THE GENERAL ASSEMBLY OF PENNSYLVANIA
INTRODUCED BY WARD, D. WHITE, VOGEL, SOLOBAY, BROWNE, ERICKSON, WAUGH, WASHINGTON, ALLOWAY, LEACH, BOSCOLA, BLAKE AND FARNESE, JUNE 15, 2011
REFERRED TO BANKING AND INSURANCE, JUNE 15, 2011
Amending the act of July 2, 1996 (P.L.514, No.85), entitled "An
act providing for certain health insurance benefits to aid
the health and well-being of mother and child following the
birth of a child; and prohibiting certain practices by
insurers," defining "covered dentist services"; and
prohibiting insurers from setting fees for noncovered dentist
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Section 2 of the act of July 2, 1996 (P.L.514,
No.85), known as the Health Security Act, is amended by adding a
definition to read:
Section 2. Definitions.
The following words and phrases when used in this act shall
have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Covered dentist services." Dental care services for which
reimbursement is available under an employee's plan contract.
The term includes dental care services for which a reimbursement
would be available if not for annual maximums.
* * *
Section 2. The act is amended by adding a section to read:
Section 4.1. Fees for noncovered dentist services.
(a) Prohibition.--An insurer's contract with a dentist may
not require that the dentist provide services to the insurer's
subscribers at a fee set by the insurer unless the insurer
compensates the dentist for covered dentist services.
(b) Effect.--A contractual provision in violation of
subsection (a) is void.
Section 3. The addition of section 4.1 of the act shall
apply to insurance policies issued or renewed on or after the
effective date of this section.
Section 4. This act shall take effect in 60 days.