H1664B3287A05064 SFR:EJH 06/21/24 #90 A05064
AMENDMENTS TO HOUSE BILL NO. 1664
Sponsor: SENATOR DiSANTO
Printer's No. 3287
Amend Bill, page 2, line 9, by striking out "dental" and
inserting
health
Amend Bill, page 2, line 11, by striking out "dental" and
inserting
health care
Amend Bill, page 2, line 11, by striking out "dentist" and
inserting
health care provider
Amend Bill, page 2, line 12, by striking out "dentist" and
inserting
health care provider
Amend Bill, page 2, line 15, by striking out "dentist" and
inserting
health care provider
Amend Bill, page 2, lines 22 and 23, by striking out
"benefits plan " and inserting
insurance policy
Amend Bill, page 7, line 3, by inserting after "PHARMACIST"
, dentist
Amend Bill, page 7, line 16, by striking out "AN" and
inserting
a health
Amend Bill, page 9, line 1, by striking out "DENTIST OR"
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Amend Bill, page 9, line 5, by striking out "DENTIST OR"
Amend Bill, page 11, lines 5 through 30; pages 12 through 21,
lines 1 through 30; page 22, lines 1 through 11; by striking out
all of said lines on said pages and inserting
CHAPTER 49
ELECTRONIC NOTICE OF INSURANCE PRACTICES
Sec.
49 01. Scope of chapter.
49 02. Definitions.
49 03. Electronic delivery of insurance notices or documents.
49 04. Changes in hardware or software requirements.
49 05. Affect, validity and enforceability of insurance notices
or documents.
49 06. Rescission of delivery by electronic means.
49 07. Prior consent for electronic delivery of insurance
notices or documents.
49 08. Alternative methods of delivery.
49 09. Limitation on civil liability.
49 10. Delivery of insurance policies and endorsements.
49 11. Construction.
4912. Regulations.
4913. Violations.
§ 49 01. Scope of chapter.
This chapter relates to electronic notice of insurance
practices.
§ 49 02. Definitions.
The following words and phrases when used in this chapter
shall have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Covered person." An individual who is entitled to receive
health care services under a health benefit plan.
"Deliver by electronic means." Any of the following:
(1) The delivery to an email address at which a covered
person has consented to receive a notice or document from an
insurer.
(2) A post on an electronic network or website
accessible via the Internet, mobile device or application,
tablet or any other electronic device, administered by an
insurer, including a separate notice of the post by delivery
to an email address at which a covered person has consented
to receive a notice or document or by any other delivery
method that has been consented by the covered person, which
contains the Internet address at which the notice or document
is posted. For purposes of this definition, delivery shall be
effective upon the post or actual delivery of the separate
notice of the post as specified under this paragraph.
"ERISA." Employee Retirement Income Security Act of 1974
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(Public Law 93-406, 88 Stat. 829).
"Health benefit plan." A policy, contract, certificate or
agreement entered into, offered by or issued by an insurer to
provide, deliver or arrange for, pay for or reimburse any of the
costs of health care services, including a vision or dental
benefit plan or a self-insured plan not subject to ERISA.
"Health insurer." An entity licensed by the department with
authority to issue a health benefit plan that is 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, including section 630 and
Article XXIV.
(2) The act of December 29, 1972 (P.L.1701, No.364),
known as the Health Maintenance Organization Act.
(3) Chapter 61 (relating to hospital plan corporations).
(4) Chapter 63 (relating to professional health services
plan corporations).
"Plan sponsor." A person or entity that establishes, adopts
or maintains a health benefit plan on behalf of a covered
person.
§ 49 03. Electronic delivery of insurance notices or documents.
(a) Transactions.--Subject to the requirements of this
section, an insurer may deliver by electronic means a notice to
a covered person or any document required by Federal or State
law in a transaction with the insurer that serves as evidence of
insurance coverage in accordance with the act of December 16,
1999 (P.L.971, No.69), known as the Electronic Transactions Act.
(b) Effect of delivery.--The delivery of a notice or
document in accordance with this section shall be considered the
equivalent to and having the same effect as a delivery method
required by Federal or State law, including delivery by first
class mail, first class mail with postage prepaid, certified
mail, certificate of mail or certificate mailing.
(c) Consent from covered persons.--Notwithstanding
subsection (d), an insurer may deliver by electronic means a
notice or document to a covered person in accordance with this
section if all of the following apply:
(1) The covered person has affirmatively consented
electronically or confirmed consent electronically in a
manner that reasonably demonstrates that the covered person
can access information in the electronic form that will be
used for a notice or document delivered by electronic means,
and the covered person has not withdrawn the consent.
(2) Before the covered person gives the consent required
under paragraph (1), the insurer provides the covered person
with a clear and conspicuous statement informing the covered
person of all of the following:
(i) The hardware and software requirements for
access to and retention of a notice or document delivered
by electronic means.
(ii) The types of notices and documents for which
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the covered person may consent to receive by delivery by
electronic means.
(iii) The right of the covered person to withdraw
consent to having a notice or document delivered by
electronic means at any time and the conditions or
consequences imposed in the event consent is withdrawn.
(iv) The procedures necessary for the covered person
to withdraw consent to having a notice or document
delivered by electronic means, which shall be no more
burdensome than the procedures required to provide
consent under paragraph (1), and the manner in which the
covered person can update the covered person's email
address for the purposes of this subsection.
(v) The right of a covered person to have a notice
or document delivered by the insurer upon request in
paper form.
(vi) The right of a covered person to request that
personal health information be treated and communicated
confidentially and the process by which a covered person
may receive confidential communication of personal health
information delivered by electronic means.
(d) Consent from plan sponsors.--A plan sponsor may, on
behalf of each covered person, provide consent to the delivery
by electronic means of communications related to the plan from
an insurer.
(e) Duties of plan sponsors.--Before consenting on behalf of
a covered person under subsection (d), a plan sponsor shall have
the following duties:
(1) To the extent applicable, confirm that the covered
person routinely uses electronic communications and is able
to access and retain electronic communications that may be
delivered by an insurer to an email address used by a covered
person.
(2) Inform the covered person no less than 30 days prior
that consent will be provided as authorized under subsection
(d) and a notice or document related to the health benefit
plan may be delivered by electronic means unless the covered
person affirmatively opts out of delivery by electronic means
prior to the expiration of the 30-day period.
(f) Duties of insurers for health benefit plans.--At least
30 days before providing delivery by electronic means of a
notice or document related to a health benefit plan, an insurer
for the plan shall have the following duties:
(1) Verify that the plan sponsor has met its duties
under subsection (e).
(2) Provide a clear and conspicuous statement informing
a covered person enrolled in the plan of all of the
following:
(i) The types of notices and documents that may be
delivered by electronic means to the covered person.
(ii) T he right of the covered person to opt out of
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having a notice or document delivered by electronic means
at any time without charge.
(iii) The procedures necessary for the covered
person to opt out of having a notice or document
delivered by electronic means and the manner in which the
covered person can update the covered person's email
address for the purposes of this subsection.
(iv) The right of the covered person to have a
notice or document delivered by the insurer upon request
in paper form without charge.
(v) The right of a covered person to request that
personal health information be treated and communicated
confidentially and the process by which a covered person
may receive the confidential communication of personal
health information delivered by electronic means.
(2) Provide an opportunity for a covered person enrolled
in the plan to opt out of delivery by electronic means.
(3) Comply with the applicable provisions of this
chapter, the Electronic Transactions Act, 45 CFR 164.530(c)
(relating to administrative requirements) and other
applicable provisions of Federal law regarding technical
safeguards such as encryption.
§ 49 04. Changes in hardware or software requirements.
After a covered person or plan sponsor provides consent in
accordance with section 49 03 (relating to electronic delivery of
insurance notices or documents ), if a change in the hardware or
software requirements necessary to access or retain a notice or
document to be delivered by electronic means creates a material
risk such that the covered person will not be able to access or
retain the notice or document for which the consent applies, an
insurer may not deliver by electronic means a notice or document
to the covered person unless the insurer complies with the
requirements of section 49 03 and provides the covered person
with a statement that describes all of the following:
(1) The revised hardware and software requirements for
access to and retention of a document delivered by electronic
means.
(2) The right of the covered person to opt out of
delivery by electronic means without the imposition of a
condition or consequence that was not disclosed at the time
of initial consent.
§ 49 05. Affect, validity and enforceability of insurance
notices or documents.
(a) Content of notices or documents.--Nothing in this
chapter shall be construed to affect requirements related to
content of an insurance notice or document or the timing related
to the notice or document required under any other provision of
Federal or State law.
(b) Confirmation receipts.--If any other applicable Federal
or State law requires confirmation of the receipt of a notice or
document from a covered person or plan sponsor of a health
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benefit plan, an insurer shall only deliver by electronic means
a notice or document if the method for delivery provides for an
active confirmation receipt by the covered person or plan
sponsor.
(c) Prior consent.--This chapter shall not apply to a notice
or document delivered by electronic means by an insurer before
the effective date of this subsection to a covered person who,
prior to the effective date of this subsection, provided consent
to the insurer to receive a notice or document delivered by
electronic means from the insurer.
(d) Validity or enforceability.--The validity or
enforceability of a contract or policy of an insurer executed by
a covered person shall not be denied solely because of the
failure of the insurer to obtain electronic consent or
confirmation of consent of the covered person in accordance with
this chapter if the notice or document is delivered in paper
form.
§ 49 06. Rescission of delivery by electronic means.
(a) Procedures.--No later than 30 days after the effective
date of this subsection, an insurer shall develop procedures by
which a covered person may opt out of delivery by electronic
means.
(b) Legality.--The decision by a covered person to opt out
of delivery by electronic means shall not affect the legality or
enforceability of a notice or document delivered by electronic
means to the covered person before the decision takes effect.
(c) Effect.--The decision by a covered person to opt out of
delivery by electronic means shall take effect no later than 30
days after the insurer receives notice of the covered person's
decision.
§ 49 07. Prior consent for electronic delivery of insurance
notices or documents.
If an insurer has a documented record from a covered person
indicating approval by the covered person for a notice or
document to be delivered by electronic means from the insurer
before the effective date of this section and the insurer
intends to deliver by electronic means an additional notice or
document under this chapter, prior to providing the additional
notice or document for delivery by electronic means, the insurer
shall comply with sections 49 03 (relating to electronic delivery
of insurance notices or documents) and 49 04 (relating to changes
in hardware or software requirements) and provide the covered
person with a statement that describes the following:
(1) A list of each notice or document that will be
delivered by electronic means that was not previously
delivered by electronic means.
(2) The covered person 's right to opt out of delivery by
electronic means without imposition of a condition or
consequence that was not previously disclosed to the covered
person .
§ 49 08. Alternative methods of delivery.
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(a) Alternative methods.--An insurer shall deliver a notice
or document to a covered person by any other method that was
authorized by Federal or State law before the effective date of
this subsection other than delivery by electronic means if
either of the following occurs:
(1) The insurer attempts to deliver the notice or
document by electronic means and has a reasonable basis for
believing that the notice or document has not been received
by the covered person .
(2) The insurer becomes aware that the email address
provided by the covered person to the insurer is no longer
valid.
(b) Confidentiality.--Nothing in this chapter shall be
construed to preclude the ability of a covered person to request
confidential communication of the covered person 's protected
health information as permitted by the Health Insurance
Portability and Accountability Act of 1996 (Public Law 104-191,
110 Stat. 1936).
(c) Construction.--Nothing in this chapter shall be
construed to preclude the ability of an insurer to deliver a
notice or document to a covered person by any method authorized
by Federal or State law.
§ 49 09. Limitation on civil liability.
An insurer or plan sponsor shall not be civilly liable under
this chapter.
§ 49 10. Delivery of insurance policies and endorsements.
(a) Authorization.--An insurer may mail, deliver or, if the
plan sponsor obtains a separate specific consent, post on the
insurer's publicly accessible Internet website an insurance
policy and endorsement that does not contain any personally
identifiable information.
(b) Internet website posting requirements.--If an insurer
elects to post an insurance policy and endorsement on the
insurer's publicly accessible Internet website, in lieu of
mailing or delivering the policy and endorsement to the insured,
the insurer shall have the following duties:
(1) The insurer shall ensure that the policy and
endorsement are accessible to the plan sponsor and producer
of record and remains accessible while the policy is in
effect.
(2) After the expiration of the policy, the insurer
shall do one of the following:
(i) Make the expired policy and endorsement
available upon request for a period of no less than five
years.
(ii) If the insurer continues to make the expired
policy or endorsement available on the insurer's publicly
accessible Internet website, keep the plan sponsor's user
identification active for a period of not less than five
years.
(c) Printable format.--If an insurer elects to post an
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insurance policy and endorsement on the insurer's publicly
accessible Internet website in lieu of mailing or delivering the
policy and endorsement to the covered person , the insurer shall
post the policy and endorsement in a manner that enables the
plan sponsor and producer of record to print and save the policy
and endorsement using a program or application that is widely
available on the Internet and free to use.
(d) Description.--The insurer shall provide the following
information to the plan sponsor in or simultaneous with each
declaration page provided at the time of issuance of an initial
insurance policy and each renewal of the policy:
(1) A description of the exact policy and endorsement
form purchased by the plan sponsor.
(2) A description of the plan sponsor's right to receive
upon request and without charge an electronic or paper copy
of the policy and endorsement.
(3) The publicly accessible Internet website at which
the policy and endorsement are posted by the insurer.
(e) Paper copies.--Upon request by the plan sponsor , the
insurer shall mail a paper copy of the plan sponsor's insurance
policy and endorsement. The insurer shall mail the first paper
copy of the insurance policy and endorsement to the plan sponsor
without charge, but may impose a fee on each subsequent request
for a paper copy.
§ 4911. Construction.
(a) Applicability.--Nothing in this chapter shall apply to
self-insured health benefit plans subject to ERISA or exempted
from ERISA under section 4(b) of ERISA.
(b) Content and timing of notices.--Nothing in this chapter
shall be construed to affect or change the time or content of a
disclosure or document required to be provided to a plan sponsor
under Federal or State law.
§ 4912. Regulations.
The department may promulgate any necessary or appropriate
regulations to effectuate this chapter.
§ 4913. Violations.
Failure to comply with the requirements of this chapter shall
be deemed an unfair insurance practice under the act of July 22,
1974 (P.L.589, No.205), known as the Unfair Insurance Practices
Act.
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