HB 1114 — Relating to individual and group health insurance coverage of insulin drugs and supplies; and to amend and reenact section 54-52.1-04.18 of the North Dakota Century Code, relating to health insurance benefits coverage of insulin drugs and supplies.

25.0118.02000 Sixty-ninth Legislative Assembly of North Dakota FIRSTIn ENGROSSMENTRegular ENGROSSEDSession Commencing Tuesday, January 7, 2025 HOUSE BILL NO.

1114 Introduced(Government by Government and Veterans Affairs CommitteeCommittee) (North Dakota Public Employees Retirement System) AAN BILLACT for an Act to create and enact a new section to chapter 26.1-36 of the North Dakota Century Code, relating to individual and group health insurance coverage of insulin drugs and supplies;

The term does not include an insulin pump, an electronic insulin-administeringinsulin- administering smart pen, or a continuous glucose monitor, or supplies needed specifically for the use of such electronic devices.

and Page(7) No.Concentrated human regular insulin.

1 25.0118.02000 Sixty-ninth Legislative Assembly (7) Concentrated human regular insulin.

(5)H. Glucagon, in injectable and nasal forms;

B.

NO.

1114 - PAGE 2 (5) Glucagon, in injectable and nasal forms;

The health benefit plan may not allow a pharmacy benefits manager or the pharmacy or distributor to charge a covered individual, require the pharmacy or distributor to Pagecollect No.from a covered individual, or require a covered individual to make a payment for a covered insulin drug or medical supplies for insulin dosing and administration in an amount exceeding the out-of-pocket limits under subsection 3.

2 25.0118.02000 Sixty-ninth Legislative Assembly collect from a covered individual, or require a covered individual to make a payment for a covered insulin drug or medical supplies for insulin dosing and administration in an amount exceeding the out-of-pocket limits under subsection 3.

The health benefit plan may not impose a deductible, copayment, coinsurance, or other cost-sharingcost- sharing requirement that causes out-of-pocket costs for prescribed insulin or medical supplies for insulin dosing and administration to exceed the amount under subsection 3.

Subsection 3 does not require the health benefit plan to implement a particular cost-cost-sharing sharing structure and does not prevent the limitation of out-of-pocket costs to less than the amount specified under subsection 3.

Health insurance benefits coverage - Insulin drug and supply out-of-out-of-pocket pocket limitations.

The term does not include an insulin pump, an electronic insulin-administeringinsulin- administering smart pen, or a continuous glucose monitor, or supplies needed specifically forH. the use of such electronic devices.

B.

NO.

1114 - PAGE 3 for the use of such electronic devices.

Page(4) No.Long-acting insulin;

3 25.0118.02000 Sixty-ninth Legislative Assembly (4) Long-acting insulin;

Covered medical supplies for insulin dosing and administration, the total of which may not exceed twenty-five dollars per pharmacy or distributor, regardless of the Pagequantity No.or manufacturer of supplies used to fill the covered individual's prescription needs.

4 25.0118.02000 Sixty-ninth Legislative Assembly quantity or manufacturer of supplies used to fill the covered individual's prescription needs.

5.H.

TheB. coverage may not impose a deductible, copayment, coinsurance, or other cost- sharing requirement that causes out-of-pocket costs for prescribed insulin or medical supplies for insulin dosing and administration to exceed the amount set forth under subsection 3.

NO.

1114 - PAGE 4 5.

The coverage may not impose a deductible, copayment, coinsurance, or other cost-sharing requirement that causes out-of-pocket costs for prescribed insulin or medical supplies for insulin dosing and administration to exceed the amount set forth under subsection 3.

PageH. No.

5B. 25.0118.02000

NO.

1114 - PAGE 5 ____________________________ ____________________________ Speaker of the House President of the Senate ____________________________ ____________________________ Chief Clerk of the House Secretary of the Senate This certifies that the within bill originated in the House of Representatives of the Sixty-ninth Legislative Assembly of North Dakota and is known on the records of that body as House Bill No.

1114.

House Vote:

Yeas 59 Nays 27 Absent 7 Senate Vote:

Yeas 39 Nays 7 Absent 1 ____________________________ Chief Clerk of the House Received by the Governor at ________M.

on _____________________________________, 2025.

Approved at ________M.

on __________________________________________________, 2025.

____________________________ Governor Filed in this office this ___________day of _______________________________________, 2025, at ________ o’clock ________M.

____________________________ Secretary of State