Bill > HF1808

This bill establishes new requirements for how health insurance companies calculate an enrollee's out-of-pocket maximum or cost-sharing contributions in Minnesota. Specifically, the bill mandates that health plan companies must include all amounts paid by the enrollee or paid on behalf of the enrollee by another person when calculating the total contribution toward out-of-pocket maximums or cost-sharing requirements, to the extent permitted by federal law. The bill defines "cost sharing" as any co-payment, coinsurance, or deductible, which helps clarify the scope of the calculation. This means that if, for example, a patient receives assistance from a charity, pharmaceutical company, or family member to help pay for medical expenses, those contributions would now be counted toward the enrollee's overall out-of-pocket maximum. The new requirements will apply to health plans offered, issued, or renewed on or after January 1, 2026, giving insurance companies time to adjust their calculation methods to comply with the new law.

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https://www.revisor.mn.gov/bills/bill.php?b=House&f=HF1808&ssn=0&y=2025