§ 6326. Specifically authorized contract provisions. A professional health service corporation may, as a condition precedent to entering into a contract with an applicant or group of applicants for professional health service, require any of the following:
(1) A physical examination of the applicant and of each of his dependents, if any, and proof of his or their substantial freedom from any disease or condition requiring immediate professional health service or likely to require it within the next 12 months, before a contract becomes effective.
(2) A waiting period after a contract is entered into and before the subscriber is entitled to professional health service.
(3) An agreement that the subscriber or someone on his behalf shall pay the stated fee or fees for professional health services in the case of any given illness or injury or other condition requiring professional health service, before becoming entitled to treatment under the terms of the contract.
(4) An agreement that, as a condition precedent to payment by the corporation for professional health services performed for the subscriber, the subscriber or someone on his behalf will submit to the corporation such information as is reasonably necessary to enable it to determine the amount of such payment, which information shall be submitted in the form and verified in the manner prescribed by the corporation.
(5) An agreement that any rights of the subscriber to receive services or payments under his contract with the corporation are personal to the subscriber and may not be assigned.
Structure Pennsylvania Consolidated & Unconsolidated Statutes
Pennsylvania Consolidated & Unconsolidated Statutes
Chapter 63 - Professional Health Services Plan Corporations
Section 6301 - Application of chapter
Section 6303 - Statement of legislative findings and policy
Section 6304 - Certification of professional health service corporations
Section 6305 - Initial reserves
Section 6306 - Standards concerning incorporators
Section 6307 - Exemptions applicable to certificated professional health service corporations
Section 6308 - Uncertificated plans prohibited
Section 6321 - Required reserves
Section 6322 - Scope of service
Section 6323 - Action as agent under Federal and other programs
Section 6324 - Rights of health service doctors
Section 6325 - Income status; effect
Section 6326 - Specifically authorized contract provisions
Section 6327 - Subscriptions provided for persons on relief
Section 6328 - Board of directors
Section 6329 - Rates and contracts
Section 6330 - Investment of funds
Section 6331 - Reports and examinations
Section 6332 - Regulation by Department of Health
Section 6333 - Dental service agents