An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in casualty insurance, providing for coverage of COVID-19 vaccines.

PRINTER'S NO. 2216
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 1802
Session of
2025
INTRODUCED BY O'MARA, PIELLI, RABB, SANCHEZ, WEBSTER,
SCHLOSSBERG, HOWARD, HOHENSTEIN, RIVERA, D. WILLIAMS, WARREN,
CIRESI, BURGOS, HADDOCK, BOROWSKI AND HILL-EVANS,
AUGUST 13, 2025
REFERRED TO COMMITTEE ON HEALTH, AUGUST 14, 2025
AN ACT
Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An
act relating to insurance; amending, revising, and
consolidating the law providing for the incorporation of
insurance companies, and the regulation, supervision, and
protection of home and foreign insurance companies, Lloyds
associations, reciprocal and inter-insurance exchanges, and
fire insurance rating bureaus, and the regulation and
supervision of insurance carried by such companies,
associations, and exchanges, including insurance carried by
the State Workmen's Insurance Fund; providing penalties; and
repealing existing laws," in casualty insurance, providing
for coverage of COVID-19 vaccines.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The act of May 17, 1921 (P.L.682, No.284), known
as The Insurance Company Law of 1921, is amended by adding a
section to read:
Section 635.11. Coverage of COVID-19 Vaccines.--(a) A
health insurance policy offered, issued or renewed in this
Commonwealth shall provide coverage for COVID-19 vaccines with
no cost-sharing.
(b) A government program shall provide coverage for COVID-19
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vaccines without cost-sharing.
(c) As used in this section, the following words and phrases
shall have the meanings given to them in this subsection unless
the context clearly indicates otherwise:
"Cost-sharing" means:
(1) The share of the health care costs covered by a health
insurance policy that an enrollee or covered person pays out-of-
pocket.
(2) The term includes a deductible, coinsurance, copayment
or similar charge.
(3) The term does not include a premium, a balance billed
amount from an out-of-network provider or the cost of a
noncovered service.
"COVID-19" means the coronavirus disease 2019, an infectious
disease caused by severe acute respiratory syndrome coronavirus
2 that was first identified during December 2019 in Wuhan,
China.
"COVID-19 vaccine" means a vaccine approved by the United
States Food and Drug Administration for use in the prevention of
COVID-19.
"Government program" means:
(1) The Commonwealth's medical assistance program
established under the act of June 13, 1967 (P.L.31, No.21),
known as the "Human Services Code."
(2) The children's health insurance program under Article
XXIII-A.
"Health insurance policy" means:
(1) A policy, subscriber contract, certificate or plan
issued by an insurer that provides medical or health care
coverage.
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(2) The term does not include any of the following:
(i) An accident only policy.
(ii) A credit only policy.
(iii) A long-term care or disability income policy.
(iv) A specified disease policy.
(v) A Medicare supplement policy.
(vi) A fixed indemnity policy.
(vii) A dental only policy.
(viii) A vision only policy.
(ix) A workers' compensation policy.
(x) An automobile medical payment policy.
(xi) A policy under which benefits are provided by the
Federal Government to active or former military personnel and
their dependents, including a Tricare policy or a Civilian
Health And Medical Program of the United States (CHAMPUS)
supplement policy.
(xii) A hospital indemnity policy.
(xiii) Any other similar policy providing for limited
benefits.
"Insurer" means an entity licensed by the Insurance
Department that offers, issues or renews a health insurance
policy that provides medical or health care coverage by a health
care facility or licensed health care provider and that is
governed under any of the following:
(1) This act, including section 630 and Article XXIV.
(2) The act of December 29, 1972 (P.L.1701, No.364), known
as the "Health Maintenance Organization Act."
(3) 40 Pa.C.S. Ch. 61 (relating to hospital plan
corporations).
(4) 40 Pa.C.S. Ch. 63 (relating to professional health
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services plan corporations).
Section 2. A health insurance policy that is in effect on
the effective date of this section and provides coverage of
COVID-19 vaccines without cost-sharing may not, during the
period between the effective date and the applicability date,
eliminate or reduce coverage of COVID-19 vaccines or impose
cost-sharing on COVID-19 vaccines.
Section 3. This act shall apply as follows:
(1) For health insurance policies for which either rates
or forms are required to be filed with the Federal Government
or the Insurance Department, the addition of section 635.11
of the act shall apply to any policy for which a form or rate
is first filed on or after the effective date of this
section.
(2) For health insurance policies for which neither
rates nor forms are required to be filed with the Federal
Government or the Insurance Department, the addition of
section 635.11 of the act shall apply to any policy issued or
renewed on or after 180 days after the effective date of this
section.
Section 4. This act shall take effect immediately.
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