An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in benefits for alcohol abuse and dependence, further providing for definitions, for inpatient detoxification, for nonhospital residential alcohol or other drug services, for outpatient alcohol or other drug services and for rules and regulations; and making editorial changes.

PRIOR PRINTER'S NO. 3299 PRINTER'S NO. 3617
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 2464
Session of
2026
INTRODUCED BY PARKER, MAYES, WAXMAN, VENKAT, BRENNAN, HILL-
EVANS, PROBST, SANCHEZ, NEILSON, D. WILLIAMS, PASHINSKI AND
WARREN, APRIL 28, 2026
AS AMENDED ON SECOND CONSIDERATION, HOUSE OF REPRESENTATIVES,
JUNE 16, 2026
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, further
providing for coverage of prescriptions; IN BENEFITS FOR
ALCOHOL ABUSE AND DEPENDENCE, FURTHER PROVIDING FOR
DEFINITIONS, FOR INPATIENT DETOXIFICATION, FOR NON-HOSPITAL
RESIDENTIAL ALCOHOL OR OTHER DRUG SERVICES, FOR OUTPATIENT
ALCOHOL OR OTHER DRUG SERVICES AND FOR RULES AND REGULATIONS;
and making editorial changes.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Sections 633(d)(1)(i), 635.2(f)(6)(i), 635.4(a)
(2)(iii) and 635.6(d)(1) of the act of May 17, 1921 (P.L.682,
No.284), known as The Insurance Company Law of 1921, are amended
to read:
SECTION 1. THE TITLE AND SECTIONS 308, 314, 337.3, 351, 354
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AND 404.2(16)(I)(C) AND (D) OF THE ACT OF MAY 17, 1921 (P.L.682,
NO.284), KNOWN AS THE INSURANCE COMPANY LAW OF 1921, ARE AMENDED
TO READ:
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] WORKERS'
INSURANCE FUND; PROVIDING PENALTIES; AND REPEALING EXISTING
LAWS.
SECTION 308. ELECTION OF DIRECTORS AND TRUSTEES; TERMS;
VACANCIES.--
ANY STOCKHOLDER OR MEMBER ELECTED TO THE POST OF DIRECTOR OR
TRUSTEE SHALL CONTINUE IN OFFICE UNLESS THE INSURANCE
COMMISSIONER, AFTER SUCH INVESTIGATION AS HE DEEMS PROPER, SHALL
DETERMINE THAT THE RESPONSIBILITY, CHARACTER, AND GENERAL
FITNESS FOR THE BUSINESS, OF SUCH INDIVIDUAL ARE NOT SUCH AS TO
COMMAND THE CONFIDENCE OF THE PUBLIC, AND TO WARRANT THE BELIEF
THAT THE BUSINESS OF THE COMPANY WILL BE HONESTLY AND
EFFICIENTLY CONDUCTED IN ACCORDANCE WITH THE INTENT AND PURPOSE
OF THIS ACT. ANY ADJUDICATION BY THE INSURANCE COMMISSIONER
PURSUANT TO THIS SECTION SHALL BE SUBJECT TO THE PROVISIONS OF
[THE "ADMINISTRATIVE AGENCY LAW," ACT OF JUNE 4, 1945
(P.L.1388).] 2 PA.C.S. CHS. 5 SUBCH. A (RELATING TO PRACTICE AND
PROCEDURE OF COMMONWEALTH AGENCIES) AND 7 SUBCH. A (RELATING TO
JUDICIAL REVIEW OF COMMONWEALTH AGENCY ACTION).
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SECTION 314. OFFICERS AND EMPLOYES; SALARIES; VACANCIES.--
ANY PERSON CHOSEN, EITHER ANNUALLY OR TO FILL A VACANCY, AS
PRESIDENT, SECRETARY, TREASURER, OR FOR ANY OTHER OFFICE, SHALL
CONTINUE TO SERVE IN SUCH OFFICE UNLESS THE INSURANCE
COMMISSIONER, AFTER SUCH INVESTIGATION AS HE DEEMS PROPER, SHALL
DETERMINE THAT THE RESPONSIBILITY, CHARACTER, AND GENERAL
FITNESS FOR THE BUSINESS, OF SUCH INDIVIDUAL ARE NOT SUCH AS TO
COMMAND THE CONFIDENCE OF THE PUBLIC, AND TO WARRANT THE BELIEF
THAT THE BUSINESS OF THE COMPANY WILL BE HONESTLY AND
EFFICIENTLY CONDUCTED IN ACCORDANCE WITH THE INTENT AND PURPOSE
OF THIS ACT. ANY ADJUDICATION BY THE INSURANCE COMMISSIONER
PURSUANT TO THIS SECTION SHALL BE SUBJECT TO THE PROVISIONS OF
[THE "ADMINISTRATIVE AGENCY LAW," ACT OF JUNE 4, 1945
(P.L.1388).] 2 PA.C.S. CHS. 5 SUBCH. A (RELATING TO PRACTICE AND
PROCEDURE OF COMMONWEALTH AGENCIES) AND 7 SUBCH. A (RELATING TO
JUDICIAL REVIEW OF COMMONWEALTH AGENCY ACTION).
SECTION 337.3. WHENEVER THE INSURANCE COMMISSIONER HAS
REASON TO BELIEVE THAT THERE IS A VIOLATION OF SECTION THREE
HUNDRED THIRTY-SEVEN, POINT ONE OR SECTION THREE HUNDRED THIRTY-
SEVEN, POINT TWO OF THIS ACT, HE SHALL SERVE UPON THE INSURANCE
COMPANY, OR THE DIRECTOR CONCERNED, A COMPLAINT SETTING FORTH
THE FACTS ALLEGED TO CONSTITUTE SUCH VIOLATION, WITH WHICH
COMPLAINT THERE SHALL BE GIVEN A NOTICE IN WRITING OF A TIME AND
PLACE OF A HEARING BEFORE THE INSURANCE COMMISSIONER, TO BE HELD
NOT LESS THAN THIRTY DAYS AFTER THE SERVICE OF SUCH COMPLAINT,
AND REQUIRING SUCH INSURANCE COMPANY OR DIRECTOR TO SHOW CAUSE
WHY AN ORDER SHOULD NOT BE MADE BY THE INSURANCE COMMISSIONER
DIRECTING SUCH INSURANCE COMPANY OR DIRECTOR TO CEASE AND DESIST
FROM SUCH VIOLATION.
ALL HEARINGS PROVIDED FOR IN THIS SECTION SHALL BE CONDUCTED,
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AND THE DECISION OF THE INSURANCE COMMISSIONER ON THE ISSUE
INVOLVED SHALL BE RENDERED, IN ACCORDANCE WITH THE PROVISIONS OF
[THE ADMINISTRATIVE AGENCY LAW APPROVED, JUNE FOURTH, ONE
THOUSAND NINE HUNDRED FORTY-FIVE (PAMPHLET LAWS 1388), OR ANY
AMENDMENT THEREOF, RELATING TO ADJUDICATION PROCEDURE.] 2
PA.C.S. CHS. 5 SUBCH. A (RELATING TO PRACTICE AND PROCEDURE OF
COMMONWEALTH AGENCIES) AND 7 SUBCH. A (RELATING TO JUDICIAL
REVIEW OF COMMONWEALTH AGENCY ACTION).
IF, UPON SUCH HEARING, THE INSURANCE COMMISSIONER FINDS THAT
THERE HAS BEEN A VIOLATION OF SECTION THREE HUNDRED THIRTY-
SEVEN, POINT ONE, OR SECTION THREE HUNDRED THIRTY-SEVEN, POINT
TWO, OF THIS ACT, HE SHALL ISSUE AND CAUSE TO BE SERVED UPON
SUCH INSURANCE COMPANY OR DIRECTOR AN ORDER RECITING THE FACTS
FOUND BY HIM, AND SETTING FORTH THE RESPECTS IN WHICH THERE HAS
BEEN A VIOLATION OF SECTION THREE HUNDRED THIRTY-SEVEN, POINT
ONE, OR SECTION THREE HUNDRED THIRTY-SEVEN, POINT TWO, OF THIS
ACT, AND DIRECTING SUCH INSURANCE COMPANY OR DIRECTOR TO CEASE
AND DESIST FROM SUCH VIOLATION.
SECTION 351. TESTIMONY; PRODUCTION OF BOOKS, ET CETERA.--NO
PERSON SHALL BE EXCUSED FROM TESTIFYING OR FROM PRODUCING ANY
BOOKS, PAPERS, CONTRACTS, AGREEMENTS, OR DOCUMENTS AT ANY
HEARING HELD BY THE INSURANCE COMMISSIONER, OR AT THE TRIAL OR
HEARING BEFORE ANY [MAGISTRATE, JUSTICE OF THE PEACE]
MAGISTERIAL DISTRICT JUDGE OR JUDGE, OF ANY PERSON OR COMPANY
CHARGED WITH VIOLATING ANY OF THE PROVISIONS OF SECTIONS THREE
HUNDRED AND FORTY-SIX (346), THREE HUNDRED AND FORTY-SEVEN
(347), THREE HUNDRED AND FORTY-EIGHT (348), AND THREE HUNDRED
AND FORTY-NINE (349) OF THIS ACT, ON THE GROUND THAT SUCH
TESTIMONY OR EVIDENCE MAY TEND TO INCRIMINATE HIMSELF, BUT NO
PERSON SHALL BE PROSECUTED FOR ANY ACT CONCERNING WHICH HE SHALL
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BE COMPELLED SO TO TESTIFY OR PRODUCE EVIDENCE, DOCUMENTARY OR
OTHERWISE, EXCEPT FOR PERJURY COMMITTED IN SO TESTIFYING.
SECTION 354. APPROVAL OF POLICIES, CONTRACTS, ETC.;
PROHIBITING THE USE THEREOF UNLESS APPROVED; JUDICIAL REVIEW;
PENALTY.--IT SHALL BE UNLAWFUL FOR ANY INSURANCE COMPANY,
ASSOCIATION, OR EXCHANGE, INCLUDING DOMESTIC MUTUAL FIRE
INSURANCE COMPANIES, DOING BUSINESS IN THIS COMMONWEALTH, TO
ISSUE, SELL, OR DISPOSE OF ANY POLICY, CONTRACT, OR CERTIFICATE,
COVERING LIFE, HEALTH, ACCIDENT, PERSONAL LIABILITY, FIRE,
MARINE, TITLE, AND ALL FORMS OF CASUALTY INSURANCE, OR CONTRACTS
PERTAINING TO PURE ENDOWMENTS OR ANNUITIES, OR ANY OTHER
CONTRACTS OF INSURANCE, OR USE APPLICATIONS, RIDERS, OR
ENDORSEMENTS, IN CONNECTION THEREWITH, UNTIL THE FORMS OF THE
SAME HAVE BEEN SUBMITTED TO AND FORMALLY APPROVED BY THE
INSURANCE COMMISSIONER, AND COPIES FILED IN THE INSURANCE
DEPARTMENT, EXCEPT RIDERS AND ENDORSEMENTS RELATING TO THE
MANNER OF DISTRIBUTION OF BENEFITS, AND TO THE RESERVATION OF
RIGHTS AND BENEFITS UNDER ANY SUCH POLICY, AND USED AT THE
REQUEST OF THE INDIVIDUAL POLICYHOLDER, AND EXCEPT ANY FORMS
WHICH, IN THE OPINION OF THE INSURANCE COMMISSIONER, DO NOT
REQUIRE HIS APPROVAL.
FORMS SO FILED, FORMS FILED UNDER THE ACT, APPROVED THE
ELEVENTH DAY OF MAY, ONE THOUSAND NINE HUNDRED FORTY-NINE
(PAMPHLET LAWS 1210), OR ANY AMENDMENTS THEREOF, OR FILED UNDER
ANY OTHER SECTION OF THIS LAW, SHALL BE DEEMED APPROVED AT THE
EXPIRATION OF THIRTY (30) DAYS AFTER FILING, UNLESS EARLIER
APPROVED OR DISAPPROVED BY THE INSURANCE COMMISSIONER. THE
INSURANCE COMMISSIONER, BY WRITTEN NOTICE TO THE INSURER MAY,
WITHIN SUCH THIRTY-DAY PERIOD, EXTEND THE PERIOD FOR APPROVAL OR
DISAPPROVAL FOR AN ADDITIONAL THIRTY (30) DAYS.
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SUCH APPROVAL SHALL BECOME VOID UPON ANY SUBSEQUENT NOTICE OF
DISAPPROVAL FROM THE INSURANCE COMMISSIONER, OR UPON ANY
SUBSEQUENT WITHDRAWAL OF LICENSE OF REFUSAL OF THE INSURANCE
COMMISSIONER TO RELICENSE ANY SUCH COMPANY, ASSOCIATION, OR
EXCHANGE, OR UPON THE SUBSEQUENT PASSAGE OF AN ACT WHICH WOULD
NO LONGER MAKE SUCH CONTRACTS OR RELATED FORMS A FIT SUBJECT FOR
APPROVAL, EXCEPT THAT THIS PROVISION SHALL NOT AFFECT CONTRACTS
ISSUED PRIOR THERETO.
UPON ANY DISAPPROVAL, THE INSURANCE COMMISSIONER SHALL NOTIFY
THE INSURER IN WRITING, SPECIFYING THE REASON FOR SUCH
DISAPPROVAL; AND WITHIN THIRTY (30) DAYS FROM THE DATE OF
MAILING OF SUCH NOTICE TO THE INSURER, SUCH INSURER MAY MAKE
WRITTEN APPLICATION TO THE INSURANCE COMMISSIONER FOR A HEARING
THEREON, AND SUCH HEARING SHALL BE HELD WITHIN THIRTY (30) DAYS
AFTER RECEIPT OF SUCH APPLICATION. THE PROCEDURE BEFORE THE
INSURANCE COMMISSIONER SHALL BE IN ACCORDANCE WITH THE
ADJUDICATION PROCEDURE SET FORTH IN [THE "ADMINISTRATIVE AGENCY
LAW,"] 2 PA.C.S. CHS. 5 SUBCH. A (RELATING TO PRACTICE AND
PROCEDURE OF COMMONWEALTH AGENCIES) AND 7 SUBCH. A (RELATING TO
JUDICIAL REVIEW OF COMMONWEALTH AGENCY ACTION), AND THE INSURER
SHALL BE ENTITLED TO THE JUDICIAL REVIEW AS PROVIDED FOR IN SAID
LAW.
ANY PERSON, CORPORATION, INSURANCE COMPANY, EXCHANGE, ORDER,
OR SOCIETY THAT SHALL, EITHER AS PRINCIPAL OR AGENT, ISSUE, OR
CAUSE TO BE ISSUED, ANY POLICY OR CONTRACT OF INSURANCE WITHIN
THE COMMONWEALTH, CONTRARY TO THIS SECTION, SHALL BE GUILTY OF A
MISDEMEANOR, AND, UPON CONVICTION THEREOF, SHALL BE SENTENCED TO
PAY A FINE NOT EXCEEDING FIVE HUNDRED DOLLARS ($500.00).
UPON SATISFACTORY EVIDENCE OF THE VIOLATION OF THIS SECTION
BY ANY SUCH PERSON, CORPORATION, INSURANCE COMPANY, EXCHANGE,
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ORDER, OR SOCIETY, THE INSURANCE COMMISSIONER MAY, IN HIS
DISCRETION, PURSUE ANY ONE OR MORE OF THE FOLLOWING COURSES OF
ACTION: (1) SUSPEND OR REVOKE THE LICENSE OF SUCH OFFENDING
PERSON, CORPORATION, INSURANCE COMPANY, EXCHANGE, ORDER OR
SOCIETY; (2) REFUSE, FOR A PERIOD OF NOT TO EXCEED ONE YEAR
THEREAFTER, TO ISSUE A NEW LICENSE TO SUCH PERSON, CORPORATION,
INSURANCE COMPANY, EXCHANGE, ORDER, OR SOCIETY; (3) IMPOSE A
FINE OF NOT MORE THAN ONE THOUSAND DOLLARS ($1,000.00) FOR EACH
AND EVERY ACT IN VIOLATION OF THIS ACT.
SECTION 404.2. INVESTMENT.--SUBJECT TO THE PROVISIONS OF
SECTIONS 405.2 AND 406.1, THE ASSETS OF ANY LIFE INSURANCE
COMPANY ORGANIZED UNDER THE LAWS OF THIS COMMONWEALTH SHALL BE
INVESTED IN THE FOLLOWING CLASSES OF INVESTMENT, PROVIDED THE
VALUE OF WHICH, AS DETERMINED FOR ANNUAL STATEMENT PURPOSES, BUT
IN NO EVENT IN EXCESS OF COST, SHALL NOT EXCEED THE SPECIFIED
PERCENTAGE OF SUCH COMPANY'S ASSETS AS OF THE THIRTY-FIRST DAY
OF DECEMBER NEXT PRECEDING THE DATE OF INVESTMENT:
* * *
(16) OTHER LOANS AND INVESTMENTS:
(I) LOANS OR INVESTMENTS NOT AUTHORIZED BY ANY OF THE
CLAUSES OF THIS SECTION TO AN AMOUNT NOT EXCEEDING THE AGGREGATE
OF TWENTY PER CENTUM (20%) OF SUCH COMPANY'S ADMITTED ASSETS.
THE TWENTY PER CENTUM (20%) LIMITATION PROVIDED ABOVE SHALL BE
INCREASED IN THE SAME AMOUNT THAT INVESTMENTS APPROVED BY THE
INSURANCE COMMISSIONER ARE MADE IN THE FOLLOWING CATEGORIES OF
INVESTMENTS PROVIDED THAT THEIR PRINCIPAL OPERATIONS OR
LOCATIONS ARE LOCATED IN THIS COMMONWEALTH:
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(C) INVESTMENTS IN BUSINESSES LOCATED IN ENTERPRISE ZONES
DESIGNATED BY THE DEPARTMENT OF COMMUNITY [AFFAIRS] AND ECONOMIC
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DEVELOPMENT.
(D) INVESTMENTS IN HOUSING FOR FAMILIES AND PERSONS OF LOW
INCOME OR IN HOUSING IN ENTERPRISE ZONES DESIGNATED BY THE
DEPARTMENT OF COMMUNITY [AFFAIRS] AND ECONOMIC DEVELOPMENT.
* * *
SECTION 2. THE DEFINITION OF "FRATERNAL BENEFIT SOCIETY" IN
SECTION 401-A OF THE ACT IS AMENDED TO READ:
SECTION 401-A. DEFINITIONS.--AS USED IN THIS ARTICLE, THE
FOLLOWING WORDS AND PHRASES SHALL HAVE THE MEANINGS GIVEN TO
THEM IN THIS SECTION:
* * *
"FRATERNAL BENEFIT SOCIETY." ANY ENTITY LICENSED TO ENGAGE
IN THE BUSINESS OF INSURANCE UNDER [THE ACT OF DECEMBER 14, 1992
(P.L.835, NO.134), KNOWN AS THE "FRATERNAL BENEFIT SOCIETIES
CODE."] ARTICLE XXIV.
* * *
SECTION 3. SECTIONS 508(I) AND 518C(A)(12)(I)(C) AND (D) OF
THE ACT ARE AMENDED TO READ:
SECTION 508. MUNICIPAL CERTIFICATE REQUIRED PRIOR TO PAYMENT
OF FIRE LOSS CLAIMS.--* * *
(I) WHEN AN ORDINANCE IS FIRST PASSED OR ADOPTED BY A
MUNICIPALITY UNDER SUBSECTIONS (A) AND (B) OF THIS SECTION OR
SUBSECTIONS (C) AND (D) OF THIS SECTION, OR BOTH, AN EXACT COPY
OF THE ORDINANCE SHALL BE FILED WITH THE DEPARTMENT OF COMMUNITY
[AFFAIRS] AND ECONOMIC DEVELOPMENT, TOGETHER WITH THE NAME,
POSITION AND PHONE NUMBER OF THE MUNICIPAL OFFICIAL RESPONSIBLE
FOR COMPLIANCE WITH THIS SECTION. EACH MUNICIPALITY ENACTING AN
ORDINANCE UNDER THIS SECTION SHALL SUPPLY THE INFORMATION
REQUIRED BY THIS SUBSECTION TO THE DEPARTMENT OF COMMUNITY
[AFFAIRS] AND ECONOMIC DEVELOPMENT AS PART OF THE IMPLEMENTATION
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OF ITS ORDINANCE. THE DEPARTMENT OF COMMUNITY [AFFAIRS] AND
ECONOMIC DEVELOPMENT SHALL PERIODICALLY PRODUCE A REGISTER
LISTING THOSE MUNICIPALITIES FILING THE ORDINANCE. THIS REGISTER
SHALL BE MADE AVAILABLE TO INSURANCE COMPANIES AT MINIMUM COST.
AN INSURANCE COMPANY, ASSOCIATION OR EXCHANGE SHALL NOT BE
REQUIRED TO COMPLY WITH ANY MUNICIPAL ORDINANCE IF THE
MUNICIPALITY FAILS TO PROVIDE A COPY OF THE ORDINANCE TO THE
DEPARTMENT OF COMMUNITY [AFFAIRS] AND ECONOMIC DEVELOPMENT.
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SECTION 518C. ELIGIBLE INVESTMENTS.--(A) EVERY DOMESTIC
STOCK FIRE, STOCK MARINE OR STOCK FIRE AND MARINE INSURANCE
COMPANY SHALL INVEST AND KEEP INVESTED ALL ITS FUNDS IN SOUND
INVESTMENTS ENUMERATED BELOW, EXCEPT SUCH CASH AS MAY BE
REQUIRED IN THE TRANSACTION OF ITS BUSINESS. SUCH INVESTMENTS
SHALL INCLUDE:
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(12) OTHER LOANS AND INVESTMENTS:
(I) LOANS OR INVESTMENTS NOT AUTHORIZED BY ANY OF THE
CLAUSES OF THIS SECTION, TO AN AMOUNT NOT EXCEEDING THE
AGGREGATE OF TWENTY PERCENTUM (20%) OF SUCH COMPANY'S ADMITTED
ASSETS. THE TWENTY PERCENTUM (20%) LIMITATION PROVIDED ABOVE
SHALL BE INCREASED IN THE SAME AMOUNT THAT INVESTMENTS APPROVED
BY THE INSURANCE COMMISSIONER ARE MADE IN THE FOLLOWING
CATEGORIES OF INVESTMENTS PROVIDED THAT THEIR PRINCIPAL
OPERATIONS OR LOCATIONS ARE LOCATED IN THIS COMMONWEALTH:
* * *
(C) INVESTMENTS IN BUSINESSES LOCATED IN ENTERPRISE ZONES
DESIGNATED BY THE DEPARTMENT OF COMMUNITY [AFFAIRS] AND ECONOMIC
DEVELOPMENT.
(D) INVESTMENTS IN HOUSING FOR FAMILIES AND PERSONS OF LOW
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INCOME OR IN HOUSING IN ENTERPRISE ZONES DESIGNATED BY THE
DEPARTMENT OF COMMUNITY [AFFAIRS] AND ECONOMIC DEVELOPMENT.
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SECTION 4. THE DEFINITION OF "PERSONAL RISKS" IN SECTION
503-A OF THE ACT IS AMENDED TO READ:
SECTION 503-A. DEFINITIONS.--AS USED IN THIS ARTICLE, THE
FOLLOWING WORDS AND PHRASES SHALL HAVE THE MEANINGS GIVEN TO
THEM IN THIS SECTION:
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"PERSONAL RISKS." PERSONAL AUTOMOBILE RISKS AS DEFINED [IN
THE ACT OF JUNE 5, 1968 (P.L.140, NO.78), ENTITLED "AN ACT
REGULATING THE WRITING, CANCELLATION OF OR REFUSAL TO RENEW
POLICIES OF AUTOMOBILE INSURANCE; AND IMPOSING POWERS AND DUTIES
ON THE INSURANCE COMMISSIONER THEREFOR,"] UNDER ARTICLE XX AND
PERSONAL PROPERTY RISKS DESCRIBED IN THE ACT OF JULY 22, 1974
(P.L.589, NO.205), KNOWN AS THE "UNFAIR INSURANCE PRACTICES
ACT."
* * *
SECTION 5. SECTIONS 631(A), 633(D)(1)(I) AND (IV), 634(A),
635.2(F)(6)(I) AND (G)(1), 635.4(A)(2)(III), 635.6(D)(1), 636
AND 639 OF THE ACT ARE AMENDED TO READ:
SECTION 631. REIMBURSEMENT FOR CANCER THERAPY.--(A)
WHENEVER ANY INDIVIDUAL OR GROUP HEALTH, SICKNESS OR ACCIDENT
INSURANCE POLICY OR SUBSCRIBER CONTRACT OR CERTIFICATE ISSUED BY
ANY ENTITY SUBJECT TO 40 PA.C.S. CHS. 61 (RELATING TO HOSPITAL
PLAN CORPORATIONS) AND 63 (RELATING TO PROFESSIONAL HEALTH
SERVICES PLAN CORPORATIONS), THIS ACT, OR [THE ACT OF JULY 29,
1977 (P.L.105, NO.38), KNOWN AS THE "FRATERNAL BENEFIT SOCIETY
CODE,"] ARTICLE XXIV PROVIDING HOSPITAL OR MEDICAL/SURGICAL
COVERAGE INCLUDES WITHIN THEIR COVERAGE BENEFITS FOR CANCER
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CHEMOTHERAPY AND CANCER HORMONE TREATMENTS AND SERVICES WHICH
HAVE BEEN APPROVED BY THE UNITED STATES FOOD AND DRUG
ADMINISTRATION FOR GENERAL USE IN TREATMENT OF CANCER, THE
COVERED INDIVIDUAL SHALL BE ENTITLED TO BENEFITS FOR CANCER
CHEMOTHERAPY AND CANCER HORMONE TREATMENTS, WHETHER PERFORMED IN
A PHYSICIAN'S OFFICE, IN AN OUTPATIENT DEPARTMENT OF A HOSPITAL,
IN A HOSPITAL AS A HOSPITAL INPATIENT OR IN ANY OTHER MEDICALLY
APPROPRIATE TREATMENT SETTING.
* * *
Section 633. Mastectomy and Breast Cancer Reconstruction.--*
* *
(d) (1) * * *
(i) Subarticle (f) of Article IV of the act of June 13, 1967
(P.L.31, No.21), known as the ["Public Welfare Code."] "Human
Services Code."
* * *
(IV) [THE ACT OF DECEMBER 14, 1992 (P.L.835, NO.134), KNOWN
AS THE "FRATERNAL BENEFIT SOCIETIES CODE."] ARTICLE XXIV.
* * *
SECTION 634. REIMBURSEMENT FOR DIABETIC SUPPLIES.--(A)
EXCEPT TO THE EXTENT ALREADY COVERED UNDER ANOTHER POLICY, ANY
INDIVIDUAL OR GROUP HEALTH, SICKNESS AND ACCIDENT INSURANCE
POLICY, GROUP HEALTH INSURANCE PLANS/POLICIES, AND ALL OTHER
FORMS OF MANAGED/CAPITATED CARE PLANS/POLICIES OR SUBSCRIBER
CONTRACT OR CERTIFICATE ISSUED BY ANY ENTITY SUBJECT TO 40
PA.C.S. CH. 61 (RELATING TO HOSPITAL PLAN CORPORATIONS) OR 63
(RELATING TO PROFESSIONAL HEALTH SERVICES PLAN CORPORATIONS) OR
THE ACT OF DECEMBER 29, 1972 (P.L.1701, NO.364), KNOWN AS THE
"HEALTH MAINTENANCE ORGANIZATION ACT," [THE ACT OF DECEMBER 14,
1992 (P.L.835, NO.134), KNOWN AS THE "FRATERNAL BENEFIT
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SOCIETIES CODE,"] ARTICLE XXIV OR THIS ACT PROVIDING HOSPITAL OR
MEDICAL/SURGICAL COVERAGE SHALL PROVIDE COVERAGE OF THE
EQUIPMENT, SUPPLIES AND OUTPATIENT SELF-MANAGEMENT TRAINING AND
EDUCATION, INCLUDING MEDICAL NUTRITION THERAPY FOR THE TREATMENT
OF INSULIN-DEPENDENT DIABETES, INSULIN-USING DIABETES,
GESTATIONAL DIABETES AND NON-INSULIN-USING DIABETES IF
PRESCRIBED BY A HEALTH CARE PROFESSIONAL LEGALLY AUTHORIZED TO
PRESCRIBE SUCH ITEMS UNDER LAW. THE BENEFITS SPECIFIED IN THIS
SECTION MAY BE PROVIDED THROUGH A COMBINATION OF POLICIES,
CONTRACTS, CERTIFICATES OR RIDERS, INCLUDING MAJOR MEDICAL
CONTRACTS.
* * *
Section 635.2. Autism Spectrum Disorders Coverage.--* * *
(f) As used in this section:
* * *
(6) "Government program" means any of the following:
(i) The Commonwealth's medical assistance program
established under the act of June 13, 1967 (P.L.31, No.21),
known as the ["Public Welfare Code."] "Human Services Code."
* * *
(G) (1) THE STATE BOARD OF MEDICINE, IN CONSULTATION WITH
THE DEPARTMENT OF [PUBLIC WELFARE] HUMAN SERVICES, SHALL
PROMULGATE REGULATIONS PROVIDING FOR THE LICENSURE OR
CERTIFICATION OF BEHAVIOR SPECIALISTS. BEHAVIOR SPECIALISTS
LICENSED OR CERTIFIED BY THE STATE BOARD OF MEDICINE SHALL BE
SUBJECT TO ALL DISCIPLINARY PROVISIONS APPLICABLE TO MEDICAL
DOCTORS AS SET FORTH IN THE ACT OF DECEMBER 20, 1985 (P.L.457,
NO.112), KNOWN AS THE "MEDICAL PRACTICE ACT OF 1985." THE STATE
BOARD OF MEDICINE MAY CHARGE REASONABLE FEES AS SET BY BOARD
REGULATION FOR LICENSURE OR CERTIFICATES OR APPLICATIONS
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PERMITTED BY THE "MEDICAL PRACTICE ACT OF 1985."
* * *
Section 635.4. Mini-COBRA Small Employer Group Health
Policies.--(a) A group policy in effect or delivered or issued
for delivery in this Commonwealth on or after the effective date
of this section by an insurer which insures employes and their
eligible dependents for hospital, surgical or major medical
insurance shall provide that covered employes, or eligible
dependents whose coverage under the group policy would otherwise
terminate because of a qualifying event, shall be entitled to
continue their hospital, surgical or major medical coverage
under that group policy subject to the following terms and
conditions:
* * *
(2) Continuation shall not be available for any person
covered under the group policy who:
* * *
(iii) is or could be covered by any other insured or
uninsured arrangement which provides hospital, surgical or major
medical coverage for individuals in a group and under which the
person was not covered immediately prior to such termination,
excluding the medical assistance program established under the
act of June 13, 1967 (P.L.31, No.21), known as the ["Public
Welfare Code,"] "Human Services Code," the children's health
care program established under Article [XXIII] XXIII-A or the
adult basic coverage insurance program established under Chapter
13 of the act of June 26, 2001 (P.L.755, No.77), known as the
"Tobacco Settlement Act," and any successors thereto.
* * *
Section 635.6. Coverage of Prescriptions.--* * *
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(d) As used in this section:
(1) "Government program" means any of the following:
(i) The Commonwealth's medical assistance program
established under the act of June 13, 1967 (P.L.31, No.21),
known as the ["Public Welfare Code."] "Human Services Code."
(ii) The Children's Health Care Program established under
Article [XXIII] XXIII-A.
(iii) The program of pharmaceutical assistance for the
elderly established under Chapter 5 of the act of August 26,
1971 (P.L.351, No.91), known as the "State Lottery Law."
* * *
Section 2. The definition of "hospital" in section 601-A of
the act is amended to read:
Section 601-A. Definitions.--As used in this article the
following words and phrases shall have the meanings given to
them in this section:
* * *
"Hospital." A facility licensed as a hospital by the
Department of Health, the Department of [Public Welfare] Human
Services, or operated by the Commonwealth and conducting an
alcoholism or drug addiction treatment program licensed by the
Department of Health.
* * *
Section 3. Section 1110.1(a) and (b) of the act are amended
to read:
SECTION 636. EMPLOYERS' MUTUAL LIABILITY INSURANCE
ASSOCIATIONS DEFINED.--AN INCORPORATED ASSOCIATION OR COMPANY
HERETOFORE OR HEREAFTER FORMED BY EMPLOYERS FOR THE PURPOSE OF
INSURING THEMSELVES, AND SUCH OTHER EMPLOYERS AS MAY BECOME
SUBSCRIBERS TO THE ASSOCIATION, AGAINST LIABILITY UNDER THE
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TERMS OF ARTICLES TWO AND THREE OF "THE [WORKMEN'S] WORKERS'
COMPENSATION ACT OF ONE THOUSAND NINE HUNDRED AND FIFTEEN," OR
ANY AMENDMENTS OR SUPPLEMENTS OR REVISIONS THEREOF, SHALL BE
KNOWN AS AN "EMPLOYERS' MUTUAL LIABILITY INSURANCE ASSOCIATION."
SECTION 639. PREMIUMS.--THE BOARD OF DIRECTORS OF ANY
EMPLOYERS' MUTUAL LIABILITY INSURANCE ASSOCIATION SHALL
DETERMINE THE AMOUNT OF THE PREMIUMS WHICH THE SUBSCRIBERS OF
THE ASSOCIATION SHALL PAY FOR THEIR INSURANCE, IN ACCORDANCE
WITH THE NATURE OF THE BUSINESS IN WHICH SUCH SUBSCRIBERS ARE
ENGAGED, AND THE PROBABLE RISK OF INJURY TO THEIR EMPLOYES UNDER
EXISTING CONDITIONS. THEY SHALL FIX PREMIUMS AT SUCH AMOUNTS AS,
IN THEIR JUDGMENT (SUBJECT TO THE APPROVAL OF THE INSURANCE
COMMISSIONER), SHALL BE SUFFICIENT TO ENABLE THE ASSOCIATION TO
CREATE AND MAINTAIN THE SURPLUS PROVIDED IN SECTION SIX HUNDRED
AND FORTY-THREE (643) OF THIS ACT, AND TO PAY TO ITS SUBSCRIBERS
ALL SUMS WHICH MAY BECOME DUE AND PAYABLE TO THEIR EMPLOYES
UNDER THE PROVISIONS OF ARTICLE THREE OF "THE [WORKMEN'S]
WORKERS' COMPENSATION ACT OF ONE THOUSAND NINE HUNDRED AND
FIFTEEN," OR ANY AMENDMENT OR REVISION THEREOF, AND ALSO THE
EXPENSES OF CONDUCTING THE BUSINESS OF THE ASSOCIATION.
IN FIXING THE PREMIUM PAYABLE BY ANY SUBSCRIBER, THE BOARD OF
DIRECTORS MAY TAKE INTO ACCOUNT THE CONDITION OF ALL THE
PROPERTY OR PREMISES OF SUCH SUBSCRIBER, IN RESPECT TO THE
SAFETY OF THOSE EMPLOYED THEREIN OR THEREON, AS SHOWN BY THE
REPORT OF ANY INSPECTOR APPOINTED BY SUCH BOARD.
THE BOARD OF DIRECTORS MAY, FROM TIME TO TIME, CHANGE THE
AMOUNT OF PREMIUMS PAYABLE BY ANY OF THE SUBSCRIBERS AS
CIRCUMSTANCES MAY REQUIRE, AND THE CONDITION OF THE PROPERTY OR
PREMISES OF SUCH SUBSCRIBER IN RESPECT TO THE SAFETY OF THEIR
EMPLOYES MAY JUSTIFY. THEY MAY INCREASE THE PREMIUMS OF ANY
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SUBSCRIBER NEGLECTING TO PROVIDE SAFETY DEVICES REQUIRED BY LAW,
OR DISOBEYING THE RULES OR REGULATIONS MADE BY THE BOARD OF
DIRECTORS IN ACCORDANCE WITH THE PROVISIONS OF SECTION SIX
HUNDRED AND THIRTY-EIGHT (638) OF THIS ACT.
NO POLICY OF INSURANCE ISSUED TO ANY SUBSCRIBER SHALL BE
EFFECTIVE UNTIL HE SHALL HAVE PAID THE PREMIUM SO FIXED AND
DETERMINED.
SECTION 6. THE HEADING OF SUBARTICLE (D) OF ARTICLE VI AND
SECTIONS 651, 652, 653, 654(A) AND (E), 655, 666(B), 667, 601-A,
602-A(A), 603-A(A), 604-A(A), 605-A(A), 607-A, 749(B) AND
754(10) AND (11) OF THE ACT ARE AMENDED TO READ:
(D) [WORKMEN'S] WORKERS' COMPENSATION INSURANCE.
SECTION 651. POLICY PROVISIONS.--EVERY POLICY OF INSURANCE
AGAINST LIABILITY UNDER "THE [WORKMEN'S] WORKERS' COMPENSATION
ACT OF NINETEEN HUNDRED AND FIFTEEN," AND ACTS AMENDATORY
THEREOF OR SUPPLEMENTARY THERETO, OR UNDER "THE PENNSYLVANIA
OCCUPATIONAL DISEASE ACT OF NINETEEN HUNDRED AND THIRTY-NINE,"
AND ACTS AMENDATORY THEREOF OR SUPPLEMENTARY THERETO, SHALL
CONTAIN THE AGREEMENT OF THE INSURER TO PAY ALL COMPENSATION AND
PROVIDE ALL MEDICAL, SURGICAL, AND HOSPITAL ATTENDANCE FOR WHICH
THE INSURED EMPLOYER MAY BECOME LIABLE UNDER SUCH ACTS DURING
THE TERM OF SUCH INSURANCE, AND THE FURTHER AGREEMENT THAT, AS
BETWEEN THE INSURER AND ANY CLAIMANT UNDER SUCH ACTS, NOTICE TO
THE EMPLOYER OR THE EMPLOYER'S KNOWLEDGE OF AN ACCIDENT OR
INJURY OR DISABILITY CAUSED BY OCCUPATIONAL DISEASE CONSTITUTING
THE BASIS OF A CLAIM UNDER SUCH ACTS SHALL BE NOTICE TO AND
KNOWLEDGE OF THE INSURER. SUCH AGREEMENTS SHALL BE CONSTRUED TO
BE A DIRECT PROMISE TO THE INJURED EMPLOYE OR TO THE DEPENDENTS
OF A DECEASED EMPLOYE HAVING A CLAIM UNDER SUCH ACTS, AND SHALL
BE ENFORCEABLE BY ACTION BROUGHT IN THE NAME OF SUCH INJURED
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EMPLOYE OR IN THE NAME OF SUCH DEPENDENTS. SUCH OBLIGATION SHALL
NOT BE AFFECTED BY ANY DEFAULT OF THE INSURED, AFTER AN ACCIDENT
OR AFTER DISABILITY CAUSED BY OCCUPATIONAL DISEASE, IN THE
PAYMENT OF PREMIUMS OR IN THE GIVING OF ANY NOTICES REQUIRED BY
SUCH POLICY OR OTHERWISE.
SECTION 652. SUITS FOR PREMIUMS.--NO SUIT SHALL BE
MAINTAINED FOR THE COLLECTION OF PREMIUMS UPON ANY POLICY OF
INSURANCE UNDER "THE [WORKMEN'S] WORKERS' COMPENSATION ACT OF
NINETEEN HUNDRED AND FIFTEEN," AND ACTS AMENDATORY THEREOF OR
SUPPLEMENTARY THERETO, OR UNDER "THE PENNSYLVANIA OCCUPATIONAL
DISEASE ACT OF NINETEEN HUNDRED AND THIRTY-NINE," AND ACTS
AMENDATORY THEREOF OR SUPPLEMENTARY THERETO, WHICH VIOLATES ANY
OF THE PROVISIONS OF THIS ACT. ALL PREMIUMS AND INTEREST CHARGES
ON ACCOUNT OF POLICIES INSURING EMPLOYES AGAINST LIABILITY UNDER
THIS CHAPTER, WHICH MAY BE DUE TO THE STATE [WORKMEN'S] WORKERS'
INSURANCE FUND, OR ANY STOCK CORPORATION OR MUTUAL ASSOCIATION
AUTHORIZED TO TRANSACT THE BUSINESS OF INSURANCE IN THIS STATE,
AND ALL JUDGMENTS RECOVERED BY THE STATE [WORKMEN'S] WORKERS'
INSURANCE FUND, OR ANY SUCH INSURANCE CORPORATION OR
ASSOCIATION, AGAINST ANY EMPLOYER ON ACTIONS BROUGHT UNDER ANY
SUCH POLICY, SHALL BE DEEMED PREFERRED CLAIMS IN ALL INSOLVENCY
OR BANKRUPTCY PROCEEDINGS, TRUSTEE PROCEEDINGS FOR
ADMINISTRATION OF ESTATES, AND RECEIVERSHIPS, INVOLVING THE
EMPLOYER LIABLE THEREFOR, OR THE PROPERTY OF SUCH EMPLOYER;
PROVIDED, HOWEVER, THAT CLAIMS FOR WAGES SHALL RECEIVE PRIOR
PREFERENCE IN ALL SUCH PROCEEDINGS.
SECTION 653. PROHIBITED POLICY PROVISIONS.--NO POLICY OF
INSURANCE AGAINST LIABILITY UNDER "THE [WORKMEN'S] WORKERS'
COMPENSATION ACT OF NINETEEN HUNDRED AND FIFTEEN," AND ACTS
AMENDATORY THEREOF OR SUPPLEMENTARY THERETO, OR UNDER "THE
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PENNSYLVANIA OCCUPATIONAL DISEASE ACT OF NINETEEN HUNDRED AND
THIRTY-NINE," AND ACTS AMENDATORY THEREOF OR SUPPLEMENTARY
THERETO, SHALL CONTAIN ANY LIMITATION OF THE LIABILITY OF THE
INSURER TO AN AMOUNT LESS THAN THAT FOR WHICH THE INSURED
EMPLOYER MAY BECOME LIABLE UNDER SUCH ACTS DURING THE TERM OF
SUCH INSURANCE. NO SUCH POLICY OR CONTRACT OF INSURANCE, NOR ANY
AGREEMENT TO DELIVER SUCH INSURANCE, SHALL BE ISSUED EXCEPT UPON
A FORM APPROVED BY THE INSURANCE COMMISSIONER AS COMPLYING WITH
ALL THE TERMS AND PROVISIONS OF THIS ACT. BUT A POLICY MAY BE
ISSUED TO A SELF INSURER, QUALIFIED UNDER SECTION THREE HUNDRED
FIVE OF ARTICLE THREE OF "THE [WORKMEN'S] WORKERS' COMPENSATION
ACT OF NINETEEN HUNDRED AND FIFTEEN," AND ACTS AMENDATORY
THEREOF OR SUPPLEMENTARY THERETO, OR UNDER SECTION THREE HUNDRED
FIVE OF ARTICLE THREE OF "THE PENNSYLVANIA OCCUPATIONAL DISEASE
ACT OF NINETEEN HUNDRED AND THIRTY-NINE," AND ACTS AMENDATORY
THEREOF OR SUPPLEMENTARY THERETO, PROVIDING FOR THE PAYMENT OF
ANY STATED LOSS IN EXCESS OF TEN THOUSAND DOLLARS FALLING UPON
SUCH SELF INSURER, UNDER THE TERMS OF THE SAID ACTS, BY REASON
OF ANY SINGLE ACCIDENT OR BY REASON OF ANY SINGLE OCCURRENCE
RESULTING IN DISABILITY FROM OCCUPATIONAL DISEASE.
EXCEPT FOR NONPAYMENT OF PREMIUMS, NO POLICY OF INSURANCE ISSUED
OR RENEWED AGAINST LIABILITY UNDER THE ACT OF JUNE 2, 1915
(P.L.736, NO.338), KNOWN AS "THE PENNSYLVANIA [WORKMEN'S]
WORKERS' COMPENSATION ACT," AND ACTS AMENDATORY THEREOF OR
SUPPLEMENTARY THERETO; OR UNDER THE ACT OF JUNE 21, 1939
(P.L.566, NO.284), KNOWN AS "THE PENNSYLVANIA OCCUPATIONAL
DISEASE ACT," AND ACTS AMENDATORY THEREOF OR SUPPLEMENTARY
THERETO; OR UNDER THE FEDERAL COAL MINE HEALTH AND SAFETY ACT OF
1969, AS AMENDED, PUB.L.91-173, DECEMBER 30, 1969, 83 STAT. 742
ET SEQ.; OR INSURING AN EMPLOYER AGAINST LIABILITY FOR ALL SUMS
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SUCH EMPLOYER SHALL BECOME LEGALLY OBLIGATED TO PAY ANY EMPLOYE
OF HIS AS DAMAGES BECAUSE OF BODILY INJURY BY ACCIDENT OR
DISEASE, INCLUDING DEATH AT ANY TIME RESULTING THEREFROM,
SUSTAINED BY SUCH EMPLOYE ARISING OUT OF AND IN THE COURSE OF
HIS EMPLOYMENT, MAY BE CANCELLED OR TERMINATED BY AN INSURER
DURING THE TERM OF THE POLICY.
SECTION 654. CLASSIFICATION OF RISKS; UNDERWRITING
RULES; PREMIUM RATES; SCHEDULE AND MERIT RATING PLANS.--(A)
THE CLASSIFICATION OF RISKS, UNDERWRITING RULES, PREMIUM RATES,
AND SCHEDULE OR MERIT RATING PLANS FOR INSURANCE OF EMPLOYERS
AND EMPLOYES UNDER "THE [WORKMEN'S] WORKERS' COMPENSATION ACT OF
NINETEEN HUNDRED AND FIFTEEN," AND ACTS AMENDATORY THEREOF OR
SUPPLEMENTARY THERETO, AND FOR INSURANCE UNDER "THE PENNSYLVANIA
OCCUPATIONAL DISEASE ACT OF NINETEEN HUNDRED AND THIRTY-NINE,"
AND ACTS AMENDATORY THEREOF OR SUPPLEMENTARY THERETO, AND FOR
INSURANCE WITH RESPECT TO THE COMMONWEALTH OF PENNSYLVANIA AS TO
LIABILITY UNDER "THE UNITED STATES LONGSHOREMEN'S AND HARBOR
[WORKERS'] WORKERS' COMPENSATION ACT" OF ONE THOUSAND NINE
HUNDRED TWENTY-SEVEN, AND ACTS AMENDATORY THEREOF OR
SUPPLEMENTARY THERETO, WRITTEN AS A PART OF A WORKMEN'S
COMPENSATION AND EMPLOYERS' LIABILITY POLICY, SHALL BE PROPOSED
ANNUALLY BY ONE OR MORE RATING BUREAUS, SAID RATING BUREAU OR
BUREAUS TO BE SITUATE WITHIN THE COMMONWEALTH OF PENNSYLVANIA,
SUBJECT TO SUPERVISION AND TO EXAMINATION BY THE INSURANCE
COMMISSIONER AND APPROVED BY THE INSURANCE COMMISSIONER AS
ADEQUATELY EQUIPPED TO COMPILE RATES ON AN EQUITABLE AND
IMPARTIAL BASIS. SUCH SCHEDULE OR MERIT RATING PLANS SHALL BE
APPLIED ONLY BY THE APPROVED RATING BUREAU OR BUREAUS, AND, IN
THE PREPARATION OF SCHEDULES, NO EMPLOYER SHALL BE DISCRIMINATED
AGAINST OR PENALIZED BECAUSE OF PHYSICAL IMPAIRMENT OF ANY
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EMPLOYE OR BECAUSE OF THE NUMBER OF DEPENDENTS OF ANY EMPLOYE.
* * *
(E) NEITHER THE STATE [WORKMEN'S] WORKERS' INSURANCE FUND,
NOR ANY INSURANCE CORPORATION, MUTUAL ASSOCIATION, OR COMPANY,
SHALL ISSUE, RENEW, OR CARRY ANY POLICY OR CONTRACT OF INSURANCE
AGAINST SUCH LIABILITY UNDER SUCH ACTS, EXCEPT IN ACCORDANCE
WITH THE CLASSIFICATIONS, UNDERWRITING RULES, PREMIUM RATES, AND
SCHEDULE OR MERIT RATING PLANS, PROPOSED BY THE RATING BUREAU OR
BUREAUS AFORESAID FOR THE RISK INSURED AND AS MODIFIED, AMENDED
OR APPROVED BY THE INSURANCE COMMISSIONER FOR SUCH INSURER.
* * *
SECTION 655. ANNUAL REPORT OF PREMIUMS AND LOSS EXPERIENCE;
PENALTIES.--THE STATE [WORKMEN'S] WORKERS' INSURANCE FUND, AND
EVERY INSURANCE COMPANY AND EVERY EMPLOYER'S MUTUAL LIABILITY
ASSOCIATION WHICH INSURES EMPLOYERS AND EMPLOYES UNDER "THE
[WORKMEN'S] WORKERS' COMPENSATION ACT OF ONE THOUSAND NINE
HUNDRED AND FIFTEEN," AND ACTS AMENDATORY THEREOF OR
SUPPLEMENTARY THERETO, OR UNDER "THE PENNSYLVANIA OCCUPATIONAL
DISEASE ACT OF NINETEEN HUNDRED AND THIRTY-NINE," AND ACTS
AMENDATORY THEREOF OR SUPPLEMENTARY THERETO, OR WITH RESPECT TO
PENNSYLVANIA UNDER THE "UNITED STATES LONGSHOREMEN'S AND HARBOR
WORKERS' COMPENSATION ACT" OF ONE THOUSAND NINE HUNDRED TWENTY-
SEVEN, AND ACTS AMENDATORY THEREOF OR SUPPLEMENTARY THERETO,
WHEN SUCH LIABILITY IS INSURED AS A PART OF A WORKMEN'S
COMPENSATION AND EMPLOYERS' LIABILITY POLICY, SHALL ANNUALLY, ON
OR BEFORE THE THIRTIETH DAY OF JUNE, FILE WITH THE INSURANCE
COMMISSIONER A SWORN REPORT OF ITS PREMIUM AND LOSS EXPERIENCE,
IN SUCH DETAIL AND FORM AS MAY BE PRESCRIBED BY THE INSURANCE
COMMISSIONER. ANY INSURANCE CARRIER WHICH NEGLECTS TO MAKE AND
FILE SUCH STATEMENT IN THE FORM OR WITHIN THE TIME HEREIN
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PROVIDED SHALL FORFEIT ONE HUNDRED DOLLARS FOR EACH DAY DURING
WHICH SUCH NEGLECT CONTINUES, AND, UPON NOTICE BY THE INSURANCE
COMMISSIONER, ITS AUTHORITY TO DO BUSINESS SHALL CEASE WHILE
SUCH DEFAULT CONTINUES.
THE INSURANCE COMMISSIONER SHALL HAVE THE POWER TO SUSPEND OR
REVOKE THE LICENSE OF ANY INSURANCE COMPANY WHICH VIOLATES ANY
OF THE PROVISIONS OF SUBDIVISION (D) OF THIS ARTICLE.
SECTION 666. GUARANTEED ARREST BOND CERTIFICATES ISSUED BY
AUTOMOBILE CLUBS OR ASSOCIATIONS.--* * *
(B) THE TERM "GUARANTEED ARREST BOND CERTIFICATE," AS USED
HEREIN, MEANS ANY PRINTED CARD OR OTHER CERTIFICATE ISSUED BY AN
AUTOMOBILE CLUB, ASSOCIATION OR INSURANCE COMPANY TO ANY OF ITS
MEMBERS OR INSUREDS, WHICH CARD OR CERTIFICATE IS SIGNED BY THE
MEMBER OR INSURED AND CONTAINS A PRINTED STATEMENT THAT THE
AUTOMOBILE CLUB, ASSOCIATION OR INSURANCE COMPANY AND A SURETY
COMPANY OR AN INSURANCE COMPANY AUTHORIZED TO TRANSACT BOTH
AUTOMOBILE LIABILITY INSURANCE AND SURETY BUSINESS, GUARANTEE
THE APPEARANCE OF THE PERSON WHOSE SIGNATURE APPEARS ON THE CARD
OR CERTIFICATE AND THAT THEY WILL, IN THE EVENT OF FAILURE OF
THE PERSON TO APPEAR IN ANY COURT OR BEFORE ANY [MAGISTRATE,
ALDERMAN OR JUSTICE OF THE PEACE] MAGISTERIAL DISTRICT JUDGE IN
THIS STATE, PAY ANY FINE OR FORFEITURE IMPOSED ON THE PERSON IN
AN AMOUNT NOT EXCEEDING TWO HUNDRED DOLLARS ($200), WHEN THE
PERSON IS ARRESTED OR FORMALLY CHARGED FOR VIOLATION OF ANY
MOTOR VEHICLE OR TRAFFIC LAW OF THIS STATE OR ORDINANCE OF ANY
LOCAL AUTHORITY OF THIS STATE PERTAINING THERETO EXCEPT AS
HEREINAFTER SET FORTH.
SECTION 667. USE OF GUARANTEED ARREST BOND CERTIFICATES.--
ANY GUARANTEED ARREST BOND CERTIFICATE WITH RESPECT TO WHICH A
SURETY COMPANY HAS BECOME SURETY OR A GUARANTEED ARREST BOND
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CERTIFICATE ISSUED BY AN INSURANCE COMPANY AUTHORIZED TO
TRANSACT BOTH AUTOMOBILE LIABILITY INSURANCE AND SURETY BUSINESS
WITHIN THIS STATE, SHALL, WHEN POSTED BY THE PERSON WHOSE
SIGNATURE APPEARS THEREON, BE ACCEPTED IN LIEU OF CASH BAIL IN
AN AMOUNT NOT EXCEEDING TWO HUNDRED DOLLARS ($200) AS A BAIL
BOND TO GUARANTEE THE APPEARANCE OF THE PERSON IN ANY COURT OR
BEFORE ANY [MAGISTRATE, ALDERMAN OR JUSTICE OF THE PEACE]
MAGISTERIAL DISTRICT JUDGE IN THIS STATE AT SUCH TIME AS MAY BE
REQUIRED BY THE COURT OR [MAGISTRATE, ALDERMAN OR JUSTICE OF THE
PEACE] MAGISTERIAL DISTRICT JUDGE WHEN THE PERSON IS ARRESTED OR
FORMALLY CHARGED FOR VIOLATION OF ANY MOTOR VEHICLE OR TRAFFIC
LAW OF THIS STATE OR ORDINANCE OF ANY LOCAL AUTHORITY PERTAINING
THERETO IN THIS STATE, EXCEPT FOR THE OFFENSES WHICH ARE
MISDEMEANORS OR FELONIES AS DEFINED IN "THE VEHICLE CODE." ANY
GUARANTEED ARREST BOND CERTIFICATE POSTED AS BAIL BOND IN ANY
COURT IN THIS STATE SHALL BE SUBJECT TO THE FORFEITURE AND
ENFORCEMENT PROVISIONS OF LAW APPLICABLE TO A BAIL BOND.
SECTION 601-A. DEFINITIONS.--AS USED IN THIS ARTICLE THE
FOLLOWING WORDS AND PHRASES SHALL HAVE THE MEANINGS GIVEN TO
THEM IN THIS SECTION:
"ALCOHOL OR DRUG ABUSE." ANY USE OF ALCOHOL OR OTHER DRUGS
WHICH PRODUCES A PATTERN OF PATHOLOGICAL USE CAUSING IMPAIRMENT
IN SOCIAL OR OCCUPATIONAL FUNCTIONING OR WHICH PRODUCES
PHYSIOLOGICAL DEPENDENCY EVIDENCED BY PHYSICAL TOLERANCE OR
WITHDRAWAL. FOR THE PURPOSES OF THIS ACT, "DRUGS" SHALL BE
DEFINED AS ADDICTIVE DRUGS AND DRUGS OF ABUSE LISTED AS
SCHEDULED DRUGS IN THE ACT OF APRIL 14, 1972 (P.L.233, NO.64),
KNOWN AS "THE CONTROLLED SUBSTANCE, DRUG, DEVICE AND COSMETIC
ACT."
"DETOXIFICATION." THE PROCESS WHEREBY AN ALCOHOL-INTOXICATED
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OR DRUG-INTOXICATED OR ALCOHOL-DEPENDENT OR DRUG-DEPENDENT
PERSON IS ASSISTED, IN A FACILITY LICENSED BY THE DEPARTMENT OF
[HEALTH] DRUG AND ALCOHOL PROGRAMS, THROUGH THE PERIOD OF TIME
NECESSARY TO ELIMINATE, BY METABOLIC OR OTHER MEANS, THE
INTOXICATING ALCOHOL OR OTHER DRUGS, ALCOHOL AND OTHER DRUG
DEPENDENCY FACTORS OR ALCOHOL IN COMBINATION WITH DRUGS AS
DETERMINED BY A LICENSED PHYSICIAN, WHILE KEEPING THE
PHYSIOLOGICAL RISK TO THE PATIENT AT A MINIMUM.
"HOSPITAL." A FACILITY LICENSED AS A HOSPITAL BY THE
DEPARTMENT OF HEALTH, THE DEPARTMENT OF [PUBLIC WELFARE] HUMAN
SERVICES, OR OPERATED BY THE COMMONWEALTH AND CONDUCTING AN
ALCOHOLISM OR DRUG ADDICTION TREATMENT PROGRAM LICENSED BY THE
DEPARTMENT OF [HEALTH] DRUG AND ALCOHOL PROGRAMS.
"INPATIENT CARE." THE PROVISION OF MEDICAL, NURSING,
COUNSELING OR THERAPEUTIC SERVICES TWENTY-FOUR HOURS A DAY IN A
HOSPITAL OR NON-HOSPITAL FACILITY, ACCORDING TO INDIVIDUALIZED
TREATMENT PLANS.
"NON-HOSPITAL FACILITY." A FACILITY, LICENSED BY THE
DEPARTMENT OF [HEALTH] DRUG AND ALCOHOL PROGRAMS, FOR THE CARE
OR TREATMENT OF ALCOHOL-DEPENDENT OR OTHER DRUG-DEPENDENT
PERSONS, EXCEPT FOR TRANSITIONAL LIVING FACILITIES.
"NON-HOSPITAL RESIDENTIAL CARE." THE PROVISION OF MEDICAL,
NURSING, COUNSELING OR THERAPEUTIC SERVICES TO PATIENTS
SUFFERING FROM ALCOHOL OR OTHER DRUG ABUSE OR DEPENDENCY IN A
RESIDENTIAL ENVIRONMENT, ACCORDING TO INDIVIDUALIZED TREATMENT
PLANS.
"OUTPATIENT CARE." THE PROVISION OF MEDICAL, NURSING,
COUNSELING OR THERAPEUTIC SERVICES IN A HOSPITAL OR NON-HOSPITAL
FACILITY ON A REGULAR AND PREDETERMINED SCHEDULE, ACCORDING TO
INDIVIDUALIZED TREATMENT PLANS.
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"PARTIAL HOSPITALIZATION." THE PROVISION OF MEDICAL,
NURSING, COUNSELING OR THERAPEUTIC SERVICES ON A PLANNED AND
REGULARLY SCHEDULED BASIS IN A HOSPITAL OR NON-HOSPITAL FACILITY
LICENSED AS AN ALCOHOLISM OR DRUG ADDICTION TREATMENT PROGRAM BY
THE DEPARTMENT OF [HEALTH] DRUG AND ALCOHOL PROGRAMS, DESIGNED
FOR A PATIENT OR CLIENT WHO WOULD BENEFIT FROM MORE INTENSIVE
THAN ARE OFFERED IN OUTPATIENT TREATMENT BUT WHO DOES NOT
REQUIRE INPATIENT CARE.
SECTION 602-A. MANDATED POLICY COVERAGES AND OPTIONS.--(A)
ALL GROUP HEALTH OR SICKNESS OR ACCIDENT INSURANCE POLICIES
PROVIDING HOSPITAL OR MEDICAL/SURGICAL COVERAGE AND ALL GROUP
SUBSCRIBER CONTRACTS OR CERTIFICATES ISSUED BY ANY ENTITY
SUBJECT TO THIS ACT, 40 PA.C.S. CH. 61 (RELATING TO HOSPITAL
PLAN CORPORATIONS) OR CH. 63 (RELATING TO PROFESSIONAL HEALTH
SERVICES PLAN CORPORATIONS), THE ACT OF DECEMBER 29, 1972
(P.L.1701, NO.364), KNOWN AS THE "HEALTH MAINTENANCE
ORGANIZATION ACT," OR [THE ACT OF JULY 29, 1977 (P.L.105,
NO.38), KNOWN AS THE "FRATERNAL BENEFIT SOCIETY CODE,"] ARTICLE
XXIV PROVIDING HOSPITAL OR MEDICAL/SURGICAL COVERAGE, SHALL IN
ADDITION TO OTHER PROVISIONS REQUIRED BY THIS ACT INCLUDE WITHIN
THE COVERAGE THOSE BENEFITS FOR ALCOHOL OR OTHER DRUG ABUSE AND
DEPENDENCY AS PROVIDED IN SECTIONS 603-A, 604-A AND 605-A.
* * *
SECTION 603-A. INPATIENT DETOXIFICATION.--(A) INPATIENT
DETOXIFICATION AS A COVERED BENEFIT UNDER THIS ARTICLE SHALL BE
PROVIDED EITHER IN A HOSPITAL OR IN AN INPATIENT NON-HOSPITAL
FACILITY WHICH HAS A WRITTEN AFFILIATION AGREEMENT WITH A
HOSPITAL FOR EMERGENCY, MEDICAL AND PSYCHIATRIC OR PSYCHOLOGICAL
SUPPORT SERVICES, MEETS MINIMUM STANDARDS FOR CLIENT-TO-STAFF
RATIOS AND STAFF QUALIFICATIONS WHICH SHALL BE ESTABLISHED BY
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THE DEPARTMENT OF [HEALTH] DRUG AND ALCOHOL PROGRAMS AND IS
LICENSED AS AN ALCOHOLISM AND/OR DRUG ADDICTION TREATMENT
PROGRAM.
* * *
SECTION 604-A. NON-HOSPITAL RESIDENTIAL ALCOHOL OR OTHER
DRUG SERVICES.--(A) MINIMAL ADDITIONAL TREATMENT AS A COVERED
BENEFIT UNDER THIS ARTICLE SHALL BE PROVIDED IN A FACILITY WHICH
MEETS MINIMUM STANDARDS FOR CLIENT-TO-STAFF RATIOS AND STAFF
QUALIFICATIONS WHICH SHALL BE ESTABLISHED BY THE [OFFICE]
DEPARTMENT OF DRUG AND ALCOHOL PROGRAMS AND IS APPROPRIATELY
LICENSED BY THE DEPARTMENT OF [HEALTH] DRUG AND ALCOHOL PROGRAMS
AS AN ALCOHOLISM OR DRUG ADDICTION TREATMENT PROGRAM. BEFORE AN
INSURED MAY QUALIFY TO RECEIVE BENEFITS UNDER THIS SECTION, A
LICENSED PHYSICIAN OR LICENSED PSYCHOLOGIST MUST CERTIFY THE
INSURED AS A PERSON SUFFERING FROM ALCOHOL OR OTHER DRUG ABUSE
OR DEPENDENCY AND REFER THE INSURED FOR THE APPROPRIATE
TREATMENT.
* * *
SECTION 605-A. OUTPATIENT ALCOHOL OR OTHER DRUG SERVICES.--
(A) MINIMAL ADDITIONAL TREATMENT AS A COVERED BENEFIT UNDER
THIS ARTICLE SHALL BE PROVIDED IN A FACILITY APPROPRIATELY
LICENSED BY THE DEPARTMENT OF [HEALTH] DRUG AND ALCOHOL PROGRAMS
AS AN ALCOHOLISM OR DRUG ADDICTION TREATMENT PROGRAM. BEFORE AN
INSURED MAY QUALIFY TO RECEIVE BENEFITS UNDER THIS SECTION, A
LICENSED PHYSICIAN OR LICENSED PSYCHOLOGIST MUST CERTIFY THE
INSURED AS A PERSON SUFFERING FROM ALCOHOL OR OTHER DRUG ABUSE
OR DEPENDENCY AND REFER THE INSURED FOR THE APPROPRIATE
TREATMENT.
* * *
SECTION 607-A. RULES AND REGULATIONS.--THE INSURANCE
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COMMISSIONER AND THE SECRETARY OF [HEALTH] DRUG AND ALCOHOL
PROGRAMS SHALL JOINTLY PROMULGATE THOSE RULES AND REGULATIONS AS
ARE DEEMED NECESSARY FOR THE EFFECTIVE IMPLEMENTATION AND
OPERATION OF THIS ARTICLE.
SECTION 749. HEARING PROCEDURE AND JUDICIAL REVIEW.--* * *
(B) ALL HEARINGS PROVIDED FOR IN THIS ARTICLE SHALL BE
CONDUCTED, AND THE DECISION OF THE COMMISSIONER ON THE ISSUE OR
FILING INVOLVED SHALL BE RENDERED, IN ACCORDANCE WITH THE
PROVISIONS OF [THE ACT OF JUNE 4, 1945 (P.L.1388), KNOWN AS THE
"ADMINISTRATIVE AGENCY LAW" RELATING TO ADJUDICATION PROCEDURE.]
2 PA.C.S. CHS. 5 SUBCH. A (RELATING TO PRACTICE AND PROCEDURE OF
COMMONWEALTH AGENCIES) AND 7 SUBCH. A (RELATING TO JUDICIAL
REVIEW OF COMMONWEALTH AGENCY ACTION).
SECTION 754. OTHER SECTIONS APPLICABLE.--IN ADDITION TO THE
PROVISIONS OF THIS ARTICLE, ONLY THE FOLLOWING PROVISIONS OF THE
LAWS GOVERNING INSURANCE COMPANIES AS PRESENTLY ENACTED AND
HEREINAFTER AMENDED, EXCEPT AS THEY ARE INCONSISTENT WITH THE
PROVISIONS OF THIS ARTICLE, SHALL APPLY TO THE BUSINESS OF TITLE
INSURANCE AND TO TITLE INSURANCE COMPANIES, WHICH SHALL BE
CONSIDERED AS WITHIN THE CLASS OF INSURANCE COMPANIES REGULATED
BY SUCH PROVISIONS SOLELY FOR THE LIMITED PURPOSE OF BEING
SUBJECT TO SUCH PROVISIONS:
* * *
(10) [SECTIONS 1 TO 12 OF THE ACT OF JUNE 5, 1947 (P.L.445),
KNOWN AS "THE INSURANCE UNFAIR PRACTICES ACT."] THE ACT OF JULY
22, 1974 (P.L.589, NO.205), KNOWN AS THE "UNFAIR INSURANCE
PRACTICES ACT."
(11) [SECTIONS 1 TO 10 OF THE ACT OF FEBRUARY 21, 1961
(P.L.33), ENTITLED "AN ACT IMPOSING A STATE TAX ON GROSS
PREMIUMS, PREMIUM DEPOSITS, AND ASSESSMENTS RECEIVED FROM
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BUSINESS TRANSACTED WITHIN THIS COMMONWEALTH BY CERTAIN
INSURANCE COMPANIES, ASSOCIATIONS, AND EXCHANGES; REQUIRING THE
FILING OF ANNUAL AND TENTATIVE REPORTS AND THE COMPUTATION AND
PAYMENT OF TAX; PROVIDING FOR THE RIGHTS, POWERS AND DUTIES OF
THE DEPARTMENT OF REVENUE, THE TAXPAYERS AND OFFICERS THEREOF;
AND PROVIDING PENALTIES."] ARTICLE IX OF THE ACT OF MARCH 4,
1971 (P.L.6, NO.2), KNOWN AS THE "TAX REFORM CODE OF 1971 ."
SECTION 7. THE DEFINITION OF "FRATERNAL BENEFIT SOCIETY" IN
SECTION 1002-A OF THE ACT IS AMENDED TO READ:
SECTION 1002-A. DEFINITIONS.--(A) AS USED IN THIS ARTICLE,
THE FOLLOWING WORDS AND PHRASES SHALL HAVE THE MEANINGS GIVEN TO
THEM IN THIS SECTION UNLESS THE CONTEXT CLEARLY INDICATES
OTHERWISE:
* * *
"FRATERNAL BENEFIT SOCIETY." AN ENTITY HOLDING A CURRENT
CERTIFICATE OF AUTHORITY IN THIS COMMONWEALTH UNDER [THE ACT OF
DECEMBER 14, 1992 (P.L.835, NO.134), KNOWN AS THE "FRATERNAL
BENEFIT SOCIETIES CODE."] ARTICLE XXIV.
* * *
SECTION 8. SECTION 1110.1(A) AND (B) OF THE ACT ARE AMENDED
TO READ:
Section 1110.1. Long-Term Care Partnership Program.--(a)
There is hereby established the Long-Term Care Partnership
Program, to be administered by the Department of [Public
Welfare] Human Services in accordance with the requirements for
qualified State long-term care insurance partnerships. The
purpose of this program is to reduce future Medicaid costs for
long-term care by delaying or eliminating dependence on Medicaid
by providing incentives for individuals to ensure against the
potentially substantial costs that arise upon the need for long-
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term care.
(b) In order to implement the program, the Department of
[Public Welfare] Human Services shall file a State plan
amendment with Centers for Medicare and Medicaid Services of the
United States Department of Health and Human Services pursuant
to Title XIX of the Social Security Act (49 Stat. 620, 42 U.S.C.
§ 1396 et seq.) within 30 days of the effective date of this
section. The program, including the treatment of assets for
Medicaid eligibility and estate recovery, shall be structured
and administered by the Department of [Public Welfare] Human
Services in accordance with Federal law and applicable Federal
guidelines for qualified State long-term care partnerships.
* * *
Section 4. The definition of "public health care coverage"
in section 1201 of the act is amended to read:
SECTION 9. THE DEFINITIONS OF "INSURER" AND "PUBLIC HEALTH
CARE COVERAGE" IN SECTION 1201 OF THE ACT ARE AMENDED TO READ:
Section 1201. Definitions.--As used in this article, the
following words and phrases shall have the meanings given to
them in this section:
* * *
"INSURER." AN ENTITY SUBJECT TO ANY OF THE FOLLOWING:
(1) 40 PA.C.S. CH. 61 (RELATING TO HOSPITAL PLAN
CORPORATIONS) OR 63 (RELATING TO PROFESSIONAL HEALTH SERVICES
PLAN CORPORATIONS).
(2) THIS ACT, INCLUDING ANY PREFERRED PROVIDER
ORGANIZATION SUBJECT TO SECTION 630.
(3) THE ACT OF DECEMBER 29, 1972 (P.L.1701, NO.364),
KNOWN AS THE "HEALTH MAINTENANCE ORGANIZATION ACT."
(4) [THE ACT OF JULY 29, 1977 (P.L.105, NO.38), KNOWN AS
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THE "FRATERNAL BENEFIT SOCIETY CODE."] ARTICLE XXIV.
"Public health care coverage." The State program of medical
assistance established under the act of June 13, 1967 (P.L.31,
No.21), known as the ["Public Welfare Code."] "Human Services
Code."
* * *
Section 5. Sections 1202(a) and (b) and 1205 of the act are
amended to read:
SECTION 10. SECTIONS 1202(A) AND (B), 1205, 1506(C) AND
2007.1(E) OF THE ACT ARE AMENDED TO READ:
Section 1202. Forms for Health Insurance Claims.--(a) Each
health insurance claim form processed or otherwise used by an
insurer, including those used by the Department of [Public
Welfare] Human Services for public health care coverage, shall
be the uniform claim form developed by the department. The claim
form shall be identical in form and content except as provided
in subsection (c). The department shall, in consultation with
the Department of [Public Welfare] Human Services, insurers and
health care providers or their representatives, first consider
the feasibility of utilizing the UB-82/HCFA-1450 and HCFA-1500
forms, or their successors, as a uniform claim form. If these
forms are deemed to be unsatisfactory, the department shall, in
consultation with the Department of [Public Welfare] Human
Services, insurers and health care providers or their
representatives, develop a uniform claim form for use by all
insurers, the Department of [Public Welfare's] Human Services'
public health care coverage program and health care providers.
The uniform claim form shall contain blank spaces at appropriate
places in the document for approved additional information
requests under subsection (c).
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(b) The feasibility study and subsequent development of the
uniform claim form shall be complete within one hundred eighty
(180) days of the effective date of this article. All insurers,
the Department of [Public Welfare's] Human Services' public
health care coverage program and health care providers shall be
required to use the uniform claim form within one hundred twenty
(120) days after the uniform claim form is developed. The
department may consider a request from the Department of [Public
Welfare] Human Services for an extension in meeting the
implementation schedule of this section.
* * *
Section 1205. Federal Compliance.--In the event the Federal
Government enacts a uniform claim form for mandatory use by all
insurers and the Department of [Public Welfare's] Human
Services' public health care coverage program, the department
shall adopt the Federal form for use by all insurers, the
Department of [Public Welfare's] Human Services' public health
care coverage program and health care providers within ninety
(90) days of the enactment of the Federal legislation or the
effective date included in the Federal act, whichever is later.
SECTION 1506. GUARANTY FUNDS AND COMPULSORY ASSOCIATIONS.--*
* *
(C) WHEN A PURCHASING GROUP OBTAINS INSURANCE COVERING ITS
MEMBERS' RISKS FROM AN ADMITTED INSURER, ONLY COVERED CLAIMS AS
DEFINED IN [THE ACT OF NOVEMBER 25, 1970 (P.L.716, NO.232),
KNOWN AS "THE PENNSYLVANIA INSURANCE GUARANTY ASSOCIATION ACT,"]
SECTION 1802 SHALL BE COVERED BY THE STATE GUARANTY FUND.
* * *
SECTION 2007.1. COVERAGE OBLIGATIONS OF LOANER VEHICLES.--*
* *
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(E) AS USED IN THIS SECTION, THE TERM "MOTOR VEHICLE DEALER"
SHALL HAVE THE SAME MEANING AS "DEALER" AS DEFINED IN SECTION
[2] 102 OF THE ACT OF DECEMBER 22, 1983 (P.L.306, NO.84), KNOWN
AS THE "BOARD OF VEHICLES ACT."
Section 6 11. The definition of "medical assistance" in
section 2301-A of the act is amended to read:
Section 2301-A. Definitions.
The following words and phrases when used in this article
shall have the meanings given to them in this section unless the
context clearly indicates otherwise:
* * *
"Medical assistance." The State program of medical
assistance established under the act of June 13, 1967 (P.L.31,
No.21), known as the [Public Welfare] Human Services Code.
* * *
Section 7 12. Sections 2302-A(d)(5) and (e)(2) and 2304-A(a)
(3)(iv) of the act are amended to read:
Section 2302-A. Children's health care.
* * *
(d) Income levels.--The provision of health care insurance
for eligible children shall be in accordance with the following:
* * *
(5) Notwithstanding paragraphs (1), (2), (3) and (4),
for purposes of determining cost-sharing obligations of a
family with income levels specified under paragraphs (2), (3)
and (4), the per member per month premium shall exclude the
cost related to an assessment imposed on a contractor
relating to managed care organization assessments under the
act of June 13, 1967 (P.L.31, No.21), known as the [Public
Welfare] Human Services Code.
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(e) Income exceeding limits.--The following apply:
* * *
(2) For purposes of this subsection, the per member per
month premium cost shall exclude the cost related to the
managed care organization assessment imposed on a contractor
under the [Public Welfare] Human Services Code.
* * *
Section 2304-A. Contracts and coverage packages.
(a) Paid from fund.--In addition to any other requirements
provided by law, the fund shall be operated in accordance with
the following:
* * *
(3) The department must award contracts paid from the
fund in accordance with the following:
* * *
(iv) In determining the amount of the contract which
may be used for the purposes specified in subparagraphs
(ii) and (iii), any Federal and State taxes that would be
deducted from premium revenue in determining an issuer's
medical loss ratio under 45 CFR 158.221 (relating to
formula for calculating an issuer's medical loss ratio),
including a managed care organization assessment imposed
on a contractor under the act of June 13, 1967 (P.L.31,
No.21), known as the [Public Welfare] Human Services
Code, shall be excluded.
* * *
Section 8 13. This act shall take effect immediately.
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