Bill Text: PA HB2735 | 2009-2010 | Regular Session | Introduced

---

Bill Title: Establishing the Office of Consumer Advocate for Health Insurance as an office within the Office of Consumer Advocate and prescribing its powers and duties; and making editorial changes.

Spectrum: Strong Partisan Bill (Democrat 42-3)

Status: (Introduced - Dead) 2010-09-22 - Re-committed to APPROPRIATIONS [HB2735 Detail]

Download: Pennsylvania-2009-HB2735-Introduced.html

---

PRINTER'S NO. 4263
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 2735 Session of2010
INTRODUCED BY CASORIO, DeLUCA, BARBIN, BEYER, BOYLE, BRADFORD, BROWN, CALTAGIRONE, D. COSTA, P. COSTA, CURRY, DEASY, DERMODY, EACHUS, FABRIZIO, FRANKEL, GERGELY, GOODMAN, HALUSKA, HANNA, HARKINS, HARPER, HENNESSEY, KORTZ, KOTIK, KULA, LEVDANSKY, MARKOSEK, MATZIE, McILVAINE SMITH, MELIO, MIRABITO, PASHINSKI, READSHAW, ROEBUCK, SAINATO, SANTARSIERO, SANTONI, SEIP, SHAPIRO, STABACK, R. TAYLOR, VITALI, WAGNER AND WILLIAMS, SEPTEMBER 20, 2010
REFERRED TO COMMITTEE ON INSURANCE, SEPTEMBER 20, 2010
AN ACT
Amending the act of April 9, 1929 (P.L.177, No.175), entitled
"An act providing for and reorganizing the conduct of the
executive and administrative work of the Commonwealth by the
Executive Department thereof and the administrative
departments, boards, commissions, and officers thereof,
including the boards of trustees of State Normal Schools, or
Teachers Colleges; abolishing, creating, reorganizing or
authorizing the reorganization of certain administrative
departments, boards, and commissions; defining the powers and
duties of the Governor and other executive and administrative
officers, and of the several administrative departments,
boards, commissions, and officers; fixing the salaries of the
Governor, Lieutenant Governor, and certain other executive
and administrative officers; providing for the appointment of
certain administrative officers, and of all deputies and
other assistants and employes in certain departments, boards,
and commissions; and prescribing the manner in which the
number and compensation of the deputies and all other
assistants and employes of certain departments, boards and
commissions shall be determined," establishing the Office of
Consumer Advocate for Health Insurance as an office within
the Office of Consumer Advocate and prescribing its powers
and duties; and making editorial changes.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Article IX-A of the act of April 9, 1929 (P.L.
177, No.175), known as The Administrative Code of 1929, is
amended by adding a subarticle heading to read:
ARTICLE IX-A
OFFICE OF CONSUMER ADVOCATE
(a) General Provisions
Section 2. Article IX-A of the act is amended by adding a
subarticle to read:
(b) Office of Consumer Advocate
for Health Insurance
Section 921-A. Definitions.
The following words and phrases when used in this subarticle
shall have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Consumer." A person who is a named insured, insured or
beneficiary of a policy of health insurance or any other person,
including employers who purchase insurance for themselves and
their employees, who may be affected in any way by the Insurance
Department's exercise of or the failure to exercise its
authority.
"Department." The Insurance Department of the Commonwealth.
"Insurer." Any "company," "association" or "exchange" as
such terms are defined in section 101 of the act of May 17, 1921
(P.L.682, No.284), known as The Insurance Company Law of 1921 or
any entity subject to 40 Pa.C.S. Ch. 61 (relating to hospital
plan corporations) or 63 (relating to professional health
services plan corporations) or Article XXIV of The Insurance
Company Law of 1921 or the act of December 29, 1972 (P.L.1701,
No.364), known as the Health Maintenance Organization Act.
Section 922-A. Office of Consumer Advocate for Health
20100HB2735PN4263 - 2 -
Insurance.
(a) Office established.--There is hereby established as an
office within the Department of Community and Economic
Development an Office of Consumer Advocate for Health Insurance
to represent the interests of consumers before the department.
(b) Consumer Advocate for Health Insurance.--The Office of
Consumer Advocate for Health Insurance shall be headed by the
Consumer Advocate for Health Insurance appointed by the Governor
who by reason of training, experience and attainment is
qualified to represent the interests of consumers. The term of
the Consumer Advocate shall be for six years, and no person
shall serve for more than two terms. Compensation shall be set
by the Executive Board, established under section 204.
(c) Conflict of interest.--No individual who serves as a
Consumer Advocate for Health Insurance shall, while serving in
the position, engage in any business, vocation or other
employment, or have other interests, inconsistent with the
official responsibilities, nor shall the individual seek or
accept employment nor render beneficial services for
compensation with any insurer subject to the authority of the
office during the tenure of the appointment and for a period of
two years immediately after the appointment is served or
terminated.
(d) Restriction.--Neither the Consumer Advocate for Health
Insurance nor an employee of the Consumer Advocate shall be
employed by or be pecuniarily interested in any insurance
company, association or exchange, or in any insurance business,
other than as a policyholder.
(e) Political office.--Any individual who is appointed to
the position of Consumer Advocate for Health Insurance shall not
20100HB2735PN4263 - 3 -
seek election nor accept appointment to any political office
during the tenure as Consumer Advocate for Health Insurance and
for a period of two years after the appointment is served or
terminated.
Section 923-A. Assistant consumer advocates for health
insurance; employees.
The Consumer Advocate for Health Insurance may appoint
attorneys as assistant consumer advocates for health insurance
and additional clerical, technical and professional staff as may
be appropriate, and may contract for additional services as
shall be necessary for the performance of the duties imposed by
this subarticle. The compensation of assistant consumer
advocates for health insurance and clerical, technical and
professional staff shall be set by the Executive Board. No
assistant consumer advocate for health insurance or other staff
employee shall, while serving in the position, engage in any
business, vocation or other employment, or have other interests,
inconsistent with official responsibilities.
Section 924-A. Powers and duties of Consumer Advocate for
Health Insurance.
(a) Representation of consumer interests.--In addition to
any other authority conferred by this subarticle, the Consumer
Advocate for Health Insurance is authorized to and shall, in
carrying out the responsibilities under this subarticle,
represent the interests of consumers as a party, or otherwise
participate for the purpose of representing an interest of
consumers, before the department in any matter properly before
the department, and before any court or agency, initiating
proceedings if, in the judgment of the Consumer Advocate for
Health Insurance, the representation may be necessary, in
20100HB2735PN4263 - 4 -
connection with any matter involving regulation by the
department or the corresponding regulatory agency of the United
States, whether on appeal or otherwise initiated.
(b) Exercise of discretion.--The Consumer Advocate for
Health Insurance may exercise discretion in determining the
interests of consumers that will be advocated in any particular
proceeding and in determining whether to participate in or
initiate any particular proceeding. In making a determination,
the Consumer Advocate for Health Insurance shall consider the
public interest, the resources available and the substantiality
of the effect of the proceeding on the interests of consumers.
The Consumer Advocate for Health Insurance may refrain from
intervening when, in the judgment of the Consumer Advocate for
Health Insurance, intervention is not necessary to represent
adequately the interests of consumers.
(c) Grants.--The Consumer Advocate for Health Insurance
shall apply for all grant moneys available from the Federal
Government through the Patient Protection and Affordable Care
Act (Public Law 111-148, 124 Stat. 119) and other related laws
and may expend all the moneys obtained from grant awards.
(d) Action on petition.--In addition to any other authority
conferred by this subarticle, the Consumer Advocate for Health
Insurance is authorized to represent an interest of consumers
that is presented for consideration upon petition in writing by
a substantial number of persons who are consumers of an insurer
subject to regulation by the department. The Consumer Advocate
for Health Insurance shall notify the principal sponsors of the
petition within a reasonable time after receipt of the petition
of the action taken or intended to be taken with respect to the
interests of consumers presented in that petition. If the
20100HB2735PN4263 - 5 -
Consumer Advocate for Health Insurance declines or is unable to
represent the interests, written notification and the reasons
for the action shall be given to the sponsors.
(e) Name in which action is brought.--Any action brought by
the Consumer Advocate for Health Insurance before a court or an
agency of this Commonwealth shall be brought in the name of the
Consumer Advocate for Health Insurance. The Consumer Advocate
for Health Insurance may name a consumer or group of consumers
in whose name the action may be brought or may join with a
consumer or group of consumers in bringing the action.
(f) Public statement.--At a time that the Consumer Advocate
for Health Insurance determines, in accordance with applicable
time limitations, to initiate, intervene or otherwise
participate in any department, agency or court proceeding, the
Consumer Advocate for Health Insurance shall issue publicly a
written statement, a copy of which shall be filed in the
proceeding in addition to any required entry of appearance,
stating concisely the specific interests of consumers to be
protected.
Section 925-A. Duties of department.
In dealing with any proposed action that may substantially
affect the interests of consumers, including, but not limited
to, a proposed change of rates and the adoption of rules,
regulations, guidelines, orders, standards or final policy
decisions, the department shall:
(1) Notify the Consumer Advocate for Health Insurance
when notice of the proposed action is given to the public or
at a time fixed by agreement between the Consumer Advocate
for Health Insurance and the department in a manner to assure
the Consumer Advocate for Health Insurance reasonable notice
20100HB2735PN4263 - 6 -
and adequate time to determine whether to intervene in the
matter.
(2) Consistent with its other statutory
responsibilities, take action with due consideration to the
interests of consumers.
Section 926-A. Reports.
The Consumer Advocate for Health Insurance shall annually
transmit to the Governor and to the General Assembly, and shall
make available to the public, an annual report on the conduct of
the Office of Consumer Advocate for Health Insurance. The
Consumer Advocate for Health Insurance shall make
recommendations as may from time to time be necessary or
desirable to protect the interests of consumers.
Section 927-A. Savings provision and construction.
(a) No bar to action.--Nothing contained in this subarticle
shall limit the right of a consumer to bring a proceeding before
either the department or a court.
(b) No impairment to department.--Nothing contained in this
subarticle shall be construed to impair the statutory authority
or responsibility of the department to regulate insurers in the
public interest.
Section 3. This act shall take effect in 60 days.
20100HB2735PN4263 - 7 -