PRINTER'S NO.  1017

  

THE GENERAL ASSEMBLY OF PENNSYLVANIA

  

SENATE BILL

 

No.

939

Session of

2011

  

  

INTRODUCED BY PIPPY, RAFFERTY, D. WHITE, FONTANA, FERLO AND BREWSTER, APRIL 8, 2011

  

  

REFERRED TO BANKING AND INSURANCE, APRIL 8, 2011  

  

  

  

AN ACT

  

1

Amending the act of July 22, 1974 (P.L.589, No.205), entitled

2

"An act relating to unfair insurance practices; prohibiting

3

unfair methods of competition and unfair or deceptive acts

4

and practices; and prescribing remedies and penalties,"

5

further providing for unfair acts.

6

The General Assembly of the Commonwealth of Pennsylvania

7

hereby enacts as follows:

8

Section 1.  Section 5(a) of the act of July 22, 1974 (P.L.

9

589, No.205), known as the Unfair Insurance Practices Act, is

10

amended by adding a paragraph to read:

11

Section 5.  Unfair Methods of Competition and Unfair or

12

Deceptive Acts or Practices Defined.--(a)  "Unfair methods of

13

competition" and "unfair or deceptive acts or practices" in the

14

business of insurance means:

15

* * *

16

(15)  Knowingly doing any of the following:

17

(i)  Requiring an insured to obtain ophthalmic services and

18

products from a vision laboratory or company as a condition of

19

obtaining the payment for the vision services.

 


1

(ii)  Imposing upon an insured who is not utilizing an

2

ophthalmic service or product from a vision laboratory or

3

company a copayment fee or other condition not imposed upon

4

insureds utilizing an ophthalmic service or product from the

5

vision laboratory or company.

6

(iii)  Hampering competition in numerous ways, including, but

7

not limited to:

8

(A)  Utilizing access to patient demographics and health

9

records, either individually or in the aggregate, to market an

10

ophthalmic service or product from the vision laboratory or

11

company.

12

(B)  Suppressing competition based upon quality and service.

13

(iv)  Creating a preferred class of providers that is not

14

held to uniform conditions of participation under the same

15

employer's purchased health care contract, vision care contract

16

or other health insurance contracts.

17

(v)  Requiring the purchase of a minimum quantity or minimum

18

dollar amount of a specified brand of materials in order to

19

participate as a provider in a vision or other health care plan.

20

(vi)  Requiring a provider to participate in a vision benefit

21

plan as a condition of participation in a health care plan.

22

Section 2.  This act shall take effect in 60 days.

- 2 -