Title 40, INSURANCE

(a) Applicability.--This section shall apply to an actuarial opinion prepared prior to the operative date of the valuation manual. (b) Regulations regarding actuarial opinion.--Through regulations, the commissioner: (1) Shall define the specifics of the actuarial opinion under th…

(a) Applicability.--This section shall apply to an actuarial opinion prepared on or after the operative date of the valuation manual. (b) Compliance with valuation manual.--The actuarial opinion under this section must comply with the requirements set forth in the valuation manua…

(a) Applicability.--This section shall govern the minimum standard for the valuation of a company's policies and contracts except as provided in the following sections: (1) Section 7116 (relating to computation of minimum standard for annuities). (2) Section 7117 (relating to com…

(a) Computation generally.--Except as provided in section 7117 (relating to computation of minimum standard by calendar year of issue), the minimum standard of valuation for individual annuity and pure endowment contracts issued on or after the operative date of section 301(c)(1)…

(a) Applicability.--The interest rates used in determining the minimum standard for the valuation of the following shall be the calendar year statutory valuation interest rates as defined in this section: (1) Life insurance policies issued in a particular calendar year on or afte…

(a) Uniform insurance amount and premiums.--Except as otherwise provided in sections 7119 (relating to reserve valuation method for annuity and pure endowment benefits), 7122 (relating to reserve calculation for valuation net premium exceeding gross premium charged) and 7124 (rel…

(a) Applicability.--This section shall apply to all annuity and pure endowment contracts other than group annuity and pure endowment contracts purchased under a retirement plan or plan of deferred compensation, established or maintained by an employer, including a partnership or …

(a) Amount calculated.--A company's aggregate reserves for all life insurance policies, excluding disability and accidental death benefits, issued on or after May 17, 1921, shall not be less than the aggregate reserves calculated by using the mortality table or tables and rate or…

(a) Issuance prior to May 17, 1921.--Reserves for policies and contracts issued prior to May 17, 1921, may be calculated, at the option of the company, according to any standards that produce greater aggregate reserves for all these policies and contracts than the minimum reserve…

(a) Calculation of minimum reserve.--The following shall apply: (1) If in any contract year the gross premium charged by a company on a policy or contract is less than the valuation net premium for the policy or contract calculated by the method used in calculating the reserve bu…

(a) Applicability.--This section shall apply to either of the following: (1) A plan of life insurance that provides for future premium determination, the amounts of which are to be determined by the insurance company based on then estimates of future experience. (2) A plan of lif…

(a) Annual valuation of reserve liabilities.--On an annual basis as of the December 31 of the preceding year, the commissioner shall value or cause to be valued, or require the insurer to value or cause to be valued the reserve liabilities of each company doing business in this C…

(a) Standard in valuation manual.--Except as provided in subsection (c) or (e), for policies issued on or after the operative date of the valuation manual, the standard prescribed in the valuation manual shall be the minimum standard of valuation required under section 7112 (rela…

(a) Characteristics of valuation.--For policies or contracts specified in the valuation manual, a company shall establish reserves using a principle-based valuation that: (1) Quantifies benefits and guarantees and the funding associated with contracts and their risks at a level o…

A company shall submit to the commissioner, or the commissioner's designee or agent, mortality, morbidity, policyholder behavior or expense experience and other data as prescribed in the valuation manual. Cross References. Section 7127 is referred to in sections 7102, 7125 of thi…

As used in this subchapter, the following words and phrases shall have the meanings given to them in this section unless the context clearly indicates otherwise: "Confidential information." Any of the following: (1) A memorandum in support of an opinion submitted under section 71…

Except as otherwise provided in this subchapter, confidential information shall be privileged and given confidential treatment and shall not be: (1) Subject to discovery or admissible as evidence in a private civil action. (2) Subject to subpoena. (3) Subject to the act of Februa…

The commissioner, department or any person who receives documents, materials or other information while acting under the authority of the commissioner or department or with whom the documents, materials or other information are shared under this chapter may not be permitted or re…

To assist in the performance of its duties, the department may: (1) Use confidential information in the furtherance of any regulatory or legal action brought against a company as a part of the department's official duties. (2) Share confidential information with regulatory or law…

The department may enter into agreements governing sharing and use of confidential information consistent with this subchapter.

(a) Sharing of information by department.--The sharing of confidential information with or by the department as authorized by section 7134 (relating to use of confidential information by department) shall not constitute a waiver of any applicable privilege or claim of confidentia…

Notwithstanding section 7132 (relating to general rule for confidential information), confidential information as defined in section 7131(1) and (4) (relating to confidential information defined): (1) May be shared with the Actuarial Board for Counseling and Discipline if the inf…

(a) Requirements.--A company may file a written request with the commissioner to exempt specific product forms or product lines issued by a domestic company from the requirements of sections 7125 (relating to valuation manual for policies issued on or after operative date of valu…

2023 Repeal. Section 7142 was repealed June 14, 2023, P.L.4, No.2, effective immediately.

(a) Findings and declarations.--The General Assembly finds and declares that the work of NAIC and the participation of the commissioner in NAIC are essential to the general implementation of this chapter. (b) Standards.--To effectuate the decision as to whether to exempt certain …

(a) Fraternal benefit organizations.--The following shall apply: (1) Section 2451(b) of The Insurance Company Law of 1921 shall apply to the minimum reserves for certificates issued after February 11, 1994 and prior to the effective date of this chapter. (2) The minimum reserves …

This part relates to health insurance markets oversight.

The General Assembly finds and declares as follows: (1) The Commonwealth intends to maintain the Commonwealth's sovereignty over the regulation of health insurance in this Commonwealth. (2) The health insurance marketplace in this Commonwealth is unique and unlike the marketplace…

Subject to additional definitions contained in subsequent provisions of this part which are applicable to specific provisions of this part, the following words and phrases when used in this part shall have the meanings given to them in this section unless the context clearly indi…

This chapter relates to the Pennsylvania Health Insurance Exchange Authority.

(a) Establishment.--The Pennsylvania Health Insurance Exchange Authority is established as a State-affiliated entity. The powers and duties of the exchange authority shall be vested in and exercised by a board, which shall have the sole power under section 9305 (relating to power…

(a) Establishment.--An advisory council is created to advise the exchange authority under section 9304(g) (relating to meetings and operation). (b) Composition.--The advisory council shall consist of the following members, who may not be in the employ of the Commonwealth: (1) Fou…

(a) Chairperson.--The members of the advisory council shall annually elect a chairperson from among its membership. (b) Terms of members.--Each member's term shall be four years, not to exceed more than two full consecutive four-year terms, except that: (1) Initial appointments s…

(a) Corporate operations.--The exchange authority shall exercise all powers and duties necessary and appropriate to carry out its purpose, including the following: (1) Adopt bylaws. (2) Employ staff. (3) Make, execute and deliver contracts. (4) Apply for, solicit and receive mone…

Except as expressly provided in this chapter, nothing in this chapter shall be construed to limit or supersede the authority vested in a Commonwealth agency, including: (1) The Insurance Department, including the department's authority to regulate the business of insurance within…

(a) General rule.--Except as provided in this chapter, all working papers, recorded information, documents and copies of working papers, recorded information and documents produced by, obtained by or disclosed to the exchange authority or any other person in the course of the exe…

Nothing in this chapter shall constitute an entitlement derived from the Commonwealth or a claim on any money of the Commonwealth.

(a) General rule.--Except as provided under subsection (b), there shall be no liability on the part of and no cause of action of any nature may arise against the exchange authority, board or advisory council or members thereof, the commissioner, the department, an insurer, insura…

(a) Annual audit.--The accounts and books of the exchange authority shall be examined and audited annually by an independent certified public accounting firm. The audit shall at a minimum: (1) Assess compliance with the requirements of this chapter. (2) Identify any material weak…

(a) Report.--The exchange authority shall prepare an annual report on the activities of the exchange authority for the year and: (1) Electronically transmit the report to: (i) The Governor. (ii) The President pro tempore of the Senate. (iii) The Minority Leader of the Senate. (iv…

(a) Establishment.--The Pennsylvania Health Insurance Exchange Fund is established as a special fund within the State Treasury. The exchange fund shall be administered by the exchange authority for the purposes set forth in this chapter, including the deposit of money that may be…

Until the exchange authority promulgates regulations, the exchange authority shall operate the exchange pursuant to: (1) any applicable Federal rules, regulations or guidance; or (2) interim State guidelines consistent with this chapter.

Upon publication of the notice under section 9703(b) (relating to action by commissioner), the exchange authority shall initiate steps to cease operations of the exchange authority and shall cease operations not later than 15 months after publication of the notice.

(a) Application.--The department is authorized to apply to the United States Secretary of Health and Human Services under section 1332 of the Affordable Care Act (Public Law 111-148, 42 U.S.C. § 18052) for a state innovation waiver to: (1) Waive any applicable provisions of the A…

(a) Implementation.--Upon approval of the department's application for an innovation waiver by the United States Department of Health and Human Services, the department shall implement a reinsurance program. (b) Establishment.--Contingent upon Federal approval, the Commonwealth H…

(a) General rule.--The department shall take all actions necessary to administer the approved reinsurance program in a manner consistent with applicable Federal and State law. (b) Functions.--The department shall perform all functions necessary and appropriate to carry out the op…