SB 53 — 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, further providing for conditions subject to which policies are to be issued and for health insurance coverage for certain children of insured parents.

PRINTER'S NO.    137

                     THE GENERAL ASSEMBLY OF PENNSYLVANIA



                        SENATE BILL
                        No. 53
                                               Session of
                                                 2025

     INTRODUCED BY SANTARSIERO, BROOKS, PISCIOTTANO, STREET, FONTANA,
        COMITTA, HUGHES, HAYWOOD, COLLETT, BAKER, COSTA, TARTAGLIONE
        AND KANE, JANUARY 29, 2025

     REFERRED TO BANKING AND INSURANCE, JANUARY 29, 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, further
12      providing for conditions subject to which policies are to be
13      issued and for health insurance coverage for certain children
14      of insured parents.
15      The General Assembly of the Commonwealth of Pennsylvania
16   hereby enacts as follows:
17      Section 1.    Sections 617(A)(3) and (9) and 617.1 of the act
18   of May 17, 1921 (P.L.682, No.284), known as The Insurance
19   Company Law of 1921, are amended to read:
20      Section 617.    Conditions Subject to Which Policies Are to Be
21   Issued.--(A)    No such policy shall be delivered or issued for
22   delivery to any person in this Commonwealth unless:
23      * * *
 1      (3)   it purports to insure only one person, except that a
 2   policy may insure, originally or by subsequent amendment, upon
 3   the application of an adult head of a family who shall be deemed
 4   the policyholder, any two or more eligible members of that
 5   family, including husband, wife, dependent children or any
 6   children under a specified age which[, except as provided under
 7   section 617.1, shall not exceed nineteen] shall be at least
 8   twenty-six years, and any other person dependent upon the
 9   policyholder; and
10      * * *
11      (9)   A policy delivered or issued for delivery after January
12   1, 1968, under which coverage of a dependent of a policyholder
13   terminates at a specified age shall, with respect to an
14   unmarried child covered by the policy prior to the attainment of
15   the age of [nineteen] twenty-six who is incapable of self-
16   sustaining employment by reason of [mental retardation or
17   physical handicap] an intellectual or physical disability and
18   who became so incapable prior to attainment of age [nineteen]
19   twenty-six and who is chiefly dependent upon such policyholder
20   for support and maintenance, not so terminate while the policy
21   remains in force and the dependent remains in such condition, if
22   the policyholder has within thirty-one days of such dependent's
23   attainment of the limiting age submitted proof of such
24   dependent's incapacity as described herein. The foregoing
25   provisions of this paragraph shall not require an insurer to
26   insure a dependent who [is a mentally retarded or physically
27   handicapped child] has an intellectual or physical disability
28   where the policy is underwritten on evidence of insurability
29   based on health factors set forth in the application or where
30   such dependent does not satisfy the conditions of the policy as

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 1   to any requirement for evidence of insurability or other
 2   provisions of the policy, satisfaction of which is required for
 3   coverage thereunder to take effect. In any such case the terms
 4   of the policy shall apply with regard to the coverage or
 5   exclusion from coverage of such dependent.
 6      * * *
 7      Section 617.1.     Health Insurance Coverage for Certain
 8   Children of Insured Parents.--(A)       (1)   A health insurance
 9   policy offered, issued or renewed in this Commonwealth that
10   provides dependent coverage of children shall continue to make
11   such coverage available for an adult child who has not attained
12   the age of twenty-six prior to the date of issuance or renewal.
13      (2)    With respect to a child who has not attained the age of
14   twenty-six, a health insurance policy:
15      (i)    May define dependent for purposes of eligibility for
16   dependent coverage of children in terms of a relationship
17   between the child and the policyholder or certificate holder,
18   including as described in 26 U.S.C. § 152(f)(1) (relating to
19   dependent defined).
20      (ii)    May not deny or restrict dependent coverage based on
21   any of the following or any combination of the following:
22      (a)    The presence or absence of the child's financial
23   dependency on any other person.
24      (b)    The residency of the child, whether by location,
25   including service area, or by residency with any other person.
26      (c)    The marital status of the child.
27      (d)    The child's enrollment in an academic or vocational
28   educational institution.
29      (e)    The child's employment status.
30      (3)    A health insurance policy providing dependent coverage

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 1   of children may deny or limit coverage, or impose additional
 2   conditions for coverage, for individuals not described in 26
 3   U.S.C. § 152(f)(1).
 4      (4)   The terms of a health insurance policy providing
 5   dependent coverage of children pursuant to this subsection may
 6   not vary based on age.
 7      (B)   (1)    An insurer that issues, delivers, executes or
 8   renews a group health [care] insurance policy in this
 9   Commonwealth under which coverage of a child would otherwise
10   terminate at a specified age shall, at the option of the
11   policyholder, provide coverage to a child of an insured employe
12   beyond that specified age, up through and including the age of
13   29, at the insured employe's expense, and provided that the
14   child meet all of the following requirements:
15      [(1)] (i)     Is not married.
16      [(2)] (ii)     Has no dependents.
17      [(3)] (iii)     Is a resident of this Commonwealth or is
18   enrolled as a full-time student at an institution of higher
19   education.
20      [(4)] (iv)     Is not provided coverage as a named subscriber,
21   insured, enrollee or covered person under any other group or
22   individual health insurance policy or enrolled in or entitled to
23   benefits under any government health care benefits program,
24   including benefits under Title XVIII of the Social Security Act
25   (49 Stat. 620, 42 U.S.C. § 1395 et seq.).
26      [(B)] (2)     Insurers may determine increases in premiums
27   related to continuation of coverage for the adult dependent
28   [past the limiting age of nineteen] twenty-six years of age or
29   older.
30      (C)   This section shall not include the following types of

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 1   insurance or any combination thereof:
 2      (1)    Hospital indemnity.
 3      (2)    Accident.
 4      (3)    Specified disease.
 5      (4)    Disability income.
 6      (5)    Dental.
 7      (6)    Vision.
 8      (7)    Civilian Health and Medical Program of the Uniformed
 9   Services (CHAMPUS) supplement.
10      (8)    Medicare supplement.
11      (9)    Long-term care.
12      (10)    Other limited benefit plans.
13      (11)    [Individual health insurance policies.] Fixed
14   indemnity.
15      (12)    Credit.
16      (13)    Workers' compensation or automobile medical payment
17   insurance.
18      (D)    For the purpose of this section:
19      "Health [care] insurance policy" means a [group] health,
20   sickness or accident policy or subscriber contract or
21   certificate issued by an entity subject to any one of the
22   following:
23      (1)    This act, including section 630.
24      (2)    The act of December 29, 1972 (P.L.1701, No.364), known
25   as the "Health Maintenance Organization Act."
26      (3)    The act of May 18, 1976 (P.L.123, No.54), known as the
27   "Individual Accident and Sickness Insurance Minimum Standards
28   Act."
29      (4)    40 Pa.C.S. Ch. 61 (relating to hospital plan
30   corporations) or 63 (relating to professional health services

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1   plan corporations).
2      (5)   Article XXIV.
3      Section 2.   The amendment of sections 617(A)(3) and (9) and
4   617.1 of the act shall apply to health insurance policies
5   offered, issued or renewed on or after the effective date of
6   this section.
7      Section 3.   All acts and parts of acts are repealed insofar
8   as they are inconsistent with this act.
9      Section 4.   This act shall take effect in 90 days.




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