Ind. Code § 27-1-50-0.5 Application of chapter
Sec. 0.5. This chapter applies to a policy of health insurance coverage that is issued, delivered, amended, or renewed after December 31, 2024.
As added by P.L.166-2023, SEC.3.
Ind. Code ch. 27-1-50
Ind. Code ch. 27-1-50
in effectInd. Code § 27-1-50-1 "Covered individual"
Sec. 1. As used in this chapter, "covered individual" means an individual who is entitled to health insurance coverage.
As added by P.L.166-2023, SEC.3.
Ind. Code § 27-1-50-2 "Defined cost sharing"
Sec. 2. As used in this chapter, "defined cost sharing" means a deductible payment or coinsurance amount imposed on a covered individual for a covered prescription drug under the covered individual's health insurance coverage.
As added by P.L.166-2023, SEC.3.
Ind. Code § 27-1-50-3 "Health insurance coverage"
Sec. 3. (a) As used in this chapter, "health insurance coverage" includes:
(1) a group policy of accident and sickness insurance (as defined in IC 27-8-5-1);
(2) 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 group health plan that limits eligibility to members of a specific group;
that is subject to state law regulating insurance and offers health insurance coverage (as defined in 42 U.S.C. 300gg-91). The term includes coverage of a dependent of the covered individual under a group 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.166-2023, SEC.3. Amended by P.L.9-2024, SEC.482.
Ind. Code § 27-1-50-4 "Insurer"
Sec. 4. As used in this chapter, "insurer" means an insurer that provides health insurance coverage to a covered individual.
As added by P.L.166-2023, SEC.3.
Ind. Code § 27-1-50-5 "Plan sponsor"
Sec. 5. As used in this chapter, "plan sponsor" means an employer or organization that offers health insurance coverage to its employees or members through an insurer.
As added by P.L.166-2023, SEC.3.
Ind. Code § 27-1-50-6 "Price protection rebate"
Sec. 6. As used in this chapter, "price protection rebate" means a negotiated price concession that accrues directly or indirectly to an insurer, or another party on behalf of an insurer, if there is an increase in the wholesale acquisition cost of a prescription drug above a specified threshold.
As added by P.L.166-2023, SEC.3.
Ind. Code § 27-1-50-7 "Rebate"
Sec. 7. As used in this chapter, "rebate" means:
(1) a discount or other negotiated price concession, including base price concessions (whether described as a rebate or otherwise) and reasonable estimates of price protection rebates, and performance based price concessions, that may accrue directly or indirectly or are anticipated to be passed through to an insurer during the coverage year from a manufacturer, dispensing pharmacy, or other party concerning the dispensing or administration of a prescription drug; and
(2) a reasonable estimate of any negotiated price concession, fee, or other administrative cost that is passed through, or is reasonably anticipated to be passed through, to the insurer and serves to reduce the insurer's liability for a prescription drug.
As added by P.L.166-2023, SEC.3.
Ind. Code § 27-1-50-8 Rebates; pass through to plan sponsor
Sec. 8. An insurer shall pass through to a plan sponsor one hundred percent (100%) of all rebates concerning the dispensing or administration of prescription drugs to the covered individuals of the plan sponsor.
As added by P.L.166-2023, SEC.3.
Ind. Code § 27-1-50-9 Offer of plans to plan sponsors
Sec. 9. (a) At the time of contracting, an insurer shall only offer to plan sponsors the following plans:
(1) A plan that applies one hundred percent (100%) of the rebates to reduce premiums for all covered individuals equally.
(2) A plan that calculates defined cost sharing for covered individuals of the plan sponsor at the point of sale based on a price that is reduced by an amount equal to at least eighty-five percent (85%) of all of the rebates received or estimated to be received by the insurer concerning the dispensing or administration of the prescription drug.
(b) A plan sponsor may choose one (1) of the plans offered under subsection (a).
As added by P.L.166-2023, SEC.3. Amended by P.L.158-2024, SEC.15.
Ind. Code § 27-1-50-10 Decrease of defined cost sharing
Sec. 10. Nothing in this chapter prohibits an insurer from decreasing a covered individual's defined cost sharing by an amount greater than the amount required under section 8 of this chapter.
As added by P.L.166-2023, SEC.3.
Ind. Code § 27-1-50-11 Disclosure of information to plan sponsor
Sec. 11. An insurer shall disclose the following information to a plan sponsor on at least an annual basis:
(1) The approximate amount of rebates expected to be received by the insurer concerning the dispensing or administration of prescription drugs to the covered individuals of the plan sponsor.
(2) An explanation that the plan sponsor may choose to:
(A) apply the rebates to reduce premiums for all covered individuals; or
(B) calculate defined cost sharing for a covered individual at the point of sale based on a price that is reduced by an amount equal to at least eighty-five percent (85%) of all rebates received or estimated to be received by the insurer concerning the dispensing or administration of the covered individual's prescription drugs.
(3) An explanation that, in the individual market, IC 27-1-49 requires that covered individual defined cost sharing be calculated at the point of sale based on a price that is reduced by at least eighty-five percent (85%) of the rebates concerning the dispensing or administration of the covered individual's prescription drugs.
As added by P.L.166-2023, SEC.3. Amended by P.L.158-2024, SEC.16.
Ind. Code § 27-1-50-12 Enforcement of chapter; violations
Sec. 12. (a) The department may enforce the requirements of this chapter to the extent permissible under applicable law.
(b) A violation of this chapter is an unfair or deceptive act or practice in the business of insurance under IC 27-4-1-4.
(c) The department may adopt rules under IC 4-22-2 that:
(1) provide for the enforcement of this chapter; and
(2) set forth fines for violations of this chapter.
As added by P.L.166-2023, SEC.3. Amended by P.L.158-2024, SEC.17.
Ind. Code § 27-1-50-13 Civil penalty
Sec. 13. The commissioner may take appropriate action to enforce this chapter by imposing a civil penalty not to exceed ten thousand dollars ($10,000) per violation.
As added by P.L.166-2023, SEC.3.
Ind. Code § 27-1-50-14 Disclosure of information; trade secret; confidentiality requirements
Sec. 14. (a) In complying with the requirements of this chapter, an insurer may not publish or otherwise reveal information regarding the actual amount of rebates the insurer receives on a product, manufacturer, or pharmacy specific basis. This information is protected as a trade secret (as defined in IC 24-2-3-2) and may not be published or otherwise disclosed directly or indirectly.
(b) An insurer shall impose the confidentiality requirements of this section on any vendor or third party that performs health care or administrative services on behalf of the insurer and that may receive or have access to the rebate information.
As added by P.L.166-2023, SEC.3.
Source: Open US Law by Vaquill AI (CC BY 4.0)URL: https://iga.in.gov/laws/2026/ic/titles/27Fetched: 10/17/2026