Amends GS 58-3-190 to require health insurance to cover emergency services necessary to transport the covered person to a medically appropriate location for screening and stabilization. Requires coverage of services provided by a health care provider who is not under contract with the insurer if the covered person did not have a choice in the ground ambulance transportation service provider due to the emergency. Adds that the prohibition on imposing cost-sharing for emergency services that differs from the cost-sharing that would be imposed if the provider were contracting with the insurer includes emergency ambulance transportation services. Adds new terms covered person, emergency medical transportation, out-of-network provider. Makes technical changes. Modifies the reference to the federal agency issuing the relevant guidelines to the term stabilize from the Health Care Financing Administration to the Centers for Medicare and Medicaid Services (CMMS) and removes medically necessary services and supplies to remain stable until the person is transferred from the definition’s description of 42 USCS 1395dd. Amends the definition of emergency services to include ambulance transportation services.

Directs that the minimum allowable reimbursement rate under any health benefit plan for emergency medical transportation services provided by an ambulance service provider that is paid to an out-of-network ambulance service provider is 100% of the rate set or approved, either by contract or in ordinance, by a local governmental entity in the jurisdiction in which the ambulance services originated. In the absence of a rate set or approved by a local governmental entity, the minimum allowable reimbursement rate under this subsection is the lesser of the following two amounts: (1) 400% of the most recent published Medicare rate for ambulance services or services by CMMS or (2) the out-of-network ambulance service provider's billed charges. Applies the following to emergency medical transportation services provided by an ambulance service provider: Payment by an insurer in compliance with GS 58-3-190(h) is considered payment in full by that insurer for the covered services. Clarifies that this does not preclude the billing for, or collection of, any copayment, coinsurance, deductible, and other cost-sharing feature amounts required to be paid by the covered person. An insurer must promptly remit payment for emergency medical transportation services directly to the ambulance services provider, regardless of the network status of that provider. An insurer cannot send any payments for the reimbursement of these services to a covered person.

An insurer cannot impose upon a covered person any cost-sharing requirement for emergency transportation services that exceeds the lesser of the two described amounts.

Clarifies that GS 58-3-190 should not be construed to prevent a self-funded group plan regulated under ERISA from opting into its provisions.

Effective October 1, 2025, applies to insurance contracts issued, renewed, or amended on or after that date and ambulance services provided on or after that date.

Repeals GS 58-3-190(3) and (4).