PRINTER'S NO. 2535
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No.
2168
Session of
2021
INTRODUCED BY FREEMAN, SCHLOSSBERG, HOHENSTEIN, HILL-EVANS,
KINSEY, McNEILL, SANCHEZ, SCHWEYER, DRISCOLL, CIRESI, DALEY
AND KIM, DECEMBER 15, 2021
REFERRED TO COMMITTEE ON LABOR AND INDUSTRY, DECEMBER 15, 2021
AN ACT
Authorizing the State Workers' Insurance Board to make available
health insurance policies for purchase by the general public;
providing for premiums; and authorizing a loan from the State
Workers' Insurance Fund.
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 the State
Workers' Insurance Board Health Insurance Program Act.
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:
"Ancillary health service provider." A clinical laboratory
permittee under the act of September 26, 1951 (P.L.1539,
No.389), known as The Clinical Laboratory Act, authorized under
the laws of this Commonwealth to provide ancillary health
services.
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"Ancillary health services." The general and usual services
rendered and care administered by ancillary health service
providers.
"Board." The State Workers' Insurance Board continued under
section 1502 of the act of June 2, 1915 (P.L.736, No.338), known
as the Workers' Compensation Act.
"Chiropractic services." The general and usual services
rendered and care administered by a chiropractor, as defined in
section 102 of the act of December 16, 1986 (P.L.1646, No.188),
known as the Chiropractic Practice Act.
"Fund." The State Workers' Insurance Fund established under
section 1504 of the Workers' Compensation Act.
"Medical services." The general and usual services rendered
and care administered by doctors of medicine under the act of
December 20, 1985 (P.L.457, No.112), known as the Medical
Practice Act of 1985.
"Osteopathic services." The general and usual services
rendered and care administered by doctors of osteopathy under
the act of October 5, 1978 (P.L.1109, No.261), known as the
Osteopathic Medical Practice Act.
"Physical therapy services." The general and usual services
rendered and care administered by licensed physical therapists,
as defined as "physical therapy" in section 2 of the act of
October 10, 1975 (P.L.383, No.110), known as the Physical
Therapy Practice Act.
"Podiatry services." The general and usual services rendered
and care administered by doctors of podiatry under the act of
March 2, 1956 (1955 P.L.1206, No.375), known as the Podiatry
Practice Act.
"Program." The program established by the board under
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section 3(a).
Section 3. Program.
(a) General rule.--In addition to any other powers and
duties imposed by law, the board shall have the power and may
establish, implement and administer a program which provides for
the sale of health insurance coverage to individuals, businesses
or other entities in a form and at premiums as the board shall,
from time to time, determine.
(b) Loan from fund.--After considering all other
expenditures from the fund, the board may borrow from the fund
in the form of a repayable loan amounts as may be necessary to
provide for the payment of claims and administrative expenses
that may arise from the program. A loan made from the fund shall
not exceed 40% of the fund's current ending balance for the
latest completed fiscal year. The board may invest the proceeds
of the loan in the same manner and subject to the same
restrictions as govern investments of the fund. All earnings
from investments of the loan proceeds shall be used for the
administration of this act.
(c) Repayments from premiums.--The board shall designate a
portion of each periodic premium payment for loan repayment.
(d) Minimum coverage.--The board, at a minimum, shall
provide coverage under the program for at least the following:
(1) Inpatient hospitalization.
(2) Outpatient hospitalization.
(3) Emergency care.
(4) Preventive care.
(5) Professional services, including:
(i) Medical services.
(ii) Osteopathic services.
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(iii) Chiropractic services.
(iv) Podiatry services.
(v) Physical therapy services.
(vi) Services provided by:
(A) Certified registered nurse anesthetists.
(B) Certified registered nurse practitioners.
(C) Certified enterostomal therapy nurses.
(6) Laboratory tests, x-rays, scans, wound dressings,
castings and other ancillary health services.
(e) Additional coverage.--The board may offer coverage under
the program for the following:
(1) Dental benefits.
(2) Vision care benefits.
(3) Prescription drug benefits.
(f) Claim forms.--The board shall use the standard medical
claim form prescribed under section 1202 of the act of May 17,
1921 (P.L.682, No.284), known as The Insurance Company Law of
1921.
(g) Marketing.--The health insurance coverage provided
through the program shall be sold directly by the board and
independent insurance agents as determined by the board.
(h) Regulations.--The board shall promulgate regulations
necessary to implement and administer the provisions of this
act.
Section 4. Effective date.
This act shall take effect January 1, 2022, or immediately,
whichever is later.
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