HB 1828 — An Act amending Title 40 (Insurance) of the Pennsylvania Consolidated Statutes, providing for immunization coverage; and imposing penalties.

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2247 THEPRINTER'S GENERALNO. ASSEMBLY OF PENNSYLVANIA HOUSE BILL Session of No.

2415 THE GENERAL ASSEMBLY OF PENNSYLVANIA HOUSE BILL Session of No.

WILLIAMS, WAXMAN, SIEGEL, MAYES, BELLMON, FRANKEL, STEELE, ISAACSON, SHUSTERMAN, BOYD, HADDOCK, HANBIDGEHANBIDGE, BOROWSKI, MUNROE, SALISBURY, OTTEN, MERSKI, KINKEAD, GREEN AND BOROWSKI,SCOTT, AUGUST 28, 2025 REFERREDAS TOREPORTED FROM COMMITTEE ON INSURANCE, AUGUSTHOUSE 28,OF REPRESENTATIVES, AS AMENDED, OCTOBER 7, 2025 AN ACT Amending Title 40 (Insurance) of the Pennsylvania Consolidated penalties.providingStatutes, providing for immunization coverage;

and imposing Thepenalties. General Assembly of the Commonwealth of Pennsylvania hereby enacts as follows:

The General Assembly of the Commonwealth of Pennsylvania hereby enacts as follows:

The term includes vaccines or other immunizing agents required to be 20250HB1828PN2415 - 2 - covered by an individual health insurance policy approved to be 20250HB1828PN2247 - 2 - offered or issued in this Commonwealth on January 1, 2025.

An insurer offering, issuing or renewing a health insurance policy, other than a grandfathered health care plan, shall <-- provide coverage and may not impose any cost-sharing requirements for an immunization to an enrollee.

THE <-- REQUIREMENTS OF THIS SECTION SHALL NOT APPLY TO A GRANDFATHERED HEALTH CARE PLAN.

(a) Authority of department.--The department maymay, IN <-- CONSULTATION WITH THE DEPARTMENT OF HEALTH, add or except an immunization from the coverage requirement if the Department of Health makes a determination consistent with the requirements of this section.

(b) Additions to coverage requirement.--The department may add an immunization to the coverage requirement and establish the manner and frequency of the administration in consultation <-- with the Department of Health, following BASED ON a <-- determination by the Department of Health in accordance with the following:

20250HB1828PN2415 - 3 - (A) Immunization of certain populations is supported by medical evidence.

20250HB1828PN2247 - 3 - (2) In making a determination under paragraph (1)(ii), the Department of Health may consider a report from any of the following entities as evidence to support a determination:

(c) Exceptions from coverage requirement.-- (1) The department may except an immunization from the coverage requirement following a determination by the Department of Health that the immunization is:is NO LONGER:

<-- (i) No longer supported by medical evidence for <-- certain populations.populations.;

AND <-- (ii) No longer effective to reduce the spread or <-- severity of infectious diseases in this Commonwealth and thereby advance the public health.

(2) The Department of Health may consider a report from any of the entities identified under subsection (b)(2) (B) as <-- evidence to support a determination under paragraph (1).

(d) Notice requirement.--After A determination of the <-- Department of Health, the department shall provide notice of the 20250HB1828PN2415 - 4 - determination and addition or exception of an immunization from the coverage requirement by:

20250HB1828PN2247 - 4 - (2) Posting the notice on the department's publicly accessible Internet website.

(a) In general.--Nothing in this chapter shall be construed 20250HB1828PN2415 - 5 - to diminish any other law that limits cost-sharing for a health care service or to prohibit an insurer from:

(2) Denying coverage for immunizations not subject to 20250HB1828PN2247 - 5 - coverage under this chapter.

20250HB1828PN2415 - 6 - (c) Protections.--Nothing in this chapter shall require a health insurance policy to cover an immunization if the enrollee is exempt by the exercise of the enrollee's constitutional protections of religious freedom under the act of December 9, 2002 (P.L.1701, No.214), known as the Religious Freedom 20250HB1828PN2247 - 6 - Protection Act, or 42 U.S.C.

(1) The act of July 22, 1974 (P.L.589, No.205), known as 20250HB1828PN2415 - 7 - the Unfair Insurance Practices Act.

(2) The act of December 18, 1996 (P.L.1066, No.159), 20250HB1828PN2247 - 7 - known as the Accident and Health Filing Reform Act.

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