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| THE GENERAL ASSEMBLY OF PENNSYLVANIA |
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| SENATE BILL |
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| INTRODUCED BY D. WHITE, BAKER, TARTAGLIONE, RAFFERTY, ERICKSON, MUSTO, FERLO, BRUBAKER, M. WHITE, DINNIMAN, WASHINGTON, EARLL AND COSTA, OCTOBER 6, 2009 |
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| REFERRED TO BANKING AND INSURANCE, OCTOBER 6, 2009 |
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| AN ACT |
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1 | Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An |
2 | act relating to insurance; amending, revising, and |
3 | consolidating the law providing for the incorporation of |
4 | insurance companies, and the regulation, supervision, and |
5 | protection of home and foreign insurance companies, Lloyds |
6 | associations, reciprocal and inter-insurance exchanges, and |
7 | fire insurance rating bureaus, and the regulation and |
8 | supervision of insurance carried by such companies, |
9 | associations, and exchanges, including insurance carried by |
10 | the State Workmen's Insurance Fund; providing penalties; and |
11 | repealing existing laws," providing for the regulation of |
12 | health insurance practices concerning parity and |
13 | nondiscrimination. |
14 | The General Assembly of the Commonwealth of Pennsylvania |
15 | hereby enacts as follows: |
16 | Section 1. The act of May 17, 1921 (P.L.682, No.284), known |
17 | as The Insurance Company Law of 1921, is amended by adding an |
18 | article to read: |
19 | ARTICLE VI-B |
20 | HEALTH INSURANCE COVERAGE PARITY |
21 | AND NONDISCRIMINATION |
22 | Section 601-B. Short title of article. |
23 | This article shall be known and may be cited as the Health |
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1 | Insurance Coverage Parity and Nondiscrimination Act. |
2 | Section 602-B. Purpose. |
3 | It is necessary to maintain the Commonwealth's sovereignty |
4 | over the regulation of health insurance in this Commonwealth by |
5 | implementing the requirements of the Paul Wellstone and Pete |
6 | Domenici Mental Health Parity and Addiction Equity Act of 2008 |
7 | (Public Law 110-343, 122 Stat. 3881), the Genetic Information |
8 | Nondiscrimination Act of 2008 (Public Law 110-233, 122 Stat. |
9 | 881) and Michelle's Law (Public Law 110-381, 122 Stat. 4081), |
10 | collectively contained in the Public Health Service Act (58 |
11 | Stat. 682, 42 U.S.C. § 201 et seq.). The provisions of this |
12 | article are intended to meet these requirements while retaining |
13 | the Commonwealth's authority to regulate health insurance in |
14 | this Commonwealth, consistent with sections 2722 and 2761 of the |
15 | Public Health Service Act. |
16 | Section 603-B. Definitions. |
17 | (a) General rule.--The following words and phrases when used |
18 | in this article shall have the meanings given to them in this |
19 | section unless the context clearly indicates otherwise: |
20 | "Commissioner." The Insurance Commissioner of the |
21 | Commonwealth. |
22 | "Department." The Insurance Department of the Commonwealth. |
23 | "Federal acts." The Federal laws known as the Paul Wellstone |
24 | and Pete Domenici Mental Health Parity and Addiction Equity Act |
25 | of 2008 (Public Law 110-343, 122 Stat. 3881), the Genetic |
26 | Information Nondiscrimination Act of 2008 (Public Law 110-233, |
27 | 122 Stat. 881) and Michelle's Law (Public Law 110-381, 122 Stat. |
28 | 4081), collectively contained in the Public Health Service Act |
29 | (58 Stat. 682, 42 U.S.C. § 201 et seq.). |
30 | "Fraternal benefit society." An entity holding a current |
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1 | certificate of authority under Article XXIV. |
2 | "Health maintenance organization." An entity holding a |
3 | current certificate of authority under the act of December 29, |
4 | 1972 (P.L.1701, No.364), known as the Health Maintenance |
5 | Organization Act. |
6 | "Hospital plan corporation." An entity holding a current |
7 | certificate of authority organized and operated under 40 Pa.C.S. |
8 | Ch. 61 (relating to hospital plan corporations). |
9 | "Insurer." A foreign or domestic insurance company, |
10 | association or exchange, health maintenance organization, |
11 | hospital plan corporation, professional health services plan |
12 | corporation, fraternal benefit society or risk-assuming |
13 | preferred provider organization. The term shall not include a |
14 | group health plan as defined in section 2791 of the Public |
15 | Health Service Act (58 Stat. 682, 42 U.S.C. § 300gg-91). |
16 | "Preferred provider organization." An entity holding a |
17 | current certificate of authority under section 630. |
18 | "Professional health services plan corporation." An entity |
19 | holding a current certificate of authority under 40 Pa.C.S. Ch. |
20 | 63 (relating to professional health services plan corporations). |
21 | This term shall not include dental service corporations or |
22 | optometric service corporations, as those terms are defined |
23 | under 40 Pa.C.S. § 6302(a) (relating to definitions). |
24 | (b) Federal law.--The words, terms and definitions found in |
25 | the Federal acts, including those in section 2791 of the Public |
26 | Health Service Act (58 Stat. 682, 42 U.S.C. 300gg-91), are |
27 | adopted for purposes of implementing this article, except as |
28 | noted in this subsection. The term "health insurance issuer" |
29 | under section 2791(b)(2) of the Public Health Service Act shall |
30 | have the meaning provided under "insurer" in subsection (a). |
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1 | Section 604-B. Adoption of Federal acts. |
2 | Insurers shall comply with the Federal acts, as contained in |
3 | sections 2701, 2702, 2705, 2707, 2721, 2753 and 2754 of the |
4 | Public Health Service Act (58 Stat. 682, 42 U.S.C. §§ 300gg, |
5 | 300gg-1, 300gg-5, 300gg-7, 300gg-21, 300gg-53 and 300gg-54). |
6 | Section 605-B. Penalties. |
7 | (a) General rule.--Upon satisfactory evidence of a violation |
8 | of this article by any insurer or other person, the commissioner |
9 | may, in the commissioner's discretion, pursue any one of the |
10 | following courses of action: |
11 | (1) Suspend, revoke or refuse to renew the license of |
12 | the offending person. |
13 | (2) Enter a cease and desist order. |
14 | (3) Impose a civil penalty of not more than $5,000 for |
15 | each action in violation of this article. |
16 | (4) Impose a civil penalty of not more than $10,000 for |
17 | each action in willful violation of this article. |
18 | (b) Limitation.--Penalties imposed against a person under |
19 | this article and under section 5 of the act of June 25, 1997 |
20 | (P.L.295, No.29), known as the Pennsylvania Health Care |
21 | Insurance Portability Act, shall not exceed $500,000 in the |
22 | aggregate during a single calendar year. |
23 | Section 606-B. Regulations. |
24 | The department may promulgate such regulations as may be |
25 | necessary or appropriate to carry out this article. |
26 | Section 2. All acts and parts of acts are repealed insofar |
27 | as they are inconsistent with the addition of Article VI-B of |
28 | the act. |
29 | Section 3. This act shall take effect immediately. |
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