SB3179 103RD GENERAL ASSEMBLY

LRB103 37210 RPS 67329 b

103RD GENERAL ASSEMBLY
State of Illinois
2023 and 2024
SB3179

Introduced 2/6/2024, by Sen. Napoleon Harris, III

SYNOPSIS AS INTRODUCED:

215 ILCS 5/513b1.5 new

Amends the Illinois Insurance Code. Provides that all compensation remitted by or on behalf of a pharmaceutical manufacturer, pharmaceutical developer, or pharmaceutical labeler, directly or indirectly, to a health insurer or to a pharmacy benefit manager under contract with a health insurer that is related to the health insurer's prescription drug benefits must be either remitted directly to the covered person at the point of sale to reduce the out-of-pocket cost to the covered person associated with a particular prescription drug or remitted to and retained by the health insurer. Requires a health insurer to file with the Department of Insurance a report demonstrating the health insurer's compliance with the provisions.

A BILL FOR

AN ACT concerning regulation.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 5. The Illinois Insurance Code is amended by adding Section 513b1.5 as follows:

(215 ILCS 5/513b1.5 new)

Sec. 513b1.5. Compensation remitted to a health insurer or pharmacy benefit manager.

(a) All compensation remitted by or on behalf of a pharmaceutical manufacturer, pharmaceutical developer, or pharmaceutical labeler, directly or indirectly, to a health insurer or to a pharmacy benefit manager under contract with a health insurer that is related to the health insurer's prescription drug benefits must be:

(1) remitted directly to the covered person at the point of sale to reduce the out-of-pocket cost to the covered person associated with a particular prescription drug; or

(2) remitted to and retained by the health insurer. Compensation remitted to the health insurer must be applied by the health insurer in the health insurer's plan design and in future plan years to offset the premium for covered persons.

(b) Beginning January 1, 2026, and annually thereafter, a health insurer shall file with the Department a report, in the manner and form determined by the Department, demonstrating the health insurer's compliance with this Section.