Pennsylvania Consolidated & Unconsolidated Statutes
Title 40 - INSURANCE

Section 3507 - Rights of subscribers whose policies are issued after adoption of plan and before effective date - (a) Notice.--A subscriber shall be sent a written notice regarding...

Section 3508 - Corporate existence - On the effective date of the conversion, the corporate existence...

Section 3509 - Conflict of interest - (a) Compensation.--A director, officer, agent or employee of the attorney...

Section 3510 - Failure to give notice - If the reciprocal insurer complies substantially and in good faith...

Section 3511 - Limitation on actions - An action challenging the validity of or arising out of...

Section 3512 - Reciprocal insurer insolvent or in hazardous financial condition - (a) Waiver of requirements.--If a reciprocal insurer seeking to convert...

Section 3513 - Rules and regulations - The commissioner may promulgate rules and regulations to administer and...

Section 3514 - Laws applicable to stock company - (a) Control of stock company.--A reciprocal insurer may not convert...

Section 3515 - Licensing of stock company and commencement of business as an insurance company - The commissioner may waive the minimum surplus requirement of a...

Section 3516 - Amendment of policies - By endorsement or rider approved by the commissioner and sent...

Section 3517 - Prohibition on acquisition of control - Except as otherwise specifically provided in section 3503 (relating to...

Chapter 37 - Unclaimed Life Insurance Benefits

Extra - Chapter Notes - Enactment. Chapter 37 was added November 3, 2016, P.L.1043, No.132,...

Section 3701 - Purpose of chapter - The purpose of this chapter is to require the complete...

Section 3702 - Definitions - The following words and phrases when used in this chapter...

Section 3703 - Death master file comparison - (a) Comparison.--An insurer shall implement procedures for performing a comparison...

Section 3704 - Applicability - This chapter shall not apply to all of the following:...

Section 3705 - Enforcement - (a) Actions.--Upon a determination by hearing that an insurer has...

Section 3706 - Regulations - The commissioner may promulgate rules and regulations to administer the...

Chapter 38 - Retroactive Denial of Reimbursements

Extra - Chapter Notes - Enactment. Chapter 38 was added November 4, 2016, P.L.1144, No.146,...

Section 3801 - Scope of chapter - This chapter shall not apply to reimbursements made as part...

Section 3802 - Definitions - The following words and phrases when used in this chapter...

Section 3803 - Retroactive denial of reimbursement - (a) General rule.--Except as provided in section 3804 (relating to...

Section 3804 - Exceptions to retroactive denial of reimbursement - The provisions of section 3803 (relating to retroactive denial of...

Section 3805 - Coordination of benefits - If an insurer retroactively denies reimbursement for services as a...

Section 3806 - Tolling - An insurer may request medical or billing records in writing...

Chapter 39 - Corporate Governance Annual Disclosure

Extra - Chapter Notes - Enactment. Chapter 39 was added October 24, 2018, P.L.1182, No.163,...

Section 3901 - Purposes and scope of chapter - (a) Purposes.--The purposes of this chapter are to: (1) Provide...

Section 3902 - Definitions - The following words and phrases when used in this chapter...

Section 3903 - Submittal of CGAD - (a) General rule.-- (1) Beginning January 1, 2020, a domestic...

Section 3904 - Contents of CGAD - (a) Contents.--The CGAD must contain the material information necessary to...

Section 3905 - Review of CGAD - (a) Procedures for review.--The review of the CGAD and any...

Section 3906 - Third-party consultants - (a) Assistance with review.--The department may retain, at the insurer...

Section 3907 - Confidentiality - (a) General rule.--The CGAD-related information in the possession or control...

Section 3908 - Penalties - An insurer or insurance group that fails to timely file...

Section 3909 - Rules and regulations - The department may promulgate rules and regulations and issue orders...

Section 3910 - Construction - Nothing in this chapter shall be construed to prescribe or...

Section 3911 - Severability - (a) General rule.--Except as provided in subsection (b): (1) The...

Chapter 40 - Medication Sychronization

Extra - Chapter Notes - Enactment. Chapter 40 was added July 2, 2019, P.L.333, No.46,...

Section 4001 - Definitions - The following words and phrases when used in this chapter...

Section 4002 - Prorated daily cost-sharing rate - A health insurance policy shall permit and apply a prorated...

Section 4003 - Denial of coverage - (a) Partial supply.--A health insurance policy providing prescription drug coverage...

Section 4004 - Certain payment structures prohibited - (a) Prorated dispensing fees.--A health insurance plan providing prescription drug...

Section 4005 - Application of chapter - (a) Prescription drugs.--This chapter does not apply to prescription drugs...

Chapter 43 - Mental Health Parity and Access to Addiction Treatment

Extra - Chapter Notes - Enactment. Chapter 43 was added October 29, 2020, P.L.736, No.89,...

Section 4301 - Scope of chapter - This chapter relates to an attestation of compliance with Federal...

Section 4302 - Definitions - The following words and phrases when used in this chapter...

Section 4303 - Annual attestation - (a) Statement regarding MHPAEA compliance.--For the form for each health...

Section 4304 - Regulations - The department may promulgate regulations necessary to implement this chapter.

Chapter 61 - Hospital Plan Corporations

Extra - Chapter Notes - Enactment. Chapter 61 was added November 15, 1972, P.L.1063, No.271,...

Section 6101 - Definitions - The following words and phrases when used in this chapter...

Section 6102 - Certification of hospital plan corporations - § 6102. Certification of hospital plan corporations. (a) General rule.--A...

Section 6103 - Exemptions applicable to certified hospital plan corporations - § 6103. Exemptions applicable to certified hospital plan corporations. (a)...

Section 6104 - Uncertified plans prohibited - § 6104. Uncertified plans prohibited. It shall be unlawful for...

Section 6105 - Penalties - § 6105. Penalties. Any person who violates any of the...

Section 6121 - Eligible hospitals - Any hospital plan corporation may enter into contracts for the...

Section 6122 - Action as agent under Federal and other programs - § 6122. Action as agent under Federal and other programs....

Section 6123 - Investment of funds - § 6123. Investment of funds. Any statute to the contrary...

Section 6124 - Rates and contracts - (a) General rule.--The rates charged to subscribers by hospital plan...

Section 6125 - Reports and examinations - § 6125. Reports and examinations. (a) Annual report.--Every hospital plan...

Section 6126 - Solicitors and agents - § 6126. Solicitors and agents. Solicitors and agents for every...

Section 6127 - Dissolution or liquidation - § 6127. Dissolution or liquidation. No hospital plan corporation shall...

Chapter 63 - Professional Health Services Plan Corporations

Extra - Chapter Notes - Enactment. Chapter 63 was added November 15, 1972, P.L.1063, No.271,...

Section 6301 - Application of chapter - (a) General rule.--This chapter shall apply to every person engaged...

Section 6302 - Definitions - (a) General rule.--The following words and phrases when used in...

Section 6303 - Statement of legislative findings and policy - § 6303. Statement of legislative findings and policy. (a) Declaration...

Section 6304 - Certification of professional health service corporations - (a) General rule.--A corporation not-for-profit incorporated for the purpose of...

Section 6305 - Initial reserves - § 6305. Initial reserves. No professional health service corporation shall...

Section 6306 - Standards concerning incorporators - No certificate of authority shall be issued to a professional...

Section 6307 - Exemptions applicable to certificated professional health service corporations - § 6307. Exemptions applicable to certificated professional health service corporations....

Section 6308 - Uncertificated plans prohibited - (a) General rule.--It shall be unlawful for any person, other...

Section 6309 - Penalties - § 6309. Penalties. Any person who violates any provision of...

Section 6310 - Enforcement - § 6310. Enforcement. When necessary to effect the purposes of...

Section 6321 - Required reserves - § 6321. Required reserves. A professional health service corporation shall...

Section 6322 - Scope of service - § 6322. Scope of service. (a) Territory of service.--The certificate...

Section 6323 - Action as agent under Federal and other programs - § 6323. Action as agent under Federal and other programs....

Section 6324 - Rights of health service doctors - § 6324. Rights of health service doctors. (a) Admission to...

Section 6325 - Income status; effect - § 6325. Income status; effect. (a) Income standards.-- (1) Every...

Section 6326 - Specifically authorized contract provisions - § 6326. Specifically authorized contract provisions. A professional health service...

Section 6327 - Subscriptions provided for persons on relief - § 6327. Subscriptions provided for persons on relief. Every government...

Section 6328 - Board of directors - (a) Professional health service corporations generally.--The business of every professional...

Section 6329 - Rates and contracts - (a) General rule.--All rates charged subscribers or groups of subscribers...

Section 6330 - Investment of funds - § 6330. Investment of funds. Any statute to the contrary...

Section 6331 - Reports and examinations - § 6331. Reports and examinations. (a) Annual report.--Every professional health...

Section 6332 - Regulation by Department of Health - § 6332. Regulation by Department of Health. (a) Annual reports.--Every...

Section 6333 - Dental service agents - § 6333. Dental service agents. Any dental service corporation may...

Section 6334 - Dissolution or liquidation - § 6334. Dissolution or liquidation. No professional health service corporation...

Section 6335 - Ancillary health services - § 6335. Ancillary health services. Anything in this chapter to...

Chapter 65 - Fraternal Benefit Societies (Repealed) -

Chapter 67 - Beneficial Societies

Extra - Chapter Notes - Enactment. Chapter 67 was added November 15, 1972, P.L.1063, No.271,...

Section 6701 - Regulation - All beneficial societies or associations not subject to regulation under...

Chapter 71 - Reserve Liabilities

Extra - Chapter Notes - Enactment. Chapter 71 was added June 30, 2016, P.L.399, No.59,...

Section 7101 - Scope of chapter - This chapter relates to standards for the valuation of reserve...

Section 7102 - Definitions - The following words and phrases when used in this chapter...

Section 7103 - Special applicability provisions - The standards for the valuation of reserve liabilities for life...

Section 7104 - Notice regarding operative date of valuation manual - Upon the occurrence of the last occurring event under the...

Section 7105 - Regulations - The department may promulgate regulations, as necessary, to implement, administer...

Section 7111 - Reserve valuation for policies and contracts issued prior to operative date of valuation manual - (a) Applicability.--This section shall apply to each policy or contract...

Section 7112 - Reserve valuation for policies and contracts issued on or after operative date of valuation manual - (a) Applicability.--This section shall apply to each policy or contract...

Section 7113 - Actuarial opinion of reserves prior to operative date of valuation manual - (a) Applicability.--This section shall apply to an actuarial opinion prepared...

Section 7114 - Actuarial opinion of reserves on or after operative date of valuation manual - (a) Applicability.--This section shall apply to an actuarial opinion prepared...

Section 7115 - Computation of minimum standard - (a) Applicability.--This section shall govern the minimum standard for the...

Section 7116 - Computation of minimum standard for annuities - (a) Computation generally.--Except as provided in section 7117 (relating to...

Section 7117 - Computation of minimum standard by calendar year of issue - (a) Applicability.--The interest rates used in determining the minimum standard...

Section 7118 - Reserve valuation method for life insurance and endowment benefits - (a) Uniform insurance amount and premiums.--Except as otherwise provided in...

Section 7119 - Reserve valuation method for annuity and pure endowment benefits - (a) Applicability.--This section shall apply to all annuity and pure...

Section 7120 - Minimum reserves - (a) Amount calculated.--A company's aggregate reserves for all life insurance...

Section 7121 - Optional reserve calculation - (a) Issuance prior to May 17, 1921.--Reserves for policies and...

Section 7122 - Reserve calculation for valuation net premium exceeding gross premium charged - (a) Calculation of minimum reserve.--The following shall apply: (1) If...

Section 7123 - Reserve calculation for indeterminate premium plans - (a) Applicability.--This section shall apply to either of the following:...

Section 7124 - Minimum standard for accident and health insurance contracts - (a) Annual valuation of reserve liabilities.--On an annual basis as...

Section 7125 - Valuation manual for policies issued on or after operative date of valuation manual - (a) Standard in valuation manual.--Except as provided in subsection (c)...

Section 7126 - Requirements of principle-based valuation - (a) Characteristics of valuation.--For policies or contracts specified in the...

Section 7127 - Experience reporting for policies in force on or after operative date of valuation manual - A company shall submit to the commissioner, or the commissioner's...

Section 7131 - Confidential information defined - As used in this subchapter, the following words and phrases...

Section 7132 - General rule for confidential information - Except as otherwise provided in this subchapter, confidential information shall...

Section 7133 - Private civil actions - The commissioner, department or any person who receives documents, materials...

Section 7134 - Use of confidential information by department - To assist in the performance of its duties, the department...

Section 7135 - Agreements - The department may enter into agreements governing sharing and use...

Section 7136 - No waiver of privilege or confidentiality - (a) Sharing of information by department.--The sharing of confidential information...

Section 7137 - Limited exceptions - Notwithstanding section 7132 (relating to general rule for confidential information),...

Section 7141 - Single-state company exemption - (a) Requirements.--A company may file a written request with the...

Section 7142 - Small company exemption - (a) Requirements.--A company seeking an exemption for any of its...

Section 7151 - Effect on The Insurance Company Law of 1921 - (a) Fraternal benefit organizations.--The following shall apply: (1) Section 2451(b)...

Chapter 91 - Preliminary Provisions

Extra - Chapter Notes - Enactment. Chapter 91 was added July 2, 2019, P.L.294, No.42,...

Section 9101 - Scope of part - This part relates to health insurance markets oversight.

Section 9102 - Purpose and intent - The General Assembly finds and declares as follows: (1) The...

Section 9103 - Definitions - Subject to additional definitions contained in subsequent provisions of this...

Chapter 93 - State-based Exchange

Extra - Chapter Notes - Enactment. Chapter 93 was added July 2, 2019, P.L.294, No.42,...

Section 9301 - Scope of chapter - This chapter relates to the Pennsylvania Health Insurance Exchange Authority.

Section 9302 - Pennsylvania Health Insurance Exchange Authority - (a) Establishment.--The Pennsylvania Health Insurance Exchange Authority is established as...

Section 9303 - Advisory council - (a) Establishment.--An advisory council is created to advise the exchange...

Section 9304 - Meetings and operation - (a) Chairperson.--The members of the advisory council shall annually elect...

Section 9305 - Powers and duties of exchange authority - (a) Corporate operations.--The exchange authority shall exercise all powers and...

Section 9306 - Limitations - Except as expressly provided in this chapter, nothing in this...

Section 9307 - Confidentiality and disclosure - (a) General rule.--Except as provided in this chapter, all working...

Section 9308 - Not an entitlement - Nothing in this chapter shall constitute an entitlement derived from...

Section 9309 - Nonliability - (a) General rule.--Except as provided under subsection (b), there shall...

Section 9310 - Audits - (a) Annual audit.--The accounts and books of the exchange authority...

Section 9311 - Reports - (a) Report.--The exchange authority shall prepare an annual report on...

Section 9312 - Exchange fund - (a) Establishment.--The Pennsylvania Health Insurance Exchange Fund is established as...

Section 9313 - Federal guidance - Until the exchange authority promulgates regulations, the exchange authority shall...

Section 9314 - Expiration - Upon publication of the notice under section 9703(b) (relating to...

Chapter 95 - Reinsurance Program

Extra - Chapter Notes - Enactment. Chapter 95 was added July 2, 2019, P.L.294, No.42,...

Section 9501 - Application - (a) Application.--The department is authorized to apply to the United...

Section 9502 - Implementation of waiver and establishment of reinsurance program - (a) Implementation.--Upon approval of the department's application for an innovation...

Section 9503 - Administration and operation of reinsurance program - (a) General rule.--The department shall take all actions necessary to...

Section 9504 - Reinsurance parameters - (a) Adoption of reinsurance terms.--The department shall, after consultation with...

Section 9505 - Insurer eligibility and duties - (a) Eligibility for payment.--An insurer shall be eligible for a...

Section 9506 - Payment of coverage and administrative costs - (a) General rule.--Consistent with Federal requirements, the department shall pay...

Section 9507 - Not an entitlement - (a) No entitlement.--The provision of reinsurance program money or benefits...

Section 9508 - Annual audit - (a) Annual audit.--The reinsurance program shall be examined and audited...

Section 9509 - Annual report of operations - (a) Report.--No later than November 1 of the year following...

Section 9510 - Reinsurance Fund - (a) Establishment and administration of Reinsurance Fund.--The Reinsurance Fund is...

Section 9511 - Procurements within one year - Notwithstanding any other provision of law and for the limited...

Section 9512 - Access to information and records - (a) Reports and access.--An insurer shall, without charge, report information...

Section 9513 - Confidentiality and information disclosure - (a) General rule.--Except as provided for in this section, all...

Section 9514 - Immunity - (a) General rule.--Except as provided in subsection (b), the department,...

Section 9515 - Regulation of insurers - Nothing in this chapter shall be construed to limit or...

Section 9516 - Expiration - Upon publication of the notice under section 9703(b) (relating to...

Chapter 97 - Miscellaneous Provisions

Extra - Chapter Notes - Enactment. Chapter 97 was added July 2, 2019, P.L.294, No.42,...

Section 9701 - Regulations - (a) Authority to promulgate.--The department and the exchange authority may...

Section 9702 - Enforcement - (a) General rule.--Upon satisfactory evidence of a violation of this...

Section 9703 - Action by commissioner - (a) Sunset.--This part shall sunset immediately if any of the...

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Pennsylvania Consolidated & Unconsolidated Statutes Title 40 - INSURANCE

Pennsylvania Consolidated & Unconsolidated Statutes
Title 40 - INSURANCE