Sec. 14.8. (a) This section applies to an employee health plan that provides coverage for prescription eye drops.
(b) As used in this section, "covered individual" means an individual who is entitled to coverage under a state employee health plan.
(c) As used in this section, "state employee health plan" means one (1) of the following:
(1) A self-insurance program established under section 7(b) of this chapter to provide group health coverage.
(2) A contract with a prepaid health care delivery plan that is entered into or renewed under section 7(c) of this chapter.
(d) A state employee health plan must provide coverage for a refill of prescription eye drops if the following are met:
(1) For a thirty (30) day supply, the covered individual requests the refill not earlier than twenty-five (25) days after the date the prescription eye drops were last dispensed to the covered individual.
(2) For a ninety (90) day supply, the covered individual requests the refill not earlier than seventy-five (75) days after the date the prescription eye drops were last dispensed to the covered individual.
(3) The prescribing practitioner has indicated on the prescription that the prescription eye drops are refillable and the refill requested by the covered individual does not exceed the refillable amount remaining on the prescription.
(e) The coverage required by subsection (d) must not be subject to dollar limits, copayments, deductibles, or coinsurance provisions that are less favorable to a covered individual than the dollar limits, copayments, deductibles, or coinsurance provisions that apply to coverage for prescription drugs generally under the state employee health plan.
(f) This section applies to a state employee health plan issued, delivered, amended, or renewed after December 31, 2015.
As added by P.L.43-2015, SEC.1.
Structure Indiana Code
Title 5. State and Local Administration
Article 10. Public Employee Benefits
Chapter 8. Group Insurance for Public Employees
5-10-8-0.1. Application of Certain Amendments to Chapter
5-10-8-0.3. Use of Certain Accrued Benefits by State Employees
5-10-8-0.4. Legalization of Certain Payments of Deductible Portion of Group Health Insurance
5-10-8-2.2. Public Safety Employees; Surviving Spouses; Dependents
5-10-8-2.7. Insurance of Rostered Volunteers
5-10-8-4. Discrimination as to Form of Insurance Between Certain Employees; Exception
5-10-8-5. Establishment of Common and Unified Plan of Group Insurance
5-10-8-6.5. General Assembly Members and Former Members
5-10-8-6.7. Election of State Employee Health Care Program by School Corporation
5-10-8-7.1. Coverage for Autism Spectrum Disorder
5-10-8-7.3. Early Intervention Services for First Steps Children
5-10-8-7.5. Prostate Specific Antigen Test
5-10-8-7.7. Surgical Treatment for Morbid Obesity
5-10-8-7.8. Colorectal Cancer Testing Coverage; Exception for High Deductible Health Plans
5-10-8-8. Retired Employees; Ability of Employer to Pay Premiums; Eligibility
5-10-8-8.1. Retired Legislators
5-10-8-8.2. Former Legislators
5-10-8-8.3. Former State and Legislative Employees; Health Benefit Plans
5-10-8-8.4. Revocation or Alteration by Employer
5-10-8-8.5. Establishment of Retiree Health Benefit Trust Fund
5-10-8-9. Coverage of Services for Mental Illness
5-10-8-10. Examining Infants for Hiv; Payment
5-10-8-10.5. Dental Care Provisions Required
5-10-8-11. Use of Diagnostic or Procedure Codes
5-10-8-13. Mail Order or Internet Based Pharmacy
5-10-8-14. Coverage for Prosthetic Devices
5-10-8-14.8. Employee Health Plan Providing Coverage for Prescription Eye Drops
5-10-8-14.9. Coverage of Methadone
5-10-8-15. Coverage for Care Related to Cancer Clinical Trials
5-10-8-16. High Breast Density
5-10-8-16.5. Post-Mastectomy Coverage
5-10-8-17. Step Therapy Protocol
5-10-8-18. Prescription Drug Coverage
5-10-8-19. Prior Authorization
5-10-8-21. Coverage for Anatomical Gifts, Transplantation, or Related Health Care Services
5-10-8-22. Coverage for Chronic Pain Management
5-10-8-22.5. Amount Paid for Prescription Drug to Be Counted Against Deductible
5-10-8-23. Reimbursement for Emergency Medical Services
5-10-8-24. Coverage for Pediatric Neuropsychiatric Disorders