PRINTER'S NO. 4578
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
2950
Session of
2020
INTRODUCED BY DAVIDSON, HOHENSTEIN, KINSEY, KENYATTA, SANCHEZ,
SHUSTERMAN, ROZZI, HANBIDGE, DONATUCCI, SCHLOSSBERG, KRUEGER,
HOWARD, YOUNGBLOOD, READSHAW, FRANKEL, HILL-EVANS, DELLOSO,
ULLMAN, DALEY, DRISCOLL, KOSIEROWSKI, T. DAVIS, McCARTER,
WARREN, DeLUCA AND OTTEN, OCTOBER 21, 2020
REFERRED TO COMMITTEE ON INSURANCE, OCTOBER 21, 2020
AN ACT
Prohibiting discrimination in certain insurance policies based
on certain drugs.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Short title.
This act shall be known and may be cited as Lloyd's Law.
Section 2. Definitions.
The following words and phrases when used in this act shall
have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Adverse action." Any of the following:
(1) Denying or canceling insurance coverage for an
applicant or enrollee.
(2) Limiting the amount, extent or kind of coverage
available for an applicant or enrollee.
(3) Charging an applicant or enrollee, or a group to
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which the applicant or enrollee belongs, a rate that is
different from the rate charged to other applicants,
enrollees or groups, respectively, for the same coverage,
without additional actuarial justification unrelated to the
need to carry an opioid overdose reversal agent.
"Applicant." An individual who seeks to obtain coverage
under an insurance policy from an insurer.
"Enrollee." A policyholder, subscriber or covered person
under an insurance policy.
"Insurance policy." A policy, subscriber contract,
certificate or plan that is offered, issued or renewed by an
insurer.
"Insurer." An entity licensed or authorized to conduct the
business of insurance that is governed under any of the
following:
(1) The act of May 17, 1921 (P.L.682, No.284), known as
The Insurance Company Law of 1921, including section 630 and
Article XXIV thereof.
(2) The act of December 29, 1972 (P.L.1701, No.364),
known as the Health Maintenance Organization Act.
(3) 40 Pa.C.S. Ch. 61 (relating to hospital plan
corporations) or 63 (relating to professional health services
plan corporations).
Section 3. Prohibition on discrimination.
(a) General rule.--Notwithstanding any other provision of
law and except as provided in subsection (b), an insurer may not
take an adverse action against an applicant or enrollee based on
the applicant's or enrollee's prior or current claim or
obtainment of a prescription for an opioid overdose reversal
agent.
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(b) Exception.--An insurer may take an adverse action
described in subsection (a) if there is clear and convincing
evidence that the applicant or enrollee is engaged in illicit
drug use that could cause an opioid-related overdose.
Section 4. Enforcement.
Violations of this act shall constitute:
(1) Unfair discrimination under section 353 of the act
of May 17, 1921 (P.L.682, No.284), known as The Insurance
Company Law of 1921.
(2) Unfair methods of competition and unfair or
deceptive acts or practices under the act of July 22, 1974
(P.L.589, No.205), known as the Unfair Insurance Practices
Act.
Section 5. Effective date.
This act shall take effect in 60 days.
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