Current through Pa Acts 2024-53, 2024-56 through 2024-79
Section 532.7b - Out-of-state coverage(a) No insurer shall issue in this Commonwealth group life insurance coverage provided under a group policy issued in another state or deliver or issue for delivery in this Commonwealth a certificate of group life insurance evidencing coverage under a group policy issued in another state unless: (1) Such coverage is in compliance with the requirements of this act and any other applicable act; or(2) For coverage under a group policy or a certificate evidencing coverage under a group policy issued to an out-of-State trustee of a fund, such coverage is issued in another state wherein the insurance supervisory official or agency of that state has determined that the issuance of the group policy or certificate is not contrary to the best interests of the general public, the issuance of the group policy or certificate would result in economies of acquisition or administration and the benefits are reasonable in relation to the premium charged. If coverage or a certificate is issued in this Commonwealth pursuant to this clause, an insurer shall file with the Insurance Department a copy of the group policy and certificate, a copy of the statute from the state in which the group policy or certificate is issued authorizing the issuance of the group policy or certificate, evidence of approval in the state where the policy or certificate is issued and copies of all supportive material used by the company to secure approval of the group policy or certificate in that state, including all the documentation required in this clause. The Insurance Commissioner, at any time subsequent to receipt of such information, after finding that the standards of this clause have not been met, may order the insurer to stop marketing such coverage in this Commonwealth.(i) This clause shall apply to any group policy or certificate evidencing coverage under a group policy issued to any organization, or to any trust or trustee of a trust established or participated in by one or more organizations, to insure certain persons: Provided, however, That the organization must be: (A) A bank, retailer or other issuer of a credit card, charge card or payment card that is issued to buy goods or services, and the policy must insure holders of that card; or(B) A bank, savings and loan association, credit union, mutual fund, money market fund, stock broker or other similar financial institution regulated by state or Federal law, and the policy must insure the depositors, account holders or members of that institution.(ii) This clause shall not apply to any group policy or certificate providing credit life insurance as defined in the act of September 2, 1961 (P.L. 1232, No. 540), known as the "Model Act for the Regulation of Credit Life Insurance and Credit Accident and Health Insurance." (b) The provisions of this act shall not apply if a group policy is issued to:(1) An out-of-State single employer.(2) A trustee of a fund established by any person acting directly as an employer having its principal office located in a state other than this Commonwealth.(3) An association, or a trust or trustee of a trust established or participated in by one or more associations, to insure association members or spouses or dependents of members: Provided, however, That the association must be organized or domiciled in a state other than this Commonwealth, have a constitution and bylaws, be organized by other than an insurer, be maintained in good faith for purposes other than those of obtaining insurance, have been in active existence for at least two years, operate from offices other than the insurer's and be controlled by principals other than the insurer's.(4) A union-negotiated out-of-State trust.(5) Other groups as may be determined by the Insurance Commissioner, subject to subsection (a).(c)(1) For group life insurance coverage provided in this Commonwealth under a group policy issued in another state, and except as provided in clause (2) of subsection (a) and subsection (b), all group policies, certificates, amendments, endorsements and enrollment forms shall be filed with the Insurance Commissioner for approval. The insurer shall also file with the Insurance Commissioner evidence of approval in the state where the group policy is issued.(2) Forms so filed for approval shall be subject to the provisions of section 354 of the act of May 17, 1921 (P.L. 682, No. 284), known as "The Insurance Company Law of 1921." (d) As used in this section, the term "out-of-State single employer" means any person acting directly as an employer and having its principal office located in a state other than this Commonwealth. "Out-of-State trustee of a fund" means a trustee of a fund established by an insurer for two or more employers or established by two or more persons acting directly as employers and the trustee having its principal office located in a state other than this Commonwealth. "Out-of-State coverage" means insurance coverage issued in this Commonwealth and provided under a group policy issued in a state other than this Commonwealth. A "union-negotiated out-of-State trust" means a trust established under a collective bargaining agreement and which is located in a state other than this Commonwealth. 1994, Feb. 3, P.L. 1, No. 1, § 6, effective in 90 days.