LEG REG REVIEW 2015, 30th Issue – October 19, 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.



Both House and Senate will be in session this week.  There are two insurance-relevant bills on the voting calendars at this time.  House Bill 347 (O’Neill-R-Bucks) regarding how ambulance services can be reimbursed by insurance carriers is on the Senate voting calendar for October 20.  It will still need one more consideration by the Senate before final passage. It allows for direct EMS reimbursement but requires them to put their names on a registry maintained by the state.  It also specifies that insurers must consider ambulance reimbursement at in-network reimbursement schedules.  In addition:

  • If it is on the registry the EMS entity may not invoice a policyholder.
  • Insurers may inspect claims via audit but may not force repayment to the insurer; instead, if the insurer identifies an improper payment, the insurer may deduct that amount from future reimbursements.

House Bill 965 (Godshall-R-Montgomery) amends the Regulatory Review Act to require notice of proposed regulations to committee members by the relevant chair when sent to the General Assembly by the Independent Regulatory Review Commission (IRRC).  Its’ purpose is to strengthen legislative committee oversight of the regulatory process.  It should be voted on by the full House this week.



The House Insurance Committee is convening an informational meeting on House Bill 1633 (Pickett-R-Bradford).  This bill moves the Children’s Health Insurance Program (CHIP) from the PA Insurance Department to the Department of Human Services (formerly DPW).  This idea was one of those considered by the Wolf Administration’s Transition Team.  HB 1633 was referred to the Insurance Committee October 15.



After the House rejected an amendment to House Bill 283 that would have taxed Marcellus Shale extraction and increased the rate of the Personal Income Tax as sought by the Wolf Administration, Governor Wolf chastised majority Republicans.  On October 15, for example, his press secretary issued a memo entitled ‘Five Things That Will Happen if Republican Leaders Fail to Take on the Status Quo’. Those consequences would be:  $1 billion less for K-12 education next year; $1 billion cut from human services programs next year; Credit Rating Agencies will downgrade PA’s rating to junk status; Property Taxes will increase even higher; Tuition rates at PA colleges and universities will increase.


Republicans countered by saying that Governor Wolf needs to see that broad-based tax increases will not be approved by the General Assembly given that nine Democrats from western PA joined Republicans to defeat the amendment handily 73-127.  In Governor Wolf’s October 6 press conference, he did not see the vote and Democratic defections as negative.  He said that “What Democrats voted for today was a really tough political act.  The fact that 73 were willing to do that…sends a strong signal of support for addressing the real problems PA faces.”  Wolf also said that broad-based taxes were not being taken off the table.



The Wolf Administration announced that 3-D mammograms must be covered at no cost to women.  Announced at a meeting of the Breast Cancer Coalition, the procedure known as tomosynthesis was not utilized as it should be since 2-D mammography was offered at no cost according to the PA Insurance Department.



  • House Bill 857 (Pickett-R-Bradford) to reauthorize CHIP is in the Senate Appropriations Committee.
  • HB 60 (Baker-R-Tioga) providing insurance payment parity for oral cancer chemotherapy is tabled in the Senate but could be called up for a final vote.
  • Senate Bill 494 (Ward-R-Westmoreland) to eliminate an Insurance Department Flood Insurance reporting requirement was reported out of Senate Appropriations Committee and could come up for a final vote.
  • Senate Bill 748 (Argall-R-Schuylkill) regarding escorts for oversized vehicles was approved by the Senate 49-0 on October 14 and is ready to go to the Governor to be signed into law.
  • Senate Bill 925 (Rafferty-R-Montgomery) provides standards for school bus drivers.  NOTE:  It does not alter insurance requirements for drivers or bus companies.  It is ready for the Governor’s signature after a 49-0 Senate vote October 14.



The National Association of Health Underwriters (NAHU) is offering Federally-Facilitated Marketplace (Exchange) training as the only insurance brokers’ organization approved by CMS to provide this required training.  Training meets CMS reporting verification requirements and includes programs on both Individual Federally-Facilitated Marketplace and for the Federally-Facilitated Marketplace SHOP plans.  Details:  nahu-ffm@nahu.org.  FYI, NAHU also has an agent locator for consumers to identify NAHU members who are certified to offer Exchange plans.  NAHU members may wish to check their status at www.nahu.org.   Centers for Medicare Medicaid Services is also offering ‘A Primer for Agents and Brokers Participating in the Federally-Facilitated Marketplace’ to prepare them for open enrollment   In addition to looking ahead to 2016, CMS will also review the upcoming revocation process for plan year 2015 and provide an overview of next steps for consumers who fail to file and reconcile advanced payments of the premium tax credit (subsidy) for plan year 2014.  Details: registrar@REGTAP.info


NAHU NOTE… NAHU’s Individual Insurance Work Group is conducting a survey regarding 2016 for individual insurance with respect to navigators, pricing and commissions.  Surveys must be completed by November 3, 2015.  https://www.surveymonkey.com/r/QV5CX3



  • PA-domiciled reciprocal insurance exchange Healthcare Providers Insurance Exchange asked for approval to reinsure its’ entire schedule of policies with N.C.’s Medical Mutual Insurance Company.
  • Applications for designation as certified reinsurers were submitted to the PA Insurance Department by Munich Re and Arch Reinsurance, Limited.
  • Radian Mortgage Guaranty, Inc. seeks a PA Certificate of Authority as a stock casualty insurer.



The Insurance Information Institute (III) listed more than $373 million in flood claim payouts for 2014 from the National Flood Insurance Program (NFIP).  Nationally, the average claim was $29,033.00.  Pennsylvania finished fifth in 2014 with 785 claims at $14.36 million.  The top state was Florida with 3,823 claims totaling a little less than one-half of the US claims total, at $115.84 million.


MARKET NOTES:  Triad Strategies reports that Lyft and Ford Warriors in Pink have teamed up to provide free rides to patients traveling to and from breast cancer treatment as part of National Breast Cancer Awareness Month…According to a press release, Sun Life Financial Inc., will acquire the US employee benefits component of Assurant…Central Penn Business Journal ranked seven insurance entities on the list of The Best Places to Work in Pennsylvania:  Insurance companies include New York Life Harrisburg office and Philadelphia Insurance Companies.  Insurance agencies listed include Gunn Mowery, McConkey Insurance & Benefits, Ritter Insurance, and Keystone Insurers Group.

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