LEG REG REVIEW 2015, 18th Issue June 8, 2015

LEG REG REVIEW is a periodic newsletter produced by PHILLIPS ASSOCIATES, a professional lobbying and consultant firm located near the State Capitol.  It contains news on the legislative and regulatory scene in Pennsylvania that may be of interest to the Insurance and Business Communities.  It is a free member benefit for those who are members of the Pennsylvania Association of Health Underwriters (PAHU).  Subscription information may be obtained by contacting PHILLIPS ASSOCIATES at 717/728-1217 FAX 717/232-7005 or e-mail to xenobun@aol.com.  Please email jtrout2792@aol.com supplying both your name and e-mail address if you wish to be removed from or added to this list.



Senate Bill 293 (Eichelberger-R-Blair) passed the PA House June 2 by a 195-0 vote.  Registering Patient Protection Affordable Care Act navigators and certified application counselors and requiring criminal background checks for those individuals, SB 293 was amended to include clarifying language from the Governor’s Office.  Since the bill specifies what navigators et al cannot do — what licensed producers do –, the Administration wanted language that repeated Federal rules as to what navigators et al are authorized to do.  It was referred to the Senate Rules Committee and is lined up for a concurrence vote this week.  The PA Association of Health Underwriters issued the following statement after the House passage:

The PA Association of Health Underwriters (PAHU) welcomes the unanimous vote today by the PA House of Representatives on Senate Bill 293 which requires unlicensed Affordable Care Act navigators and certified application counselors to register with the PA Insurance Department and undergo individual background checks.  This is an important piece of consumer protection legislation which shows that reasonable people from both Democratic and Republican sides of the aisle can reach a constructive goal.  PAHU hopes that the Senate will concur with the House and speedily move the bill to the Governor for his signature into law. 



The Senate Finance Committee is convening a hearing May 10 on the Wolf Administration proposal to expand the reach of PA’s sales tax to several hundred professional fee-based services and consumer purchases.  Insurance and financial services are not singled out (legal, accounting, computer services, tour firms, etc. services would also be taxed), there are a number of provisions that directly affect insurance producers’ clients:

–          Investment advice

–          Human resources; presumably COBRA and ERISA counseling

–          Employee benefit plan design

–          Third party administration



By a unanimous vote, the PA Senate approved Governor Tom Wolf’s nomination of Teresa Miller as Pennsylvania’s Insurance Commissioner.  Other nominees approved this last week were:

Pedro Cortes – Secretary of the Department of State; Ted Dallas – Secretary of Human Services; Cindy Dunn – Secretary of Conservation and Natural Resources; Robin Wiessmann – Secretary of Banking and Securities;

Pedro Rivera – Secretary of Education; and John Quigley – Secretary of Environmental Protection.



  • On June 2, the Senate Banking & Insurance Committee reported out two pieces of legislation.  First was Senate Bill 861 (White-R-Indiana) to clarify which insurance covers a loaner car.  This legislation requires the customer’s personal auto insurance policy to be responsible for third party damages and, within the limits of the driver’s policy, physical damages to the loaner vehicle. Likewise, when the dealer has custody of the customer’s vehicle, the dealership’s policy shall be liable for third party damages and damages to the customer’s automobile up to the limits in the customer’s personal auto insurance policy.
  • Senate Bill 747 (Vogel-R-Beaver) passed the committee by a party line vote with Democrats voting no.  SB 747 (Vogel-R-Beaver) requires that the Insurance Commissioner do a study listing amounts of punitive damages paid by the following in the last ten years; 1) physicians 2) long-term care nursing facilities licensed by the Department of Health and 3) personal care homes licensed by the Department of Human Services.  It also capped punitive damage awards.



On June 1, Highmark announced that the Insurance Department approved its merger with Blue Cross of Northeastern PA.  The merger was called “a natural progression” of the business relationship between the two carriers and adds 550,000 subscribers from 13 northeastern PA counties to Highmark’s overall coverage figures.  Highmark is the Nation’s fourth largest Blue Cross and Blue Shield affiliated company and is one of the U.S.’ ten largest health insurers with 5.3 million subscribers.


Other Highmark news: On May 29, Governor Wolf issued a statement regarding the Commonwealth Court’s decision blocking “UPMC’s decision to cancel Medicare Advantage for over 180,000 seniors” in the dispute between Highmark and UPMC.  He said that the UPMC decision was “wrong” and that “the feud between these two companies must end.”



  • In the latest major skirmish of the State Budget gauntlet, the PA House unanimously defeated an amendment to Tax Code House Bill 283 which would have adopted Governor Wolf’s proposed tax increases (Personal Income Tax from 3.07 to 3.70 percent; sales tax from 6% to 6.6%; expansion of sales tax).  Republicans called it a demonstration of the unacceptability of the Governor’s proposals.  Democrats, including the Governor, labeled it as a stunt, which is why all House Democrats voted no.
  • May revenue collections again showed an increase over projections ($50 million or 2.6%), meaning that year-to-date collections are up by 2.3%.  This suggests about a half-billion dollar surplus at the end of the current fiscal year and gives credence to Republican suggestions that the budget deficit — although formidable at $1.5 billion — is not as bad as is claimed by the Wolf Administration ($2.5 billion)



On June 6, the PA Department of Labor & Industry issued two Notices regarding Workers’ Compensation.  The first relates to payment of prescription drugs under Workers’ Compensation.  The Bureau of Workers’ Compensation uses the Red Book published by Truven Health Analytics to determine the average price of wholesale drugs.  The second notice lists the range of 2014 fees and average fees charged by Utilization Review Organizations and Peer Review Organizations for services provided under the Workers’ Compensation Act.  Details: www.pabulletin.com/secure/data/vol45/45-23/1080.html



  • The Patient Safety Authority (under MCARE) meets June 9 at CentralPennCollege in Summerdale.
  • Deadline for submitting comments to the Insurance Department on what the 2017 Essential Health Benefits (EHBs) will be for PA consumers is June 12.  EHBs are mandated benefits that must be included in individual and small group health plans per the Patient Protection Affordable Care Act.  The Federal law says that states may chose between benefits offered by the 3 largest plans in the state small group market by enrollment (Keystone Health Plan East, Highmark Health Insurance Company, Geisinger Quality Options), largest HMO (Keystone Health Plan East), largest national health benefit program plans (Blue Cross/ Blue Shield Service Benefit Plan and Government Employees Health Association, Inc. Benefit Plan), and the PA Employees Benefit Trust.  Currently, EHBs are modeled on an Aetna POS plan which is no longer offered by that company.  If PA does not choose, the Federal Government will choose benefits of the Keystone Health Plan East.  Details: ra-in-press@pa.gov


COMMITTEE NOTE: The PA House Health Committee is holding a June 10 hearing on certificate of need.

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