THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

INTRODUCED BY MURT, BELFANTI, DALEY, YOUNGBLOOD AND CALTAGIRONE, MAY 12, 2010

REFERRED TO COMMITTEE ON INSURANCE, MAY 12, 2010  

AN ACT

Amending Title 40 (Insurance) of the Pennsylvania Consolidated

Statutes, further providing for rates and contracts.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  Section 6329 of Title 40 of the Pennsylvania

Consolidated Statutes is amended to read:

§ 6329.  Rates and contracts.

(a)  General rule.--[All] Except as provided under subsection

(c), all rates charged subscribers or groups of subscribers by

any professional health service corporation, and the form and

content of all contracts between any such corporation and its

subscribers or groups of subscribers, all methods and rates of

payment by such corporation to health service doctors serving

its subscribers, all acquisition costs in procuring subscribers,

the reserves to be maintained by such corporation, and all

contracts entered into by any such corporation and extending

over a period of more than one year or calling for the

expenditure by the corporation of any amount in excess of 20% of

its reserves, shall be approved by the department before they

become effective.

(b)  Procedure.--Every application for such approval shall be

made to the department in writing and shall be subject to the

provisions of subsections (c) through (f) of section 6102 of

this title (relating to certification of hospital plan

corporations), except that the department may substitute

publication in the Pennsylvania Bulletin of notice of reasonable

opportunity to submit written comments for publication of

opportunity for hearing in any case where the right to an oral

hearing is not conferred by the Constitution of the United

States or the Constitution of Pennsylvania. Within 60 days after

the filing of the application the department shall approve or

refuse such application.

(c)  Dental service corporations.--The following shall apply:

(1)  A dental service corporation may contract with its

subscribers for dental services as may be provided under any

dental service plan adopted by the corporation.

(2)  The rates charged by the dental service corporation

to its subscribers shall be consistent with the proper

conduct of its business and interests of the public and shall

be subject to the approval of the department.

(3)  Nothing contained in this chapter or in any dental

service plan shall affect the ordinary professional

relationship between the person rendering dental services

under the plan and the subscriber to whom the services are

rendered. No action based upon or arising out of the

relationship or relating to dental services rendered pursuant

to a dental service plan may be maintained against the dental

service corporation operating the plan.

(4)  No contract between a dental service corporation and

a dentist for the provision of services to patients may

require that the dentist indemnify or hold harmless the

dental service corporation for any expenses and liabilities,

including subscribers at a fee set by the dental service

corporation unless the dental service corporation compensates

the dentist for the service to the patient.

Section 2.  The amendment of 40 Pa.C.S. § 6329 shall apply to

all contracts entered into by a dental service corporation and

its subscribers or groups of subscribers on or after the

effective date of this section.

Section 3.  This act shall take effect immediately.