THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

INTRODUCED BY MATZIE, D. COSTA, DeLUCA, BELFANTI, BRADFORD, BRENNAN, BROWN, FRANKEL, GRUCELA, HENNESSEY, KORTZ, MAHONEY, MELIO, M. O'BRIEN AND READSHAW, JUNE 2, 2009

AS REPORTED FROM COMMITTEE ON INSURANCE, HOUSE OF REPRESENTATIVES, AS AMENDED, AUGUST 5, 2009   

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," providing for the regulation of

health insurance practices concerning parity and

nondiscrimination.

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 an

article to read:

ARTICLE VI-B

HEALTH INSURANCE COVERAGE PARITY

AND NONDISCRIMINATION

Section 601-B.  Short title of article.

This article shall be known and may be cited as the Health

Insurance Coverage Parity and Nondiscrimination Act.

Section 602-B.  Purpose.

It is necessary to maintain the Commonwealth's sovereignty

over the regulation of health insurance in this Commonwealth by

implementing the requirements of the Paul Wellstone and Pete

Domenici Mental Health Parity and Addiction Equity Act of 2008

(Public Law 110-343, 122 Stat. 3881), the Genetic Information

Nondiscrimination Act of 2008 (Public Law 110-233, 122 Stat.

881) and Michelle’s Law (Public Law 110-381, 122 Stat. 4081),

collectively contained in the Public Health Service Act (58

Stat. 682, 42 U.S.C. § 201 et seq.). The provisions of this

article are intended to meet these requirements while retaining

the Commonwealth's authority to regulate health insurance in

this Commonwealth, consistent with sections 2722 and 2761 of the

Public Health Service Act.

Section 603-B.  Definitions.

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

in this article shall have the meanings given to them in this

section unless the context clearly indicates otherwise:

"Commissioner."  The Insurance Commissioner of the

Commonwealth.

"Department."  The Insurance Department of the Commonwealth.

"Federal acts."  The Federal laws known as the Paul Wellstone

and Pete Domenici Mental Health Parity and Addiction Equity Act

of 2008 (Public Law 110-343, 122 Stat. 3881), the Genetic

Information Nondiscrimination Act of 2008 (Public Law 110-233,

122 Stat. 881) and Michelle’s Law (Public Law 110-381, 122 Stat.

4081), collectively contained in the Public Health Service Act

(58 Stat. 682, 42 U.S.C. § 201 et seq.).

"Fraternal benefit society."  An entity holding a current

certificate of authority under Article XXIV.

"Health maintenance organization."  An entity holding a

current certificate of authority under the act of December 29,

1972 (P.L.1701, No.364), known as the Health Maintenance

Organization Act.

"Hospital plan corporation."  An entity holding a current

certificate of authority organized and operated under 40 Pa.C.S.

Ch. 61 (relating to hospital plan corporations).

"Insurer."  A foreign or domestic insurance company,

association or exchange, health maintenance organization,

hospital plan corporation, professional health services plan

corporation, fraternal benefit society or risk-assuming

preferred provider organization. The term shall not include a

group health plan as defined in section 2791 of the Public

Health Service Act (58 Stat. 682, 42 U.S.C. § 300gg-91).

"Preferred provider organization."  An entity holding a

current certificate of authority under section 630.

"Professional health services plan corporation."  An entity

holding a current certificate of authority under 40 Pa.C.S. Ch.

63 (relating to professional health services plan corporations).

This term shall not include dental service corporations or

optometric service corporations, as those terms are defined

under 40 Pa.C.S. § 6302(a) (relating to definitions).

(b)  Federal law.--The words, terms and definitions found in

the Federal acts, including those in section 2791 of the Public

Health Service Act (58 Stat. 682, 42 U.S.C. 300gg-91), are

adopted for purposes of implementing this article, except as

noted in this subsection. The term "health insurance issuer"

under section 2791(b)(2) of the Public Health Service Act shall

have the meaning provided under "insurer" in subsection (a).

Section 604-B.  Adoption of Federal acts.

Insurers shall comply with the Federal acts, as contained in

sections 2701, 2702, 2705, 2707, 2721, 2753 and 2754 of the

Public Health Service Act (58 Stat. 682, 42 U.S.C. §§ 300gg,

300gg-1, 300gg-5, 300gg-7, 300gg-21, 300gg-53 and 300gg-54).

Section 605-B.  Penalties.

(a)  General rule.--Upon satisfactory evidence of a violation

of this article by any insurer or other person, the commissioner

may, in the commissioner's discretion, pursue any one of the

following courses of action:

(1)  Suspend, revoke or refuse to renew the license of

the offending person.

(2)  Enter a cease and desist order.

(3)  Impose a civil penalty of not more than $5,000 for

each action in violation of this article.

(4)  Impose a civil penalty of not more than $10,000 for

each action in willful violation of this article.

(b)  Limitation.--Penalties imposed against a person under

this article and under section 5 of the act of June 25, 1997

<--

(P.L.295, No.29), known as the Pennsylvania Health Care

Insurance Portability Act, shall not exceed $500,000 in the

aggregate during a single calendar year.

Section 606-B.  Regulations.

The department may promulgate such regulations as may be

necessary or appropriate to carry out this article.

Section 2.  All acts and parts of acts are repealed insofar

as they are inconsistent with the addition of Article VI-B of

the act. 

Section 3.  This act shall take effect immediately.