PRINTER'S NO. 1597
No. 1183 Session of 2007
INTRODUCED BY FOLMER, EICHELBERGER, PICCOLA, WAUGH, REGOLA AND
M. WHITE, NOVEMBER 30, 2007
REFERRED TO BANKING AND INSURANCE, NOVEMBER 30, 2007
AN ACT
1 Providing for the expiration of certain State-mandated health
2 care insurance benefits and the provisions of certain acts
3 that impose mandatory covered providers and covered persons
4 on qualified high deductible health plans; and requiring the
5 Health Care Cost Containment Council to submit a periodic
6 report to the General Assembly.
7 The General Assembly of the Commonwealth of Pennsylvania
8 hereby enacts as follows:
9 Section 1. Short title.
10 This act shall be known and may be cited as the State-
11 mandated Health Care Insurance Expiration Act.
12 Section 2. Definitions.
13 The following words and phrases when used in this act shall
14 have the meanings given to them in this section unless the
15 context clearly indicates otherwise:
16 "Council." The Health Care Cost Containment Council of the
17 Commonwealth.
18 "Health insurance policy." An individual or group health,
19 sickness or accident policy or subscriber contract or
1 certificate issued by an entity subject to any one of the
2 following:
3 (1) The act of May 17, 1921 (P.L.682, No.284), known as
4 The Insurance Company Law of 1921.
5 (2) The act of December 29, 1972 (P.L.1701, No.364),
6 known as the Health Maintenance Organization Act.
7 (3) The act of May 18, 1976 (P.L.123, No.54), known as
8 the Individual Accident and Sickness Insurance Minimum
9 Standards Act.
10 (4) 40 Pa.C.S. Ch. 61 (relating to hospital plan
11 corporations) or 63 (relating to professional health services
12 plan corporations).
13 "Qualified high deductible health plan." A health insurance
14 policy that would qualify as a high deductible health plan under
15 section 223(c)(2) of the Internal Revenue Code of 1986 (Public
16 Law 99-514, 26 U.S.C. § 223(c)(2)).
17 "State-mandated health care insurance benefit." The right,
18 established by an act of the General Assembly, of an insured
19 under a health insurance policy to receive reimbursement from
20 the insurer of an expenditure or cost of a medical test,
21 procedure or service related to the health of the insured, which
22 test, procedure or service is provided by a medical provider.
23 Section 3. Mandatory covered benefit expiration.
24 (a) Existing provisions affected.--Notwithstanding any other
25 provision of law to the contrary, the State-mandated health care
26 insurance benefits under the following provisions of law shall
27 be inapplicable on and after January 1, 2008, as to qualified
28 high deductible health plans:
29 Sections 602-A, 603-A and 2111(4) and (7) of the act
30 of May 17, 1921 (P.L.682, No.284), known as The Insurance
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1 Company Law of 1921.
2 Section 4 of the act of May 18, 1976 (P.L.123,
3 No.54), known as the Individual Accident and Sickness
4 Insurance Minimum Standards Act.
5 Section 4 of the act of December 19, 1986 (P.L.1737,
6 No.209), known as the Insurance Payment to Registered
7 Nurse Law.
8 Section 3 of the act of May 21, 1992 (P.L.239,
9 No.35), known as the Childhood Immunization Insurance
10 Act.
11 Section 4 of the act of April 22, 1994 (P.L.136,
12 No.20), known as the Women's Preventative Health Services
13 Act.
14 Section 3 of the act of July 2, 1996 (P.L.514,
15 No.85), known as the Health Security Act.
16 Section 4 of the act of December 20, 1996 (P.L.1492,
17 No.191), known as the Medical Foods Insurance Coverage
18 Act.
19 (b) Future provisions affected.--Any act or part of an act
20 of the General Assembly that is enacted after the effective date
21 of this section and provides for the imposition of a State-
22 mandated health care insurance benefit on qualified high
23 deductible health plans shall expire five years after the
24 effective date of such act or part of the act.
25 Section 4. Mandatory covered provider expiration.
26 (a) Existing provisions.--Notwithstanding any other
27 provision of law to the contrary, the following provisions of
28 law shall be inapplicable on and after January 1, 2008, as to
29 qualified high deductible health plans:
30 The act of December 27, 1965 (P.L.1247, No. 506),
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1 entitled "An act relating to the reimbursement or
2 payments for providing and furnishing optometric services
3 in contracts, certificates and policies by various
4 insurance and other companies, and limiting the
5 provisions in relation thereto."
6 The act of August 12, 1971 (P.L.313, No.78), entitled
7 "An act providing for elimination of discriminatory
8 provisions relating to compensation for services and
9 treatment under sickness and accident insurance contracts
10 and providing for nondiscriminatory reimbursement of
11 sickness and bodily injury claims thereunder."
12 The act of April 18, 1978 (P.L.33, No.16), entitled
13 "An act providing reimbursement to insured by insurance
14 company for services performed by a psychologist."
15 The act of December 23, 1981 (P.L.583, No.168),
16 entitled "An act providing for reimbursement by insurance
17 companies and others for facilities used by or for
18 services performed by licensed certified nurse midwives."
19 The act of December 19, 1986 (P.L.1737, No.209),
20 known as the Insurance Payment to Registered Nurse Law.
21 (b) Future provisions affected.--Any act or part of an act
22 of the General Assembly that is enacted after the effective date
23 of this section and requires insurers of health or accident
24 insurance to reimburse for services provided by any provider of
25 medical services of any kind under qualified high deductible
26 health plans shall expire five years after the effective date of
27 such act or part of the act.
28 Section 5. Mandatory covered persons expiration.
29 (a) Existing provisions.--Notwithstanding any other
30 provision of law to the contrary, the following provisions shall
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1 be inapplicable on and after January 1, 2008, as to qualified
2 high deductible health plans:
3 Sections 617(A)(9) and 621.2(d) of the act of May 17,
4 1921 (P.L.682, No.284), known as The Insurance Company
5 Law of 1921.
6 The act of August 1, 1975 (P.L.157, No.81), entitled
7 "An act providing for the health and welfare of newborn
8 children and their parents by regulating certain health
9 insurance coverage for newborn children."
10 The act of December 16, 1994 (P.L.1333, No.152),
11 entitled, "An act requiring health insurers to cover
12 adopted children."
13 (b) Future provisions affected.--Any act or part of an act
14 of the General Assembly that is enacted after the effective date
15 of this section and requires insurers of health or accident
16 insurance to reimburse for services provided to certain
17 specified covered persons as insureds under qualified high
18 deductible health plans expire five years after the effective
19 date of such act or part of the act.
20 Section 6. Report to General Assembly.
21 No later than 60 days prior to the expiration of the
22 provisions of the acts identified under section 3(a), 4(a) or
23 5(a) and the expiration of the provisions of an act to which
24 section 3(b), 4(b) or 5(b) applies, the council shall submit a
25 written report to the General Assembly that includes an analysis
26 of the impact that the provisions of those acts identified under
27 section 3(a), 4(a) or 5(a) or that act to which section 3(b),
28 4(b) or 5(b) applies, on the cost of health insurance premiums
29 for qualified high deductible health plans in this Commonwealth.
30 Section 7. Effective date.
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1 This act shall take effect in 60 days.
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