Illinois HB 4008: INS-COST SHARING/DRUG REBATES

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104TH GENERAL ASSEMBLY 
State of Illinois 
2025 and 2026
HB4008

Introduced 3/4/2025, by Rep. Harry Benton 

SYNOPSIS AS INTRODUCED:

215 ILCS 5/356z.80 new

 Amends the Illinois Insurance Code. Provides that a group or individual policy of accident and health insurance amended, delivered, issued, or renewed on or after January 1, 2026 that provides coverage for prescription drugs shall require that a covered individual's defined cost sharing for each prescription drug shall be calculated at the point of sale based on a price that is reduced by an amount equal to at least 100% of all rebates received in connection with the dispensation or administration of the prescription drug. Provides that an insurer shall apply any rebate amount in excess of the defined cost sharing amount to the health plan to reduce premiums. Provides that the provisions shall not preclude an insurer from decreasing a covered individual's defined cost sharing by an amount greater than the stated amount at the point of sale. Provides that the Department of Insurance may adopt rules to implement the provisions.

LRB104 12572 BAB 23098 b

A BILL FOR

HB4008LRB104 12572 BAB 23098 b

1 AN ACT concerning regulation.

2 Be it enacted by the People of the State of Illinois, 

3represented in the General Assembly:

4 Section 5. The Illinois Insurance Code is amended by 

5adding Section 356z.80 as follows:

6 (215 ILCS 5/356z.80 new)

7 Sec. 356z.80. Cost sharing; prescription rebates. 

8 (a) A group or individual policy of accident and health 

9insurance amended, delivered, issued, or renewed on or after 

10January 1, 2026 that provides coverage for prescription drugs 

11shall require that a covered individual's defined cost sharing 

12for each prescription drug