THE GENERAL ASSEMBLY OF PENNSYLVANIA

SENATE BILL

INTRODUCED BY WARD, D. WHITE, VOGEL, SOLOBAY, BROWNE, ERICKSON, WAUGH, WASHINGTON, ALLOWAY, LEACH, BOSCOLA, BLAKE AND FARNESE, JUNE 15, 2011

REFERRED TO BANKING AND INSURANCE, JUNE 15, 2011  

AN ACT

Amending the act of July 2, 1996 (P.L.514, No.85), entitled "An

act providing for certain health insurance benefits to aid

the health and well-being of mother and child following the

birth of a child; and prohibiting certain practices by

insurers," defining "covered dentist services"; and

prohibiting insurers from setting fees for noncovered dentist

services.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  Section 2 of the act of July 2, 1996 (P.L.514,

No.85), known as the Health Security Act, is amended by adding a

definition to read:

Section 2.  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:

"Covered dentist services."  Dental care services for which

reimbursement is available under an employee's plan contract.

The term includes dental care services for which a reimbursement

would be available if not for annual maximums.

* * *

Section 2.  The act is amended by adding a section to read:

Section 4.1.  Fees for noncovered dentist services.

(a)  Prohibition.--An insurer's contract with a dentist may

not require that the dentist provide services to the insurer's

subscribers at a fee set by the insurer unless the insurer

compensates the dentist for covered dentist services.

(b)  Effect.--A contractual provision in violation of

subsection (a) is void.

Section 3.  The addition of section 4.1 of the act shall

apply to insurance policies issued or renewed on or after the

effective date of this section.

Section 4.  This act shall take effect in 60 days.