(a) “Health benefit plan” has the meaning given that term in ORS 743B.005.
(b) “Insulin” has the meaning given that term in ORS 689.696.
(2) A health benefit plan offered in this state may not require an enrollee in the plan to incur cost-sharing or other out-of-pocket costs that exceed $35 for each 30-day supply of a type of insulin prescribed for the treatment of diabetes or $105 for each 90-day supply.
(3) The coverage under this section may not be subject to a deductible imposed by a health benefit plan.
(4) This section does not prohibit a health benefit plan from using a drug formulary or other utilization review protocol applicable to prescription drug coverage under the plan.
(5) This section is not subject to ORS 743A.001. [2021 c.160 §2; 2024 c.18 §7]
Note: 743A.069 was added to and made a part of the Insurance Code by legislative action but was not added to ORS chapter 743A or any series therein. See Preface to Oregon Revised Statutes for further explanation.