Ind. Code § 27-1-49-0.5 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.2.
Ind. Code ch. 27-1-49
Ind. Code ch. 27-1-49
in effectInd. Code § 27-1-49-1 "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.2.
Ind. Code § 27-1-49-2 "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.2.
Ind. Code § 27-1-49-3 "Health insurance coverage"
Sec. 3. (a) As used in this chapter, "health insurance coverage" includes:
(1) an individual 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) 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 basis;
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 an individual 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.2. Amended by P.L.9-2024, SEC.481.
Ind. Code § 27-1-49-4 "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.2.
Ind. Code § 27-1-49-5 "Price protection rebate"
Sec. 5. 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.2.
Ind. Code § 27-1-49-6 "Rebate"
Sec. 6. 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.2.
Ind. Code § 27-1-49-7 Defined cost sharing for prescription drugs
Sec. 7. A covered individual's defined cost sharing for a prescription drug must be:
(1) calculated at the point of sale; and
(2) based on a price that is reduced by an amount equal to at least eighty-five percent (85%) of all rebates in connection with the dispensing or administration of the prescription drug.
As added by P.L.166-2023, SEC.2.
Ind. Code § 27-1-49-8 Decrease of defined cost sharing
Sec. 8. 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 7 of this chapter.
As added by P.L.166-2023, SEC.2.
Ind. Code § 27-1-49-9 Enforcement of chapter; violations
Sec. 9. (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 to set forth fines for violations of this chapter.
As added by P.L.166-2023, SEC.2. Amended by P.L.158-2024, SEC.14.
Ind. Code § 27-1-49-10 Civil penalty
Sec. 10. 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.2.
Ind. Code § 27-1-49-11 Disclosure of information; trade secret; confidentiality requirements
Sec. 11. (a) In complying with the requirements of this chapter, an insurer or an insurer's agent 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 rebate information.
As added by P.L.166-2023, SEC.2.
Source: Open US Law by Vaquill AI (CC BY 4.0)URL: https://iga.in.gov/laws/2026/ic/titles/27Fetched: 10/17/2026