PRINTER'S NO. 2237

THE GENERAL ASSEMBLY OF PENNSYLVANIA


HOUSE BILL

No. 1856 Session of 1993


        INTRODUCED BY COLAFELLA, COLAIZZO, VEON, BUXTON, CLARK, NICKOL,
           OLASZ, LAUB, DeLUCA, LAUGHLIN, BATTISTO, KASUNIC, JOSEPHS,
           SATHER, JAROLIN, GEIST, MELIO, PETRONE, TRELLO, PRESTON AND
           PISTELLA, JUNE 22, 1993

        REFERRED TO COMMITTEE ON INSURANCE, JUNE 22, 1993

                                     AN ACT

     1  Amending the act of May 17, 1921 (P.L.789, No.285), entitled, as
     2     amended, "An act relating to insurance; establishing an
     3     insurance department; and amending, revising, and
     4     consolidating the law relating to the licensing,
     5     qualification, regulation, examination, suspension, and
     6     dissolution of insurance companies, Lloyds associations,
     7     reciprocal and inter-insurance exchanges, and certain
     8     societies and orders, the examination and regulation of fire
     9     insurance rating bureaus, and the licensing and regulation of
    10     insurance agents and brokers; the service of legal process
    11     upon foreign insurance companies, associations or exchanges;
    12     providing penalties, and repealing existing laws," providing
    13     for cease and desist authority and for regulations of
    14     insurance administrators and multiple employer welfare
    15     arrangements.

    16     The General Assembly of the Commonwealth of Pennsylvania
    17  hereby enacts as follows:
    18     Section 1.  The act of May 17, 1921 (P.L.789, No.285), known
    19  as The Insurance Department Act of 1921, is amended by adding a
    20  section to read:
    21     Section 107.  Cease and Desist Authority.--(a)  In addition
    22  to the penalties provided for in this act and upon reasonable
    23  belief that any person, insurance company, association or


     1  exchange has violated any provision of this act or any order or
     2  requirement of the Insurance Commissioner issued or promulgated
     3  pursuant to authority expressly granted the Insurance
     4  Commissioner by any provision of this act or law, or is about to
     5  violate any such provision, order or requirement, the Insurance
     6  Commissioner may issue a cease and desist order. Notice of the
     7  cease and desist order and notice of hearing shall be served by
     8  first class mail.
     9     (b)  Unless  mutually agreed upon by the Insurance Department
    10  and the insurance company, association, exchange or person, the
    11  hearing shall be held not more than fifteen days after issuance
    12  of the order. Any adjudication of the Insurance Commissioner
    13  under this subsection shall be in accordance with and subject to
    14  review and appeal in accordance with 2 Pa.C.S. Ch. 5 Subch. A
    15  (relating to practice and procedure of Commonwealth agencies)
    16  and Ch. 7 Subch. A (relating to judicial review of Commonwealth
    17  agency action).
    18     (c)  Upon satisfactory evidence that any person, insurance
    19  company, association or exchange has willfully violated a cease
    20  and desist order issued under this subsection, the Insurance
    21  Commissioner may, in his discretion, impose a civil penalty of
    22  not more than five thousand dollars ($5,000) for each and every
    23  act in violation of the cease and desist order.
    24     Section 2.  The act is amended by adding articles to read:
    25                             ARTICLE X
    26                 INSURANCE ADMINISTRATOR LICENSURE
    27     Section 1001.  Short Title.--This article shall be known and
    28  may be cited as the "Insurance Administrator Licensure Act."
    29     Section 1002.  Definitions.--The following words and phrases
    30  when used in this article shall have the meanings given to them
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     1  in this section unless the context clearly indicates otherwise:
     2     "Administrator" means any person who collects charges or
     3  premiums from or who adjusts or settles claims for residents of
     4  this Commonwealth in connection with life or health coverage or
     5  annuities. The term shall specifically include any person who
     6  collects charges or premiums from or who adjusts or settles
     7  claims for residents of this Commonwealth in connection with
     8  life or health coverages or annuities provided by or through an
     9  employe benefit plan, including, but not limited to, multiple
    10  employer welfare arrangements and self-insured municipalities or
    11  other political subdivisions. The term shall not include any of
    12  the following:
    13     (1)  An employer on behalf of its employes or the employes of
    14  one or more subsidiary or affiliated corporations of such
    15  employer.
    16     (2)  A union on behalf of its members.
    17     (3)  An insurance company which is either licensed in this
    18  Commonwealth or acting as an insurer with respect to a policy
    19  lawfully issued and delivered by it and pursuant to the laws of
    20  a state in which the insurer was authorized to do an insurance
    21  business.
    22     (4)  Professional health services plan corporations organized
    23  under 40 Pa.C.S. Ch. 63 (relating to professional health
    24  services plan corporations) or hospital plan corporations
    25  organized under Ch. 61 (relating to hospital plan corporations),
    26  subject to any limitations imposed by Chs. 61 and 63.
    27     (5)  A life or health agent or broker licensed in this
    28  Commonwealth, whose activities are limited exclusively to the
    29  sale of insurance.
    30     (6)  A creditor on behalf of its debtors with respect to
    19930H1856B2237                  - 3 -

     1  insurance covering a debt between the creditor and its debtors.
     2     (7)  A trust, its trustees and employes acting thereunder
     3  established in conformity with section 302 of the Labor
     4  Management Relations Act, 1947 (61 Stat. 136, 29 U.S.C. 186).
     5     (8)  A trust exempt from taxation under section 501(a) of the
     6  Internal Revenue Code of 1954 (68A Stat. 3, 26 U.S.C.), its
     7  trustees, and employes acting thereunder, or a custodian, its
     8  agents and employes acting pursuant to a custodian account which
     9  meets the requirements of section 401(f) of the Internal Revenue
    10  Code of 1954.
    11     (9)  A bank, credit union or other financial institution
    12  which is subject to supervision or examination by Federal or
    13  State banking authorities.
    14     (10)  A credit card issuing company which advances for its
    15  credit cardholders and collects premiums or charges from its
    16  credit cardholders who have authorized it to do so, provided
    17  such company does not adjust or settle claims.
    18     (11)  A person who adjusts or settles claims in the normal
    19  course of his practice or employment as an attorney-at-law and
    20  who does not collect charges or premiums in connection with life
    21  and health insurance coverage or annuities.
    22     (12)  A person licensed as a managing general agent in this
    23  Commonwealth, whose activities are limited exclusively to the
    24  scope of activities conveyed under that license.
    25     "Benefit plan" means an insured or wholly or partially self-
    26  funded coverage plan which, by means of direct payment,
    27  reimbursement or other arrangement, provides partial or complete
    28  coverage for services, including, but not limited to, medical,
    29  surgical, chiropractic, physical therapy, speech pathology,
    30  audiology, professional mental health, dental, hospital or
    19930H1856B2237                  - 4 -

     1  vision care or for drugs or other items reasonably related
     2  thereto.
     3     "Commissioner" means the Insurance Commissioner of the
     4  Commonwealth.
     5     "Department" means the Insurance Department of the
     6  Commonwealth.
     7     Section 1003.  License Required; Application; Unlicensed
     8  Activity.--On and after the effective date of this act, no
     9  person shall act as or hold himself out to be an administrator
    10  in this Commonwealth, other than an adjuster licensed in this
    11  Commonwealth for the kinds of business for which he is acting as
    12  an administrator, unless he shall hold a license as an
    13  administrator issued by the department. The license shall be
    14  renewable biennially. The license shall be issued by the
    15  department to an administrator unless the department determines
    16  that the administrator is not competent, trustworthy,
    17  financially responsible or of good personal and business
    18  reputation or has had a previous application for an insurance
    19  license denied for cause within five years. All applications
    20  shall be accompanied by a filing fee of one hundred dollars
    21  ($100). An applicant whose license is denied may request a
    22  hearing pursuant to 2 Pa.C.S. (relating to administrative law
    23  and procedure).
    24     Section 1004.  Financial Responsibility and Security
    25  Requirements.--All administrators shall be required to maintain
    26  an errors and omissions insurance policy and also to maintain
    27  financial responsibility in the form of a fidelity bond or a
    28  clean irrevocable and unconditional and ever-green letter of
    29  credit or, as established by regulation, other form of security
    30  acceptable to the department. Financial responsibility shall be
    19930H1856B2237                  - 5 -

     1  established and maintained each year in an amount equal to fifty
     2  per centum of the average amount of funds entrusted to the
     3  administrator by benefit plans for the preceding twelve months,
     4  but not to exceed five hundred thousand dollars ($500,000) for
     5  any plans other than multiple employer welfare arrangements.
     6     Section 1005.  Written Agreement Necessary.--An administrator
     7  must have a written agreement between the administrator and the
     8  entity providing the benefit plan. The written agreement shall
     9  be retained as part of the official records of the administrator
    10  for the duration of the agreement and five years thereafter. The
    11  written agreement shall comply with the requirements of this
    12  act. Where an insurance policy is issued to a trustee or
    13  trustees, a copy of the trust agreement and any amendments
    14  thereto shall be furnished to the insurer by the administrator
    15  and shall be retained as part of the official records of both
    16  the benefit plan and the administrator for the duration of the
    17  contract and five years thereafter.
    18     Section 1006.  Payment to Administrator.--The payment to the
    19  administrator of any premiums or charges for benefit coverage by
    20  or on behalf of those persons covered by the benefit plan shall
    21  be deemed to have been received by the benefit plan, and the
    22  payment of return premiums, charges or claims by the benefit
    23  plan to the administrator shall not be deemed payment to the
    24  person or claimant until the payments are received by the person
    25  or claimant. Nothing in this section shall limit any right of a
    26  benefit plan against the administrator resulting from its
    27  failure to make payments to the benefit plan, those persons
    28  covered by the benefit plan or claimants.
    29     Section 1007.  Maintenance of Information; Examination.--
    30  Every administrator shall maintain, at its principal
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     1  administrative office for the duration of the written agreement
     2  referred to in section 1005 and five years thereafter, adequate
     3  books of all transactions and records of all transactions
     4  between it, the benefit plan and persons covered under the
     5  benefit plan. The commissioner shall have access to all books
     6  and records which are the property of administrators required to
     7  be maintained by this act for the purpose of examination, audit,
     8  inspection and investigation. Books and records, the property of
     9  bona fide employe benefit plans established by an employer or
    10  employe organization, or both, may be available to the
    11  department for audit, inspection, examination or investigation
    12  at the option of the employer or employe organization. Nothing
    13  in this subsection is intended to abridge or interfere with the
    14  department's authority to review all records necessary to
    15  determine jurisdiction over any entity that may be subject to
    16  this or other insurance laws generally. Expenses incurred by the
    17  department in examination of administrators shall be paid by the
    18  administrator in the same manner, and in the same amounts,
    19  pursuant to the examination provisions of this act and
    20  applicable regulations. Trade secrets, including the identity
    21  and addresses of policyholders and certificate holders, will be
    22  treated as confidential by the department, except the department
    23  may use that information in proceedings instituted against the
    24  administrator. The entity providing the benefit plan shall
    25  retain the right to continuing access to the books and records
    26  of the administrator sufficient to permit the benefit plan to
    27  fulfill all of its contractual obligations to the persons
    28  covered under the benefit plan, subject to any restrictions in
    29  the written agreement between the entity providing the benefit
    30  plan and the administrator on the proprietary rights of the
    19930H1856B2237                  - 7 -

     1  parties in the books and records.
     2     Section 1008.  Approval of Advertising.--The administrator
     3  may use only advertising or solicitation materials of persons
     4  covered by a benefit plan as has been approved in advance by the
     5  entity providing the benefit plan.
     6     Section 1009.  Premium Collection.--All charges or premiums
     7  collected by an administrator on behalf of or for a benefit plan
     8  and return charges or premiums received from a benefit plan
     9  shall be held by the administrator in a fiduciary capacity. The
    10  funds shall be immediately remitted to the person or persons
    11  entitled thereto or shall be deposited promptly in one or more
    12  appropriately identified bank accounts in banks that are members
    13  of the Federal Reserve System. If charges or premiums so
    14  deposited have been collected on behalf of or for more than one
    15  benefit plan, the administrator shall maintain the accounts to
    16  clearly record the deposits in and withdrawals from the account
    17  on behalf of each benefit plan. The administrator shall promptly
    18  obtain and keep copies of all such records and, upon request of
    19  an entity providing a benefit plan, shall furnish the entity
    20  providing a benefit plan with copies of records pertaining to
    21  deposits and withdrawals on behalf of or for the benefit plan.
    22  The administrator shall not pay any claim by withdrawals from
    23  the fiduciary account. Withdrawals from the fiduciary account
    24  shall be made, as provided in the written agreement between the
    25  administrator and the entity providing a benefit plan, for:
    26     (1)  Remittance to a benefit plan entitled thereto.
    27     (2)  Deposit in an account maintained in the name of the
    28  benefit plan.
    29     (3)  Transfer to and deposit in a claims-paying account.
    30     (4)  Payment to a benefit plan for remittance to an insurer
    19930H1856B2237                  - 8 -

     1  entitled thereto.
     2     (5)  Payment to the administrator of its commission, fees or
     3  charges.
     4     (6)  Remittance of return premiums or charges to the person
     5  or persons entitled thereto.
     6     Section 1010.  Claim Adjustment and Settlement.--With respect
     7  to any contracts where an administrator adjusts or settles
     8  claims, the compensation to the administrator with regard to the
     9  contracts shall in no way be contingent upon claim experience.
    10  This section shall not prevent the compensation of an
    11  administrator from being based upon premiums or charges
    12  collected or number of claims paid or processed.
    13     Section 1011.  Notification Required.--Where services of an
    14  administrator are utilized, the administrator shall provide a
    15  written notice approved by the entity providing the benefit plan
    16  to persons covered by the benefit plan advising them of the
    17  identity of and relationship among the administrator, the entity
    18  providing the benefit plan and the insurer, if any. Where an
    19  administrator collects funds, it must identify and state
    20  separately in writing to the person paying any charge or premium
    21  to the administrator for coverage the amount of any such charge
    22  or premium specified by the benefit plan for the coverage.
    23     Section 1012.  Regulations; Applicability of Laws.--The
    24  commissioner may promulgate rules and regulations to implement
    25  and enforce the provisions of this article. The provisions of
    26  the act of July 22, 1974 (P.L.589, No.205), known as the "Unfair
    27  Insurance Practices Act," shall apply to administrators subject
    28  to this article.
    29     Section 1013.  Penalties; Suspension and Revocation.--(a)
    30  Failure to hold a license shall subject the administrator to a
    19930H1856B2237                  - 9 -

     1  civil penalty of not less than one thousand dollars ($1,000) nor
     2  more than five thousand dollars ($5,000) for each instance of
     3  unlicensed activity.
     4     (b)  After notice and hearing, the commissioner may do any
     5  one or more of the following:
     6     (1)  Suspend, revoke or refuse to renew the license of an
     7  administrator.
     8     (2)  Impose a civil penalty on an administrator of not more
     9  than five thousand dollars ($5,000) for each violation.
    10     (3)  Order restitution upon finding that the administrator
    11  violated any of the requirements of this act or regulations or
    12  the administrator is not competent, trustworthy, financially
    13  responsible or of good personal and business reputation. All
    14  proceedings shall be pursuant to 2 Pa.C.S. (relating to
    15  administrative law and procedure).
    16                             ARTICLE XI
    17                         MULTIPLE EMPLOYER
    18                        WELFARE ARRANGEMENTS
    19     Section 1101.  Short Title.--This article shall be known and
    20  may be cited as the "Multiple Employer Welfare Arrangement Act."
    21     Section 1102.  Definitions.--The following words and phrases
    22  when used in this article shall have the meanings given to them
    23  in this section unless the context clearly indicates otherwise:
    24     "Commissioner" means the Insurance Commissioner of the
    25  Commonwealth.
    26     "Department" means the Insurance Department of the
    27  Commonwealth.
    28     "Fully insured" means a policy or certificate approved for
    29  use by the Insurance Department completely underwritten by an
    30  insurance company licensed to do business in this Commonwealth
    19930H1856B2237                 - 10 -

     1  and does not refer to stop-loss coverage, partial coverage or
     2  reinsurance.
     3     "Multiple Employer Welfare Arrangement" or "MEWA" means the
     4  term as defined in section 3 of the Employee Retirement Income
     5  Security Act of 1974 (ERISA) (Public Law 93-406, 88 Stat. 829)
     6  and which meets either or both of the following criteria:
     7     (1)  One or more of the employer members of the MEWA is
     8  either domiciled in this Commonwealth or has its principal
     9  headquarters or principal administrative office in this
    10  Commonwealth.
    11     (2)  The MEWA solicits one or more employers that are
    12  domiciled in this Commonwealth or have their principal
    13  headquarters or principal administrative office in this
    14  Commonwealth.
    15     "Net worth" means the excess of total admitted assets over
    16  liabilities, but not including fully subordinated debt.
    17     "Person" means any natural individual or individuals,
    18  association, exchange, copartnership, corporation, partnership,
    19  agent, company, insurer, organization, society, reciprocal or
    20  interinsurance exchange, syndicate, business trust, Lloyd's
    21  association, entity, group or department of underwriters.
    22     Section 1103.  Certificate of Authority.--(a)  No MEWA shall
    23  operate in this Commonwealth without first obtaining a
    24  certificate of authority or an exemption from the department.
    25     (b)  Any MEWA desiring to provide coverage in this
    26  Commonwealth shall apply to the department for a certificate of
    27  authority on forms prescribed by the department, and the
    28  application shall be verified by an officer, director or
    29  authorized representative of the applicant. Each application for
    30  a certificate of authority and all accompanying documents shall
    19930H1856B2237                 - 11 -

     1  be submitted in triplicate. Each application shall set forth or
     2  be accompanied by the following information:
     3     (1)  A complete description of the plan, including
     4  eligibility requirements for members, procedures for membership
     5  withdrawal and expulsion, any employe contributions, benefits
     6  provided and limitations and exclusions.
     7     (2)  A copy of the constitution, articles of association or
     8  bylaws of the trade association, industry association or
     9  professional association of employers or professionals which has
    10  established the multiple employer health care plan.
    11     (3)  A copy of any trust agreement under which a trust fund
    12  is to exist and operate.
    13     (4)  The names, addresses and biographical summaries of the
    14  plan's trustees, officers, directors or any other member of the
    15  governing body of the plan.
    16     (5)  The names of persons who will solicit, negotiate,
    17  procure or affect applications for coverage under the plan.
    18     (6)  A listing of the names and addresses of the employers
    19  participating in the plan, including those employers whose
    20  principal office or headquarters is located outside of this
    21  Commonwealth.
    22     (7)  A copy of the service contract or written agreement made
    23  with a third-party administrator. A copy of any service contract
    24  or written agreement to provide administrative services made
    25  with an insurer, health maintenance organization, nonstock
    26  health services plan or nonstock dental or optometric services
    27  plan.
    28     (8)  The names, addresses and professional qualifications of
    29  the individuals who are responsible for the conduct of the
    30  affairs of the plan's third-party administrator.
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     1     (9)  Financial statements showing the applicant's assets,
     2  liabilities and sources of financial support and a copy of the
     3  applicant's most recent audited financial statement prepared by
     4  a certified public accountant, unless the department directs
     5  that additional or more recent financial information is
     6  required. The department may require that additional reports,
     7  exhibits or statements be filed to furnish full information
     8  concerning the condition, solvency, experience, transactions or
     9  affairs of the plan. The department may also require the plan to
    10  provide pro forma financial statements showing the plan's
    11  projection of anticipated operating results for the following
    12  year or years.
    13     (10)  A copy of the policy, contract, certificate, plan
    14  description, schedule of benefits or other evidence of coverage
    15  provided to covered employes which shall contain a statement of
    16  the coverage provided, an explanation of the plan, including the
    17  rights and benefits afforded the employe and his beneficiaries,
    18  any limitations and exclusions and a provision respecting the
    19  rights to the continuance of the same or similar coverage upon
    20  termination of an individual's coverage or termination of the
    21  plan. If the plan makes no provision for such rights to
    22  continue, the statement of coverage shall contain a specific
    23  declaration to that effect.
    24     (11)  A copy of fidelity bond or officers and directors
    25  liability insurance policy equal to an amount determined by the
    26  department and issued in the name of the MEWA covering its
    27  trustees, employes, administrator or other individuals handling
    28  funds or assets. In no case shall the bond or insurance policy
    29  be less than fifty thousand dollars ($50,000).
    30     (12)  The total amount of each member's annual contribution
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     1  and the basis for establishing the annual contribution of the
     2  plan's members. The contributions shall be based on reasonable
     3  assumptions and certified as to the sufficiency of such
     4  contributions by an actuary or other person satisfactory to the
     5  department.
     6     (13)  Any other information the department requires
     7  pertaining to the business of the MEWA.
     8     (14)  Restrictions that employers in the MEWA are members of
     9  an association or group of five or more businesses which are in
    10  the same trade or industry, including closely related businesses
    11  which provide support, services or supplies primarily to that
    12  trade or industry, and that the association or group of
    13  employers in the MEWA is engaged in substantial activity for its
    14  members other than sponsorship of an employe welfare benefit
    15  plan.
    16     (15)  Verification that the association or group of employers
    17  in the MEWA has been in existence for a period of not less than
    18  one year.
    19     (16)  Evidence that employe welfare benefit plan of the
    20  association or group is controlled by or sponsored directly by
    21  participating employers or employes, members or both.
    22     (17)  Evidence that the MEWA has applications from not less
    23  than five employers and will provide similar benefits for not
    24  less than two hundred separate participating employes. The
    25  annual gross premiums of or contributions to the plan will be
    26  not less than twenty thousand dollars ($20,000) for a plan that
    27  provides only vision benefits, seventy-five thousand dollars
    28  ($75,000) for a plan that provides only dental benefits and two
    29  hundred thousand dollars ($200,000) for all other plans.
    30     (18)  Each application must be accompanied by an application
    19930H1856B2237                 - 14 -

     1  fee of one thousand two hundred dollars ($1,200) payable to the
     2  Commonwealth of Pennsylvania.
     3     (c)  The department shall issue a certificate of authority to
     4  a MEWA after the receipt of a complete application and payment
     5  of the application fee required by subsection (b) if the
     6  department is satisfied that the persons responsible for the
     7  conduct of the affairs of the applicant are competent,
     8  trustworthy and possess good reputations, the MEWA is
     9  financially responsible and may reasonably be expected to meet
    10  its obligations to its members and their employes and the MEWA
    11  is organized and operating in accordance with ERISA. The
    12  department shall refuse to grant a certificate of authority to
    13  an applicant who fails to meet the requirements outlined in this
    14  article. Notice of refusal shall be in writing and shall set
    15  forth the basis for refusal.
    16     (d)  Each MEWA licensed in this Commonwealth shall obtain
    17  from the department annually a renewal of its certificate of
    18  authority on the first day of March of each year. The fee for a
    19  renewal shall be one hundred twenty-five dollars ($125).
    20     Section 1104.  Annual Report.--(a)  Every MEWA shall
    21  annually, on or before the first day of March, file the
    22  following with the department on a form prescribed by the
    23  department:
    24     (1)  An annual financial statement of the plan, including its
    25  balance sheet, statement of income, receipts and expenses for
    26  the preceding year, with a fee of one hundred twenty-five
    27  dollars ($125).
    28     (2)  An actuarial certification as to the adequacy of loss
    29  reserves prepared by an actuary acceptable to the department.
    30     (3)  An audited statement of the MEWA's financial condition
    19930H1856B2237                 - 15 -

     1  prepared by a certified public accountant acceptable to the
     2  department.
     3     (4)  Any other information the department requires, including
     4  additional reports, exhibits or statements concerning the
     5  condition, solvency, experience, transactions or affairs of the
     6  plan.
     7     (b)  The department may require a financial statement to be
     8  filed on a quarterly basis if it finds that the financial
     9  condition of a MEWA has changed significantly and that the
    10  filing of such quarterly statement would be in the best
    11  interests of the plan's participants, members and creditors.
    12     Section 1105.  Financial Condition Requirements.--Each MEWA
    13  shall maintain at all times a minimum unimpaired net worth equal
    14  to the greater of one million dollars ($1,000,000) or three
    15  months uncovered health care expenditures. The department may
    16  require that such net worth amount be based upon the anticipated
    17  operating and claims expenses for a reasonable period in excess
    18  of thirty days. The method of calculation shall be determined by
    19  the department.
    20     Section 1106.  Examinations; Form Filing Requirements.--(a)
    21  Any MEWA issued a certificate of authority by the department
    22  shall be subject to the examination provisions pursuant to this
    23  act, including a requirement to reimburse the department for all
    24  costs of the examination.
    25     (b)  No contract, certificate, policy, schedule of benefits,
    26  evidence of coverage, application or enrollment form, or any
    27  amendment thereto, shall be delivered, issued for delivery or
    28  put into effect by or on behalf of any MEWA operating in this
    29  Commonwealth until a copy of the form or amendment thereto has
    30  been filed with and approved by the department pursuant to the
    19930H1856B2237                 - 16 -

     1  filing requirements specified by this act.
     2     Section 1107.  Penalties; Injunctive Relief; Suspension and
     3  Revocation.--(a)  Any person, including any licensed or
     4  unlicensed insurer, agent, broker or administrator, who violates
     5  any provision of this article shall be guilty of a felony of the
     6  third degree and subject to a minimum fine of five thousand
     7  dollars ($5,000) and a maximum fine of ten thousand dollars
     8  ($10,000) per violation. Additionally, any violation of this
     9  article shall constitute a basis for suspension or revocation of
    10  that person's agent's, broker's or administrator's license or
    11  certificate of authority in accordance with the applicable Rules
    12  of Administrative Procedure for notice and hearing.
    13     (b)  Failure to hold a current certificate of authority or
    14  failure to file an application with true, correct and complete
    15  information as required by this article shall constitute prima
    16  facie evidence of irreparable harm to the interests of the MEWA,
    17  its policy or certificate holders, creditors and the public and
    18  shall form a basis on which the commissioner may exercise
    19  summary powers under section 510 of this act and under this
    20  article.
    21     (c)  (1)  The commissioner may suspend or revoke the license
    22  of any MEWA whenever the commissioner finds that the plan has
    23  violated any provision of this article or finds that the MEWA:
    24     (i)  Has refused to submit its books, papers, accounts or
    25  other documentation required under this article or requested by
    26  the commissioner.
    27     (ii)  Has refused or its agents, officers or trustees have
    28  refused to furnish satisfactory evidence of its financial
    29  soundness and solvency.
    30     (iii)  Is insolvent or is in such a condition that any
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     1  further transaction of business may be hazardous to the plan,
     2  its policy or certificate holders, creditors or the public.
     3     (iv)  Has had its certificate of authority revoked in the
     4  state in which it is organized.
     5     (v)  Has been found insolvent by a court of any other state
     6  or by the commissioner or other appropriate officer or agency of
     7  any other state and has been prohibited from doing business in
     8  that state.
     9     (vi)  No longer meets the criteria as a MEWA as defined under
    10  ERISA.
    11     (vii)  No longer operates as a MEWA in compliance with ERISA.
    12     (2)  The commissioner shall not revoke or suspend the license
    13  of a MEWA under this subsection until the commissioner has given
    14  the plan ten days' notice of the proposed revocation or
    15  suspension and the grounds for it and has given the plan an
    16  opportunity to introduce evidence and be heard, except that the
    17  commissioner may immediately suspend the license on the grounds
    18  specified in paragraph (1)(iv) and (v) without prior notice. The
    19  suspension shall remain in force until an administrative hearing
    20  is held and a determination is made by the commissioner.
    21     (3)  When the license of a MEWA is revoked, the commissioner
    22  may make any orders necessary to ensure the orderly winding up
    23  of its affairs and to protect the interests of the participants.
    24  The plan shall conduct no further business except as authorized
    25  by the commissioner.
    26     Section 1108.  Nonapplicability of Article.--This article
    27  shall not be applicable to a MEWA fully insured by a licensed
    28  Pennsylvania insurer, any plan established and maintained
    29  pursuant to a collective bargaining agreement or any plan
    30  established or maintained by a rural electric cooperative. Any
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     1  plan which claims exemption under this provision must register
     2  with the Commonwealth, providing clear and convincing proof of
     3  qualification. Any person who fails to comply with the
     4  registration requirements of this section shall be subject to
     5  the penalties outlined in this article.
     6     Section 1109.  Regulations.--The commissioner shall
     7  promulgate rules and regulations to enforce the provisions of
     8  this article.
     9     Section 3.  This act shall take effect in 60 days.














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