Bill Text: PA HB278 | 2009-2010 | Regular Session | Introduced

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Bill Title: Further providing for definitions, for unfair acts and for exclusions.

Spectrum: Slight Partisan Bill (Republican 17-8)

Status: (Introduced - Dead) 2009-02-06 - Referred to INSURANCE [HB278 Detail]

Download: Pennsylvania-2009-HB278-Introduced.html

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PRINTER'S NO. 300
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 278 Session of2009
INTRODUCED BY COX, BARRAR, BELFANTI, COHEN, CREIGHTON, DALEY, EVERETT, FABRIZIO, GINGRICH, GROVE, HUTCHINSON, MELIO, MOUL, PEIFER, PICKETT, ROAE, ROCK, ROHRER, STABACK, VULAKOVICH AND WANSACZ, FEBRUARY 6, 2009
REFERRED TO COMMITTEE ON INSURANCE, FEBRUARY 6, 2009
AN ACT
Amending the act of July 22, 1974 (P.L.589, No.205), entitled
"An act relating to unfair insurance practices; prohibiting
unfair methods of competition and unfair or deceptive acts
and practices; and prescribing remedies and penalties,"
further providing for definitions, for unfair acts and for
exclusions.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Section 3 of the act of July 22, 1974 (P.L.589,
No.205), known as the Unfair Insurance Practices Act, amended
April 4, 1996 (P.L.100, No.24) and July 7, 2006 (P.L.363, No.
78), is amended to read:
Section 3. Definitions.--As used in this act:
"Abuse" has the meaning given in 23 Pa.C.S. § 6102(a)
(relating to definitions), notwithstanding the limited
applicability provision in paragraph (5) of the definition of
"abuse" in 23 Pa.C.S. § 6102(a). The term also means attempting
to cause or intentionally, knowingly or recklessly causing
damage to property so as to intimidate or attempt to control the
behavior of another person covered under 23 Pa.C.S. Ch. 61
(relating to protection from abuse).
"Commissioner" means the Insurance Commissioner of the
Commonwealth of Pennsylvania.
"Family or household members" has the meaning given in 23
Pa.C.S. § 6102(a) (relating to definitions).
"Insurance policy" or "insurance contract" means any contract
of insurance, indemnity, health care, suretyship, title
insurance, or annuity issued, proposed for issuance or intended
for issuance by any person.
"Person" means:
(1) any individual, corporation, association, partnership,
reciprocal exchange, inter-insurer, Lloyds insurer, fraternal
benefit society, beneficial association, agent, broker, adjuster
and any other legal entity engaged in the business of insurance;
[, including agents, brokers and adjusters and also means health
care plans as defined in 40 Pa.S. Ch.61 relating to hospital
plan corporations, 40 Pa.S. Ch.63 relating to professional
health services plan corporations, 40 Pa.S. Ch.65 relating to
fraternal and beneficial societies, 40 Pa.S. Ch.67 relating to
beneficial societies and the act of December 29, 1972 (P.L.1701,
No.364), known as the "Voluntary Nonprofit Health Service Act of
1972."]
(2) a health care plan as defined in 40 Pa.C.S. Ch. 61
(relating to hospital plan corporations), 40 Pa.C.S. Ch. 63
(relating to professional health services plan corporations), 40
Pa.C.S. Ch. 67 (relating to beneficial societies), Article XXIV
of the act of act of May 17, 1921 (P.L.682, No.284), known as
"The Insurance Company Law of 1921" and the act of December 29,
1972 (P.L.1701, No.364), known as the "Health Maintenance
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Organization Act";
(3) a self-insured or multiple employer welfare arrangement
not exempt from State regulation by the Employee Retirement
Income Security Act of 1974 (Public Law 93-406, 29 U.S.C. § 1001
et seq.); and
(4) an employer-organized insurance association.
For purposes of this act, health care plans, fraternal benefit
societies and beneficial societies shall be deemed to be engaged
in the business of insurance.
"Renewal" or "to renew" means the issuance and delivery by an
insurer of a policy superseding at the end of the policy period
a policy previously issued and delivered by the same insurer,
such renewal policy to provide types and limits of coverage at
least equal to those contained in the policy being superseded,
or the issuance and delivery of a certificate or notice
extending the term of a policy beyond its policy period or term
with types and limits of coverage at least equal to those
contained in the policy being extended: Provided, however, That
any policy with a policy period or term of less than twelve
months or any period with no fixed expiration date shall for the
purpose of this act be considered as if written for successive
policy periods or terms of twelve months.
"Victim" means an individual who is or has been subjected to
abuse.
"Victim of abuse" means an individual who is a victim or an
individual who seeks or has sought medical or psychological
treatment for abuse, protection from abuse or shelter from
abuse.
Section 2. Section 5(a) of the act is amended by adding a
paragraph to read:
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Section 5. Unfair Methods of Competition and Unfair or
Deceptive Acts or Practices Defined.--(a) "Unfair methods of
competition" and "unfair or deceptive acts or practices" in the
business of insurance means:
* * *
(15) Knowingly doing any of the following:
(i) Requiring an insured to obtain drugs from a mail-order
pharmacy as a condition of obtaining the payment for the
prescription drugs.
(ii) Imposing upon an insured who is not utilizing a mail-
order pharmacy a copayment fee or other condition not imposed
upon insureds who utilize a mail-order pharmacy.
(iii) Denying or impairing the right of an insured to
determine from where drugs are dispensed.
* * *
Section 3. Section 14 of the act is amended to read:
Section 14. Exclusions.--Health care plans administered by
joint boards of trustees pursuant to section 302 of the Labor
Management Relations Act, 29 U.S.C. § 141, et seq., and employer
administered health care plans pursuant to collective bargaining
agreements which pay benefits from the assets of the trust or
the funds of the employer as opposed to payments through an
insurance company shall not be subject to any of the provisions
of this act except section 5(a)(15).
Section 4. The amendment or addition of sections 5(a)(15)
and 14 of the act shall apply to insurance policies issued or
renewed on or after the effective date of this section.
Section 5. This act shall take effect in 60 days.
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