THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

INTRODUCED BY PICKETT, BAKER, BEAR, BOYD, CALTAGIRONE, CAUSER, CLYMER, CREIGHTON, CUTLER, ELLIS, FABRIZIO, FLECK, GEIST, GEORGE, GIBBONS, GINGRICH, GOODMAN, GROVE, GRUCELA, HENNESSEY, HESS, M. KELLER, LONGIETTI, MELIO, MILLARD, MILNE, MUSTIO, PHILLIPS, PYLE, RAPP, READSHAW, REICHLEY, ROHRER, SCAVELLO, SIPTROTH, STABACK, STERN, STEVENSON, SWANGER, VULAKOVICH, WALKO, WANSACZ, WATSON, YOUNGBLOOD AND MOUL, FEBRUARY 4, 2009

REFERRED TO COMMITTEE ON INSURANCE, FEBRUARY 4, 2009  

AN ACT

Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An

act relating to insurance; amending, revising, and

consolidating the law providing for the incorporation of

insurance companies, and the regulation, supervision, and

protection of home and foreign insurance companies, Lloyds

associations, reciprocal and inter-insurance exchanges, and

fire insurance rating bureaus, and the regulation and

supervision of insurance carried by such companies,

associations, and exchanges, including insurance carried by

the State Workmen's Insurance Fund; providing penalties; and

repealing existing laws," in casualty insurance, providing

for professional and trade association rate protection.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  The act of May 17, 1921 (P.L.682, No.284), known

as The Insurance Company Law of 1921, is amended by adding a

section to read:

Section 633.1.  Professional and Trade Association Rate

Protection.--(a)  An insurer that offers group health, sickness

and accident insurance policies, and all other forms of managed

or capitated care plans or policies or subscriber contracts in

this Commonwealth to members of a professional or trade

association on or after the effective date of this section shall

base the premiums for association members based upon actual

claims and expense experience for such group provided that the

association's membership is comprised of at least fifty

individuals.

(b)  This section does not include the following policies:

(1)  Accident only.

(2)  Hospital indemnity.

(3)  Limited benefit.

(4)  Credit.

(5)  Dental.

(6)  Vision.

(7)  Specified disease.

(8)  Medicare supplement.

(9)  CHAMPUS (Civilian Health and Medical Program for the

Uniformed Services) supplement.

(10)  Long-term care.

(11)  Disability income.

(12)  Workers' compensation.

(13)  Automobile medical payment.

(c)  As used in this section:

(1)  "Insurer" means any entity subject to this act, the act

of December 29, 1972 (P.L.1701, No.364), known as the "Health

Maintenance Organization Act," or 40 Pa.C.S. Ch. 61 (relating to

hospital plan corporations) or 63 (relating to professional

health services plan corporations).

(2)  "Professional or trade association" means a bona fide

organization whose membership consists of businesses associated

together for legitimate purposes of mutual benefit or lawful

convenience that purchases insurance on a group basis on behalf

of members. An association cannot be formed for the sole purpose

of purchasing insurance.

Section 2.  This act shall take effect immediately.