40 Pa. Stat. § 776.3

Current through Pa Acts 2024-53, 2024-56 through 2024-92
Section 776.3 - Standards for policy provisions
(a) The Insurance Commissioner shall issue regulations to establish specific standards, including standards of full and fair disclosure, that set forth the manner, content and required disclosures for their sale for individual policies of accident and health insurance and subscriber contracts of health plan corporations and nonprofit health service plans and certificates issued by fraternal benefit societies and required disclosures for their sale. These regulations shall be in addition to applicable laws of this Commonwealth and may cover but shall not be limited to:
(1) terms of renewability;
(2) initial and subsequent conditions of eligibility;
(3) non-duplication of coverage provisions;
(4) coverage of dependents;
(5) pre-existing conditions;
(6) termination of insurance;
(7) probationary periods;
(8) limitations;
(9) exceptions;
(10) reductions;
(11) elimination periods;
(12) requirements for replacement;
(13) recurrent conditions; and
(14) the definition of terms, including but not limited to, the following: "hospital," "accident," "sickness," "injury," "physician," "accidental means," "total disability," "partial disability," "nervous disorder," "guaranteed renewable," and "non-cancellable."
(b) The Insurance Commissioner may issue regulations that specify prohibited policy provisions not otherwise specifically prohibited by statute which in the opinion of the Insurance Commissioner are unjust, unfair, or unfairly discriminatory to the policyholder, subscriber, any person insured under the policy, or beneficiary.

40 P.S. § 776.3

1976, May 18, P.L. 123, No. 54, § 3.