PRINTER'S NO. 3963
No. 2766 Session of 2000
INTRODUCED BY MUNDY, DeLUCA, WANSACZ, GRUCELA, ROONEY, MANN,
CAWLEY, BELARDI, TIGUE, SANTONI, STABACK, BLAUM, YUDICHAK,
BELFANTI, FREEMAN, CAPPABIANCA, GEORGE, SAYLOR, NAILOR,
DeWEESE, VEON, TRICH, M. COHEN, BARRAR, LaGROTTA, NICKOL,
HENNESSEY, HALUSKA, COY, SURRA, CORRIGAN, SHANER, LAUGHLIN,
SOLOBAY, PETRARCA, MANDERINO, FAIRCHILD, WOJNAROSKI, BEBKO-
JONES, WALKO, WRIGHT, TANGRETTI, JAMES, CURRY, STURLA,
SCRIMENTI, MAHER, PLATTS, COSTA, WASHINGTON, FRANKEL, FLICK
AND YOUNGBLOOD, SEPTEMBER 27, 2000
REFERRED TO COMMITTEE ON INSURANCE, SEPTEMBER 27, 2000
AN ACT
1 Amending Title 40 (Insurance) of the Pennsylvania Consolidated
2 Statutes, providing for employer-group health insurance
3 coverage.
4 The General Assembly of the Commonwealth of Pennsylvania
5 hereby enacts as follows:
6 Section 1. Section 6101 of Title 40 of the Pennsylvania
7 Consolidated Statutes is amended by adding definitions to read:
8 § 6101. Definitions.
9 The following words and phrases when used in this chapter
10 shall have, unless the context clearly indicates otherwise, the
11 meanings given to them in this section:
12 "Eligible employer." A person that employs no more than 50
13 individuals.
14 "Eligible individual." Any of the following:
15 (1) An individual who is employed by an eligible
1 employer.
2 (2) An individual who operates a sole proprietorship.
3 (3) A spouse or dependent child of an individual listed
4 in paragraph (1) or (2).
5 "Employer group." A group of at least 500 eligible
6 individuals which the Insurance Department certifies as eligible
7 for group health insurance coverage on the basis of inability to
8 secure favorable health insurance coverage.
9 * * *
10 Section 2. Title 40 is amended by adding a section to read:
11 § 6126.1. Employer groups.
12 A hospital plan corporation shall do all of the following:
13 (1) Accept an employer group as a subscriber.
14 (2) Establish a rate for each employer group accepted
15 under paragraph (1). The rate is subject to approval by the
16 Insurance Department.
17 Section 3. Section 6302(a) of Title 40 is amended by adding
18 definitions to read:
19 § 6302. Definitions.
20 (a) General rule.--The following words and phrases when used
21 in this chapter shall have, unless the context clearly indicates
22 otherwise, the meanings given to them in this section:
23 * * *
24 "Eligible employer." A person that employs no more than 50
25 individuals.
26 "Eligible individual." Any of the following:
27 (1) An individual who is employed by an eligible
28 employer.
29 (2) An individual who operates a sole proprietorship.
30 (3) A spouse or dependent child of an individual listed
20000H2766B3963 - 2 -
1 in paragraph (1) or (2).
2 "Employer group." A group of at least 500 eligible employers
3 which the Insurance Department certifies as eligible for group
4 health insurance coverage on the basis of inability to secure
5 favorable health insurance coverage.
6 * * *
7 Section 4. Section 6322(b) of Title 40 is amended to read:
8 § 6322. Scope of service.
9 * * *
10 (b) Classes and kinds of services.--The certificate of
11 authority, bylaws, or resolutions of the board of directors of a
12 professional health service corporation may limit the
13 professional health services that will be provided for its
14 subscribers, and may divide such professional health services as
15 it elects to provide into classes or kinds, and it may enter
16 into contracts with its subscribers or groups of subscribers to
17 secure professional health services of any kind or class so
18 delimited. A general medical services corporation shall make
19 available to its subscribers or groups of subscribers, including
20 employer groups, upon request of any individual for his
21 individual subscriptions or any group for its group
22 subscriptions, contracts which provide coverage for professional
23 health services with appropriate premiums.
24 * * *
25 Section 5. This act shall take effect in 60 days.
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