Eligible Indiana health plans would reward members for lower-paid care

Organizations running health plans would offer shopping help and give rewards for eligible lower-priced care. This covers members of plans started, changed, or renewed after 2026 who choose comparable care from a provider in the plan’s network. Dental care, vision care, and cosmetic surgery do not count. The network provider must be paid less than the plan’s average for comparable care. Members would get at least half the plan’s savings as cash or a credit, but plans could skip rewards when savings are $50 or less. Rewards would apply before and after members reach their yearly out-of-pocket limit. The shopping program and reward requirement would begin January 1, 2028.

Organizations running health plans would offer members an online comparison portal and yearly instructions. This covers members of plans started, changed, or renewed after 2026. Members could request their own costs, average payments to network providers, and available provider quality data. Organizations may also offer this information by phone. They would explain how to use the tools and earn rewards on their websites and in plan materials. The portal requirement would begin December 1, 2027. Yearly notices would begin January 1, 2028.

Organizations running health plans would report reward payments to the state insurance department. The state insurance department would combine the reports and send the results to legislative committees that handle insurance. Reports would cover the number and average size of reward payments, use of rewarded care, and member participation. The insurance commissioner may limit reports to more commonly used services. Annual plan reports would begin January 1, 2029, for the most recent calendar year. The department’s yearly report would be due by April 1, beginning in 2029.