s requirements will increase workload
for the Department of Insurance (DOI) and State Personnel Department (SPD), but should be able to be
implemented using existing staffing and resources of the agencies. [The DOI is funded through a dedicated
agency fund.]
SB 140 1 The bill’s requirements may result in changes to costs for any future contracts between the State Employee
Health Plan (SEHP) and pharmacy benefit managers (PBM). Any resulting change in future costs will depend
on the terms of the contracts.
Notice of Material Change: The bill delays by one year the implementation of Indiana Code relating to
notices of material change for automobile and homeowner insurance policies. This will provide DOI an
additional year to promulgate rules required under IC 27-2-28-12.
Additional Information:
(Revised) Pharmacy Benefits: The bill allows, but does not require, SPD to create a PBM to fulfill the PBM
requirements for the SEHP. If created, this option would result in an indeterminate increase in workload for
SPD and an indeterminate impact on costs for the SEHP.
The bill sets minimum reimbursement amounts to be paid from an insurer, PBM, or other administrator to
a pharmacy or pharmacist for a prescription drug or other service based on whether or not the pharmacy is
a licensed premises (located within a building where alcoholic beverages are authorized by a permit to be
kept, manufactured, or sold).
Explanation of State Revenues: Notice of Material Change: The bill delays by one year the implementation
of Indiana Code relating to notices of material change for automobile and homeowner insurance policies.
This will result in a delay of penalty revenue resulting from the rules required under IC 27-2-28-12.
Explanation of Local Expenditures:
Explanation of Local Revenues:
State Agencies Affected: Department of Insurance; State Personnel Department; all state agencies.
Local Agencies Affected:
Information Sources: 405 IAC 5-24-6;
https://www.in.gov/pla/professions/pharmacy-home/pharmacy-board/#Current_Year_Board_Agendas.
Fiscal Analyst: Jason Barrett, 317-232-9809.
SB 140 2