PA Insurance Commissioner’s thoughts on AHPs & STLD Plans- Live Webinar Summary from 10/24/18

In case you missed last week’s PAHU Webinar – AHPs and STLD Plans with PA Insurance Commissioner Jessica Altman… Below are the highlights from a webinar held on October 24, 2018 hosted by PA Insurance Commissioner, Jessica Altman, her chief of staff, Alison Bean, and her counsel, Sandy Yakima.  The webinar was moderated by Jessica Waltman, PAHU Legislative Chair.  The Insurance Commissioner was pulled from the webinar at the last minute due to an emergent issue, but her staff explained the State’s position on the issues of association health plans and short-term, limited duration plans.  This was an exclusive event for GPAHU and PAHU members.  If you missed the webinar, access the recorded session here Association Health Plans Background On June 19, 2018, the Department of Labor (DOL) issued the Final Rule on association health plans (AHPs), following a prior Executive Order, and proposed regulations. Although the Final Rule appears to lessen requirements for association groups to establish and operate an AHP in a compliant manner, the AHP must comply with a collection of laws including ERISA, the Internal Revenue Code, the Affordable Care Act (ACA), and state laws. The Final Rule specifically affirms that the state regulatory structures overseeing … Read More

LEG REG REVIEW 2017, 24th Issue July 10th, 2017

IN ADDITION TO THE BUDGET DRAMA… the General Assembly acted on a number of insurance-related pieces of legislation: Medicaid Oversight:House Bill 1354 (Grove-R-York) seeks to rein in Medicaid expenditures by creating the Office of Independent Medicaid Director.  The July 7 vote was 111-79 with Democrats voting no.  Democrats argued that the selection process (Governor appoints from a list of three nominees from the General Assembly) would not result in a person with the best qualifications. Prescription Drugs: House Bill 1532 (Phillips-Hill – R-York) amends the Achieving Better Care by Monitoring All Prescription Program (ABC-MAP).  On July, it passed the House 112-78 with all Democrats except for Rep. Bryan Barbin (D-Cambria) voting no.  The bill’s purpose is to give access to ABC-MAP prescription data to Medicaid managed care organizations to hopefully identify patterns of patient abuse re opioids. Travel Insurance without a license: House Bill 1576 (Pickett-R-Bradford) allowing unlicensed employees of travel agencies to discuss travel insurance options without a license requires that there must be one licensed insurance producer at each location to review policy applications was reported out by the House Insurance Committee June 21 and is on the House calendar.  Senate Bill 630 (Reschenthaler-R-Allegheny) does not have this … Read More

LEG REG REVIEW 2017, 23rd Issue June 26th, 2017

AGENT FEE BILL INTRODUCED On June 21, Rep. Mike Tobash (R-Schuylkill) introduced legislation designed to allow insurance agents’ re-entry into the individual health insurance market.  House Bill 1605 states that insurance producers may charge a fee for helping consumers evaluate coverage options, networks and formulary issues, etc. and assist with the application itself when no commissions are paid.  Currently, Act 147 says that no fees may be paid to an insurance producer for completing an application.  The PA Insurance Department has interpreted the law to say that working with clients before reaching the actual application stage is part of “completing the application.”  The PA Association of Health Underwriters (PAHU) met with the Insurance Department repeatedly on this issue before finally resorting to legislation.  PAHU had originally asked the Department to issue a Notice in the PA Bulletin spelling out when fees could and could not be paid.  The Insurance Department rebuffed this approach, saying that Act 147 did not allow any fee for completing an application (with their expanded definition of completing an application) and that the law would have to be changed in the General Assembly. Background:  For the most part, carriers stopped paying commissions for individual health insurance … Read More

LEG REG REVIEW 2017, 22nd Issue June 19th, 2017

CONSOLIDATION UPDATE Reorganization of four Cabinet departments into one PA Department of Health & Human Services (DHHS) is drawing attention now that the General Assembly passed partial pension reform (Senate Bill 1 signed into law by Governor Tom Wolf June 12 as Act 5 of 2017).  The proposal would merge the Departments of Health, Aging, Human Services and Drug & Alcohol Programs into the new DHHS.  Along the way, language was modified in answer to critics who argued that a consolidation would mean less attention paid to special areas such as services to the aged.  The new version has a Secretary of DHHS and commissioners for specialty areas who would also have direct access to the Governor.  The bills are Senate Bill 746 (Schwank-D-Berks) and House Bill 1000 (Bloom-R-Cumberland). There is pushback however.  Three Republican Senators, Carmen Bartolotta (Beaver/Greene/Washington), Lisa Baker (Luzerne/Pike/Susquehanna), and Michelle Brooks (Erie/Mercer/Warren/Crawford) circulated a sponsorship memo June 13 calling for a resolution to develop a process to determine how to proceed with possible unification.  The resolution delays implementation until a thorough assessment can be done regarding perceived cost savings and impacts on stakeholder groups.  The resolution has not yet been formally introduced.  Brooks is Majority Chair … Read More

LEG REG REVIEW 2017, 16th Issue April 24, 2017

INSURANCE PRODUCER FEE SPONSORSHIP MEMO CIRCULATED Rep. Mike Tobash (R-Schuylkill) is circulating a sponsorship memo to members of the House of Representatives which would permit agents and brokers to charge a fee if no commission is paid for individual health insurance policies.  This is the number one priority of the PA Association of Health Underwriters (PAHU). Many insurance producers have been forced to stop helping consumers with individual coverage because carriers ceased paying commissions.  Rep. Tobash’s aim is to allow producers back into the business of helping individuals compare coverages and networks to help find the best policy for them to choose.  PAHU’s Day on the Hill is Tuesday, April 25.  Details on PAHU’s efforts:, 717-232-0022.  Following is a link to Rep. Tobash’s sponsorship memo.   INSURANCE BILLS TO BE CONSIDERED This coming week, there will be committee review/action on a number of bills relating to insurance. House Bill 324 (Kampf-R-Chester/Montgomery) would provide state protection for pensioners in non-ERISA “pension de-risking” where an employer transfers pension obligations to an insurer. (House Insurance Committee) Senate Labor & Industry Committee will consider Senate Bill 269 (Baker-R-Luzerne) which makes it easier for PA to adopt changes in the International Code Council … Read More

LEG REG REVIEW 2017, 8th Issue February 13, 2017

INSURANCE COMMITTEE CONVENES PRESCRIPTION PRICE TRANSPARENCY HEARING On February 8, the House Insurance Committee held a hearing on House Bill 161 (DeLuca-D-Allegheny), mandating the drug manufacturers to supply data to the Insurance Department on drug prices and costs of production including research and development costs versus consumer marketing costs.  HB 161 would require reporting by drug companies if the price increase exceeded a certain level and would not be triggered if a price increase was in normal range. Testifiers included PA Insurance Commissioner Teresa Miller, Pharma (manufacturers), insurance companies, pharmacists, AARP, and PA Association of Health Underwriters (PAHU).  Drug companies insisted that their prices were justified by the long expense trail of development costs.  Regarding a trademark where manufacturers has a de facto monopoly on a new drug, the testifier said that trademark protection is warranted given that 90% of the market is quickly grabbed by generics from the brand name drug when the trademark protection period ends. PAHU pointed out that however unpleasant insurance premiums are, they are a symptom of increasing health care costs, much of which are fueled by prescription drug price increases.   Rep. Eli Evankovich (R-Westmoreland/Allegheny) suggested that there needs to be transparency from manufacturer … Read More

2017, 7th Issue February 10, 2017 SPECIAL BUDGET ISSUE

SPECIAL BUDGET ISSUE THE STATE BUDGET Overall, the proposed State Budget for the fiscal year beginning July 1, 2017, sees General Fund spending at $32.3 billion.  To put in perspective, the General Fund is only one part of the state’s total operating budget which is $81 billion.  In addition to the General Fund, Federal funds account for an additional $28.7 billion, lottery $1.8 billion, Motor License Fund $2.9 billion, and fees, etc. $3.7 billion.  Following are general questions as a quick reference.   Where does General Fund money come from? Personal Income Tax 40.1% Sales Tax 31.8% Corporate Net Income Tax 8.4% “Gross Receipts” Tax 3.8% Cigarette Tax 3.7% Non-tax Revenue & Other Taxes 10.0%   Where does the money go? Medical Assistance (Medicaid) & Long-Term Care 22.8% Other Health & Human Services 17.1% Pre-K through 12 Education 36.7% Higher Education 5.0% Criminal Justice (incl. Corrections) 7.8% Interest paid on state debt (loan servicing) 3.0% Everything else 6%   What new taxes will there be? Given the state’s dismal fiscal situation, the big news generally – no broad-based increase in PA Personal Income Tax or Sales Tax – was greeted with relief.   The Governor seeks a Marcellus Shale extraction … Read More

LEG REG REVIEW 2017, 6th Issue February 6 2017

WELCOME TO GENERAL ASSEMBLY BUDGET WEEK On February 7, Governor Tom Wolf will present his proposals for state spending. In his speech to the General Assembly, he will announce spending priorities and further tout his idea for consolidation of four separate Cabinet departments into one. Previously, he said that he would not propose broad-based tax increases but would like to tax natural extraction. Note: The PA Insurance Department budget will be unaffected by the upcoming budget debate since its general government operations budget comes from a 2013 law, Act 46, which created a dedicated fund, the Insurance Regulation & Oversight Fund. An upcoming LEG REG Review will describe key elements of the Governor’s State Budget proposal. Later in February, House and Senate Appropriations Committee hearings will take place. LEGISLATIVE HAPPENINGS • Senate Resolution 15 (White-R-Indiana) was adopted by the Senate January 30, declaring February 6 to be “Mutual Insurance Day” at the State Capitol. • Senate Urban Affairs & Housing Committee reported out two bills January 25 dealing with flood notifications. Senate Bill 50 and 51 (Greenleaf-R-Montgomery) require that the seller of a property disclose its location in a flood zone and whether or not any floods had actually occurred. … Read More

LEG REG REVIEW 2017, 9th Issue February 20, 2017

LEG REG REVIEW 2017, 9th Issue *** February 20, 2017 BUDGET HEARINGS BEGIN House and Senate Appropriations Committees kick off the annual gauntlet of legislative hearings on the State Budget proposed by Governor Tom Wolf. Most hearings will be covered by PCN. PA Cable Network’s schedule may be found at A selected list of hearings follows. Note that PCN program times may differ depending on their broadcast schedule. Neither House nor Senate has scheduled a hearing for the PA Insurance Department. Department of Agriculture: Feb. 27. Senate – March 1. House Dept. of Environmental Protection: Feb. 27 House – March 9. Senate Labor & Industry (think Workers’ Compensation): Feb. 22 House – Feb. 28 Senate Transportation: Feb. 22 House – Feb. 27 Senate Education: March 6 House – March 7 Senate Dept. Conservation & Natural resources: Feb. 27 House – March 1 Senate Dept. Community & Economic Development: March 2 House – March 6 Senate Governor’s Budget Office: March 9 House – March 10 Senate Regarding the Governor’s proposal to combine four separate Cabinet departments into one to be called Dept. of Health & Human Services, the House and Senate Appropriations Committees are taking different approaches. The Senate Appropriations … Read More

LEG REG REVIEW 2017, 5th Issue January 30, 2017

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 Pennsylvania legislation and regulations impacting the Insurance and Business Communities.  It is a free member benefit for those who are members of the Pennsylvania Association of Health Underwriters (PAHU).   PHILLIPS ASSOCIATES at 717/728-1217 or e-mail to  CONSOLIDATION ISSUE NOW ON TABLE Media reports over the weekend confirmed that Governor Tom Wolf is likely to try consolidating several cabinet departments as a way to reduce budget expenses this fiscal year as part of his effort to mitigate a HUGE budget deficit at the end of this fiscal year.  Presumably, this would mean consolidation of the PA Department of Aging, Department of Health and the PA Department of Drug & Alcohol Programs into a renamed PA Department of Health and Human Services (now the Dept. of Human Services).  What gives this added weight is the firing of PA Department of Drug & Alcohol Programs Secretary Gary Tennis.  Although no reason was given, Reading news media speculated that Tennis utilized a long-time lobbyist Deb Beck to vet potential employees, prompting his removal.  Former Secretary … Read More

LEG REG REVIEW 2016, 17th Issue — October 24, 2016

LEG REG REVIEW 2016, 18th Issue *** October 24, 2016   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 Pennsylvania legislation and regulations impacting 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  Please email supplying both your name and e-mail address if you wish to be removed from or added to this list. Whether it means meeting your CE need or helping with a particular problem/question, please visit our web site to explore how PHILLIPS ASSOCIATES may be of service to you, your employees and your clients.    LATE SESSION INSURANCE BILLS ADVANCE Even though the legislative session is winding down, a number of insurance bills are seeing traction as they make their way through the legislative process. LYFT/UBER: The House approved Senate Bill 984 (Bartolotta-R-Washington) by a 188-0 vote on October 19 and sent it back to the Senate for concurrence, which, if done, puts the … Read More