§ 776.4. Minimum standards for benefits
Purdon's Pennsylvania Statutes and Consolidated StatutesTitle 40 P.S. Insurance
Purdon's Pennsylvania Statutes and Consolidated Statutes
Title 40 P.S. Insurance (Refs & Annos)
Chapter 2. Insurance Companies (Refs & Annos)
Article VI. Casualty Insurance (Refs & Annos)
(b) Health and Accident Insurance (Refs & Annos)
Individual Accident and Sickness Insurance Minimum Standards (Refs & Annos)
40 P.S. § 776.4
§ 776.4. Minimum standards for benefits
(a) The Insurance Commissioner shall issue regulations to establish minimum standards for benefits under each of the following categories of coverage in 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:
(c) No policy or contract shall be delivered or issued for delivery in this State which does not meet the prescribed minimum standards for those categories of coverage listed in paragraphs (1) through (8) of subsection (a) which are contained within the policy or contract unless the Insurance Commissioner finds that such policy or contract will not be unjust, unfair or unfairly discriminatory to the policyholder, subscriber, any person insured under the policy, or beneficiary. Changes to a policy or contract required by regulations promulgated pursuant to this act, including changes to premium rates applicable thereto, shall be permitted by endorsement or rider unless the commissioner shall determine that such change or changes substantially alters the policy or contract.
(d) Notwithstanding any other provision of this act or regulations promulgated hereunder, any policy or contract submitted for approval which does not meet the prescribed minimum standards for those categories of coverage listed in paragraphs (1) through (8) of subsection (a) which are contained within the policy or contract may be approved if, in the opinion of the Insurance Commissioner, such policy or contract is not unjust, unfair, or unfairly discriminatory to the policyholder, subscriber, any person insured under the policy or beneficiary.
Credits
1976, May 18, P.L. 123, No. 54, § 4.
40 P.S. § 776.4, PA ST 40 P.S. § 776.4
Current through Act 10 of the 2024 Regular Session. Some statute sections may be more current, see credits for details.
End of Document |