PRIORH0470B0455A05215 PRINTER'SSFR:EJH 04/22/20 #90 A05215 AMENDMENTS TO HOUSE BILL NO.

455470 PRINTER'SSponsor: NO.

3615REPRESENTATIVE THEGROVE GENERALPrinter's ASSEMBLY OF PENNSYLVANIA HOUSE BILL Session of 2019 No.

INTRODUCED455 BYAmend FRANKEL,Bill, DeLUCA,page RAVENSTAHL,1, KORTZ,line DONATUCCI,13, PASHINSKI,by STURLA,inserting MADDEN,after SAPPEY,"benefits" MARKOSEK,and MULLINS,for SANCHEZ,coverage BRIGGS,for ZABEL,General WILLIAMS,Assembly DELLOSOand ANDother MALAGARI,Commonwealth FEBRUARYemployees 11,Amend 2019Bill, ASpage AMENDED,1, COMMITTEElines ON17 INSURANCE,and HOUSE18, OFby REPRESENTATIVES,striking APRILout 27,"a 2020section" ANand ACTinserting Amendingsections theAmend actBill, ofpage May4, 17,line 19219, (P.L.682,by No.284),striking entitledout "Anall actof relatingsaid toline insurance;and inserting Section 635.9.

amending,Coverage revising,for andGeneral consolidatingAssembly theand lawOther providingCommonwealth forEmployes.--No thelater incorporationthan ofJuly insurance1, companies,2020, andor the regulation,conclusion supervision,of andthe protectioncontract offor homehealth andinsurance foreigncoverage insurancethat companies,was Lloydsin associations,effect reciprocalon andthe inter-insuranceeffective exchanges,date andof firethis insurancesection, ratingwhichever bureaus,occurs andlater, the regulationfollowing andshall supervisiononly ofparticipate insurancein carriedhealth byinsurance suchcoverage companies,under the StatePatient Workmen'sProtection Insuranceand Fund;Affordable Care Act (Public Law 111-148, 124 Stat.

providing119) penalties;or its successor:

and(1) repealingAll existingmembers, laws,"officers in casualty insurance, providing for prohibition on lifetime and annualemployes limitsof onthe essentialSenate healthor benefitsthe ANDHouse FORof COVERAGERepresentatives. FOR GENERAL ASSEMBLY AND <-- OTHER COMMONWEALTH EMPLOYEES.

The(2) GeneralAll Assemblyemployes of the CommonwealthGovernor's ofOffice. Pennsylvania hereby enacts as follows:

Section(3) 1.All employes of a department, agency, office, authority, board or commission of the Commonwealth that is subject to the policy supervision and control of the Governor.

The(4) actAll employes of Maythe 17,Office 1921of (P.L.682,Lieutenant No.284),Governor, knownthe asOffice The Insurance Company Law of 1921,Attorney isGeneral, amendedthe byDepartment addingof aAuditor <--General sectionor SECTIONSthe toTreasury read:Department.

<--(5) SectionAll 635.8.employes of a board or commission of an entity specified in paragraph (4).

Prohibition(6) onAll Lifetimeemployes andof Annuala Limitsdepartment, onagency, Essentialoffice, Healthauthority, Benefits.--(a)board A health insurance policy offered, issued or renewedcommission inof thisthe Commonwealth shallthat is not establishsubject ato lifetimethe limitpolicy orsupervision annualand limitcontrol of the dollarGovernor. amount on essential health benefits for an individual.

(b) Notwithstanding any other provision of law, the provisions of this section providing greater protections to individuals insured under a health insurance policy shall be construed to supersede any law relating to a requirement of the Patient Protection and Affordable Care Act (Public Law 111-148, 124 Stat.

119), except to the extent this section prevents the application of a requirement of the Patient Protection and Affordable Care Act.

(c) This act shall apply as follows:

(1) For health insurance policies for which either rates or forms are required to be filed with the Insurance Department or the Federal Government, this act shall apply to any policy for which a form or rate is first filed on or after the effective date of this section.

(2) For health insurance policies for which neither rates nor forms are required to be filed with the Insurance Department or the Federal Government, this act shall apply to any policy issued or renewed on or after one hundred eighty days after the effective date of this section.

(d) The Insurance Department may promulgate regulations necessary for the implementation and administration of this section.

(e) As used in this section, the following words and phrases shall have the meanings given to them in this subsection unless the context clearly indicates otherwise:

"Essential health benefits." Health care services and benefits in the following categories:

(1) Ambulatory patient services.

20190HB0470PN3615 - 2 - (2) Emergency services.

(3) Hospitalization.

(4) Maternity and newborn health care.

(5) Mental health and substance use disorder services, including, but not limited to, behavioral health treatment.

(6) Prescription drugs.

(7) Rehabilitative and habilitative services and devices.

(8) Laboratory services.

(9) Preventive and wellness services and chronic disease management.

(10) Pediatric services, including, but not limited to, oral and vision care.

"Health insurance policy." A policy, subscriber contract, certificate or plan issued by an insurer that provides medical or health care coverage.

The term does not include any of the following policies:

(1) Accident only.

(2) Credit only.

(3) Long-term care or disability income.

(4) Specified disease.

(5) Medicare supplement.

(6) Tricare, including a Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) supplement.

(7) Fixed indemnity.

(8) Dental only.