THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

INTRODUCED BY DeLUCA, BELFANTI, CALTAGIRONE, CASORIO, D. COSTA, DALEY, DONATUCCI, GOODMAN, GRUCELA, HARKINS, JOSEPHS, McILVAINE SMITH, MELIO, OLIVER, PASHINSKI, PAYTON, READSHAW, SIPTROTH, K. SMITH AND SWANGER, SEPTEMBER 24, 2010

REFERRED TO COMMITTEE ON INSURANCE, SEPTEMBER 24, 2010  

AN ACT

Providing for the Commonwealth Access to Health Insurance Reform

Act; establishing the Pennsylvania Health Insurance Reform

Implementation Authority and the Health Information Exchange;

and imposing duties on the Insurance Department, Department

of Health and the Office of Administration.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  Short title.

This act shall be known and may be cited as the Commonwealth

Access to Health Insurance Reform Act.

Section 2.  Legislative intent.

The General Assembly recognizes the following public policy

purposes and declares that the following objectives of the

Commonwealth are to be served by this act:

(1)  Reduce the number of uninsured Pennsylvanians by

creating an organized, transparent marketplace in this

Commonwealth for the purchase for affordable, quality health

care coverage to claim available Federal tax credits and

cost-sharing subsidies and to meet the personal

responsibility requirements imposed under the Federal act.

(2)  Strengthen the health care delivery system.

(3)  Guarantee the availability and renewability of

health care coverage through the private health insurance

market to qualified individuals and qualified small

employers.

(4)  Require that health care service plans and health

insurers issuing coverage in the individual and small

employer markets compete on the basis of price, quality and

service, not on risk selection.

(5)  Meet the requirements of the Federal act and

applicable Federal guidance and regulations.

(6)  Assist citizens of this Commonwealth in ensuring

compliance with Federal law.

Section 3.  Definitions.

The following words and phrases when used in this act shall

have the meanings given to them in this section unless the

context clearly indicates otherwise:

"Authority."  The Pennsylvania Health Insurance Reform

Implementation Authority established in section 3.

"Department."  The Insurance Department of the Commonwealth.

"Federal act."  The Patient Protection and Affordable Care

Act (Public Law 111-148, 124 Stat. 119).

"Health department."  The Department of Health of the

Commonwealth.

"Health insurance benefit plan."  Any individual or small

group health insurance policy, subscriber contract, certificate

or plan which provides health or sickness and accident coverage

which is offered by an insurer. The term shall not include any

of the following:

(1)  An accident only policy.

(2)  A credit only policy.

(3)  A long-term or disability income policy.

(4)  A long-term care policy.

(5)  A specified disease policy.

(6)  A Medicare supplement policy.

(7)  A Civilian Health and Medical Program of the

Uniformed Services (CHAMPUS) supplement policy.

(8)  A fixed indemnity policy.

(9)  A dental only policy.

(10)  A vision only policy.

(11)  A workers' compensation policy.

(12)  An automobile medical payment policy under 75

Pa.C.S. (relating to vehicles).

(13)  Any other similar policies providing for limited

benefits.

"Health insurance producer."  An individual or entity

licensed by the department to sell, solicit or negotiate health

insurance in this Commonwealth.

"Health insurer."  A company or health insurance entity

licensed in this Commonwealth to issue any individual or group

health, sickness or accident policy or subscriber contract or

certificate or plan that provides medical or health care

coverage by a health care facility or licensed health care

provider that is offered or governed under any of the following:

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

The Insurance Company Law of 1921.

(2)  The act of December 29, 1972 (P.L.1701, No.364),

known as the Health Maintenance Organization Act.

(3)  The act of May 18, 1976 (P.L.123, No.54), known as

the Individual Accident and Sickness Insurance Minimum

Standards Act.

(4)  40 Pa.C.S. Ch. 61 (relating to hospital plan

corporations) or 63 (relating to professional health services

plan corporations).

"Office of Administration."  The Office of Administration of

the Commonwealth.

"Small employer."  In connection with a group health plan

with respect to a calendar year and a plan year, an employer who

employs an average of at least two but not more than 50 eligible

employees on business days during the preceding calendar year

and who employs at least two eligible employees on the first day

of the plan year. In the case of an employer which was not in

existence throughout the preceding calendar year, the

determination whether an employer is a small employer shall be

based on the average number of eligible employees the employer

is reasonably expected to employ on business days in the current

calendar year.

 "Small group health benefit plan."  A health benefit plan

offered to a small employer.

Section 4.  Pennsylvania Health Insurance Reform Implementation

Authority.

(a)  Establishment.--The Pennsylvania Health Insurance Reform

Implementation Authority is hereby established.

(b)  Duties.--The authority shall:

(1)  In cooperation with the department, the health

department and the Office of Administration, and in

accordance with the electronic standards developed under this

act, establish a Health Insurance Exchange that:

(i)  Is capable of providing access to private and

government health insurance websites and their electronic

application forms and submission procedures.

(ii)  Provides a consumer comparison of and

enrollment in a health benefit plan posted on the Health

Insurance Exchange by a health insurer for the:

(A)  Small employer group market.

(B)  The individual market.

(iii)  Include information and a link to enrollment

in premium assistance programs and other government

assistance programs.

(2)  Facilitate a private sector method for the

collection of health insurance premium payments made for a

single policy by multiple payers, including the policyholder,

one or more employers of one or more individuals covered by

the policy, government programs and others by educating

employers and insurers about collection services available

through private vendors including financial institutions.

(3)  Assist employers with a free or low-cost method for

establishing mechanisms for the purchase of health insurance

by employees using pre-tax dollars.

(4)  Periodically convene health care providers, payers

and consumers to monitor the progress being made regarding

the delivery of health care delivery and payment reform.

(5)  Establish a list on the Health Insurance Exchange of

insurance producers who are appointed producers for the

Health Insurance Exchange.

(6)  Apply for and expend Federal grants available for

the planning, development and implementation of the Health

Information Exchange, or standards to be provided insureds

including the summary of benefits and coverage explanations.

(7)  Engage the services of private consultants to render

professional and technical assistance and advice in carrying

out the purposes of this act.

(8)  Provide for the operation of a toll-free telephone

hotline to respond to requests for assistance.

(9)  Maintain an Internet website through which enrollees

and prospective enrollees of health insurance benefit plans

may obtain standardized comparative information on those

plans.

(10)  Assign a rating to each health insurance benefit

plan offered through the Health Insurance Exchange in

accordance with the criteria developed by the United States

Secretary of Health and Human Services.

(11)  Utilize a standardized format for presenting health

benefits plan options on the Health Insurance Exchange,

including the use of the uniform outline of coverage

established under section 2715 of the Public Health Service

Act (58 Stat. 682, 42 U.S.C. § 201 et seq.).

(12)  Inform individuals of eligibility requirements for

the program created under Chapter 13 of the act of June 26,

2001 (P.L.755, No.77), known as the Tobacco Settlement Act, 

or an applicable State or local public program. If the Health

Insurance Exchange determines an individual is eligible for a

program through screening applications, it shall enroll the

individual in the program.

(13)  Establish and make available by electronic means a

calculator to determine the cost of coverage after the

application of a premium tax credit under section 36B of the 

Internal Revenue Code of 1986 (Public Law 99-514, 26 U.S.C. §

1 et seq.) and a cost-sharing reduction under section 1402 of

the Federal act.

(14)  Grant a certification attesting that, for purposes

of the individual responsibility penalty under section 5000A

of the Internal Revenue Code of 1986, an individual is exempt

from the individual requirement or the penalty imposed by the

section because of either of the following:

(i)  There is no affordable qualified health

insurance benefit plan available through the Health

Insurance Exchange or the individual's employer covering

the individual.

(ii)  The individual meets the requirements for

another exemption from the individual responsibility

requirement or penalty.

(15)  Transfer to the Secretary of the Treasury the

following:

(i)  A list of the individuals issued a certification

under paragraph (14), including the name and taxpayer

identification number of each individual.

(ii)  The name and taxpayer identification number of

each individual who was an employee of an employer but

was determined to be eligible for the premium tax credit

under section 36B of the Internal Revenue Code of 1986

because of either of the following:

(A)  The employer did not provide minimum

essential coverage.

(B)  The employer provided the minimum essential

coverage but it was determined under section 36B(c)

(2)(C) of the Internal Revenue Code of 1986 to either

be unaffordable to the employee or not provide the

required minimum actuarial value.

(iii)  The name and taxpayer identification number

of:

(A)  Each individual who notifies the Health

Insurance Exchange under section 1411(b) of the

Federal act that the individual has changed

employers.

(B)  Each individual who ceases coverage under a

qualified health plan during a plan year and the

effective date of the cessation.

(16)  Provide to each employer the name of each employee

of the employer who ceases coverage under a qualified health

plan during a plan year and the effective date of the

cessation.

(17)  Perform duties required of, or delegated to, the

Health Insurance Exchange by the United States Secretary of

Health and Human Services or the Secretary of the Treasury

related to determining eligibility for premium tax credits,

reduced cost sharing or individual responsibility exemptions.

(18)  Establish the navigator program in accordance with

section 1311(i) of the Federal act. An entity chosen by the

Health Insurance Exchange as a navigator shall do the

following:

(i)  Conduct public education activities to raise

awareness of the availability of health insurance benefit

plans.

(ii)  Distribute fair and impartial information

concerning enrollment in qualified health plans and the

availability of premium tax credits under section 36B of

the Internal Revenue Code of 1986 and cost-sharing

reductions under section 1402 of the Federal act.

(iii)  Facilitate enrollment in qualified health

insurance benefit plans.

(iv)  Provide referrals to an applicable office of

health insurance consumer assistance or health insurance

ombudsman established under section 2793 of the Public

Health Service Act or another appropriate State agency

for an enrollee with a grievance, complaint or question

regarding his health plan, coverage or a determination

under the plan or coverage.

(v)  Provide information in a manner that is

culturally and linguistically appropriate to the needs of

the population being served by the Health Insurance

Exchange.

(19)  Establish the Small Business Health Options

Program, separate from the activities of the authority

related to the individual market, to assist qualified small

employers in facilitating the enrollment of their employees

in health insurance business plans offered through the Health

Insurance Exchange in the small employer market in a manner

consistent with section 1312(a)(2) of the Federal act.

(20)  Determine the criteria and process for eligibility,

enrollment and disenrollment of enrollees and potential

enrollees in the Health Insurance Exchange and coordinate the

process with State and local government entities

administering other health care coverage programs, including

the Department of Public Welfare in order to ensure

consistent eligibility and enrollment processes and seamless

transitions between coverage.

(21)  Require, as a condition of participation in the

Health Insurance Exchange, insurers to fairly and

affirmatively offer, market and sell in the Health Insurance

Exchange at least one product within each of the five levels

of coverage contained in section 1302(d) and (e) of the

Federal act. The authority may require insurers to offer

additional products within each of those five levels of

coverage.

(22)  Require, as a condition of participation in the

Health Insurance Exchange, carriers that sell any products

outside the Health Insurance Exchange to do both of the

following:

(i)  Fairly and affirmatively offer, market and sell

products made available to individuals in the Health

Insurance Exchange to individuals purchasing coverage

outside the Health Insurance Exchange.

(ii)  Fairly and affirmatively offer, market and sell

products made available to small employers in the Health

Insurance Exchange to small employers purchasing coverage

outside the Health Insurance Exchange.

(23)  Require, as condition of participation in the

Health Insurance Exchange, insurers that sell products

outside the Health Insurance Exchange to do both of the

following:

(i)  Fairly and affirmatively offer, market and sell

products made available to individuals in the Health

Insurance Exchange to individuals purchasing coverage

outside the Health Insurance Exchange.

(ii)  Fairly and affirmatively offer, market and sell

products made available to small employers in the Health

Insurance Exchange to small employers purchasing coverage

outside the Health Insurance Exchange.

(24)  Determine when an enrollee's coverage commences and

the extent and scope of coverage.

(25)  Provide for the processing of applications and the

enrollment and disenrollment of enrollees.

(26)  Determine and approve cost-sharing provisions for

health insurance benefit plans.

(27)  Establish uniform billing and payment policies for

health insurance benefit plans offered in the Health

Insurance Exchange to ensure consistent enrollment and

disenrollment activities for individuals enrolled in the

Health Insurance Exchange.

(28)  Undertake activities necessary to market and

publicize the availability of health care coverage and

Federal subsidies through the Health Insurance Exchange. The

board shall also undertake outreach and enrollment activities

that seek to assist enrollees and potential enrollees with

enrolling and reenrolling in the Health Insurance Exchange in

the least burdensome manner, including populations that may

experience barriers to enrollment, such as persons with

disabilities and those with limited English language

proficiency.

(29)  Select and set performance standards and

compensation for navigators selected under paragraph (18)(i).

(30)  Assess a charge on the health insurance benefit

plans offered by carriers that is reasonable and necessary to

support the development, operations and prudent cash

management of the Health Insurance Exchange. This charge

shall not affect the requirement under section 1301 of the

Federal act that insurers charge the same premium rate for

each qualified health plan whether offered inside or outside

the Health Insurance Exchange.

(31)  Keep an accurate accounting of activities, receipts

and expenditures and annually submit to the United States

Secretary of Health and Human Services a report concerning

that accounting.

(32)  Exercise powers reasonably necessary to carry out

and comply with the duties, responsibilities and requirements

of this act and the Federal act.

(33)  Facilitate the purchase of qualified health plans

in the Health Insurance Exchange by qualified individuals and

qualified small employers no later than January 1, 2014.

(34)  Require insurers participating in the Health

Insurance Exchange to immediately notify the Health Insurance

Exchange under the terms and conditions established by the

authority when an individual is or will be enrolled in or

disenrolled from a qualified health plan offered by the

carrier.

(35)  Ensure that the Health Insurance Exchange provides

oral interpretation services in any language for individuals

seeking coverage through the Health Insurance Exchange and

makes available a toll-free telephone number for the hearing

and speech impaired. The authority shall ensure that written

information made available by the Health Insurance Exchange

is presented in a plainly worded, easily understandable

format and made available in prevalent languages.

(36)  Require insurers participating in the Health

Insurance Exchange to make available to the Health Insurance

Exchange and regularly update an electronic directory of

contracting health care providers so that individuals seeking

coverage through the Health Insurance Exchange can search by

health care provider name to determine which health plans in

the Health Insurance Exchange include that health care

provider in their network. The authority may also require a

carrier to provide regularly updated information to the

Health Insurance Exchange as to whether a health care

provider is accepting new patients for a particular health

plan. The Health Insurance Exchange may provide an integrated

and uniform consumer directory of health care providers

indicating which carriers the providers contract with and

whether the providers are currently accepting new patients.

The Health Insurance Exchange may also establish methods by

which health care providers may transmit relevant information

directly to the Health Insurance Exchange rather than through

an insurer.

(37)  By no later than December 31, 2012, notify and

receive approval of the United States Department of Health

and Human Services of the implementation of a State-based

Health Insurance Exchange.

(c)  Prohibitions.--The authority may not:

(1)  Regulate health insurers, health insurance plans or

health insurance producers.

(2)  Act as an appeals entity for resolving disputes

between a health insurer and an insured.

(d)  Fees.--The authority may establish and collect a fee for

the transaction cost of:

(1)  Processing an application for a health insurance

benefit plan from the Internet portal to an insurer.

(2)  Accepting, processing and submitting multiple

premium payment sources.

(e)  Uniform electronic standards.--The authority shall

establish uniform electronic standards for:

(1)  A health insurer to use when:

(i)  Transmitting information to:

(A)  The department under this act.

(B)  The Health Insurance Exchange as required by

this act.

(ii)  Receiving information from the Health Insurance

Exchange.

(iii)  Receiving or transmitting the universal health

application to or from the Health Insurance Exchange.

(2)  Facilitating the transmission and receipt of premium

payments from multiple sources in the defined contribution

arrangement market.

(3)  The use of the uniform health insurance application

required by this act on the Health Insurance Exchange.

(f)  Concise consumer comparison.--The authority shall

designate the level of detail that would be helpful for a

concise consumer comparison of the items described in the Health

Insurance Exchange.

(g)  Advisory board.--The authority shall create an advisory

board to advise the exchange concerning the operation of the

exchange and transparency issues with the following members:

(1)  Two health insurance producers who are registered

with the Health Insurance Exchange.

(2)  Two consumers.

(3)  One representative from an insurer who is licensed

under 40 Pa.C.S. Ch. 61 (relating to hospital plan

corporations) or 63 (relating to professional health services

plan corporations) and participates on the exchange.

(4)  One representative from an insurer who is not a

licensed insurer under 40 Pa.C.S. Ch. 61 or 63 and

participates on the exchange.

(5)  One representative from the department.

(6)  One representative from the Office of

Administration.

(h)  Posting requirements.--The authority shall post or

facilitate the posting of:

(1)  The information required by this act on the Health

Insurance Exchange created by this act.

(2)  Links to websites that provide cost and quality

information from neutral entities with a broad base of

support from the provider and health insurance payer

communities.

Section 5.  Composition of authority.

(a)  Membership.--The authority shall consist of the

following members:

(1)  Three members of the general public appointed by the

Governor.

(2)  Two members of the Senate appointed by the Majority

Leader of the Senate.

(3)  Two members of the Senate appointed by the Minority

Leader of the Senate.

(4)  Two members of the House of Representatives

appointed by the Majority Leader of the House of

Representatives.

(5)  Two members of the House of Representatives

appointed by the Minority Leader of the House of

Representatives.

(6)  The Secretary of the Budget.

(7)  The Secretary of Health.

(8)  The Secretary of Public Welfare.

(9)  The Insurance Commissioner.

(b)  Chairperson.--The Governor shall appoint a chairperson

of the authority from one of the three gubernatorial appointees.

A member appointed under subsection (a)(2), (3), (4) or (5) may

appoint a designee to attend meetings on the member's behalf.

(c)  Qualifications.--The members of the authority shall be

21 years of age or older, citizens of the United States and

residents of this Commonwealth.

(d)  Initial appointments.--Initial appointments to the

authority shall be made within 30 days of the effective date of

this section and shall be made as follows:

(1)  Gubernatorial appointees initially appointed under

subsection (a)(1) shall serve initial terms of two, three and

four years, respectively, as designated by the Governor at

the time of appointment and until their successors are

appointed and qualified.

(2)  Legislative appointees initially appointed under

subsection (a)(2), (3), (4) or (5) shall serve until the

third Tuesday in January 2011 and until their successors are

appointed and qualified.

(e)  Terms of office.--Upon the expiration of a term of a

member appointed under subsection (a), the following shall

apply:

(1)  The term of office of a gubernatorial appointee

shall be three years and until a successor is appointed and

qualified.

(2)  The term of office of a legislative appointee shall

be two years and until a successor is appointed and

qualified.

(3)  A legislative appointee shall serve no more than

three full consecutive terms.

(4)  A gubernatorial appointee shall serve no more than

two full consecutive terms.

(f)  Vacancies.--Appointments to fill vacancies shall be made

within 60 days of the creation of the vacancy. Members who are

appointed to fill vacancies may continue to serve on the

authority as follows:

(1)  A member appointed to fill a vacancy under

subsection (e)(1) may serve two full terms following the

expiration of the term related to the vacancy.

(2)  A member appointed to fill a vacancy under

subsection (e)(2) may serve three full terms following the

expiration of the term related to the vacancy.

(g)  Reimbursement for expenses.--Members of the authority

may be reimbursed for reasonable expenses for their attendance

at authority meetings as well as committee meetings.

(h)  Meetings.--The authority shall hold meetings as often as

necessary but no less than on a quarterly basis. The first

meeting of the authority shall be held within 60 days of the

effective date of this section.

(i)  Quorum.--For the purpose of conducting authority

business, a quorum shall be at least one more than half the

number of authority members.

(j)  Qualified majority vote.--A majority of members of the

authority present at a meeting constitute a qualified majority

vote.

Section 6.  Health insurers.

(a)  Uniform electronic standards.--A health insurer shall

use the uniform electronic standards when transmitting

information to the Health Insurance Exchange or receiving

information from the Health Insurance Exchange.

(b)  Plans to small employers.--A health insurer who offers a

health insurance benefit plan to a small employer in this

Commonwealth shall:

(1)  Post the health insurance benefit plans in which the

insurer is enrolling new groups on the Health Insurance

Exchange.

(2)  Comply with the provisions of this section.

(c)  Individual plans.--A health insurer who offers

individual health insurance benefit plans:

(1)  Shall post on the Health Insurance Exchange the

basic health insurance benefit plan.

(2)  May publish on the Health Insurance Exchange any

other health insurance benefit plans that it offers in the

individual market.

(d)  Posting on exchange.--A health insurer who posts a

health insurance benefit plan on the Health Insurance Exchange:

(1)  Shall comply with the provisions of this section for

every health insurance benefit plan it posts on the Health

Insurance Exchange.

(2)  Shall not offer products on the Health Insurance

Exchange that are not health insurance benefit plans.

(e)  Description of benefits.--Each health insurance benefit

plan offered through the Health Insurance Exchange shall contain

a detailed description of benefits offered, and shall be

compliant with the Federal act.

(f)  Plan contracts.--Commencing January 1, 2014, a health

insurer shall, with respect to plan contracts that cover

hospital, medical or surgical expenses benefits, only sell the

five levels of coverage contained in section 1302(d) and (e) of

the Federal act, except that a health insurer that does not

participate in the Health Insurance Exchange shall, with respect

to plan contracts that cover hospital, medical or surgical

benefits, only sell the four levels of coverage contained in

section 1302(d) of the Federal act.

(g)  Information disclosure.--A health insurer shall provide

the Health Insurance Exchange with the following information for

each health insurance benefit plan submitted to the Health

Insurance Exchange:

(1)  Plan design, benefits and options offered by the

health insurance benefit plan.

(2)  Provider networks.

(3)  Wellness programs and incentives.

(4)  Descriptions of prescription drug benefits,

exclusions or limitations.

(h)  Prohibition.--Only health insurance benefit plans

offered by a health insurer that has been authorized by the

Insurance Commissioner may be offered to residents of this

Commonwealth.

(i)  Submission of information.--A health insurer offering a

health insurance benefit plan in this Commonwealth shall submit

the information described in subsection (g)(2) to the department

in the electronic format required by section 3(e).

(j)  Additional submissions.--A health insurer who offers a

health insurance benefit plan in this Commonwealth shall submit

to the Health Insurance Exchange the following operational

measures:

(1)  The percentage of claims paid by the health insurer

within 30 days of the date a claim is submitted to the

insurer for the prior year.

(2)  For the health insurance benefit plans offered by

the insurer in this Commonwealth, the number of insurer's

denied health claims.

(3)  The cost of denied claims transferred to providers.

(4)  The average out-of-pocket expenses incurred by

participants in each health benefit plan offered by an

insurer in the Health Insurance Exchange.

(5)  The relative efficiency and quality of claims

administration and other administrative processes for each

insurer offering plans in the Health Insurance Exchange.

(6)  Other information as the department shall require.

(k)  Forwarding of information.--The department shall forward

to the Health Insurance Exchange the information submitted by a

health insurer in accordance with this section.

(l)  Solvency rating.--The department shall post on the

Health Insurance Exchange the department's solvency rating for

each health insurer who posts a health benefit plan on the

Health Insurance Exchange. The solvency rating for each health

insurer shall be based on methodology established by the

department by regulation and shall be updated each calendar

year.

(m)  Request of information.--The department may request

information from an insurer to verify the data submitted to the

department and to the Health Insurance Exchange under this

section.

(n)  Applications.--A health insurer shall accept and process

an application for a health insurance benefit plan from the

Health Insurance Exchange in accordance with this section.

(o)  Discrimination prohibited.--No health insurance benefit

plan shall be offered through the Health Insurance Exchange that

excludes an individual from coverage because of race, color,

religion, national origin, sex or other reason that is

prohibited by the act of July 22, 1974 (P.L.589, No.205), known

as the Unfair Insurance Practices Act.

Section 7.  Additional charges.

(a)  Surcharge.--The authority is authorized to apply a

surcharge to health insurance benefit plans which shall be used

only to pay for administrative and operational expenses of the

Health Insurance Exchange, provided, however, that the surcharge

shall be applied uniformly to health insurance benefit plans

offered through the Health Insurance Exchange. The surcharge

shall not be used to pay premium assistance payments under a

Commonwealth health care insurance program.

(b)  Fees.--Fees charged by health insurers to an enrollee

for a uniform application form or electronic submission of the

application form shall be subject to review and approval by the

department. Insurers may use fees filed with the department, but

not acted upon by the department 30 days after filing.

Section 8.  Confidentiality.

Information collected by or on behalf of the Health Insurance

Exchange and information maintained by the Health Insurance

Exchange shall be confidential and privileged and shall not be

subject to subpoena, discovery or the act of February 14, 2008

(P.L.6, No.3), known as the Right-to-Know Law or 65 Pa.C.S. Ch.

7 (relating to open meetings).

Section 9.  Reporting requirements.

The authority shall, by no later than January 30 of each

year, submit annually to the chairman and minority chairman of

the Banking and Insurance Committee of the Senate and the

chairman and minority chairman of the Insurance Committee of the

House of Representatives a report that provides the statement of

operations for the previous calendar year's expenses including

the expenditures under this act.

Section 10.  Implementation.

This act shall be implemented consistent with the American

Health Benefit Exchange under the Federal act.

Section 19.  Applicability.

This act shall apply to health insurance benefit plans

providing coverage on or after January 1, 2014.

Section 20.  Effective date.

This act shall take effect in 180 days.