yourstate.us
Cal. Insurance Code § 10123.2045

Cal. Insurance Code § 10123.2045

California · California Insurance Code · Status: effective · Effective 2026-01-01

Get this as JSONEmbed this
Cite this
Citation
Cal. Insurance Code § 10123.2045, California, version 1 as recorded 2026-07-25, yourstate.us, https://yourstate.us/provision/879593
Permanent ID
ys:prov:879593@1
SHA-256
4b17bfab5a0d26fa1f8627e1a9da0b2d571af3468b52d5993d00948da6d262bd

The hash is SHA-256 of this version's text, with every run of whitespace collapsed to a single space and the ends trimmed. The ID always leads back here, and checking it says whether the text you cited is still the current version.

Full text

(a) A health insurance policy issued, amended, or renewed on or after January 1, 2026, that provides prescription drug coverage shall not calculate an insured’s cost sharing at an amount that exceeds the actual rate paid by the insurer for the prescription drug. Cost sharing shall include deductibles and coinsurance. (b) To the extent that a health insurance policy with a pharmacy benefit manager issued, amended, or renewed on or after January 1, 2026, includes disclosure of the net price paid by the pharmacy benefit manager or group purchasing organization, then an insured’s cost sharing shall not be calculated at an amount that exceeds that net price paid. (c) (1) Commencing January 1, 2026, if a preexisting contract between a pharmacy benefit manager licensed pursuant to Article 6.1 (commencing with Section 1385.001) of Chapter 2.2 of Division 2 of the Health and Safety Code and a health insurer authorizes spread pricing, as that term is defined by Section 1385.001 of the Health and Safety Code, any subsequent amendment or renewal of that contract shall not authorize spread pricing. (2) A contract that is executed on or after January 1, 2026, between a pharmacy benefit manager licensed pursuant to Article 6.1 (commencing with Section 1385.001) of Chapter 2.2 of Division 2 of the Health and Safety Code and a health insurer shall not authorize spread pricing, as that term is defined by Section 1385.001 of the Health and Safety Code.