This bill addresses several key provisions related to health insurance, pharmacy benefits managers (PBMs), and prescription drug cost-sharing. The bill requires that an enrollee’s out-of-pocket costs (defined cost-sharing) for prescription drugs be calculated at the point of sale by reducing the price by at least 80% of all expected rebates. It prohibits PBMs from deriving income from pharmacy benefits management services except through a specific management fee, which cannot be based on drug prices, savings, rebates, or other metrics. The bill establishes a new “pharmacy benefits manager duty” that requires PBMs to act with care, skill, transparency, and in the best interest of enrollees, providers, and health plans. PBMs must now annually certify their compliance to the State Corporation Commission and can face civil penalties for violations. The legislation also protects rebate information as confidential and trade secret, preventing its public disclosure. Additionally, the bill creates a private right of action for individuals who believe a PBM has breached its duty, allowing them to sue in court. These changes aim to increase transparency, reduce prescription drug costs for consumers, and regulate the practices of pharmacy benefits managers more stringently.