THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

INTRODUCED BY EACHUS, MAY 21, 2009

REFERRED TO COMMITTEE ON INSURANCE, MAY 21, 2009  

AN ACT

Establishing the Expanded Adult Basic Coverage Insurance

Program; making appropriations; and making related repeals.

TABLE OF CONTENTS

Chapter 1.  Preliminary Provisions

Section 101.  Short title.

Section 102.  Definitions.

Chapter 3.  Pennsylvania Expanded Adult Basic Coverage Insurance

Program

Section 301.  Scope of chapter.

Section 302.  Definitions.

Section 303.  Pennsylvania Expanded Adult Basic Coverage

Insurance Program.

Section 304.  Duties of contractors.

Section 305.  Premiums and charges.

Section 306.  Data matching.

Section 307.  Information sharing.

Section 308.  Regulations.

Section 309.  Funding.

Section 310.  Federal waivers or State plan amendments.

Section 311.  Federal funds.

Section 312.  Federal programs.

Section 313.  Establishment.

Section 314.  Deposits into fund and appropriation.

Chapter 51.  Miscellaneous Provisions

Section 5101.  Repeals.

Section 5102.  Effective date.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

CHAPTER 1

PRELIMINARY PROVISIONS

Section 101.  Short title.

This act shall be known and may be cited as the Expanded

Adult Basic Coverage Insurance Program Act.

Section 102.  Definitions.

The following words and phrases when used in this act shall

have the meanings given to them in this section unless the

context clearly indicates otherwise:

"Commissioner."  The Insurance Commissioner of the

Commonwealth.

"Department."  The Insurance Department of the Commonwealth.

CHAPTER 3

PENNSYLVANIA EXPANDED ADULT BASIC COVERAGE INSURANCE PROGRAM

Section 301.  Scope of chapter.

This chapter relates to offering health care coverage to

eligible adults. 

Section 302.  Definitions.

The following words and phrases when used in this chapter

shall have the meanings given to them in this section unless the

context clearly indicates otherwise:

"Behavioral health services."  Mental health or substance

abuse services.

"Benefit package."  Insurance coverage which provides the

benefits set forth under section 303(h) for eligible adults.

"Children's Health Insurance Program."  The Children's Health

Care Program established under Article XXIII of the act of May

17, 1921 (P.L.682, No.284), known as The Insurance Company Law

of 1921. 

"Chronic care and disease management."  A model of health

care that manages chronic diseases in accordance with evidence-

based treatment guidelines and includes all of the following:

(1)  Planned, regular interactions with caregivers to

systematically assess the patient's condition and guide

patient self-care to prevent exacerbation and complications

of the chronic illness.

(2)  Support for the patient's role as self-manager

through education and continuing follow-up initiated by the

health care practice. 

(3)  Use of information systems to organize care and

monitor patient progress. 

"Contractor."  An insurer or other entity or its subsidiaries

awarded a contract to provide health care services under this

chapter.

"Eligible adult."  A low-income adult who meets all of the

following:

(1)  Legally resides within the United States.

(2)  Is a resident of this Commonwealth at the time of

application to the program.

(3)  Is not currently covered by a health insurance plan,

a self-insurance plan or a self-funded plan.

(4)  Has not been covered by a health insurance plan, a

self-insurance plan or a self-funded plan during the six

months immediately preceding the determination of

eligibility, except if one of the following apply: 

(i)  The low-income adult is eligible to receive

benefits under the act of December 5, 1936 (2nd Sp.Sess.,

1937 P.L.2897, No.1), known as the Unemployment

Compensation Law.

(ii)  The low-income adult was covered under a health

insurance plan, a self-insurance plan or a self-funded

plan, but, at the time of application for coverage, is no

longer employed and is ineligible to receive benefits

under the Unemployment Compensation Law. 

(iii)  The low-income adult lost coverage as a result

of divorce or separation from a covered individual or the

death of a covered individual.

(iv)  The low-income adult lost coverage as a result

of a change in employment status of a covered individual

resulting in either of the exceptions set forth under

subparagraph (i) or (ii) and both the eligible adult and

the spouse are low-income adults and applying for

coverage.

(v)  The low-income adult is transferring from

another government-subsidized health insurance program,

including a transfer that occurs as a result of failure

to meet income eligibility requirements.

(5)  The low-income adult is ineligible to receive

continuous eligibility coverage under Title XIX or XXI of the

Social Security Act (49 Stat. 620, 42 U.S.C. § 301 et seq.),

except for benefits authorized under a waiver granted by the

United States Department of Health and Human Services to

implement the program.

(6)  The low-income adult is ineligible for Medicare.

"Enrollee."  An eligible adult who meets all the requirements

of this chapter and is enrolled in the Pennsylvania Expanded

Adult Basic Coverage Insurance Program.

"Health benefit plan."  An insurance coverage plan that

provides the benefits set forth under section 303(h). The term

shall not include any of the following:

(1)  An accident-only policy.

(2)  A credit-only policy.

(3)  A long-term care or disability income policy.

(4)  A specified-disease policy.

(5)  A Medicare supplement policy.

(6)  A Civilian Health and Medical Program of the

Uniformed Services (CHAMPUS) supplement policy.

(7)  A fixed-indemnity policy.

(8)  A dental-only policy.

(9)  A vision-only policy.

(10)  A workers' compensation policy.

(11)  An automobile medical payment policy under 75

Pa.C.S. (relating to vehicles). 

(12)  Other similar policies providing for limited

benefits.

"Health maintenance organization" or "HMO."  An entity

organized and regulated under the act of December 29, 1972

(P.L.1701, No.364), known as the Health Maintenance Organization

Act.

"Hospital."  A hospital as defined and licensed under the act

of July 19, 1979 (P.L.130, No.48), known as the Health Care

Facilities Act.

"Hospital plan corporation."  A hospital plan corporation as

defined in 40 Pa.C.S. § 6101 (relating to definitions). 

"Insurer."  A company or health insurance entity licensed in

this Commonwealth to issue any individual or group health,

sickness or accident policy or subscriber contract or

certificate or plan that provides medical or health care

coverage by a health care facility or licensed health care

provider that is offered or governed under any of the following:

(1)  The act of May 17, 1921 (P.L.682, No.284), known as

The Insurance Company Law of 1921.

(2)  The act of December 29, 1972 (P.L.1701, No.364),

known as the Health Maintenance Organization Act.

(3)  The act of May 18, 1976 (P.L.123, No.54), known as

the Individual Accident and Sickness Insurance Minimum

Standards Act.

(4)  40 Pa.C.S. Ch. 61 (relating to hospital plan

corporations) or 63 (relating to professional health services

plan corporations).

"Low-income adult."  An individual who is at least 19 years

of age but less than 65 years of age and whose household income

is less than 200% of the Federal poverty level at the time of

eligibility determination.

"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 Code.

"Medicare."  The Federal program established under Title

XVIII of the Social Security Act (49 Stat. 620, 42 U.S.C. § 1395

et seq.).

"Offeror."  An insurer that submits a bid or proposal in

response to a solicitation issued under section 303(h).

"Pre-existing condition."  A disease or physical condition

for which medical advice, diagnosis, care or treatment was

recommended or received prior to the effective date of coverage.

"Premium assistance program."  A component of the

Pennsylvania Expanded Adult Basic Coverage Insurance Program,

approved under a State plan or approved waiver, under which the

Commonwealth pays part or all of the premium for an enrollee’s

group health insurance or coverage under a group health plan. 

"Prescription drug."  A controlled substance, other drug or

device for medication dispensed by order of an appropriately

licensed medical professional. 

"Professional health services plan corporation."  A not-for-

profit corporation operating under the provisions of 40 Pa.C.S.

Ch. 63 (relating to professional health services plan

corporations).

"Program."  The Pennsylvania Expanded Adult Basic Coverage

Insurance Program.

"Unemployment Compensation Law."  The act of December 5, 1936

(1937 2nd Sp.Sess., P.L. 2897, No.1), known as the Unemployment

Compensation Law.

"Wait-list enrollee."  An eligible adult who meets all the

requirements of this chapter who is not enrolled in the program

due to insufficient appropriations, but who individually

purchases the benefit package.

Section 303.  Pennsylvania Expanded Adult Basic Coverage

Insurance Program.

(a)  Program establishment.--There is established in the

department the Pennsylvania Expanded Adult Basic Coverage

Insurance Program. The program is contingent on, and shall not

be authorized without, sufficient Federal financial

participation to fund the program. Appropriations to the

department for the program shall be used for contracts to

provide basic health care insurance for eligible adults and

administration of outreach activities and for program operating

costs. The department shall, to the greatest extent practicable,

ensure that all eligible adults in this Commonwealth have access

to the program established in this section.

(b)  Eligible adult responsibilities.--An eligible adult

seeking to purchase coverage under the program shall:

(1)  Submit an application to the department or a

contractor.

(2)  Pay to the department, or the contractor with whom

the eligible adult is to be enrolled, the amount of the

premium specified under this subsection. Except to the extent

that changes may be necessary to meet Federal requirements

under section 310, subsidies for the 2009-2010 fiscal year

shall result in the following premium amount based on

household income for a health benefit plan:

(i)  For an enrollee whose household income is not

greater than 150% of the Federal poverty level, a monthly

premium of $0.

(ii)  For an enrollee whose household income is

greater than 150% but not greater than 175% of the

Federal poverty level, a monthly premium of $40.

(iii)  For an enrollee whose household income is

greater than 175% but not greater than 200% of the

Federal poverty level, a monthly premium of $50.

(3)  Be responsible for any required copayments for

health care services rendered under the benefit package in

subsection (h).

(4)  Notify the department or the contractor with whom

the eligible adult is enrolled of any change in the eligible

adult's household income.

(c)  Purchase of insurance.--An eligible adult's payment to

the department or the contractor with whom the eligible adult is

enrolled under subsection (b)(2) shall be used to purchase the

benefit package and shall be remitted so that it is received by

the department or the contractor before the first day of the

month for which coverage is provided. A grace period for

remittance shall be permitted as provided by Federal or State

law.

(d)  Premium assistance program.--The department shall

implement a premium assistance program permitted under Federal

regulations and as permitted through a Federal waiver or State

plan amendment made under this chapter. Notwithstanding any

other law to the contrary, in the event that it is more cost-

effective to purchase health care from an enrollee's employer-

based program and the employer-based program provides, at a

minimum, the benefits package described in subsection (h)(8),

employer-based coverage may be purchased in place of enrollment

in the program established under this chapter. An insurer shall

honor a request for enrollment and purchase of employee group

health insurance requested on behalf of an enrollee.

(e)  Waiting list.—-The department shall maintain a waiting

list of eligible adults who have applied for coverage under the

program but who are not enrolled due to insufficient

appropriations. An eligible adult on the waiting list may

purchase the benefit package at the monthly per-member premium

cost negotiated by the department. The department shall create a

procedure to remove eligible adults from the waiting list and

enroll them in the program based upon available funding.

(f)  Entitlements and claims.--Nothing in this chapter shall

constitute an entitlement derived from the Commonwealth or a

claim on any funds of the Commonwealth. The Department of Public

Welfare, in conjunction with the department, shall seek approval

of State plan amendments and revisions to Federal waivers as are

necessary to ensure that expenditures in the program shall not

exceed available funding.

(g)  Department responsibilities.--The department shall work

in consultation and cooperation with other appropriate

Commonwealth agencies, including the Department of Public

Welfare, to carry out the functions of this chapter and shall:

(1)  Administer the program on a Statewide basis.

(2)  Enter into contracts for health care insurance for

the benefit package. Contracts may be awarded on a multiple-

award basis.

(3)  (i)  In order to effectuate the program promptly

upon receipt of all applicable waivers and approvals from

the Federal government, contracts as currently exist

under the Adult Basic Program or the Physical Health

Health Choices Program of the Department of Public

Welfare may be amended to provide benefits under the

program established in this section or may otherwise

procure services outside the competitive procurement

process.

(ii)  This paragraph shall expire at the same time as

the contracts awarded under this section, but not later

than 18 months after the effective date of this section.

(4)  Subject to Federal requirements, impose reasonable

cost-sharing arrangements establishing and adjusting

copayments to be incorporated into the program by

contractors, thereby encouraging appropriate use by

contractors of cost-effective health care providers who will

provide quality health care. Changes to copayments shall be

forwarded to the Legislative Reference Bureau for publication

as notices in the Pennsylvania Bulletin.

(5)  Conduct monitoring, oversight and audits of executed

contracts for enforcement purposes.

(6)  Ensure that the eligibility of enrollees receiving

subsidization of the benefit package is redetermined on an

annual basis.

(7)  Monitor, review and evaluate each contractor’s

benefit package for the adequacy, accessibility and

availability of the services required under subsection (h).

(8)  Establish and coordinate development, implementation

and supervision of an outreach plan to ensure that all those

who may be eligible are aware of the program. The outreach

plan shall include provisions for:

(i)  Reaching special populations, including nonwhite

and non-English speaking individuals and individuals with

disabilities.

(ii)  Reaching different geographic areas, including

rural and inner-city areas.

(iii)  Assuring that special efforts are coordinated

within the overall outreach activities throughout this

Commonwealth.

(iv)  Allowing for the acceptance of applications at

county assistance offices operated by the Department of

Public Welfare.

(9)  Prepare and submit, by March 1, 2010, and annually

thereafter, a report to the chairman and minority chairman of

the Banking and Insurance Committee of the Senate and to the

chairman and minority chairman of the Insurance Committee of

the House of Representatives regarding the number of eligible

adults purchasing coverage under the program with a

geographic distribution, the identity of the contractors, the

scope of the services being provided, the level of outreach,

the cost of the insurance and the amount an eligible adult

contributes toward the insurance, including any copayments

and adjustments to the premiums. The annual report shall be

made available for public inspection and posted on the

department's publicly accessible Internet website.

(10)  Undertake efforts as are required to seek receipt

of and qualify for Federal financial participation.

(h)  Solicitation.--The department shall solicit bids or

proposals for the program. The solicitation shall require an

offeror to assure that if selected as a contractor it will do

all of the following:

(1)  Ensure that enrollees and wait-list enrollees have

access to qualified, cost-effective health care providers.

(2)  Contract with qualified, cost-effective health care

providers, which shall include primary health care

physicians, certified registered nurse practitioners,

physician assistants, clinical nurse specialists, nurse-

midwives, clinics and health maintenance organizations, to

provide health care for organizations, to provide health care

for enrollees and wait-list enrollees in a manner that best

manages the costs of the services and utilizes other

appropriate medical cost-effective methods and in a manner

consistent with the provider's permitted scope of practice.

(3)  Ensure that the individual applying for coverage is

an eligible adult. If a review of the individual's

application for coverage indicates that the individual is not

eligible for adult basic coverage insurance, but may be

eligible for medical assistance, the application for benefits

and all accompanying documentation shall be promptly

transmitted to the appropriate county assistance office for a

determination of eligibility for medical assistance or other

Federal, State and local resources available to the

individual.

(4)  Not prohibit enrollment based upon a preexisting

condition nor exclude a diagnosis or treatment for the

condition based on the condition's preexistence.

(5)  Provide an insurance identification card to each

enrollee or wait-list enrollee covered under a contract

executed under this section. The card shall not identify the

enrollee or wait-list enrollee as low income.

(6)  Require each provider providing primary care

services under this section to make necessary arrangements

for admission to hospitals and for necessary specialty care.

(7)  Not pay any claim on behalf of an enrollee or wait-

list enrollee unless all other Federal, State and local

resources are first utilized and utilize subrogation and

coordination of benefits processes so that the program is the

payor of last resort.

(8)  Provide a benefit package to enrollees and wait-list

enrollees consistent with the scope and duration requirements

determined by the department. The Commonwealth may elect to

provide any benefit independently and outside the scope of

any contract entered into with any contractor to provide the

benefit package under the program. The benefit package

determined by the department may include any of the following

services:

(i)  Preventive and wellness care.

(ii)  Outpatient primary care and specialist

services.

(iii)  Inpatient hospitalization.

(iv)  Outpatient services.

(v)  Emergency care.

(vi)  Laboratory and radiology.

(vii)  Clinic services.

(viii)  Prescription drugs.

(ix)  Diabetic medical supplies and equipment.

(x)  Emergency dental care.

(xi)  Maternity care.

(xii)  Skilled nursing.

(xiii)  Home health, palliative and hospice care.

(xiv)  Chronic care and disease management.

(xv)  Inpatient and outpatient behavioral health

services.

(i)  Bids or proposals.--Each professional health service

plan corporation, hospital plan corporation, health maintenance

organization owned or controlled by a professional health

service plan corporation or a hospital plan corporation and each

entity that provides services under the Department of Public

Welfare's Physical Health HealthChoices Program shall be

required to submit a bid or proposal to the department to carry

out the purposes of this chapter. Each professional health

service plan corporation and hospital plan corporation, and

subsidiaries and affiliates doing business in this Commonwealth,

shall submit a bid or proposal to the department to carry out

the purposes of this section in the geographic area serviced by

that entity. Each health maintenance organization owned or

controlled by a health service plan corporation or hospital plan

corporation shall submit a bid or proposal with all eligible

licenses and certificates of authority under its control, in all

service zones in which it is licensed to do business in more

than 50% of the counties in that zone. The service zones shall

be determined by the department in consultation with the

Department of Health and the Department of Public Welfare. Each

entity that provides services under the Physical Health

HealthChoices Program of the Department of Public Welfare shall

submit a bid or proposal in all counties in which it provides

the services. All other insurers may submit a bid or proposal to

the department to carry out the purposes of this section.

(j)  Reviewing, scoring and selecting bids or proposals.--The

department, in consultation with the Department of Public

Welfare, shall review and score bids or proposals on the basis

of all of the requirements for the program. The department may

include other criteria in the solicitation and in the scoring

and selection of the bids or proposals that the department, in

the exercise of its administrative duties under this section and

in consultation with the Department of Public Welfare, deems

necessary. The department shall:

(1)  Select, to the greatest extent practicable, offerors

that contract with providers to provide health care services

on a cost-effective basis and that use appropriate cost-

management methods that enable the program to provide

coverage to the maximum number of eligible adults and that,

whenever possible, pursue and utilize available public and

private funds.

(2)  Select, to the greatest extent practicable, only

offerors that comply with all procedures relating to

coordination of benefits as required by the department and

the Department of Public Welfare.

(3)  Select offerors that limit administrative expenses

to no more than 10% of the amount of the contract. If a

contractor presents documented evidence that administrative

expenses for operational changes from the previous AdultBasic

Program to the program implemented under this act are in

excess of 10% of the amount of the contract, the department

shall make an additional allotment of funds, not to exceed 1%

of the amount of the contract, to the contractor to the

extent that the department finds the expenses reasonable and

necessary.

(k)  Rates and negotiations.--Rates for the program shall be

approved annually by the department and may vary by region and

contractor. Rates shall be based on an actuarially sound and

adequate review. The department shall not negotiate a contract

for a period in excess of four years.

(l)  Limitation.--In no case shall the total aggregate amount

of annual contracts entered into pursuant to this section exceed

the amount of the aggregate annual appropriations to the

department for the program.

Section 304.  Duties of contractors.

A contractor that contracts with the department to provide a

health benefit plan to eligible adults:

(1)  Shall process claims for the coverage.

(2)  Shall implement copayment adjustments as soon as

practicable following publication in the Pennsylvania

Bulletin, but in no event more than 120 days following

publication.

(3)  May not deny coverage to an eligible adult who has

been approved by the department to participate in the

program.

(4)  Shall provide to the department all data, including

individual claims data, as the department determines is

necessary for use in performance measurement and program

improvement.

(5)  Shall fulfill all requirements of any contract

issued to it pursuant to this section.

Section 305.  Premiums and charges.

(a)  Limitation on fees.--No eligible adult shall be assessed

a fee or other charge, other than those specified in this

chapter, as a requirement for participating in the program.

(b)  Premium adjustment.--For each fiscal year beginning

after June 30, 2010, the department may adjust the premium

amounts under section 303(b)(2) to reflect changes in the cost

of medical services and shall forward notice of the new premium

amounts to the Legislative Reference Bureau for publication as a

notice in the Pennsylvania Bulletin.

(c)  Copayment adjustment.--For each fiscal year beginning

after June 30, 2010, the department may adjust the copayment

amounts under section 303(b)(3) to reflect changes in the cost

of medical services and shall forward notice of the new premium

amounts to the Legislative Reference Bureau for publication as a

notice in the Pennsylvania Bulletin.

Section 306.  Data matching.

(a)  Covered adults.--All entities providing health insurance

or health care coverage within this Commonwealth shall, at least

once every month, provide the names, identifying information and

any additional information on coverage and benefits as the

department may specify for persons for whom the entities provide

insurance or coverage.

(b)  Use of information.--The department shall use the

information obtained under subsection (a) to determine whether

another entity has primary liability for health care claims paid

by the program. If a determination is made that the enrollee or

wait-list enrollee has other health care coverage, the

eligibility of the enrollee or wait-list enrollee shall be

reevaluated, as shall the most cost-effective means of providing

coverage for that enrollee or wait-list enrollee.

Section 307.  Information sharing.

Notwithstanding any provision of law to the contrary, the

program and other departments or programs of the Commonwealth

with information relating to the eligibility of individuals for

a Commonwealth program, shall share the information with each

other for purposes of determining and coordinating eligibility

for any State program. Those departments and programs include,

but are not limited to, the Department of Revenue, the

Department of Labor and Industry, the Department of Public

Welfare, the Children's Health Insurance Program and the

program. The information shall be confidential, shall be exempt

from disclosure under the act of February 14, 2008 (P.L.6,

No.3), known as the Right-to-Know Law, and may not be subject to

subpoena and may not be made public by any department or

program, except that it may be disclosed to another Commonwealth

agency or law enforcement official of the Federal or State

government at any time so long as the agency or office receiving

the information agrees in writing to hold it confidential and in

a manner consistent with this act. No individual who receives

information while acting under the authority of this act shall

be permitted or required to testify in a private civil or other

action concerning the information subject to this section. 

Section 308.  Regulations.

The department may promulgate regulations for the

implementation and administration of the program. Until final

regulations are adopted, the department shall operate the

program under interim guidelines consistent with this chapter.

Section 309.  Funding.

(a)  Funding contingency for subsidization.--Subsidization of

premiums and copayments paid under subsection (b) is contingent

upon the amount of the funding available to the program and the

Federal poverty levels approved by the Federal waiver or State

plan amendments granted under section 310, and is limited to

eligible adults who are in compliance with the requirements

under this chapter.

(b)  Use of funding.--Funding shall be used by the department

to pay the difference between the total monthly cost of the

health benefit plan and the premium payments and copayments by

the eligible adult and for administration and outreach

activities required under subsection 303(f).

Section 310.  Federal waivers or State plan amendments.

(a)  Application for waivers or amendments.--The Department

of Public Welfare, in cooperation with the department, shall

apply for all applicable waivers from the Federal Government and

shall seek approval to amend the State plan under Title XIX of

the Social Security Act (49 Stat. 620, 42 U.S.C. § 1396 et seq.)

as necessary to carry out the provisions of this chapter. 

(b)  Notice of approval.--If the Department of Public Welfare

receives approval of a waiver or approval of a State plan

amendment, it shall notify the department and shall transmit

notice of the waiver or State plan amendment approvals to the

Legislative Reference Bureau for publication as a notice in the

Pennsylvania Bulletin. 

(c)  Program changes.--The department is authorized to change

the benefits under section 303(h), the premium amounts payable

under section 303(b) and any eligibility requirements under this

chapter in order for the program to meet Federal requirements.

Section 311.  Federal funds.

Notwithstanding any other provision of law, the Department of

Public Welfare, in cooperation with the department, shall do all

of the following:

(1)  Seek the receipt of Federal financial participation

under Title XIX of the Social Security Act (49 Stat. 620, 42

U.S.C. § 1396 et seq.) for coverage and services provided

under this article.

(2)  Qualify for available Federal financial

participation under Title XIX of the Social Security Act.

Section 312.  Federal programs.

If the Federal Government enacts programs similar to the

program, the program shall be construed to only supplement the

Federal programs; and adults qualified for coverage under the

Federal program shall utilize that Federal program before

utilizing the program.

Section 313.  Establishment.

There is established within the State Treasury a special fund

to be known as the Pennsylvania Expanded Adult Basic Coverage

Insurance Program Fund. 

Section 314.  Deposits into fund and appropriation.

(a)  Health Care Provider Retention Account.--On the

effective date of this section, the sum of $362,000,000 shall be

transferred from the Health Care Provider Retention Account to

the Pennsylvania Expanded Adult Basic Coverage Insurance Program

Fund.

(b)  Tobacco Settlement Act.--Notwithstanding section

5101(b), funds appropriated under section 306(b)(1)(vi) of the

act of June 26, 2001 (P.L.755, No.77), known as the Tobacco

Settlement Act, for the program established in former Chapter 13

of that act, shall be deposited into the Pennsylvania Expanded

Adult Basic Coverage Insurance Program Fund.

(c)  Premium tax.--Commencing with calendar years beginning

after December 31, 2010, every hospital plan corporation and

professional health service plan corporation operating in this

Commonwealth shall pay the tax on gross premiums payable under

Article IX of the act of March 4, 1971 (P.L.6, No.2), known as

the Tax Reform Code of 1971. The tax payable in calendar year

2011 shall be for gross premiums received in calendar year 2010.

Notwithstanding the provisions of any law to the contrary, the

sums received by the Commonwealth as a result of this tax shall

be deposited into the Pennsylvania Expanded Adult Basic Coverage

Insurance Program Fund. This subsection shall not be effective

if the Agreement on Community Health Reinvestment entered into

February 2, 2005, by the department and Capital BlueCross,

Highmark, Inc., Hospital Service Association of Northeastern

Pennsylvania and Independence Blue Cross and published in the

Pennsylvania Bulletin at 35 Pa.B. 4155 (July 23, 2005) is

extended or otherwise renegotiated to continue, at least, at the

level of Annual Community Health Reinvestment contributed under

that agreement. In that event, the sums received by the

Commonwealth shall be deposited into the Pennsylvania Expanded

Adult Basic Coverage Insurance Program Fund.

(d)  Appropriation.--Money in the Pennsylvania Expanded Adult

Basic Coverage Insurance Program Fund is appropriated, upon

approval of the Governor, for health care coverage and services

under this chapter.

CHAPTER 51

MISCELLANEOUS PROVISIONS

Section 5101.  Repeals.

(a)  Declaration of policy.--The General Assembly declares

that the repeal under subsection (b) is necessary to effectuate

this act.

(b)  Specific.--Chapter 13 of the act of June 26, 2001

(P.L.755, No.77), known as the Tobacco Settlement Act, is

repealed.

(c)  Inconsistent.--All acts and parts of acts are repealed

insofar as they are inconsistent with this act.

Section 5102.  Effective date.

This act shall take effect in 90 days.