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Health Insurance

Details: Choosing health insurance is one of the most important choices you can make to help protect the health and well-being of you and your family. There are various types of health insurance and different markets. Pennsylvania’s health

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Accident and Health

Details: Disclosure Requirements for Accident and Sickness Policies or Certificates: Guide to Health Insurance for People with Medicare Outline of coverage for Medicare Supplement Insurance Plans sold on or after January 1, 2020

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› Url: https://www.insurance.pa.gov/Companies/ProductAndRateRequire/Pages/Accident-and-Health.aspx Go Now

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Health Companies

Details: Health Insurance. COVID Insurance Info. Product & Rate Info. File A Complaint. Find an Insurance Professional. Special Funds. Pennsylvania Insurance Department > Companies > Filing Requirements > Health Companies. Begin Main Content Area Health Companies ITEMS OF INTEREST:

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› Url: https://www.insurance.pa.gov/Companies/FilingRequire/Pages/Health-Companies.aspx Go Now

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Know Your Rights: I Have Individual Health Insurance

Details: All individual health plans are required to cover mental health and substance use disorder services, including behavioral health services. This is because individual health insurance plans are required to cover certain benefits called Essential Health Benefits. Essential Health Benefits include certain categories of services, one of which is mental health and substance use …

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› Url: https://www.insurance.pa.gov/Coverage/Pages/IndividualHealthMHSUD.aspx Go Now

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Know Your Rights: My Small Employer Provides My Health

Details: Health insurance provided by a small employer (50 or fewer employees) that is fully insured is called small group insurance. Most small group health plans are required to cover mental health and substance use disorder services, including behavioral health services. This is because all non-grandfathered small group health insurance plans are

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› Url: https://www.insurance.pa.gov/Coverage/Pages/SmallGroupMHSUD.aspx Go Now

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Marketplace Alternative

Details: Health Insurance Outside of the Marketplace. If you are thinking about buying health insurance outside of the marketplace or short-term health insurance, you need to pay very close attention to what is covered because there are plans that do not have to meet minimum requirements for comprehensive coverage under the Affordable Care Act. Health insurance helps you to be …

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› Url: https://www.insurance.pa.gov/Coverage/Pages/Marketplace-Alternative.aspx Go Now

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Affordable Care Act in Pennsylvania Fact Sheet

Details: their parents’ health insurance up to age 26. • Free preventive care: Under the ACA, health plans must cover preventive services — like flu shots, cancer screenings, contraception, and mammograms – at no extra cost to consumers. This provision benefits 6.1 million people in Pennsylvania. •

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› Url: https://www.insurance.pa.gov/SiteAssets/Pages/default/ACA%20Fact%20Sheet.pdf Go Now

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BEFORE THE INSURANCE DEPARTMENT OF THE …

Details: It does not provide core health insurance services, such as provider contracting, care management, and routine claims processing. Because, in the event of a covered loss, covered

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› Url: https://www.insurance.pa.gov/Companies/IndustryActivity/Documents/HIGHMARK-BCNEPA%20CUMULATIVE%20LOG/0829.pdf Go Now

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Filing at a Glance

Details: American Progressive Life & Health Insurance Company of New York NAIC #80624 Request for Rate Revision – Long Term Care Forms: HHC 1/98, PRNHO, PRNHOQ, QHHC American Progressive Life & Health Insurance Company of New York is requesting the approval of a 65% composite premium rate increase on the above-referenced forms.

› Verified 7 days ago

› Url: https://www.insurance.pa.gov/Consumers/Documents/UNAM-131884155.pdf Go Now

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Filing at a Glance

Details: American Progressive Life & Health Insurance Company of New York NAIC #80624 Request for Rate Revision – Long Term Care Forms: HHC 1/98, PRNHO, PRNHOQ, QHHC American Progressive Life & Health Insurance Company of New York is requesting the approval of a 25% premium rate increase on the above-referenced forms.

› Verified 7 days ago

› Url: https://www.insurance.pa.gov/Consumers/Documents/UNAM-130502444.pdf Go Now

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How to Buy Health Insurance

Details: Healthcare.gov is the health insurance exchange website operated by the federal govern-ment, a marketplace where you can compare options and buy insurance. You can purchase a health plan outside of open en-rollment if you experience certain life changes including losing coverage from an employer, moving, getting married, or having a baby.

› Verified 6 days ago

› Url: https://www.insurance.pa.gov/Coverage/Documents/Health/How-to-Buy-Health-Insurance.pdf Go Now

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PENNSYLVANIA INSURANCE DEPARTMENT

Details: Accident and Health 16-02 or 16-03 Bonds: All Classes 16-05 or 16-06 Liability other than Motor Vehicle 16-05 or 16-06 Workers’ Compensation Insurance 16-05 or 16-06 Miscellaneous Exam Series Nonprofit Hospitalization 16-02 or 16-03 Title Insurance 16-10 Health Maintenance Organization 16-02 or 16-03

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› Url: https://www.insurance.pa.gov/Licensees/BeforeYouApply/Documents/PA%20Insurance%20Department%20Licensing%20Examination%20CIB.pdf Go Now

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2021 Health Rate Filings

Details: The Department recognizes the need for health insurance rate stability, affordability, and availability. It is the Department's goal to approve rates that best reflect future health care costs, while maintaining a health insurance market that is stable and competitive. Timeline: May 19, 2020; Initial filings without COVID assumptions; July 16, 2020

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› Url: https://www.insurance.pa.gov/Consumers/HealthInsuranceFilings/Pages/2021-Health-Rate-Filings.aspx Go Now

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HEALTHCARE PROVIDERS INSURANCE EXCHANGE

Details: Healthcare Providers Insurance Exchange - Assets and Liabilities. The Financial Statement Disclosure is an integral part of this statement. It is necessary to read the disclosure to fully understand the statements. The order of distribution of claims from the insurer's estate is set forth in detail in Article V of the Insurance Department Act

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› Url: https://www.insurance.pa.gov/Regulations/LiquidationRehab/Pages/HEALTHCARE-PROVIDERS-INSURANCE-EXCHANGE---ASSETS-AND-LIABILITIES.aspx Go Now

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2022 ACA-Compliant Health Insurance Rate Filing Guidance

Details: regulated under the single risk pool requirements in the ACA, and those that must follow all ACA health reform rating rules. This term excludes grandfathered, transitional, and student health plans. Student health guidance is posted on the Department’s website at

› Verified 5 days ago

› Url: https://www.insurance.pa.gov/Companies/ProductAndRateRequire/Documents/2021%20ACA/Final%20Rate%20Guidance%202022%20Updated%204.7.21.pdf Go Now

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The Pennsylvania Insurance Department is here to

Details: 4 Accidental Death Benefit Accidental Death Benefit pays a specified dollar benefit to the personal representative of a person who dies as a result of injuries sustained in an auto accident.

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› Url: https://www.insurance.pa.gov/Coverage/Documents/Auto/AutomobileInsuranceGuide-WEB.pdf Go Now

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How to Get Health Insurance

Details: How to Get Health Insurance. There are various types of health insurance and different markets. Pennsylvania's health insurance market can be broken down into Medicaid and CHIP, Medicare, and commercial fully insured and self-insured.There are different ways to obtain coverage depending on the market and the type of insurance that's best for you.

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› Url: https://www.insurance.pa.gov/Coverage/Pages/how-to-get-health-insurance.aspx Go Now

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Know Your Rights: My Large Employer Provides My Health

Details: Health insurance provided by a large employer (51 or more employees) that is fully insured is called large group insurance. Pennsylvania law requires large group insurance to cover certain serious mental illnesses as well as minimum levels of benefits for alcohol and substance use treatment, as explained in more detail below.

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› Url: https://www.insurance.pa.gov/Coverage/Pages/LargeGroupMHSUD.aspx Go Now

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Health Insurance for Seniors

Details: Throughout your adult life, you have probably had health insurance mostly through your employer or your spouse’s employer. Employer-provided insurance has costs for employees such as paying a portion of the monthly premium, a deductible, and co-pays for certain services.

› Verified 7 days ago

› Url: https://www.insurance.pa.gov/Coverage/Pages/Health-Insurance-for-Seniors.aspx Go Now

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PENNSYLVANIA MEDICARE SUPPLEMENT AVAILABLE PLANS

Details: CIGNA Health and Life Insurance Company 1021 Reams Fleming Boulevard Franklin, TN 37064 Erie Family Life Insurance Company Individual 2010 Plans A, B, F, G and N Central States Health & Life Co. of Omaha Capitol Life Insurance Company (The) Scranton, PA 18505 800-745-4927 1-800-558-4444 P.O. Box 34350 Omaha, NE 68134-0350 866-887-9323

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› Url: https://www.insurance.pa.gov/Coverage/Documents/Older%20Pennsylvanians/Med%20Supp%20List%207.13.2021.pdf Go Now

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COMMONWEALTH OF PENNSYLVANIA INSURANCE …

Details: Aetna Health Inc., a Pennsylvania corporation (“AHI”) (NAIC #95109) AHI was incorporated in the Commonwealth of Pennsylvania on May 7, 1981 and acquired the net assets and operations of a prepaid health care plan, which had operated as a health maintenance organization (HMO) in southeastern Pennsylvania since 1976. The Company commenced HMO

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› Url: https://www.insurance.pa.gov/Regulations/Regulatory%20Actions/Documents/Current%20Market%20Conduct/Aetna_FinalExamReport_01042019.pdf Go Now

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Filing Health INSURANCEAPPEALS

Details: health care services for a covered individual based on the coverage provided by the policy and the medical judgment of health care professionals. IROs do not work for the insurance companies and can fairly decide whether the insurance company or the covered individual is correct.

› Verified 7 days ago

› Url: https://www.insurance.pa.gov/Coverage/Documents/Health/FilingHealthInsuranceAppeals.pdf Go Now

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ACA Health Rate Filings

Details: aca code Affordable Care Act Health Rate Filings. Insurance companies offering individual and small group health insurance plans are required to file proposed rates with the Pennsylvania Insurance Department for review and approval before plans can be sold to consumers.

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› Url: https://www.insurance.pa.gov/Consumers/HealthInsuranceFilings/Pages/ACA-Health-Rate-Filings.aspx Go Now

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Health Insurance Glossary

Details: Qualified Health Plans (QHPs) but that doesn't cover any benefits other than 3 primary care visits per year before the plan's deductible is met. The premium amount you pay each month for a catastrophic health plan is generally lower than for other QHPs, but the out-of-pocket costs for deductibles, copayments, and coinsurance are generally higher.

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› Url: https://www.insurance.pa.gov/Coverage/Documents/Health/Health%20Insurance%20Glossary.pdf Go Now

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UPMC Health Coverage– Individual Plans

Details: UPMC Health Coverage– Individual Plans . Rate Request filing ID # UPMC-132801380 – This document is prepared by the insurance company submitting the rate filing as a consumer tool to help explain the rate filing. It is not intended to describe or include all factors or information considered in the review process. For more information, see the

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› Url: https://www.insurance.pa.gov/Consumers/Documents/UPMC.Health.Coverage.Ind.Decision.Summary.pdf Go Now

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File a Complaint

Details: File a Complaint. Whether you have a general question or want to file a complaint, you can get help by using Pennsylvania Consumer Services Online.. Customer Services Online or, CSO - is the Pennsylvania Insurance Department’s fast and secure online customer service tool.

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› Url: https://www.insurance.pa.gov/Consumers/insurance-complaint/Pages/default.aspx Go Now

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Geisinger Health Plan – Individual Plans

Details: Geisinger Health Plan – Individual Plans . Rate Request filing ID # GSHP-132824247 – This document is prepared by the insurance company submitting the rate filing as a consumer tool to help explain the rate filing. It is not intended to describe or include all factors or information considered in the review process. For more information

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› Url: https://www.insurance.pa.gov/Consumers/Documents/GHP.Ind.Decision.Summary.pdf Go Now

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AMERICAN NETWORK INSURANCE COMPANY

Details: Health Insurance. COVID Insurance Info. Product & Rate Info. File A Complaint. Find an Insurance Professional. Special Funds. Pennsylvania Insurance Department > Regulation > Liquidation & Rehab > AMERICAN NETWORK INSURANCE COMPANY. Begin Main Content Area AMERICAN NETWORK INSURANCE COMPANY

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Home [www.insurance.pa.gov]

Details: You can always contact the Pennsylvania Insurance Department to ask a question or file a complaint. You can call us at 1-877-881-6388 or click here. Additional Pet Insurance information can be found on the National Association of Insurance Commissioners (NAIC) website. Opens In A New Window.

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› Url: https://www.insurance.pa.gov/Coverage/Pet/Pages/PetInsurance.aspx Go Now

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UPMC Health Options– Individual Plans

Details: UPMC Health Options– Individual Plans . Rate Request filing ID # UPMC-132801412 – This document is prepared by the insurance company submitting the rate filing as a consumer tool to help explain the rate filing. It is not intended to describe or include all factors or information considered in the review process. For more information, see the

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› Url: https://www.insurance.pa.gov/Consumers/Documents/UPMC.Health.Options.Ind.Decision.Summary.pdf Go Now

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Insurance Producer (Non-Resident Business)

Details: Non-Resident Business Entities: For non-resident business entities, the business entity name will be reviewed upon application submission. Registration with the Pennsylvania Department of State may be required. Instructions will be sent upon issuance of the license. National Insurance Producer Registry (NIPR)

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› Url: https://www.insurance.pa.gov/Licensees/MaintainYourLicense/Pages/Insurance-Producer-(Non-Resident-Business).aspx Go Now

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THE INSURANCE DEPARTMENT OF COMMONWEALTH OF

Details: United Concordia Life and Health Insurance Company By UPE, a Pennsylvania nonprofit corporation RESPONSE TO PID INFORMATION REOUEST 3.7 FROM THE PENNSYLVANIA INSURANCE DEPARTMENT REQUEST 3.7: Provide a full and complete copy of any written testimony given on behalf of the

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› Url: https://www.insurance.pa.gov/Companies/IndustryActivity/CorporateTransactionsofPublicInterest/HighmarkWestPennAlleghenyHealthSystem/Documents/Highmark%20-%20West%20Penn%20Cumulative%20Log/0131.pdf Go Now

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PENNSYLVANIA MEDICARE SUPPLEMENT AVAILABLE PLANS

Details: CIGNA Health and Life Insurance Company 1021 Reams Fleming Boulevard Franklin, TN 37064 866-459-4272 Individual 2010 A, B, F, F (high deductible), G and N PO Box 5700 Carmel, IN 46032 866-459-4272 CIGNA National Health Insurance Company 11825 North Pennsylvania Street Colonial Penn Life Insurance Company 800-800-2254 Columbian Mutual Life

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› Url: https://www.insurance.pa.gov/Coverage/Documents/Older%20Pennsylvanians/Med%20Supp%20List%2012.30.2020.pdf Go Now

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Filing at a Glance

Details: The form listed above is a Preferred Provider Organization (PPO) health insurance product marketed to small employers. Benefits are comprehensive in nature, and include prescription drugs. Each plan included in this filing provides coverage for the essential health benefits, has an annual out-of-pocket limit,

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› Url: https://www.insurance.pa.gov/Consumers/ProductNotices/Documents/FEMC-130466230.pdf Go Now

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IN THE COMMONWEALTH COURT OF PENNSYLVANIA

Details: Senior Health Insurance Company of Pennsylvania (“SHIP”), hereby applies to this Court for its approval of a Second Case Management Order (“Second CMO”) establishing the necessary dates and procedures leading up to and for conducting a hearing on …

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› Url: https://www.insurance.pa.gov/Regulations/LiquidationRehab/Documents/SHIP/SHIP_FEBRUARY_3_2021_SECOND_CASE_MANAGEMENT_ORDER.pdf Go Now

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Bracing for change

Details: Some key provisions of the health care reform law Effective years 3 Major tranches of health care reform Regulation & Coverage 2010 - 2013 • Extending dependent care for adult children until age 26 • Eliminating pre-existing condition coverage exclusion for children • Temporary high risk pools for adults with pre-existing conditions

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› Url: https://www.insurance.pa.gov/Mcare%20Documents/PWC%20_MPL_2014_Presentation.pdf Go Now

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Health Insurance Questions

Details: The Office of Mental Health and Substance Abuse Services (OMHSAS) partnered with the Center for Community Resources to offer a 24/7 mental health and crisis support line for people dealing with anxiety or other difficult emotions. Callers will be able to speak with staff who are trained in trauma-informed principles and will listen, assess the

› Verified 8 days ago

› Url: https://www.insurance.pa.gov/coronavirus/Pages/Health-Insurance-Questions.aspx Go Now

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UPMC Health Benefits, Inc. Small Group Plans

Details: For small employer health plans: The employer’s premium will vary based on their employees’ age, the employer’s location, their employee’s family size, and the benefits they choose. Claims/Medical Costs: What the health plan spends on direct medical services including hospital stays, providers, and prescription drugs.

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› Url: https://www.insurance.pa.gov/Consumers/HealthInsuranceFilings/Documents/UPMC-132364942%20Decision%20Summary.pdf Go Now

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Current Enforcement

Details: Current Enforcement Actions. View Archived Enforcement Actions. A. A Plus Insurance Agency LLC (West Deptford, NJ) 5/21. Abdelhak, Matthew Samy (Oakdale, PA) 11/19. Absolute Abstract Agency, Inc. (Mr. Pocono, PA) and Elwood C. Kurtz, III (Tannersville, PA) 3/1. Adair Brian Joseph (Pittsburgh, PA) 6/19. Aggrey-Finn, John (Stroudsburg, PA) 3/20.

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› Url: https://www.insurance.pa.gov/Regulations/Regulatory%20Actions/Pages/CurrentEnforcement.aspx Go Now

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Archived 2020 Health Insurance Rate Filings

Details: Archived 2020 Health Insurance Rate Filings. Insurance companies offering individual and small group health insurance plans are required to file proposed rates with the Pennsylvania Insurance Department for review and approval before plans can be sold to consumers.

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› Url: https://www.insurance.pa.gov/Consumers/HealthInsuranceFilings/Pages/2020-Health-Rate-Filings.aspx Go Now

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Mental Health Parity FAQs

Details: The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is a federal law that requires the same health insurance coverage for mental health and/or substance use disorder (MH/SUD) conditions as patients would receive for coverage of medical/surgical (M/S) services. This law was adopted into Pennsylvania law in 2010.

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› Url: https://www.insurance.pa.gov/Coverage/Pages/Mental-Health-Parity-FAQs.aspx Go Now

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Exchange Assisters Contact List

Details: Exchange Assisters Contact List. *Additions will be made to this list as they are received and verified. The Pennsylvania Insurance Department does not endorse any exchange assister organization. York County. Wyoming County. Westmoreland County. Wayne County. Washington County. Warren County.

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› Url: https://www.insurance.pa.gov/Coverage/Pages/Exchange%20Assisters.aspx Go Now

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APPROVED LONG TERM CARE CARRIERS IN PENNSYLVANIA

Details: American Progressive Life and Health Insurance Company of New York 6 International Drive . Suite 190 . Rye Brook, NY 10573-1068 Phone: 800-332-3377 . NAIC #80624 . Amex Assurance Company 480 Pilgrim Way . Suite 1400 . Green Bay, WI 54304 Phone: 920-431-4051 . NAIC #27928 . Assurity Life Insurance Company - ** Partnership Approved Policy Available

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