1Authorizing the State Workers' Insurance Board to make available
2health insurance policies for purchase by the general public;
3providing for premiums; and authorizing a loan from the State
4Workers' Insurance Fund.

5The General Assembly of the Commonwealth of Pennsylvania
6hereby enacts as follows:

7Section 1. Short title.

8This act shall be known and may be cited as the Optional
9Health Insurance Program of the State Workers' Insurance Fund
10Act.

11Section 2. Definitions.

12The following words and phrases when used in this act shall
13have the meanings given to them in this section unless the
14context clearly indicates otherwise:

15"Ancillary health service providers." Clinical laboratory
16permittees under the act of September 26, 1951 (P.L.1539,
17No.389), known as The Clinical Laboratory Act, duly licensed or
18certified under the laws of this Commonwealth to provide
19ancillary health services.

1"Ancillary health services." The general and usual services
2rendered and care administered by ancillary health service
3providers.

4"Board." The State Workers' Insurance Board continued under
5section 1502 of the act of June 2, 1915 (P.L.736, No.338), known
6as the Workers' Compensation Act.

7"Chiropractic services." The general and usual services
8rendered and care administered by a chiropractor, as defined in
9section 102 of the act of December 16, 1986 (P.L.1646, No.188),
10known as the Chiropractic Practice Act.

11"Fund." The State Workers' Insurance Fund established under
12section 1504 of the act of June 2, 1915 (P.L.736, No.338), known
13as the Workers' Compensation Act.

14"Medical services." The general and usual services rendered
15and care administered by doctors of medicine, as defined in the
16act of December 20, 1985 (P.L.457, No.112), known as the Medical
17Practice Act of 1985.

18"Osteopathic services." The general and usual services
19rendered and care administered by doctors of osteopathy, as
20defined in the act of October 5, 1978 (P.L.1109, No.261), known
21as the Osteopathic Medical Practice Act.

22"Physical therapy services." The general and usual services
23rendered and care administered by licensed physical therapists,
24as defined as "physical therapy" in the act of October 10, 1975
25(P.L.383, No.110), known as the Physical Therapy Practice Act.

26"Podiatry services." The general and usual services rendered
27and care administered by doctors of podiatry, as defined in the
28act of March 2, 1956 (1955 P.L.1206, No.375), known as the
29Podiatry Practice Act.

30Section 3. Optional health insurance program.

1(a) General rule.--In addition to any other powers and
2duties imposed by law, the board shall have the power and may
3establish, implement and administer a program which provides for
4the sale of health insurance coverage to such individuals or
5businesses or other entities in such forms and at such premiums
6as the board shall, from time to time, determine.

7(b) Loan from fund.--After considering all other
8expenditures from the fund, the board may borrow from the fund
9in the form of a repayable loan such amounts as may be necessary
10to provide for the payment of claims and the payment of any
11administrative expenses that may arise from any health insurance
12program provided by the board. Any loan made from the fund shall
13not exceed 40% of the fund's current ending balance for the
14latest completed fiscal year. The board may invest the proceeds
15of the loan in the same manner and subject to the same
16restrictions as govern investments of the fund. All earnings
17from investments of the loan proceeds shall be used for the
18administration of this act.

19(c) Repayments from premiums.--The board shall designate a
20portion of each periodic premium payment for loan repayment.

21(d) Minimum health insurance coverage.--The board, at a
22minimum, shall provide coverage for at least the following:

23(1) Inpatient hospitalization.

24(2) Outpatient hospitalization.

25(3) Emergency care.

26(4) Preventive care.

27(5) Professional services, including:

28(i) Medical services.

29(ii) Osteopathic services.

30(iii) Chiropractic services.

1(iv) Podiatry services.

2(v) Physical therapy services.

3(vi) Services provided by:

4(A) Certified registered nurse anesthetists.

5(B) Certified registered nurse practitioners.

6(C) Certified enterostomal therapy nurses.

7(6) Laboratory tests, x-rays, scans, wound dressings,
8castings and other ancillary services.

9(e) Additional insurance coverage.--The board may offer
10coverage for the following:

11(1) Dental benefits.

12(2) Vision care benefits.

13(3) Prescription drug benefits.

14(f) Claim forms.--The board shall use the standard medical
15claim form prescribed under section 1202 of the act of May 17,
161921 (P.L.682, No.284), known as The Insurance Company Law of
171921.

18(g) Marketing.--The health insurance coverage shall be sold
19directly by the board and such independent insurance agents as
20determined by the board.

21(h) Regulations.--The board shall promulgate all regulations
22necessary to implement and administer the provisions of this
23act.

24Section 4. Effective date.

25This act shall take effect January 1, 2014.