HB 1802 — An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in casualty insurance, providing for coverage of COVID-19 vaccines.

PRINTER'S NO.   2216

                     THE GENERAL ASSEMBLY OF PENNSYLVANIA



                         HOUSE BILL
                         No. 1802
                                               Session of
                                                 2025

     INTRODUCED BY O'MARA, PIELLI, RABB, SANCHEZ, WEBSTER,
        SCHLOSSBERG, HOWARD, HOHENSTEIN, RIVERA, D. WILLIAMS, WARREN,
        CIRESI, BURGOS, HADDOCK, BOROWSKI AND HILL-EVANS,
        AUGUST 13, 2025

     REFERRED TO COMMITTEE ON HEALTH, AUGUST 14, 2025


                                    AN ACT
 1   Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An
 2      act relating to insurance; amending, revising, and
 3      consolidating the law providing for the incorporation of
 4      insurance companies, and the regulation, supervision, and
 5      protection of home and foreign insurance companies, Lloyds
 6      associations, reciprocal and inter-insurance exchanges, and
 7      fire insurance rating bureaus, and the regulation and
 8      supervision of insurance carried by such companies,
 9      associations, and exchanges, including insurance carried by
10      the State Workmen's Insurance Fund; providing penalties; and
11      repealing existing laws," in casualty insurance, providing
12      for coverage of COVID-19 vaccines.
13      The General Assembly of the Commonwealth of Pennsylvania
14   hereby enacts as follows:
15      Section 1.    The act of May 17, 1921 (P.L.682, No.284), known
16   as The Insurance Company Law of 1921, is amended by adding a
17   section to read:
18      Section 635.11.    Coverage of COVID-19 Vaccines.--(a)   A
19   health insurance policy offered, issued or renewed in this
20   Commonwealth shall provide coverage for COVID-19 vaccines with
21   no cost-sharing.
22      (b)   A government program shall provide coverage for COVID-19
 1   vaccines without cost-sharing.
 2      (c)     As used in this section, the following words and phrases
 3   shall have the meanings given to them in this subsection unless
 4   the context clearly indicates otherwise:
 5      "Cost-sharing" means:
 6      (1)     The share of the health care costs covered by a health
 7   insurance policy that an enrollee or covered person pays out-of-
 8   pocket.
 9      (2)     The term includes a deductible, coinsurance, copayment
10   or similar charge.
11      (3)     The term does not include a premium, a balance billed
12   amount from an out-of-network provider or the cost of a
13   noncovered service.
14      "COVID-19" means the coronavirus disease 2019, an infectious
15   disease caused by severe acute respiratory syndrome coronavirus
16   2 that was first identified during December 2019 in Wuhan,
17   China.
18      "COVID-19 vaccine" means a vaccine approved by the United
19   States Food and Drug Administration for use in the prevention of
20   COVID-19.
21      "Government program" means:
22      (1)     The Commonwealth's medical assistance program
23   established under the act of June 13, 1967 (P.L.31, No.21),
24   known as the "Human Services Code."
25      (2)     The children's health insurance program under Article
26   XXIII-A.
27      "Health insurance policy" means:
28      (1)     A policy, subscriber contract, certificate or plan
29   issued by an insurer that provides medical or health care
30   coverage.

20250HB1802PN2216                    - 2 -
 1      (2)    The term does not include any of the following:
 2      (i)    An accident only policy.
 3      (ii)     A credit only policy.
 4      (iii)     A long-term care or disability income policy.
 5      (iv)     A specified disease policy.
 6      (v)    A Medicare supplement policy.
 7      (vi)     A fixed indemnity policy.
 8      (vii)     A dental only policy.
 9      (viii)     A vision only policy.
10      (ix)     A workers' compensation policy.
11      (x)    An automobile medical payment policy.
12      (xi)     A policy under which benefits are provided by the
13   Federal Government to active or former military personnel and
14   their dependents, including a Tricare policy or a Civilian
15   Health And Medical Program of the United States (CHAMPUS)
16   supplement policy.
17      (xii)     A hospital indemnity policy.
18      (xiii)     Any other similar policy providing for limited
19   benefits.
20      "Insurer" means an entity licensed by the Insurance
21   Department that offers, issues or renews a health insurance
22   policy that provides medical or health care coverage by a health
23   care facility or licensed health care provider and that is
24   governed under any of the following:
25      (1)    This act, including section 630 and Article XXIV.
26      (2)    The act of December 29, 1972 (P.L.1701, No.364), known
27   as the "Health Maintenance Organization Act."
28      (3)    40 Pa.C.S. Ch. 61 (relating to hospital plan
29   corporations).
30      (4)    40 Pa.C.S. Ch. 63 (relating to professional health

20250HB1802PN2216                    - 3 -
 1   services plan corporations).
 2      Section 2.   A health insurance policy that is in effect on
 3   the effective date of this section and provides coverage of
 4   COVID-19 vaccines without cost-sharing may not, during the
 5   period between the effective date and the applicability date,
 6   eliminate or reduce coverage of COVID-19 vaccines or impose
 7   cost-sharing on COVID-19 vaccines.
 8      Section 3.   This act shall apply as follows:
 9          (1)    For health insurance policies for which either rates
10      or forms are required to be filed with the Federal Government
11      or the Insurance Department, the addition of section 635.11
12      of the act shall apply to any policy for which a form or rate
13      is first filed on or after the effective date of this
14      section.
15          (2)    For health insurance policies for which neither
16      rates nor forms are required to be filed with the Federal
17      Government or the Insurance Department, the addition of
18      section 635.11 of the act shall apply to any policy issued or
19      renewed on or after 180 days after the effective date of this
20      section.
21      Section 4.   This act shall take effect immediately.




20250HB1802PN2216                   - 4 -