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 firstname.lastname@example.org. Please email email@example.com supplying both your name and e-mail address if you wish to be removed from or added to this list.
TO THE GOVERNOR
The Senate completed work on Senate Bill 487 (McIlhinney-R-Bucks) on July 14. This legislation limits co-payments for insured medical services provided by physical therapists, chiropractors and occupational therapists. The final vote was 46-0 (concurrence with House amendments) and the bill will shortly be at the Governor’s desk for his signature.
FAQs ON BUDGET IMPASSE ISSUED BY ADMINISTRATION
Wolf Administration issued a set of FAQs describing what happens when the new fiscal year is delayed. https://www.pa.gov/Pages/budgetFAQs.aspx#.VaeUD7XcBjw . It focuses on what state payments may still be made and what is suspended until a new budget takes effect.
RIDESHARING LEGISLATION CLARIFIED
A question came up from Leg Reg Review’s article on Act 22 of 2015 (House Bill 140 (Killion-R-Delaware) exempting van ride-sharing from PUC regulation. The question was whether Act 22 meant that these vans are not considered livery. Here is the legislation text:
Section 5 page 5, starting at line 26
Insurance rates and policy exclusions.
(a) General rule.–Provisions in an insurance policy which deny coverage for any motor vehicle used for commercial purposes or as a public or livery conveyance shall not apply to a vehicle used in a ridesharing arrangement.
(b) Approval of Insurance Commissioner.–Premiums charged for ridesharing vehicles shall be approved by the Insurance Commissioner in conformity with the act of June 11, 1947 (P.L. 538, No.246), known as The Casualty and Surety Rate Regulatory Act.
A person would also need to observe the conditions where van ridesharing would be exempt from PUC oversight:
- The group must not exceed 15 persons
- The group does not consist of school-age children
- The vehicle weighs 10,000 pounds or less
- The group is transported round trip where the driver is also driving to and from his or her home and place of work or educational or other institution.
PPACA ISSUES EXCHANGE PLAN SELECTIONS BY COUNTY
The Office of the HHS Assistant Secretary for Planning & Evaluation issued a July 2015 Issue Brief showing the breakdown of enrollment in the (exchange) federally-facilitated marketplace for the enrollment period ending February 15, 2015. In PA, there were 472,680 enrollees. Of these, for example, 34% of enrollees were those through age 34. Other information includes enrollment by county and even by zip code. Details: https://aspe.hhs.gov/health/reports/2015/MarketPlaceEnrollment/EnrollmentByCounty/rpt_EnrollmentByCounty_July2015.cfm
PA INSURANCE DEPT. OFFERS PPACA RATE RESOURCES
The PA Insurance Department posted a number of resources for insurance producers and consumers to utilize when seeking information about proposed rate increases for health insurance under the Patient Protection Affordable Care Act (PPACA). NOTE: These are NOT approved by the Department. They are proposed rate changes.
- Proposed PPACA Rate Filings
- Consumer Guide to the Rate review Process
- Proposed premiums
- PSI sent out a notice to PA continuing education providers July 17 that there was a snafu in course renewal invoices. They had the old Prometric payment address instead of the new PSI location. PSI also said that revised, corrected course renewal notices will be sent. Questions: 844/889-8970
- ACE Reinsurance (Switzerland), Ltd. applied to the PA Insurance Department for renewal of its designation as a certified reinsurer in PA.
- The Patient Safety Authority (MCARE) meeting originally set for July 21 is cancelled. The next meeting will take place in Harrisburg September 8. Details: 717/346-0469
- Maryland: On July 17, the Maryland Insurance Administration issued Bulletin 15-22 regarding insurance producer commission sharing.
US EXPANDS INDEPENDENT CONTRACTOR RULES
On July 15, the US Department of Labor Wage and Hour Division issued Administrator’s Interpretation No. 2015-1 to reduce what it considers misclassification of employees as independent contractors. The redefinition of employee places more emphasis on the “economic reality” test which looks at whether the worker is economically dependent on the employer or in business for his/her self. The guidance states that correct classification as employees or independent contractors “has critical implications for the legal protections that workers receive (earnings, overtime, benefits, etc.)”.
The Interpretation gives examples. If a worker provides cleaning services for a cleaning company but does not schedule assignments, solicit work from other clients, advertise, and has a lack of managerial responsibility, that person is an employee subject to the Fair Labor Standards Act (FLSA). Another example from the 11-page memo suggests that even if the worker made an investment, for instance in tools and equipment, that does not automatically classify the worker as an independent contractor. A third consideration is the skill of the worker where DOL feels that a skill set by itself is not enough to meet the requirements for an independent contractor. A carpenter, for example, may be skilled but still works under the direction of others and “does not demonstrate the skill and initiative of an independent contractor.” Two other variables were identified: Is the relationship between worker and employer indefinite or for a specified term? (Independent contractors would have a specific time frame for the work to be done.); the notion of employer control must be tempered by seeing whether or not the worker is economically dependent on the employer. Details:
POLITICS: Lt. Governor Mike Stack set the date for the special election to fill the Allegheny County vacancy created when former Democratic Senator Matt Smith resigned. It will be November 3.