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| THE GENERAL ASSEMBLY OF PENNSYLVANIA |
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| HOUSE BILL |
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| INTRODUCED BY BAKER, MICOZZIE, CUTLER, GINGRICH, BOBACK, CAUSER, CLYMER, DENLINGER, EVERETT, GABLER, GEIST, GOODMAN, KAUFFMAN, MILNE, MOUL, MURT, OBERLANDER, PICKETT, READSHAW, REICHLEY, SAYLOR, SWANGER AND VULAKOVICH, JUNE 18, 2009 |
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| REFERRED TO COMMITTEE ON INSURANCE, JUNE 18, 2009 |
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| AN ACT |
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1 | Providing for affordable health insurance. |
2 | The General Assembly of the Commonwealth of Pennsylvania |
3 | hereby enacts as follows: |
4 | Section 1. Short title. |
5 | This act shall be known and may be cited as the Affordable |
6 | Health Insurance Act. |
7 | Section 2. No unfair trade practice. |
8 | Insurers that include and operate wellness and health |
9 | promotion programs, disease and condition management programs, |
10 | health risk appraisal programs and similar provisions in their |
11 | high deductible health policies in keeping with Federal |
12 | requirements shall not be considered to be engaging in unfair |
13 | trade practices under any provision of law relating to unfair |
14 | trade practices with respect to the practices of illegal |
15 | inducements, unfair discrimination and rebating. |
16 | Section 3. No required relationship. |
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1 | There shall be no required relationship between preferred |
2 | provider and nonpreferred provider plan reimbursements for |
3 | health savings account-eligible high deductible plans using |
4 | nonpreferred provider reimbursements. Such plans shall not: |
5 | (1) unfairly deny health benefits for medically |
6 | necessary covered services; |
7 | (2) have differences in benefit levels payable to |
8 | preferred providers compared to other providers that unfairly |
9 | deny benefits for covered services; |
10 | (3) have a plan coinsurance percentage applicable to |
11 | benefit levels for services provided by nonpreferred |
12 | providers that is less than 60% of the benefit levels under |
13 | the policy for such services; or |
14 | (4) have an adverse effect on the availability or the |
15 | quality of services. |
16 | Section 4. Health reimbursement arrangement-only plans. |
17 | The following shall apply: |
18 | (1) The Insurance Commissioner shall be authorized to |
19 | allow health reimbursement arrangement-only plans that |
20 | encourage employer financial support of health insurance or |
21 | health-related expenses recognized under Federal law. |
22 | (2) Health reimbursement arrangement-only plans that are |
23 | not sold in connection with or packaged with health insurance |
24 | coverage shall not be considered insurance. |
25 | (3) Individual health insurance policies funded through |
26 | health reimbursement arrangement-only plans shall not be |
27 | considered employer sponsored or group coverage and nothing |
28 | in this section shall be interpreted to require an insurer to |
29 | offer an individual health insurance policy for sale in |
30 | connection with or packaged with a health reimbursement |
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1 | arrangement-only plan or to accept premiums from health |
2 | reimbursement arrangement-only plans for individual health |
3 | insurance policies. |
4 | Section 5. Deductions. |
5 | In addition to other deductions allowed by law, a taxpayer in |
6 | this Commonwealth may deduct from taxable income for State |
7 | income tax purposes an amount equal to 100% of the premium paid |
8 | by the taxpayer during the taxable year for high deductible |
9 | health plans which are eligible to be used with a health savings |
10 | account under the applicable provisions of section 223 of the |
11 | Internal Revenue Code of 1986 (Public Law 99-514, 26 U.S.C. § |
12 | 223) to the extent the deduction has not been included in |
13 | Federal adjusted gross income and the expenses have neither been |
14 | provided from a health reimbursement arrangement nor included in |
15 | itemized nonbusiness deductions excluded from the taxpayer's |
16 | taxable income. |
17 | Section 6. Credits. |
18 | The following shall apply: |
19 | (1) A taxpayer shall be allowed a credit against the |
20 | income tax imposed by law for qualified health insurance |
21 | expenses in an amount of $250 for each employee enrolled for |
22 | 12 consecutive months in a qualified health insurance plan if |
23 | qualified health insurance is made available to all of the |
24 | employees and compensated individuals of the employer under |
25 | the applicable provisions of section 125 of the Internal |
26 | Revenue Code of 1986 (Public Law 99-514, 26 U.S.C. § 125). |
27 | (2) In no event shall the total amount of the tax credit |
28 | under this section for a taxable year exceed the taxpayer's |
29 | income tax liability. Any unused tax credit shall be allowed |
30 | the taxpayer against succeeding years' tax liability. No such |
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1 | credit shall be allowed the taxpayer against prior years' tax |
2 | liability. |
3 | (3) The Department of Revenue shall promulgate rules and |
4 | regulations necessary to implement and administer this |
5 | section. |
6 | (4) The credit allowed by this section shall apply only |
7 | with regard to qualified health insurance expenses. |
8 | (5) As used in this section, the following words and |
9 | phrases shall have the meanings given to them in this |
10 | paragraph: |
11 | "Qualified health insurance." A high deductible health plan |
12 | that includes, at a minimum, catastrophic health care coverage |
13 | which is eligible to be used with a health savings account under |
14 | the applicable provisions of section 223 of the Internal Revenue |
15 | Code of 1986 (Public Law 99-514, 26 U.S.C. § 223). |
16 | "Qualified health insurance expense." The expenditure of |
17 | funds of at least $250 annually for health insurance premiums |
18 | for qualified health insurance. |
19 | "Taxpayer." An employer who employs directly, or who pays |
20 | compensation to individuals whose compensation is reported on |
21 | Internal Revenue Service Form 1099, 50 or fewer persons and for |
22 | whom the employer provides high deductible health plans, that |
23 | include catastrophic health care coverage, which are established |
24 | and used with a health savings account under the applicable |
25 | provisions of section 223 of the Internal Revenue Code of 1986 |
26 | (Public Law 99-514, 26 U.S.C. § 223) and in which the employees |
27 | are enrolled. |
28 | Section 7. Exemption from insurance premium tax. |
29 | Insurers shall be exempt from otherwise applicable taxes on |
30 | insurance premiums paid by residents for high deductible health |
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1 | plans eligible to be used with a health savings account under |
2 | the applicable provisions of section 223 of the Internal Revenue |
3 | Code of 1986 (Public Law 99-514, 26 U.S.C. § 223). |
4 | Section 8. Duties of Insurance Commissioner. |
5 | The Insurance Commissioner shall: |
6 | (1) Develop flexible guidelines for coverage and |
7 | approval of health savings account eligible high deductible |
8 | plans designed to qualify under Federal and State |
9 | requirements as high deductible health plans for use with |
10 | health savings accounts. |
11 | (2) Encourage and promote the marketing of health |
12 | savings account eligible high deductible plans by accident |
13 | and sickness insurers. Nothing in this section shall be |
14 | construed to authorize the sale of insurance in violation of |
15 | requirements relating to the transaction of insurance or |
16 | prohibiting the interstate sale of insurance. |
17 | (3) Conduct a study of health savings account eligible |
18 | high deductible plans available in all other states and |
19 | determine whether, and in what manner, they serve the |
20 | uninsured and whether they should be made available to the |
21 | citizens of this Commonwealth. |
22 | (4) Develop an automatic or fast track approval process |
23 | for health savings account eligible high deductible plans |
24 | already approved under the laws and regulations of this |
25 | Commonwealth or other states. |
26 | (5) Promulgate rules and regulations for the design, |
27 | promotion and regulation of health savings account eligible |
28 | high deductible plans, including rules and regulations for |
29 | expedited review of standardized policies, advertisements, |
30 | solicitations and other matters deemed relevant. |
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1 | Section 9. Effective date. |
2 | This act shall take effect in 60 days. |
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