Deregulation of Accident and Health Forms [27 Pa.B. 3118] The Insurance Commissioner hereby deregulates certain group accident and health, blanket accident and sickness, and blanket student accident and sickness forms, as set forth in Annex A. This deregulation applies to forms offered by Hospital Plan Corporations operating under 40 Pa.C.S. Ch. 61 and Professional Health Services Plan Corporations operating under 40 Pa.C.S. Ch. 63. This deregulation is authorized by sections 3(A) and 3(B) of the Accident and Health Filing Reform Act, Act 159 of 1996.
Statutory Authority
Section 3(A) of Act 159, the Accident and Health Filing Reform Act, requires that insurers, including Hospital Plan Corporations and Professional Health Services Plan Corporations, file policy forms with the Insurance Department, except those which, in the opinion of the Commissioner, do not require filing. Section 3(B) of Act 159 expressly authorizes and describes the method for the Commissioner to exempt forms from the filing process. In accordance with that authority, the Commissioner hereby exempts from filing the forms for the lines of business listed in Annex A.
Insurers Eligible for Exemption
This deregulation applies only to the following entities that offer group accident and health policies, blanket accident and health policies, and blanket student accident and health policies:
A Hospital Plan Corporation, organized and operating under 40 Pa.C.S. Ch. 61.
A Professional Health Services Plan Corporation, organized and operating under 40 Pa.C.S. Ch. 63.
Forms Which are Not Deregulated
The Commissioner's action extends to certain types of group accident and health, blanket accident and health, and blanket student accident and health policy forms used by Hospital Plan Corporations and Professional Health Services Plan Corporations. Individual policy forms offered by Hospital Plan Corporations and Professional Health Services Plan Corporations are not deregulated hereunder.
Provider Agreements required to be filed in accordance with section 9 of Act 159 of 1996, are not exempted from filing by this notice.
Group Long Term Care policy forms as defined in Article XI of The Insurance Company Law of 1921 (40 P. S. § 991.1101 et seq.) and 31 Pa. Code Chapter 89, are not exempted from filing by this notice.
Group Medicare Supplement policies as defined in the Medicare Supplement Insurance Act (40 P. S. § 3101 et seq.) and 31 Pa. Code Chapter 89, are not exempted from filing by this notice.
This deregulation shall not apply to any filing required by the Department of Health.
Group accident and health, blanket accident and health, and blanket student accident and health forms issued by commercial insurance companies, health maintenance organization (HMOs) and preferred provider organizations (PPOs) are not deregulated hereunder. Such forms issued by these types of insurers were previously deregulated. See 25 Pa.B. 1453 (March 30, 1996) and 27 Pa.B. 1893 (April 12, 1997). With this deregulation notice, all types of insurers are now treated consistently with respect to the forms which are exempt from filing with the Department.
Continuing Authority of the Commissioner
Notwithstanding the deregulation of forms as specified herein, the Commissioner will retain complete authority to request and be provided a copy of any form being issued in this Commonwealth, as provided by section 10 of Act 159 of 1996.
Under section 3(B) of Act 159 of 1996, the Commissioner will retain complete authority to reassume regulatory authority over the types of forms deregulated hereunder at the Commissioner's discretion. Notice of intent to resume regulatory authority shall be published in the Pennsylvania Bulletin.
All forms, including those regulated herein, must continue to comply with applicable Pennsylvania law including, but not limited to:
Childhood Immunization Insurance, Act 35 of 1992, (40 P. S. §§ 3501 et seq.)
Coverage for Mammographic Examinations (40 P. S. § 764c) Women's Preventative Health Services Act (40 P. S. §§ 1571 et seq.)
Effective Date
This deregulation action is effective as of July 1, 1997.
Questions
Questions concerning this notice may be directed to Gregory Martino, Deputy Insurance Commissioner, Office of Rate and Policy Regulation, 1311 Strawberry Square, Harrisburg, PA 17120, (717) 783- 5079.
Annex A Insurance Department Deregulated Hospital Plan Corporation and Professional Health Services Plan Corporation Forms The Insurance Commissioner, by this notice, hereby deregulates the following lines of business written by Hospital Plan Corporations and Professional Health Services Plan Corporations, under the authority of sections 3(A) and 3(B) of Act 159 of 1996, effective July 1, 1997.
1). Group accident and health policy forms.
2). Blanket accident and sickness policy forms, as defined in section 621.3 of The Insurance Company Law of 1921 (40 P. S. § 756.3) and 31 Pa. Code Chapter 89.
3). Blanket student accident and sickness policy forms as defined in section 621.3 of The Insurance Company Law of 1921 (40 P. S. § 756.3) and 31 Pa. Code Chapter 89.
4). Group dental and vision policy forms as defined in section 621.2 of The Insurance Company Law of 1921 (40 P. S. § 756.2) and 31 Pa. Code Chapter 89.
5). Franchise accident and health policy forms as defined in section 621.4 of The Insurance Company Law of 1921 (40 P. S. § 756.4) and 31 Pa. Code Chapter 89.
6). For the purpose of this notice, forms include, but are not limited to the following: policies, contracts, certificates, riders, agreements, evidences of coverage, applications, endorsements, enrollee literature and advertising material.
LINDA S. KAISER,
Insurance Commissioner[Pa.B. Doc. No. 97-1051. Filed for public inspection June 27, 1997, 9:00 a.m.]
