THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

INTRODUCED BY DeLUCA, OCTOBER 17, 2012

REFERRED TO COMMITTEE ON INSURANCE, OCTOBER 17, 2012  

AN ACT

Amending Title 40 (Insurance) of the Pennsylvania Consolidated

Statutes, in hospital plan corporations, further providing

for definitions and for certification of hospital plan

corporations; and, in professional health services plan

corporations, further providing for definitions and for

certification of professional health service corporations.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  Section 6101 of Title 40 of the Pennsylvania

Consolidated Statutes is amended by adding a definition to read:

§ 6101.  Definitions.

The following words and phrases when used in this chapter

shall have, unless the context clearly indicates otherwise, the

meanings given to them in this section:

"Affiliate."  A domestic or foreign corporation, association,

trust or other organization:

(1)  that owns a 10% or greater interest in a hospital

plan corporation; or

(2)  in which a hospital plan corporation owns a 10% or

greater interest.

* * *

Section 2.  Section 6102(a) and (d) of Title 40 are amended

to read:

§ 6102.  Certification of hospital plan corporations.

(a)  General rule.--A corporation not-for-profit incorporated

for the purpose of establishing, maintaining and operating a

nonprofit hospital plan shall not commence business until it

shall have received from the department a certificate of

authority authorizing the corporation to establish, maintain and

operate such a nonprofit hospital plan. A corporation not-for-

profit may not establish, maintain or operate a nonprofit

hospital plan if the corporation or affiliate is certified as a

professional health services corporation under section 6304

(relating to certification of professional health service         

corporations).

* * *

(d)  Standards for issuance of certificate.--A certificate of

authority shall be issued by order of the department only if and

when the department shall find and determine that the

application complies with the provisions of this chapter and the

regulations of the department thereunder. The department may not

issue a certificate of authority to a corporation not-for-profit

if the corporation or an affiliate is certified as a

professional health services corporation under section 6304.

* * *

Section 3.  Section 6302(a) of Title 40 is amended by adding

a definition to read:

§ 6302.  Definitions.

(a)  General rule.--The following words and phrases when used

in this chapter shall have, unless the context clearly indicates

otherwise, the meanings given to them in this section:

"Affiliate."  A domestic or foreign corporation, association,

trust or other organization:

(1)  that owns a 10% or greater interest in a

professional health service corporation; or

(2)  in which a professional health service corporation

owns a 10% or greater interest.

* * *

Section 4.  Section 6304(a) and (c) of Title 40 are amended

to read:

§ 6304.  Certification of professional health service         

corporations.

(a)  General rule.--A corporation not-for-profit incorporated

for the purpose of establishing, maintaining and operating a

nonprofit professional health service plan, nonprofit dental

service plan or nonprofit optometric service plan shall not

commence business until it shall have received from the

department a certificate of authority authorizing the

corporation to establish, maintain and operate a nonprofit

professional health service plan, a nonprofit dental service

plan or a nonprofit optometric service plan, as the case may be.

A corporation not-for-profit may not establish, maintain or

operate a nonprofit professional health service plan, a

nonprofit dental service plan or a nonprofit optometric service

plan if the corporation or affiliate is certified as a hospital

plan corporation under section 6102 (relating to certification

of hospital plan corporations).

* * *

(c)  Form of application.--Every application for a

certificate of authority under this section shall be made to the

Insurance Department in writing and shall be in such form and

contain such information as the regulations of the Department of

Health and the Insurance Department may require. The Insurance

Department shall forward the application to the Department of

Health for action thereon and report to the Insurance

Department. The Insurance Department may not forward an

application to the Department of Health if the applicant or an

affiliate is certified as a hospital plan corporation under

section 6102.

* * *

Section 5.  This act shall take effect in 60 days.