(a) General rule.--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.
1996 Partial Repeal. Section 14 of Act 159 of 1996, known as the Accident and Health Filing Reform Act, provided that subsec. (a) is repealed insofar as it provides for the approval of rates and contracts.
References in Text. Section 14 of Act 159 of 1996, known as the Accident and Health Filing Reform Act, was renumbered 5101 by the act of December 22, 2011, P.L.614, No.134.
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