ORE INS Insulin Cost-Share Adjustment


On Apr. 29, ORE INS proposed to repeal insulin cost-sharing rule.


  • ORE INS proposed rule to repeal regulation on the adjustment of insulin cost-sharing.
  • Overview
  • ORE Revised Statutes 743A.069 (ORE INS 743A.069) imposes a certain limit on health benefit plans for enrollee cost-sharing or other out-of-pocket costs for insulin.
  • SB 1508 established permanent statutory cap of $35 for a 30-day supply and $105 for a 90-day supply, and removed requirement to revisit these caps each year, #202975.
  • To comply with SB 1508, ORE INS proposes to repeal Insurance Regulation 836-053-0025 (ORE INS 836-053-0025) on insulin co-pay amount for health benefit plans.
  • Hearing and Comment Period
  • Hearing will be held on May 22, 2024, comments on proposal due by May 29, 2024.
  • Nov. 2024 ORE INS Repeal
  • On Nov. 26, 2024, ORE INS finalized repeal of regulation, effective on Jan. 1, 2025.

Regulators ORE INS
Entity Types Ins
Reference RF ID 38-2024, 11/26/2024; RF, 4/29/2024; Citation: *ORE INS* 743A.069, 836-053-0025;
Functions Claims/Accelerated Benefits; Compliance; Legal; Product Administration
Countries United States of America
Category
State
Products Insurance; Insurance-Health
Regions Am
Rule Type Final
Rule Date 4/29/2024
Effective Date 1/1/2025
Rule Id 210421
Linked to Rule :202975
Reg. Last Update 11/26/2024
Report Section US Consumer

Last substantive update on 11/30/2024