PRINTER'S NO. 351
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
334
Session of
2015
INTRODUCED BY DeLUCA, D. COSTA, KORTZ, BISHOP, CALTAGIRONE,
READSHAW, THOMAS, COHEN AND MURT, FEBRUARY 4, 2015
REFERRED TO COMMITTEE ON INSURANCE, FEBRUARY 4, 2015
AN ACT
Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An
act relating to insurance; amending, revising, and
consolidating the law providing for the incorporation of
insurance companies, and the regulation, supervision, and
protection of home and foreign insurance companies, Lloyds
associations, reciprocal and inter-insurance exchanges, and
fire insurance rating bureaus, and the regulation and
supervision of insurance carried by such companies,
associations, and exchanges, including insurance carried by
the State Workmen's Insurance Fund; providing penalties; and
repealing existing laws," in casualty insurance, providing
for cranial hair vacuum prosthesis coverage standards for
health insurance policies.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The act of May 17, 1921 (P.L.682, No.284), known
as The Insurance Company Law of 1921, is amended by adding a
section to read:
Section 635.7. Cranial Hair Vacuum Prosthesis Insurance
Coverage.--(a) A health insurance policy shall provide that the
health insurance benefits applicable under the policy include
coverage for the cost of a medically necessary cranial hair
vacuum prosthesis when prescribed by a physician for a person
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who sustains hair loss as a result of alopecia totalis or
alopecia universalis.
(b) If a health insurance policy provides coverage or
benefits to a resident of this Commonwealth, it shall be deemed
to be delivered in this Commonwealth within the meaning of this
section, regardless of whether the insurer issuing or delivering
the policy is located within or outside this Commonwealth.
(c) Benefits for a cranial hair vacuum prosthesis shall be
subject to any annual deductible, copayment and coinsurance
provisions of a health insurance policy to the extent that other
medical services covered by the policy are subject to those
provisions. A benefit limit of one thousand five hundred dollars
once every three years shall apply to cranial hair vacuum
prostheses covered under this section.
(d) This section shall apply to any health insurance policy
offered, issued or renewed on or after the effective date of
this section in this Commonwealth: Provided, That this section
shall not include the following policies: accident only, fixed
indemnity, limited benefit, credit, dental, vision, specified
disease, Medicare supplement, CHAMPUS (Civilian Health and
Medical Program of the Uniformed Services) supplement, long-term
care, disability income, workers' compensation or automobile
medical payment.
(e) As used in this section:
(1) " Alopecia totalis " means an autoimmune disease resulting
in complete scalp hair loss.
(2) " Alopecia universalis " means an autoimmune disease
resulting in complete body hair loss.
(3) " Cranial hair vacuum prosthesis " means a custom designed
system utilizing specialized materials to replace hair loss due
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to alopecia totalis or alopecia universalis.
(4) " Health insurance policy " means any group health,
sickness or accident policy or subscriber contract or
certificate issued by an entity subject to one of the following:
(i) This act.
(ii) The act of December 29, 1972 (P.L.1701, No.364) , known
as the "Health Maintenance Organization Act."
(iii) 40 Pa.C.S. Ch. 61 (relating to hospital plan
corporations) or 63 (relating to professional health services
plan corporations).
(5) " Insurer " means an entity that issues a health insurance
policy.
Section 2. This act shall take effect in 60 days.
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