1Providing for the American Health Benefit Exchange Act;
2establishing the Pennsylvania Health Insurance Exchange;
3imposing duties on the Insurance Department; and providing
4for powers and duties of the exchange, for health benefit
5plan certification, for funding and publication of costs and
6for regulations.

7The General Assembly of the Commonwealth of Pennsylvania
8hereby enacts as follows:

9Section 1.  Short title.

10This act shall be known and may be cited as the American
11Health Benefit Exchange Act.

12Section 2.  Purpose and intent.

13The purpose of this act is to provide for the establishment
14of an American Health Benefit Exchange to facilitate the
15purchase and sale of qualified health plans in the individual
16market in this Commonwealth and to provide for the establishment
17of a Small Business Health Options Program to assist qualified
18small employers in this Commonwealth in facilitating the
19enrollment of their employees in qualified health plans offered

1in the small group market.

2Section 3.  Definitions.

3The following words and phrases when used in this act shall
4have the meanings given to them in this section unless the
5context clearly indicates otherwise:

6"Commissioner."  The Insurance Commissioner of the
7Commonwealth.

8"Department."  The Insurance Department of the Commonwealth.

9"Educated health care consumer."  An individual who is
10knowledgeable about the health care system and has background or
11experience in making informed decisions regarding health,
12medical and scientific matters.

13"Exchange."  The Pennsylvania Health Insurance Exchange
14established under section 4.

15"Federal act."  The Patient Protection and Affordable Care
16Act (Public Law 111-148, 124 Stat. 119) and regulations or
17guidance issued thereunder.

18"Health benefit plan."

19(1)  A policy, contract, certificate or agreement offered
20or issued by a carrier to provide, deliver, arrange for, pay
21for or reimburse the costs of health care services.

22(2)  The term does not include:

23(i)  coverage only for accident or disability income
24insurance or a combination thereof;

25(ii)  coverage issued as a supplement to liability
26insurance;

27(iii)  liability insurance, including general
28liability insurance and automobile liability insurance;

29(iv)  workers' compensation or similar insurance;

30(v)  automobile medical payment insurance;

1(vi)  credit-only insurance;

2(vii)  coverage for on-site medical clinics; or

3(viii)  other similar insurance coverage specified in
4Federal regulations issued under the Health Insurance 
5Portability and Accountability Act of 1996 (Public Law
6104-191, 110 Stat. 1936) under which benefits for medical
7care are secondary or incidental to other insurance
8benefits.

9(3)  The term does not include the following benefits if
10provided under a separate policy, certificate or contract of
11insurance or otherwise not an integral part of the plan:

12(i)  limited scope dental or vision benefits;

13(ii)  benefits for long-term care, nursing home care,
14home health care, community-based care, or any
15combination thereof; or

16(iii)  other similar, limited benefits specified in
17Federal regulations issued under the Health Insurance
18Portability and Accountability Act of 1996.

19(4)  The term does not include the following benefits if
20the benefits are provided under a separate policy,
21certificate or contract of insurance, there is no
22coordination between the provision of the benefits and an
23exclusion of benefits under a group health plan maintained by
24the same plan sponsor, and the benefits are paid for an event
25without regard to whether benefits are provided for the event
26under a group health plan maintained by the same plan
27sponsor:

28(i)  coverage only for a specified disease or
29illness; or

30(ii)  hospital indemnity or other fixed indemnity

1insurance.

2(5)  The term does not include the following if offered
3as a separate policy, certificate or contract of insurance:

4(i)  Medicare supplemental health insurance as
5defined under section 1882(g)(1) of the Social Security 
6Act (49 Stat. 620, 42 U.S.C. § 1395ss);

7(ii)  coverage supplemental to the coverage provided
8under 10 U.S.C. Ch. 55 (relating to medical and dental
9care); or

10(iii)  similar supplemental coverage provided to
11coverage under a group health plan.

12"Health carrier" or "carrier."  An entity subject to 40
13Pa.C.S. Ch. 61 (relating to hospital plan corporations) or 63
14(relating to professional health services plan corporations) or
15other insurance laws and regulations of this Commonwealth, or
16subject to the jurisdiction of the commissioner, that contracts
17or offers to contract to provide, deliver, arrange for, pay for
18or reimburse the costs of health care services, including a
19sickness and accident insurance company, a health maintenance
20organization, a nonprofit hospital and health service
21corporation, hospital plan corporation, professional health
22services plan corporation or any other entity providing a plan
23of health insurance, health benefits or health services.

24"Qualified dental plan."  A limited scope dental plan that
25has been certified in accordance with section 7(d).

26"Qualified employer."  A small employer that elects to make
27its full-time employees eligible for one or more qualified
28health plans offered through the SHOP exchange and, at the
29option of the employer, some or all of its part-time employees
30provided the employer:

1(1)  has its principal place of business in this
2Commonwealth and elects to provide coverage through the
3exchange to its eligible employees, wherever employed; or

4(2)  elects to provide coverage through the SHOP exchange
5to its eligible employees who are principally employed in
6this Commonwealth.

7"Qualified health plan."  A health benefit plan that has
8certification the plan meets the criteria for certification
9described in section 1311(c) of the Federal act and section 7 in
10effect.

11"Qualified individual."  An individual, including a minor,
12who:

13(1)  Is seeking to enroll in a qualified health plan
14offered to individuals through the exchange.

15(2)  Resides in this Commonwealth.

16(3)  At the time of enrollment, the individual is not
17incarcerated, other than incarceration pending the
18disposition of charges.

19(4)  Is reasonably expected to be, for the entire period
20for which enrollment is sought, a citizen or national of the
21United States or an alien lawfully present in the United
22States.

23"Secretary."  The Secretary of the United States Department
24of Health and Human Services.

25"SHOP exchange."  The Small Business Health Options Program
26that the exchange is required to establish under section 6(a)
27(12).

28"Small employer."

29(1)  An employer that employed an average of not more
30than 50 employees during the preceding calendar year.

1(2)  The following shall apply:

2(i)  All persons treated as a single employer under
3subsection (b), (c), (m) or (o) of section 414 of the
4Internal Revenue Code of 1986 (Public Law 99-514, 26
5U.S.C. § 414) shall be treated as a single employer.

6(ii)  An employer and a predecessor employer shall be
7treated as a single employer.

8(iii)  All employees shall be counted, including
9part-time employees and employees who are not eligible
10for coverage through the employer.

11(iv)  If an employer was not in existence throughout
12the preceding calendar year, the determination of whether
13that employer is a small employer shall be based on the
14average number of employees that is reasonably expected
15that employer will employ on business days in the current
16calendar year.

17(v)  An employer that makes enrollment in qualified
18health plans available to its employees through the SHOP
19exchange and would cease to be a small employer by reason
20of an increase in the number of its employees, shall
21continue to be treated as a small employer for purposes
22of this act as long as it continuously makes enrollment
23through the SHOP program available to its employees.

24Section 4.  Pennsylvania Health Insurance Exchange.

25(a)  Establishment.--The Pennsylvania Health Insurance
26Exchange is hereby established.

27(b)  Membership.--The exchange shall consist of the following
28members:

29(1)  Three members of the general public appointed by the
30Governor.

1(2)  Two members of the Senate appointed by the Majority
2Leader of the Senate.

3(3)  Two members of the Senate appointed by the Minority
4Leader of the Senate.

5(4)  Two members of the House of Representatives
6appointed by the Majority Leader of the House of
7Representatives.

8(5)  Two members of the House of Representatives
9appointed by the Minority Leader of the House of
10Representatives.

11(6)  The Secretary of the Budget.

12(7)  The Secretary of Health.

13(8)  The Secretary of Public Welfare.

14(9)  The Insurance Commissioner.

15(c)  Chairperson.--The Governor shall appoint a chairperson
16of the exchange from one of the three gubernatorial appointees.
17A member appointed under subsection (b)(2), (3), (4) or (5) may
18appoint a designee to attend meetings on the member's behalf.

19(d)  Qualifications.--The members of the exchange shall be 21
20years of age or older, citizens of the United States and
21residents of this Commonwealth.

22(e)  Initial appointments.--Initial appointments to the
23exchange shall be made within 30 days of the effective date of
24this section and shall be made as follows:

25(1)  Gubernatorial appointees initially appointed under
26subsection (b)(1) shall serve initial terms of two, three and
27four years, respectively, as designated by the Governor at
28the time of appointment and until their successors are
29appointed and qualified.

30(2)  Legislative appointees initially appointed under

1subsection (b)(2), (3), (4) or (5) shall serve until the
2third Tuesday in January 2016 and until their successors are
3appointed and qualified.

4(f)  Terms of office.--Upon the expiration of a term of a
5member appointed under subsection (b), the following shall
6apply:

7(1)  The term of office of a gubernatorial appointee
8shall be three years and until a successor is appointed and
9qualified.

10(2)  The term of office of a legislative appointee shall
11be two years and until a successor is appointed and
12qualified.

13(3)  A legislative appointee shall serve no more than
14three full consecutive terms.

15(4)  A gubernatorial appointee shall serve no more than
16two full consecutive terms.

17(g)  Vacancies.--Appointments to fill vacancies shall be made
18within 60 days of the creation of the vacancy. Members who are
19appointed to fill vacancies may continue to serve on the
20exchange as follows:

21(1)  A member appointed to fill a vacancy under
22subsection (f)(1) may serve two full terms following the
23expiration of the term related to the vacancy.

24(2)  A member appointed to fill a vacancy under
25subsection (f)(2) may serve three full terms following the
26expiration of the term related to the vacancy.

27(h)  Reimbursement for expenses.--Members of the exchange may
28be reimbursed for reasonable expenses for their attendance at
29exchange meetings as well as any committee meetings.

30(i)  Meetings.--The exchange shall hold meetings as often as

1necessary but no less than on a quarterly basis. The first
2meeting of the exchange shall be held within 60 days of the
3effective date of this section.

4(j)  Quorum.--For the purpose of conducting exchange
5business, a quorum shall be at least one more than half the
6number of exchange members.

7(k)  Qualified majority vote.--A majority of members of the
8exchange present at a meeting constitute a qualified majority
9vote.

10Section 5.  General requirements.

11(a)  Deadline.--The exchange shall make qualified health
12plans available to qualified individuals and qualified employers
13beginning on or before January 1, 2015.

14(b)  Prohibition.--The exchange shall not make available any
15health benefit plan that is not a qualified health plan.

16(c)  Limited scope dental benefits.--The exchange shall allow
17a health carrier to offer a plan that provides limited scope
18dental benefits meeting the requirements of section 9832(c)(2)
19(A) of the Internal Revenue Code of 1986 (Public Law 99-514, 26
20U.S.C. 9232(c)(2)(A)) through the exchange, either separately or
21in conjunction with a qualified health plan, if the plan
22provides pediatric dental benefits meeting the requirements of
23section 1302(b)(1)(J) of the Federal act.

24(d)  Additional prohibition.--Neither the exchange nor a
25carrier offering health benefit plans through the exchange may
26charge an individual a fee or penalty for termination of
27coverage if the individual enrolls in another type of minimum
28essential coverage because the individual has become newly
29eligible for that coverage or because the individual's employer-
30sponsored coverage has become affordable under the standards of

1section 36B(c)(2)(C) of the Internal Revenue Code of 1986.

2Section 6.  Powers and duties of exchange.

3(a)  Duties.--The exchange shall:

4(1)  Facilitate the purchase and sale of qualified health
5plans.

6(2)  Provide for the establishment of a SHOP exchange,
7separate from the activities of the exchange related to the
8individual market and that is designed to assist qualified
9small employers in this Commonwealth in facilitating the
10enrollment of their employees in qualified health plans.

11(3)  Meet the requirements of this act and any
12regulations implemented under this act.

13(4)  Implement procedures for the certification,
14recertification and decertification, consistent with
15guidelines developed by the secretary under section 1311(c)
16of the Federal act and section 7, of health benefit plans as
17qualified health plans.

18(5)  Provide for the operation of a toll-free telephone
19hotline to respond to requests for assistance.

20(6)  Provide for enrollment periods, as determined by the
21secretary under section 1311(c)(6) of the Federal act.

22(7)  Maintain an Internet website through which enrollees
23and prospective enrollees of qualified health plans may
24obtain standardized comparative information on the plans.

25(8)  Assign a rating to each qualified health plan
26offered through the exchange in accordance with the criteria
27developed by the secretary under section 1311(c)(3) of the
28Federal act and determine each qualified health plan's level
29of coverage in accordance with regulations issued by the
30secretary under section 1302(d)(2)(A) of the Federal act.

1(9)  Use a standardized format for presenting health
2benefit options in the exchange, including the use of the
3uniform outline of coverage established under section 2715 of
4the Public Health Service Act (58 Stat. 682, 42 U.S.C.
5§ 300gg-15).

6(10)  In accordance with section 1413 of the Federal act,
7inform individuals of eligibility requirements for the
8Medicaid program under Title XIX of the Social Security Act
9(49 Stat. 620, 42 U.S.C. § 1396 et seq.), the Children's
10Health Insurance Program under Title XXI of the Social
11Security Act or an applicable State or local public program
12and if through screening of the application by the exchange,
13the exchange determines an individual is eligible for a
14program, enroll the individual in the program.

15(11)  Establish and make available by electronic means a
16calculator to determine the actual cost of coverage after
17application of any premium tax credit under section 36B of
18the Internal Revenue Code of 1986 (Public Law 99-514, 26
19U.S.C. § 36B) and any cost-sharing reduction under section 
201402 of the Federal act.

21(12)  Establish a SHOP exchange through which qualified
22employers may access coverage for their employees, which
23shall enable a qualified employer to specify a level of
24coverage so its employees may enroll in a qualified health
25plan offered through the SHOP exchange at the specified level
26of coverage.

27(13)  Subject to section 1411 of the Federal act, grant a
28certification attesting that, for purposes of the individual
29responsibility penalty under section 5000A of the Internal
30Revenue Code of 1986, an individual is exempt from the

1individual responsibility requirement or from the penalty
2imposed by that section because:

3(i)  there is no affordable qualified health plan
4available through the exchange or the individual's
5employer covering the individual; or

6(ii)  the individual meets the requirements for
7another exemption from the individual responsibility
8requirement or penalty.

9(14)  Transfer the following to the United States
10Secretary of the Treasury:

11(i)  A list of the individuals who are issued a
12certification under paragraph (13), including the name
13and taxpayer identification number of each individual.

14(ii)  The name and taxpayer identification number of
15each individual who was an employee of an employer but
16who was determined to be eligible for the premium tax
17credit under section 36B of the Internal Revenue Code of
181986 because:

19(A)  the employer did not provide minimum
20essential health benefits coverage; or

21(B)  the employer provided the minimum essential
22health benefits coverage, but it was determined under
23section 36B(c)(2)(C) of the Internal Revenue Code of
241986 to either be unaffordable to the employee or not
25provide the required minimum actuarial value.

26(iii)  The name and taxpayer identification number
27of:

28(A)  Each individual who notifies the exchange
29under section 1411(b)(4) of the Federal act that the
30individual has changed employers.

1(B)  Each individual who ceases coverage under a
2qualified health plan during a plan year and the
3effective date of that cessation.

4(15)  Provide to each employer the name of each employee
5of the employer described in paragraph (14)(ii) who ceases
6coverage under a qualified health plan during a plan year and
7the effective date of the cessation.

8(16)  Perform duties required of the exchange by the
9secretary or the United States Secretary of the Treasury
10related to determining eligibility for premium tax credits,
11reduced cost-sharing or individual responsibility requirement
12exemptions.

13(17)  Select entities qualified to serve as navigators in
14accordance with section 1311(i) of the Federal act and award
15grants to enable navigators to:

16(i)  Conduct public education activities to raise
17awareness of the availability of qualified health plans.

18(ii)  Distribute fair and impartial information
19concerning enrollment in qualified health plans, and the
20availability of premium tax credits under section 36B of
21the Internal Revenue Code of 1986 and cost-sharing
22reductions under section 1402 of the Federal act.

23(iii)  Facilitate enrollment in qualified health
24plans.

25(iv)  Provide referrals to an applicable office of
26health insurance consumer assistance or health insurance
27ombudsman established under section 2793 of the Public
28Health Service Act, or other appropriate State agency,
29for an enrollee with a grievance, complaint or question
30regarding the enrollee's health benefit plan, coverage or

1a determination under the plan or coverage.

2(v)  Provide information in a manner that is
3culturally and linguistically appropriate to the needs of
4the population being served by the exchange.

5(18)  Review the rate of premium growth within the
6exchange and outside the exchange, and consider the
7information in developing recommendations on whether to
8continue limiting qualified employer status to small
9employers.

10(19)  Consult with stakeholders relevant to carrying out
11the activities required under this act, including:

12(i)  Educated health care consumers who are enrollees
13in qualified health plans.

14(ii)  Individuals and entities with experience in
15facilitating enrollment in qualified health plans.

16(iii)  Representatives of small businesses and self-
17employed individuals.

18(iv)  The medical assistance program within the
19Department of Public Welfare.

20(v)  Advocates for enrolling hard to reach
21populations.

22(20)  Meet the following financial integrity
23requirements:

24(i)  Keep an accurate accounting of activities,
25receipts and expenditures and annually submit to the
26secretary, the Governor, the commissioner and the General
27Assembly a report concerning the accountings.

28(ii)  Fully cooperate with an investigation conducted
29by the secretary under the secretary's authority under
30the Federal act and allow the secretary, in coordination

1with the Inspector General of the United States
2Department of Health and Human Services, to:

3(A)  Investigate the affairs of the exchange.

4(B)  Examine the properties and records of the
5exchange.

6(C)  Require periodic reports in relation to the
7activities undertaken by the exchange.

8(iii)  In carrying out its activities under this act,
9not use funds intended for the administrative and
10operational expenses of the exchange for staff retreats,
11promotional giveaways, excessive executive compensation
12or promotion of Federal or State legislative and
13regulatory modifications.

14(b)  Contracting.--The exchange may contract with an eligible
15entity for any of its functions described in this act. An
16eligible entity includes, but is not limited to, the Department
17of Public Welfare or an entity that has experience in individual
18and small group health insurance, but a health carrier or an
19affiliate of a health carrier is not an eligible entity.

20(c)  Information-sharing agreements.--The exchange may enter
21into information-sharing agreements with Federal and State
22agencies and other State exchanges to carry out its
23responsibilities under this act provided the agreements include
24adequate protections with respect to the confidentiality of the
25information to be shared and comply with Federal and State laws
26and regulations.

27Section 7.  Health benefit plan certification.

28(a)  Permissible certification.--The department may certify a
29health benefit plan as a qualified health plan if:

30(1)  The plan provides the essential health benefits

1package described in section 1302(a) of the Federal act,
2except that the plan is not required to provide essential
3benefits that duplicate the minimum benefits of qualified
4dental plans, as provided in subsection (d), if:

5(i)  The exchange has determined that an adequate
6choice of qualified dental plans is available to
7supplement the plan's coverage.

8(ii)  The carrier makes prominent disclosure at the
9time it offers the plan, in a form approved by the
10exchange, that the plan does not provide the full range
11of essential pediatric benefits and that qualified dental
12plans providing those benefits and other dental benefits
13not covered by the plan are offered through the exchange.

14(2)  The premium rates and contract language have been
15approved by the commissioner.

16(3)  The plan provides at least a bronze level of
17coverage, unless the plan is certified as a qualified
18catastrophic plan, meets the requirements of the Federal act
19for catastrophic plans and will only be offered to
20individuals eligible for catastrophic coverage.

21(4)  The plan's cost-sharing requirements do not exceed
22the limits established under section 1302(c)(1) of the
23Federal act and if the plan is offered through the SHOP
24exchange, the plan's deductible does not exceed the limits
25established under section 1302(c)(2) of the Federal act.

26(5)  The health carrier offering the plan:

27(i)  Is licensed and in good standing to offer health
28insurance coverage in this Commonwealth.

29(ii)  Offers at least one qualified health plan in
30the silver level and at least one plan in the gold level

1through each component of the exchange in which the
2carrier participates, where "component" refers to the
3SHOP exchange and the exchange for individual coverage.

4(iii)  Charges the same premium rate for each
5qualified health plan without regard to whether the plan
6is offered through the exchange and without regard to
7whether the plan is offered directly from the carrier or
8through an insurance producer.

9(iv)  Does not charge cancellation fees or penalties
10in violation of section 5(d).

11(v)  Complies with the regulations developed by the
12secretary under section 1311(d) of the Federal act and
13other requirements as the exchange may establish.

14(6)  The plan meets the requirements of certification as
15promulgated by regulation by the secretary under section 
161311(c)(1) of the Federal act and by the exchange under
17section 9.

18(7)  The exchange determines that making the plan
19available through the exchange is in the interest of
20qualified individuals and qualified employers in this
21Commonwealth.

22(b)  Prohibitions.--The department shall not exclude a health
23benefit plan:

24(1)  on the basis that the plan is a fee-for-service
25plan;

26(2)  through the imposition of premium price controls by
27the department; or

28(3)  on the basis that the health benefit plan provides
29treatments necessary to prevent patients' deaths in
30circumstances the exchange determines are inappropriate or

1too costly.

2(c)  Requirements.--The exchange shall require each health
3carrier seeking certification of a plan as a qualified health
4plan to:

5(1)  Subject to the act of December 18, 1996 (P.L.1066,
6No.159), known as the Accident and Health Filing Reform Act,
7submit a justification for a premium increase before
8implementation of the increase. The carrier shall prominently
9post the information on its publicly available Internet
10website. The exchange shall take the information, along with
11the information and the recommendations provided to the
12exchange by the commissioner under section 2794(b) of the
13Public Health Service Act (58 Stat. 682, 42 U.S.C. § 300gg-
1494), into consideration when determining whether to allow the
15carrier to make plans available through the exchange.

16(2)  (i)  Make available to the public, in the format
17described in subparagraph (ii), and submit to the
18exchange, the secretary and the commissioner, accurate
19and timely disclosure of the following:

20(A)  Claims payment policies and practices.

21(B)  Periodic financial disclosures.

22(C)  Data on enrollment.

23(D)  Data on disenrollment.

24(E)  Data on the number of claims that are
25denied.

26(F)  Data on rating practices.

27(G)  Information on cost-sharing and payments
28with respect to any out-of-network coverage.

29(H)  Information on enrollee and participant
30rights under Title I of the Federal act.

1(I)  Other information as determined appropriate
2by the secretary.

3(ii)  The information required in subparagraph (i)
4shall be provided in plain language, as that term is
5defined in section 1311(e)(3)(B) of the Federal act.

6(3)  Permit individuals to learn, in a timely manner upon
7the request of the individual, the amount of cost-sharing,
8including deductibles, copayments and coinsurance, under the
9individual's plan or coverage that the individual would be
10responsible for paying with respect to the furnishing of a
11specific item or service by a participating provider. At a
12minimum, the information shall be made available to the
13individual through an Internet website and through other
14means for individuals without access to the Internet.

15(d)  Applicability.--

16(1)  The provisions of this act that are applicable to
17qualified health plans shall also apply to the extent
18relevant to qualified dental plans except as modified in
19accordance with the provisions of paragraphs (2), (3) and (4)
20of this subsection or by regulations adopted by the exchange.

21(2)  The health carrier shall be licensed to offer dental
22coverage but need not be licensed to offer other health
23benefits.

24(3)  The plan shall be limited to dental and oral health
25benefits, without substantially duplicating the benefits
26typically offered by health benefit plans without dental
27coverage, and shall include, at a minimum, the essential
28pediatric dental benefits prescribed by the secretary under
29section 1302(b)(1)(J) of the Federal act and other minimum
30dental benefits as the exchange or the secretary may specify

1by regulation.

2(4)  A health carrier and a dental carrier may jointly
3offer a comprehensive plan through the exchange in which the
4dental benefits are provided by the dental carrier and the
5other benefits are provided by the health carrier.

6Section 8.  Funding and publication of costs.

7(a)  Funding.--The exchange may charge assessments or user
8fees to health carriers or otherwise may generate funding
9necessary to support its operations provided under this act.

10(b)  Publication of costs.--The exchange shall publish the
11average costs of licensing, regulatory fees and other payments
12required by the exchange and the administrative costs of the
13exchange on a publicly available Internet website to educate
14consumers on the costs. The information shall include
15information on money lost to waste, fraud and abuse.

16Section 9.  Regulations.

17The exchange and the department may individually or jointly
18promulgate regulations to implement the provisions of this act.
19Regulations promulgated under this section shall not conflict
20with or prevent the application of regulations promulgated by
21the secretary under Subtitle D of Title I of the Federal act.

22Section 10.  Relation to other laws.

23Nothing in this act and no action taken by the exchange under
24this act shall be construed to preempt or supersede the
25authority of the department and the commissioner to regulate the
26business if insured within this Commonwealth. Except as
27expressly provided to the contrary in this act, health carriers
28offering qualified health plans in this Commonwealth shall
29comply with the applicable insurance laws and regulations of
30this Commonwealth and orders issued by the department or

1commissioner.

2Section 20.  Effective date.

3This act shall take effect in 180 days.