Ind. Code § 27-1-51-1 Applicability
Sec. 1. This chapter applies to a policy of health insurance coverage that is issued, delivered, amended, or renewed after December 31, 2025.
As added by P.L.237-2025, SEC.10.
Ind. Code ch. 27-1-51
Ind. Code ch. 27-1-51
in effectInd. Code § 27-1-51-2 "Administrator"
Sec. 2. As used in this chapter, "administrator" means a person who, directly or indirectly and on behalf of an insurer:
(1) underwrites; or
(2) collects charges or premiums from or adjusts or settles claims on:
(A) residents of Indiana; or
(B) residents of another state from offices in Indiana;
in connection with health insurance coverage offered or provided by an insurer.
As added by P.L.237-2025, SEC.10.
Ind. Code § 27-1-51-3 "Cost sharing"
Sec. 3. As used in this chapter, "cost sharing" means any copayment, coinsurance, deductible, or other similar charge that is:
(1) required of a covered individual for a health care service covered by a policy of health insurance coverage, including a prescription drug; and
(2) paid:
(A) by; or
(B) on behalf of;
the covered individual.
As added by P.L.237-2025, SEC.10.
Ind. Code § 27-1-51-4 "Covered individual"
Sec. 4. As used in this chapter, "covered individual" means an individual who is entitled to health insurance coverage.
As added by P.L.237-2025, SEC.10.
Ind. Code § 27-1-51-5 "Health care service"
Sec. 5. As used in this chapter, "health care service" means a service or good furnished for the purpose of preventing, alleviating, curing, or healing:
(1) human illness;
(2) physical disability; or
(3) injury.
As added by P.L.237-2025, SEC.10.
Ind. Code § 27-1-51-6 "Health insurance coverage"
Sec. 6. (a) As used in this chapter, "health insurance coverage" means:
(1) an individual or group policy of accident and sickness insurance (as defined in IC 27-8-5-1);
(2) an individual contract (as defined in IC 27-13-1-21) or a group contract (as defined in IC 27-13-1-16) that provides coverage for basic health care services (as defined in IC 27-13-1-4); and
(3) any other health plan that is issued on an individual or group basis;
that is subject to state law and rules regulating insurance or subject to the jurisdiction of the department. The term includes coverage of a dependent of the covered individual under a policy or contract described in subdivisions (1) through (3).
(b) The term does not include a self-funded health benefit plan that complies with the federal Employee Retirement Income Security Act (ERISA) of 1974 (29 U.S.C. 1001 et seq.).
As added by P.L.237-2025, SEC.10.
Ind. Code § 27-1-51-7 "Insurer"
Sec. 7. As used in this chapter, "insurer" means an insurer that provides health insurance coverage to a covered individual.
As added by P.L.237-2025, SEC.10.
Ind. Code § 27-1-51-8 "Person"
Sec. 8. As used in this chapter, "person" means a natural person, corporation, mutual company, unincorporated association, partnership, joint venture, limited liability company, trust, estate, foundation, not-for-profit corporation, unincorporated organization, government, or governmental subdivision or agency.
As added by P.L.237-2025, SEC.10.
Ind. Code § 27-1-51-9 Limitation on cost sharing
Sec. 9. An insurer and an administrator shall apply the annual limitation on cost sharing set forth in the federal Patient Protection and Affordable Care Act under 42 U.S.C. 18022(c)(1) to prescription drugs that:
(1) are covered under a policy or contract of health insurance coverage offered or issued by the insurer;
(2) are life-saving or intended to manage chronic pain; and
(3) do not have an approved generic version.
As added by P.L.237-2025, SEC.10.
Ind. Code § 27-1-51-10 Calculating covered individual's contribution
Sec. 10. (a) Except as provided in subsection (b), when calculating a covered individual's contribution to an applicable cost sharing requirement, an insurer and administrator must include any cost sharing amounts paid:
(1) by the covered individual; and
(2) on behalf of the covered individual by another person.
(b) If application of subsection (a) would result in a covered individual becoming ineligible for a health savings account under Section 223 of the Internal Revenue Code, the requirement under subsection (a) applies with respect to the deductible of a high deductible health plan after the covered individual satisfies the minimum deductible under Section 223 of the Internal Revenue Code. However, subsection (a) applies to items or services that are preventative care under Section 223(c)(2)(C) of the Internal Revenue Code regardless of whether the minimum deductible under Section 223 of the Internal Revenue Code is satisfied.
As added by P.L.237-2025, SEC.10.
Ind. Code § 27-1-51-11 Terms of health insurance coverage
Sec. 11. An insurer and an administrator may not directly or indirectly:
(1) set;
(2) alter;
(3) implement; or
(4) condition;
the terms of health insurance coverage, including the benefit design, based in part or entirely on information about the availability or amount of financial or product assistance available for a prescription drug.
As added by P.L.237-2025, SEC.10.
Ind. Code § 27-1-51-12 Certification of compliance
Sec. 12. Before December 31 of each year, each insurer and administrator shall certify to the commissioner that the insurer or administrator has fully and completely complied with the requirements of this chapter during the previous calendar year. The certification must be signed by the chief executive officer or chief financial officer of the insurer or administrator.
As added by P.L.237-2025, SEC.10.
Ind. Code § 27-1-51-13 Adoption of rules
Sec. 13. The commissioner may adopt rules under IC 4-22-2 to implement this chapter.
As added by P.L.237-2025, SEC.10.
Source: Open US Law by Vaquill AI (CC BY 4.0)URL: https://iga.in.gov/laws/2026/ic/titles/27Fetched: 10/17/2026