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Pennsylvania Statutes, Title 40

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Pennsylvania/Statutes

← All Pennsylvania coverage

Title 40, INSURANCE

23 chapters · 216 sections in this title.

All chapters in Title 40216 Ch 71, Reserve Liabilities33 Ch 63, Professional Health Services Plan Co…25 Ch 45, Insurance Data Security18 Ch 35, Medical Professional Liability Recip…17 Ch 95, Reinsurance Program16 Ch 93, State-based Exchange14 Ch 50, Electronic Notice of Insurance Practices13 Ch 61, Hospital Plan Corporations12 Ch 39, Corporate Governance Annual Disclosure11 Ch 47, Pet Insurance11 Ch 37, Unclaimed Life Insurance Benefits6 Ch 38, Retroactive Denial of Reimbursements6 Ch 51, Rebates and Inducements6 Ch 40, Medication Synchronization5

216 sections·Filtered byTitle 40✕

40 Pa.C.S. § 4303 Annual attestation
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(a) Statement regarding MHPAEA compliance.--For the form for each health insurance policy offered, issued or renewed by an insurer, the insurer shall annually file with the department a statement attesting to the insurer's documented analyses of efforts to comply with MHPAEA and …
40 Pa.C.S. § 4304 Regulations
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The department may promulgate regulations necessary to implement this chapter.
40 Pa.C.S. § 4501 Scope of chapter
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This chapter relates to insurance data security.
40 Pa.C.S. § 4502 Definitions
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The following words and phrases when used in this chapter shall have the meanings given to them in this section unless the context clearly indicates otherwise: "Authorized individual." An individual known to and screened by a licensee and determined to be necessary and appropriat…

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40 Pa.C.S. § 4511 Differentiation between types of information

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For purposes of determining what constitutes publicly available information, a licensee is deemed to have a reasonable basis to believe that information is lawfully made available to the general public if the licensee has taken steps to determine: (1) that the information is of t…

40 Pa.C.S. § 4512 Risk assessment

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A licensee shall conduct a risk assessment, which must: (1) Identify reasonably foreseeable internal or external threats that could result in unauthorized access, transmission, disclosure, misuse, alteration or destruction of nonpublic information, including the security of infor…

40 Pa.C.S. § 4513 Information security program

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(a) Requirement for implementation and objectives.--Each licensee shall develop, implement and maintain a comprehensive written information security program based on the licensee's risk assessment that: (1) Contains administrative, technical and physical safeguards for the protec…

40 Pa.C.S. § 4514 Corporate oversight

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(a) Duties.--If a licensee has a board of directors, the board or an appropriate committee of the board shall, at a minimum: (1) Require the licensee's executive management or delegates to develop, implement and maintain the licensee's information security program. (2) Require th…

40 Pa.C.S. § 4515 Oversight of third-party service provider arrangements

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A licensee shall: (1) Exercise due diligence in selecting its third-party service provider. (2) Require a third-party service provider to implement appropriate administrative, technical and physical measures to protect and secure the information systems and nonpublic information …

40 Pa.C.S. § 4516 Certification

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(a) Requirement.--No later than the April 15 that is at least one year after the effective date of this section, and each April 15 thereafter, each insurer domiciled in this Commonwealth shall submit to the commissioner, in the form and manner prescribed by the department, a writ…

40 Pa.C.S. § 4517 Investigation of cybersecurity event

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(a) Requirement.--If a licensee discovers that a cybersecurity event has or may have occurred regarding the licensee, the licensee or an outside vendor or service provider designated to act on behalf of the licensee shall conduct a prompt investigation. (b) Determination.--During…

40 Pa.C.S. § 4518 Notification of cybersecurity event

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(a) Notification to commissioner.--A licensee shall notify the commissioner as promptly as possible, but in no event later than five business days from a determination, that a cybersecurity event involving nonpublic information that is in the possession of the licensee has occurr…

40 Pa.C.S. § 4521 Power to examine licensees

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(a) Insurers.--The commissioner shall have the powers provided under Article IX of the act of May 17, 1921 (P.L.789, No.285), known as The Insurance Department Act of 1921, to examine and investigate an insurer to determine whether the insurer has been or is engaged in conduct in…

40 Pa.C.S. § 4522 Penalties

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Upon the determination, after notice and hearing, that this chapter has been violated, the commissioner may impose the following penalties: (1) Suspension or revocation of the licensee's license, authorization to operate or registration. (2) Refusal to issue or renew a license, a…

40 Pa.C.S. § 4531 Confidentiality

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(a) Requirement.--All information, documents, materials and copies thereof in the possession or control of the department that are produced by, obtained by or disclosed to the department or any other person in the course of an examination or investigation under this chapter shall…

40 Pa.C.S. § 4532 Exemptions

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(a) Licensee criteria.--A licensee meeting any of the following criteria shall be exempt from sections 4512 (relating to risk assessment), 4513 (relating to information security program), 4514 (relating to corporate oversight), 4515 (relating to oversight of third-party service p…

40 Pa.C.S. § 4533 Rules and regulations

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The commissioner may issue rules and regulations necessary to carry out the provisions of this chapter.

40 Pa.C.S. § 4534 Construction with other laws

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(a) Private cause of action.--Nothing in this chapter shall be construed to: (1) Create or imply a private cause of action for a violation of this chapter. (2) Curtail a private cause of action that otherwise exists in the absence of this chapter. (b) Exclusive standards.--Notwit…

40 Pa.C.S. § 4535 Prevention or abrogation of agreements

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Nothing in this chapter shall prevent or abrogate an agreement between a licensee and another licensee, a third-party service provider or any other party to fulfill any of the investigation requirements imposed under section 4517 (relating to investigation of cybersecurity event)…

40 Pa.C.S. § 4536 Initial compliance

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Licensees shall have one year from the effective date of this section to implement sections 4512 (relating to risk assessment), 4513 (relating to information security program), 4514 (relating to corporate oversight) and 4516 (relating to certification) and two years from the effe…

40 Pa.C.S. § 4701 Purpose and scope of chapter

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(a) Purpose.--The purpose of this chapter is to create a comprehensive legal framework for the sale, solicitation and negotiation of pet insurance policies in this Commonwealth. (b) Applicability.--This chapter applies to a pet insurance policy that is: (1) sold, solicited or neg…

40 Pa.C.S. § 4702 Definitions

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The following words and phrases when used in this chapter shall have the meanings given to them in this section unless the context clearly indicates otherwise: "Chronic condition." A condition that can be treated or managed, but not cured. "Commissioner." The Insurance Commission…

40 Pa.C.S. § 4703 Use of definitions in pet insurance policy

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(a) Terms.--If a pet insurer uses any of the terms in section 4702 (relating to definitions) in a pet insurance policy, the definition under section 4702 shall apply and the pet insurer shall include the definition of the term in the pet insurance policy. (b) Website.--A pet insu…

40 Pa.C.S. § 4704 Right to examine and return pet insurance policy

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(a) General rule.--Except as provided in subsection (b), an individual who applies for a pet insurance policy may examine the pet insurance policy and, if not satisfied with the pet insurance policy for any reason, may return the pet insurance policy to the company that produced …

40 Pa.C.S. § 4705 Policy disclosures

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(a) Information.--A pet insurer shall clearly and conspicuously disclose, in accordance with subsection (b), the following information to an insured or a prospective insured in a pet insurance policy: (1) Whether the pet insurance policy excludes coverage due to any of the follow…

40 Pa.C.S. § 4706 Policy conditions

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(a) Preexisting conditions.-- (1) A pet insurer may issue pet insurance policies that exclude coverage on the basis of one or more preexisting conditions if the pet insurer follows the disclosure requirements of section 4705 (relating to policy disclosures). (2) A pet insurer has…

40 Pa.C.S. § 4707 Sales practices for pet insurance policies

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A pet insurer: (1) May not make any false, deceptive or misleading statement in the advertisement of a pet insurance policy. (2) Shall disclose in any advertisement regarding a pet insurance policy a statement as to whether the pet insurer will reduce coverage or increase premium…

40 Pa.C.S. § 4708 Sales practices for wellness programs

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(a) Prohibitions.--A pet insurer or insurance producer may not characterize a wellness program as pet insurance. (b) Conditions.--The sale, solicitation or negotiation of a wellness program by a pet insurer or insurance producer shall be in accordance with the following requireme…

40 Pa.C.S. § 4709 Insurance producer training

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(a) Prohibitions.--An insurance producer may not sell, solicit or negotiate a pet insurance policy or related product unless the insurance producer is appropriately licensed in this Commonwealth and has completed the training requirements of subsection (c). (b) Requirement.--A pe…

40 Pa.C.S. § 4710 Violations

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(a) Penalties and remedies.--Upon a determination by hearing that this chapter has been violated, the commissioner may pursue one or more of the following courses of action: (1) Issue an order requiring the person in violation to cease and desist from engaging in the violation. (…

40 Pa.C.S. § 4711 Rules and regulations

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The commissioner may promulgate rules and regulations to administer and enforce this chapter.

40 Pa.C.S. § 4801 Scope of chapter

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This chapter relates to telemedicine.

40 Pa.C.S. § 4802 Definitions

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The following words and phrases when used in this chapter shall have the meanings given to them in this section unless the context clearly indicates otherwise: "Agreement with the Department of Human Services." As follows: (1) An agreement between an MA or CHIP managed care plan …

40 Pa.C.S. § 4803 Insurance coverage of telemedicine

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(a) General rule.-- (1) A health insurance policy offered, issued or renewed in this Commonwealth shall provide coverage for medically necessary health care services provided through telemedicine and delivered by a participating network provider who provides a covered health care…

40 Pa.C.S. § 4804 Medical assistance and children's health insurance program coverage

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(a) MA or CHIP managed care plan payment.-- (1) MA or CHIP managed care plan payments shall be made on behalf of enrollees for medically necessary health care services provided through telemedicine, if all of the following apply: (i) The health care service would be covered throu…

40 Pa.C.S. § 4805 Standard of care

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A health care provider providing health care services through telemedicine shall be subject to the same standard of care that would apply to the health care services in an in-person setting.

40 Pa.C.S. § 4901 Definitions

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The following words and phrases when used in this chapter shall have the meanings given to them in this section unless the context clearly indicates otherwise: "Commissioner." The Insurance Commissioner of the Commonwealth. "Covered person." A policyholder, subscriber or other in…

40 Pa.C.S. § 4902 Payment

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(a) Payment.--A health insurer or its contracted vendor may not restrict the method of payment to a participating health care provider so that the exclusive payment method is a credit card payment. (b) Changing payment.--If initiating or changing payments to a participating healt…

40 Pa.C.S. § 4903 Regulations

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The department may promulgate regulations necessary to implement this chapter.

40 Pa.C.S. § 4904 Enforcement

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(a) Penalties.--Upon satisfactory evidence of the violation of this chapter by a health insurer or any other person, one or more of the following penalties may be imposed at the commissioner's discretion: (1) A fine of not more than $5,000 for each violation of this chapter. (2) …

40 Pa.C.S. § 5001 Scope of chapter

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This chapter relates to electronic notice of insurance practices.

40 Pa.C.S. § 5002 Definitions

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The following words and phrases when used in this chapter shall have the meanings given to them in this section unless the context clearly indicates otherwise: "Covered person." An individual who is entitled to receive health care services under a health benefit plan. "Deliver by…

40 Pa.C.S. § 5003 Electronic delivery of insurance notices or documents

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(a) Transactions.--Subject to the requirements of this section, an insurer may deliver by electronic means a notice to a covered person or any document required by Federal or State law in a transaction with the insurer or deliver in a manner that serves as evidence of insurance c…

40 Pa.C.S. § 5004 Changes in hardware or software requirements

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After a covered person or plan sponsor provides consent in accordance with section 5003 (relating to electronic delivery of insurance notices or documents), if a change in the hardware or software requirements necessary to access or retain a notice or document to be delivered by …

40 Pa.C.S. § 5005 Affect, validity and enforceability of insurance notices or documents

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(a) Content of notices or documents.--Nothing in this chapter shall be construed to affect requirements related to content of an insurance notice or document or the timing related to the notice or document required under any other provision of Federal or State law. (b) Confirmati…

40 Pa.C.S. § 5006 Rescission of delivery by electronic means

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(a) Procedures.--No later than 30 days after the effective date of this subsection, an insurer shall develop procedures by which a covered person may opt out of delivery by electronic means. (b) Legality.--The decision by a covered person to opt out of delivery by electronic mean…

40 Pa.C.S. § 5007 Prior consent for electronic delivery of insurance notices or documents

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If an insurer has a documented record from a covered person indicating approval by the covered person for a notice or document to be delivered by electronic means from the insurer before the effective date of this section and the insurer intends to deliver by electronic means an …

40 Pa.C.S. § 5008 Alternative methods of delivery

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(a) Alternative methods.--An insurer shall deliver a notice or document to a covered person by any other method that was authorized by Federal or State law before the effective date of this subsection other than delivery by electronic means if either of the following occurs: (1) …

40 Pa.C.S. § 5009 Limitation on civil liability

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An insurer or plan sponsor shall not be civilly liable under this chapter.

40 Pa.C.S. § 5010 Delivery of insurance policies and endorsements

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(a) Authorization.--An insurer may mail, deliver or, if the plan sponsor obtains a separate specific consent, post on the insurer's publicly accessible Internet website an insurance policy and endorsement that does not contain any personally identifiable information. (b) Internet…