Ifiegislatifr.e ~Journal

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1 COMMONWEALTH OF PENNSYLVANIA Ifiegislatifr.e ~Journal WEDNESDAY, NOVEMBER 13,1996 SESSION OF TH OF THE GENERAL ASSEMBLY No. 58 SENATE WEDNESDAY, November 13, 1996 The Senate met at 11:30 a.m., Eastern Standard Time. The PRESIDENT pro tempore (Robert C. Jubelirer) in the Chair. PRAYER The Chaplain, Reverend BRUCE D. FARRElL, of Trinity United Church of Christ, Palmyra, offered the following prayer: Let us pray. Our most gracious Creator, we stop before the opening of this Session of the Senate today and acknowledge Your still and quiet presence with us. In spite of all our accomplishments, You, not we, are the center of the universe. Hear this moment of silence as we acknowledge You. (Pause.) On this day as we hustle about our business, many in our midst cany heavy burdens, secret fears, gnawing anxieties, and troublesome blind spots. May Your word to them break through the background noise of this day's routine. May they find in You the tjue peace that passes all human understanding. We ask Your comforting presence to be with those in this Chamber and the House who will not be returning next year because of retirement or an unsuccessful reelection bid. Give them a renewed sense of Your work for them, which is the highest calling of all. Be with the many campaign supporters who wodced so hard for their candidates. Encomage them not to give up working for the betterment of the Commonwealth. Be with all those retwning and the newly-elected as well, that they may not lose sight of what is truly important, the overall best for the citizens of the Commonwealth. May tjue hmnility be their gift this day and in the year ahead. Please give the Senators and staff wisdom in their deliberations, a vision for the long-tenn effects of their actions, courage to do right, and graciousness to work with others. God bless the Commonwealth of Pennsylvania. In Your holy name we pray. Amen. The PRESIDENf pro tempore. The Chair thanks Reverend Farrell, who is the guest today of Senator Brightbill. JOURNAL APPROVED The PRESIDENT pro tempore. A quonun of the Senate being present, the Oede will read the Jomnal of the preceding Session of November 12, The Clerk proceeded to read the Journal of the preceding Session, when, on motion ofsenator LOEPER, further reading was dispensed with and the Journal was approved. GENERAL COMMUNICATION ANNUAL REPORT ON THE RADIATION PRarECfION ACf The PRESIDENT pro tempore laid before the Senate the following communication, which was read by the Clerk as follows: PENNSYLVANIA EMERGENCY MANAGEMENT AGENCY Box 3321 Hanisburg, Pennsylvania Date: November 7, 1996 Subject: Annual Report on the Radiation Protection Act for Fiscal Year To: From: The Honorable Tom Ridge The Honorable Mark S. Schweikcr Ueutenant, President ofthe Senate and Chairman, Pennsylvania Emergency Management Council Honorable Matthew J. Ryan Speaker of the House of Representatives Honorable Robert C. Jubelirer President Pro Tempore of the Senate CHARLES F. WYNNE Director This report, covering activity and proposals, is submitted in accordance with Section 503.(c) of the Radiation Protection Act The regulations implementing this Act were published in the Pennsylvania Bulletin on August 3, 1985, and they appear in TItle 4 PA Code, Chapters 116 and 117. The PRESIDENT pro tempore. This report will be filed in the Library.

2 2574 LEGISLATIVE JOURNAL - SENATE NOVEMBER 13, SPECIAL ORDER OF BUSINESS ANNOUNCEMENT BY THE SECRETARY The SECRETARY. Consent has been given for the Committee OIl Environmental Resources and Energy to meet during today's Session to consider House Bill No REPORTS FROM COMMITTEES Senator PETERSON, from the Committee OIl Public Health and Welfare, reported the following bills: SB 1662 (Pr. No. 2259) An Act amending the act of April 14, 1972 (P. L. 233, No. 64), entitled "1be Controlled Substance, Omg, Device and Cosmetic Act," further providing for schedules of controlled substances. SB 1720 (Pr. No. 2370) An Act amending the act of July 19, 1979 (p. L. 130, No. 48), entitled "Health Care Facilities Act," further providing for the expiration of certificate of need requirements. DB 206S (Pr. No. 4216) (Amended) An Act amending the act of April 14, 1972 (p.l.221, No.63), known as the Pennsylvania Orog and Alcohol Abuse Control Act, adding a definition; providing for commibnent ofminors and further providing for financial obligation. Senator HOlL, from the Cmunittee on Banking and Insurance, reported the following bills: SB 1122 (Pr. No. 2394) (Amended) (Rereported) An Act amending the act of October 15, 1975 (p. L. 390, No. 111), entitled "Health Care Services Malpractice Act," further providing for definitions, for statutes of limitation, for professional liability insurance and the Medical Professional Uability Catastrophe Loss Fund and for administration of that fund, for liability of excess earners; providing for a Medical Professional Insurance Fund Advisory Board and for surcharge limits; and further providing for plan operation and rates, for reports to the Insurance Commissioner, for foims of doing business and for the Joint Study Committee. DB 2210 (Pr. No. 4215) (Amended) An Act amending the act of October 15, 1975 (pl.390, No.lll), known as the Health Care Services Malpractice Act, fmtber providing for liability insurance and the Medical Professional Liability Catastrophe Loss Fund. DB 2617 (Pr. No. 4214) (Amended) An Act amending the act of October 28, 1966 (1st Sp.Sess., P.L.55, No.7), known as the Goods and Services Installment Sales Act, further providing for installment contract service charges and installment account service charges and for the minimum service charge. Senator BELL, from the Committee on Consumer Protection and Professional Licensure, reported the following bills: DB 1782 (Pr. No. 3657) An Act amending the act of May 26, 1947 (p. L. 318, No. 140), known as The C.P.A. Law, amending the title; further providing for the short title, for definitions, for the Public Accountants' Advisory Committee, for the State Board ofaccountancy and its general powers, for general qualifications, for education and experience and for reciprocity; providing for foreign reciprocity; further providing for licensure, for partnership and corporate licensure and for registration of public accountants; providing for licensure of films and for peer review; further providing for discipline, for reinstatement, for revocation and suspension, for agency, for work product, for privilege, for penalties and remedies, for construction and for audits; regulating the professional responsibility oflicensees; and reenacting certain provisions. lib 1988 (Pr. No. 3807) An Act regulating tanning facilities; providing for the registration ofpersons operating tanning facilities; requiring that certain warnings be given and safeguards be taken; providing penalties; and making a repeal. lib 2595 (Pr. No. 4209) (Amended) An Act amending the act of February 19, 1980 (p.l. 15, No.9), known as Real Estate Ucensing and Registration Act, providing for commercial real estate broker liens. LEGISLATIVE LEAVE The PRESIDENf pro tempore. The Chair recognizes the gentleman from Indiana, Senator Stapleton. Senator STAPLEION. Mr. President, I request a temporary Capitol leave for Senator Bodack. The PRESIDENf pro tempore. Senator Stapleton requests a temporary Capitol leave for Senator Bodack. Without objection, that leave is granted. LEAVES OF ABSENCE Senator WEPER. asked and obtained leaves of absence for Senator SALVATORE, Senator HELFRICK, and Senator RHOADES, for today's Session, for personal reasons. CALENDAR SB 1682 CALLED UP OUT OF ORDER SB 1682 (Pr. No. 2391) -- Without objection, the bill was called up out of order, from page 1 of the Third Consideration Calendar, by Senator WEPER.. BILL REREPORTED FROM COMMITIEE AS AMENDED ON TIDRD CONSIDERATION AND FINAL PASSAGE SB 1682 (Pr. No. 2391) - The Senate proceeded to consideration of the bill, entitled: An Act providing for alternatives to achieve 180 days of instruction for school districts of the third class affected by flash floods occurring July 19, Considered the third time and agreed to, And the amendments made thereto having been printed as required by the Constitution, On the question, Shall the bill pass finally?

3 1996 LEGISLATIVE JOURNAL - SENATE 2575 The yeas and nays were taken agreeably to the provisions of the Constitution and were as follows, viz: YEAS--46 Aftlerbach Gerlach MeDow Stapleton Andrezeslci Greenleaf Mowery Stewart Armstrong Hart Musto Stout Belan Heckler O'Pake Tartaglione BeD Holl Peterson Thompson Bodack Hughes Piccola Tilghman Brightbill Jubelirer Porterfield Tomlinson Corman Kasunic Punt Uliana Costa LaValle Robbins Wagner Delp Lemmond Schwartz Wenger Fisher Loeper Shaffer Williams FuDlO Madigan NAYS-o A constitutional majority of all the Senators having voted "aye," the question was determined in the affirmative. Ordered, That the Secretary of the Senate present said bill to the House of Representatives for concurrence. SPECIAL ORDER OF BUSINESS GUESTS OF SENATOR ROY C. AFFLERBACH PRESENTED TO THE SENATE gentleman from Lehigh, Senator Mflerbach. Senator AFFLERBACH. Mr. President, in the gallery we have the Hunt family from the 16th Senatorial District. They are James, Sheryl, Jonathan, and Kristin. They have traveled to Harrisburg today to shadow their Senator throughout the course of his duties to fmd out precisely what we are doing, and I must say they have done an admirable job of keeping up with us on this day as we have raced from committee meeting to committee meeting and to rallies in the Rotunda, and so forth. I would ask the Senate, in its usual fashion, to provide a warm welcome to these visitors from the Lehigh Valley. The PRESIDENf pro tempore. Would the guests of Senator Afflerbach please rise so that the Senate may give you a wmm welcome. (Applause.) GUESTS OF SENATOR DAVID J. BRIGHTBILL PRESENTED TO THE SENATE gentleman from Lebanon, Senator Brightbill. Senator BRIGHfBILL. Mr. President, I am pleased to have in the gallery today the family of Reverend Bruce D. Farrell, Dr. Farrell, and he, of course, was our Chaplain for today. With us today is his wife, Susan, and his children, Ruth, Caleb, and Bethany. I would mention that Ruth is a 16-year-old freshman at Lebanon Valley College. I would also mention that we should extend to Reverend Farrell a very special thanks on behalf of the Long family for the outstanding work he did at the funeral of Pearl Weaver Long. I know that the Long family was very pleased and his comments were very inspirational. The PRESIDENT pro tempore. Would the guests of Senator Brightbill who are in the gallery please rise so that the Senate may welcome you. (Applause.) GUESTS OF SENATOR DANIEL S. DELP PRESENTED TO THE SENATE gentleman from York, Senator Delp. Senator DaR Mr. President, with us today acting as guest Pages are two foreign exchange students with the Rotary exchange program. They are limea Gaal. who is frm Hungary, and her host family is Betsy and Dave Meck:Iey; and Santiago Vega, from Ecuador. I would appreciate it if the Senate would give them its usual warm welcome. The PRESIDENT pro tempore. Would the guests ofsenator Delp please rise. (Applause.) The PRESIDENf pro tempore. The Chair welcomes all guests to the Senate of Pennsylvania. RECESS gentleman from Delaware, Senator Loeper. Senator LOEPER. Mr. President, at this time I ask for a recess of the Senate for the purpose of a Republican caucus to be held in the Rules room at the rear of the Senate Chamber. I anticipate that the caucus should be no more than a half-hour, Mr. President, and we should be able to return to the floor hopefully by 12:45, 1:00 at the latest. gentleman from Indiana, Senator Stapleton. Senator STAPLElON. Mr. President, I would ask all Democrats to report to their caucus room immediately. The PRESIDENT pro tempore. For pmposes of Republican and Democratic caucuses to take place in the Rules room and the Democratic caucus room, the Senate will stand in recess. AFTER RECESS The PRESIDENf pro tempore. The time of recess having expired, the Senate will come to order. LEGISLATIVE LEAVE CANCELLED The PRESIDENT pro tempore. The Chair notes the presence on the floor of Senator Bodack. His temporary Capitol leave is hereby cancelled. CONSIDERATION OF CALENDAR RESUMED THIRD CONSIDERATION CALENDAR BILLS REREPORlED FROM COMMITIEE AS AMENDED OVER IN ORDER SB 1320, lib 2572 and lib Without objection, the bills were passed over in their order at the request of Senator LOEPER.

4 2576 LEGISLATIVE JOURNAL - SENATE NOVEMBER 13, BILL ON THIRD CONSIDERATION AND FINAL PASSAGE SB 471 (Pr. No. 490) -- The Senate proceeded to consideration of the bill, entitled: An Act amending the act of June 11, 1968 (p. L. 149, No. 84), entitlc:d, as amended, "\blunteer F'Jrefighters' Relief Association Act," further providing for the pwposes for which funds of an association may be spent Considered the third time and agreed to, On the question, Sball the bill pass fmally? LEGISLATIVE LEAVES gentleman from Lackawanna, Senator Mellow. Senator MElLOW Mr. President, I request temporary Capitol leaves for Senator Afflerbach, Senator Kasunic, Senator Stapleton, Senator Stout, Senator Belan, and Senator Williams. The PRESIDENT pro tempore. Senator Mellow requests temporary Capitol leaves for Senator Mflerbach, Senator Kasunic, Senator Stapleton, Senator Stout, Senator Belan, and Senator Wtlliams. Without objection, those leaves are granted. The Chair recognizes the gentleman film Delaware, Senator Loeper. Senator WEPER. Mr. President, I request a temporary Capitol leave on behalf of Senator Peterson, who has been called to his office. The PRESIDENT pro tempore. Senator Loeper requests a temporary Capitol leave for Senator Peterson. Without objection, that leave will be granted. And the question recurring, Shall the bill pass fmally? The yeas and nays were taken agreeably to the provisions of the Constitution and were as follows, viz: YEAS-46 Afilerbach Gerlach Mellow Stapleton Andrezeski Greenleaf Mowery Stewart Armstrong Hart Musto Stout Belan Heckler O'Pake Tartaglione Bell Holl Peterson Thompson Bodack Hughes Piccola Tilghman Brightbill Jubelirer Porterfield Tomlinson Corman Kasunic Punt Uliana Costa LaValle Robbins Wagner Delp Lemmond Schwartz Wenger Fisher Loeper Shaffer Williams Furno Madigan NAYS-4> A constitutional majority of all the Senators having voted "aye," the question was determined in the affrrmative. Ordered, That the Secretary of the Senate present said bill to the House of Representatives for concurrence. BILLS OVER IN ORDER HB 6ID, lib 683, lib 684, lib 686 and HB Without objection, the bills were passed over in their order at the request of Senator WEPER. BILL ON THIRD CONSIDERATION AND FINAL PASSAGE SB 1071 (Pr. No. 1187) -The Senate proceeded to consideration of the bill, entitled: An Act amending ntle 18 (Crimes and Offenses) of the Pennsylvania Consolidated Statutes, further providing for harassment and stalking. Considered the third time and agreed to, On the question, Shall the bill pass fmally? The yeas and nays were taken agreeably to the provisions of the Constitution and were as follows, viz: YEAS-46 Afilerbach Gerlach Mellow Stapleton Andrezeski Greenleaf Mowery Stewart Armstrong Hart Musto Stout Belao Heckler O'Pake Tartag1ione Bell Holl Peterson Thompson Bodack Hughes Piccola Tilghman Brightbill Jubelirer Porterfield Tomlinson Corman Kasunic Punt Uliana Costa LaValle Robbins Wagner Delp Lemmond Schwartz Wenger Fisher Loeper Shaffer Williams Furno Madigan NAYS-4> A constitutional majority of all the Senators having voted "aye," the question was determined in the affumative. Ordered, That the Secretary ofthe Senate present said bill to the House of Representatives for concurrence. BILL OVER IN ORDER SB Without objection, the bill was passed over in its order at the request of Senator WEPER. BILL AMENDED SB 1462 (Pr. No. 2390) -The Senate proceeded to consideration of the bill, entitled: A Slg)1cment to the act of (P. L., No. ), entitled "Capital Budget Project Itemization Act for ," itemizing public improvement projects, furniture and equipmentprojects, transportation assistance projects, redevelopment assistance and redevelopment assistance capital projects, flood control projects, Keystone Recreation, Park and Conservation projects and forestry bridge projects to be constructed or acquired or assisted by the Department of General Services, the Department of Conservation and Natural Resources, the Deparbnent of Environmental Protection, the Deparbnent of Community and Economic Development, the Department of Transportation, the Pennsylvania Fish and Boat Commission or the Pennsylvania Game Commission, together with their estimated financial

5 1996 LEGISLATIVE JOURNAL - SENATE 2577 costs; authorizing the incuning of debt without the approval of the e1ectms f01' the pmpose of financing the projects to be constiucted or acquired or assisted by the Department of General Services, the Department of Conservation and Natural Resources, the Department of Environmental Protection, the Department of Community and Economic Development or the Department of Transportation; stating the estimated useful life of the projects; authorizing certain waivers; making appropriations; and making repeals. On the question, Will the Senate agree to the bill on third consideration? Senator WEPER offered the following amendment No. A7087: Amend Sec. 6, page 55, by inserting between lines 9 and 10: (iv) Altoona-Blair County Development Ccnporation (A) Multi-Modal Industrial Park Distribution Center 3,000,000 (8) Altoona-Blair County Air Park -Air Freight!Air Cargo Distribution Facilities 3,500,000 (C) BusinesslResearch Park Corridor Location 2,500,000 (D) EntrepreneuriallBusiness Resource Center 2,500,000 On the question, Will the Senate agree to the amendment? It was agreed to. Without objection, the bill, as amended, was passed over in its order at the request of Senator WEPER. BllL ON TIllRD CONSIDERATION AND FINAL PASSAGE lib 1468 (Pr. No. 4048) -- The Senate proceeded to consideration of the bill, entitled: An Act exempting medical care savings accounts from State personal income tax; and providing for mandated benefits. On the question, Will the Senate agree to the bill on third consideration? Senator SCHWARTZ offered the following amendment No. A64II: Amend TItle, page 1, line 4, by striking out "AND" Amend Bill, page 1, line 4, by removing the period after ''BENE FITS" and inserting: ; requiring all health insurers, health service corporations and health maintenance Organizations to provide individual health benefits coverage on an open enrollment basis; and establishing the Individual Health Coverage Program.. TABLE OF CONTENTS Chapter 1. General Provisions Section 101. Short title. Chapter 3. Medical Savings Accounts Section 301. Legislative intent. Section 302. Treatment of contribution, interest and reimbursements. Section 303. Mandated benefits. Chapter 5. Individual Health Insurance Section 501. Definitions. Section 502. Individual health benefits plans required. Section 503. Guarantee of coverage and renewal of policy. Section 504. Duties of board. Section 505. Exceptions to required coverage. Section 506. Rates and filings. Section 507. Individual Health Coverage Program and board. Section 508. Powers and authority of program and board. Section 509. Program losses; immunity; payments; and nongroup persons. Section 510. Statement of net paid losses and reimbursement Section 511. DeteJmination of carriers with disproportionate share of substandud risks and recommendations for remedial action. Section 512. Sale of plan. Section 513. Rate filings. Section 514. Action by boud' Section 515. Prohibition. Section 516. Applicability; duplicative coverage; penalties; rates. Chapter 11. Miscellaneous Provisions Section Effective date. Amend Bill, page 1, by inserting between lines 6 and 7: CHAPTER 1 GENERAL PROVISIONS Amend Sec. 1, page 1, line 7, by striking out "1" and inserting: 101 Amend Sec. 1, page 1, line 9, by inserting after "Account": and Individual Health Insurance Amend Bill, page 10, by inserting between lines 29 and 30: CHAPI'ER 3 MEDICAL SAVINGS ACCOUNTS Amend Sec. 2, page 10, line 30, by striking out "2" and inserting: 301 Amend Sec. 3, page 11, line 6, by striking out "3" and inserting: 302 Amend Sec. 4, page 11, line 15, by striking out "4" and inserting: 303 Amend Bill, page 11, lines 21 and 22, by striking out all of said lines and inserting: CHAPI'ER 5 INDIVIDUAL HEALnI INSURANCE Section 501. Definitions. The following words and phrases when used in this chapter shall have the meanings given to them in this section unless the context clearly indicates otherwise: "Board." The board of directors of the Individual Health Coverage Program. "Carrier." An insurance company, health service coiporation or health maintenance organization authorized to issue health benefits plans in this Commonwealth. For purposes of this chapter, carriers that are affiliated companies shall be treated as one carrier. "Commissioner." The Insurance Commissioner ofthe Commonwealth. "Community rating." A rating system in which the premium for all persons covered by a contnlct is the same, based on the experience of all persons covered by that contract, without regard to age, sex, health status, occupation and geographical location. "Department" The Insmance Department of the Commonwealth. "Dependent" The spouse or child of an eligible person, subject to applicable terms of the individual health benefits plan. "Eligible person." A person who is a resident of this Commonwealth who is not eligible to be insured under a group health insurance policy, Medicare or Medicaid. "Financially impaired." A carrier which, after the effective date of this chapter, is not insolvent rot is deemed by the Insmance Commissioner to be potentially unable to fulfill its contractual obligations, 01' a carner which is placed under an order of rehabilitation 01' conservation by a court of competent jurisdiction. "Group health benefits plan." A health benefits plan for groups of two or more persons. "Health benefits plan." A hospital and medical expense insurance policy, health service coiporation contract or health maintenance organization subscriber contract delivered or issued for delivery in this Commonwealth. The term does not include the following plans, policies or contracts: accident only, credit, disability, long-term care,

6 2578 LEGISLATIVE JOURNAL - SENATE NOVEMBER 13, Medicare supplement coverage, CHAMPUS supplement coverage, cow:ragc b ~ sc:rvic:es pursuant to a contract with the Federal Government, coverage for Medicaid services pursuant to a contract with the Commonwealth, coverage arising out of a workers' compensation or similar law, automobile medical payment insurance or hospital confinement indemnity coverage. "Hospital C'Jtpense8." Any chalges billed by and payable directly by a carrier to a hospital. "Individual health benefits plans." Includes: (1) A health benefits plan for eligible persons and their dependents. (2) A certificate issued to an eligible person which evidences coverage under a policy or contract issued to a trust or association, regardless of the situs of delivcl}' of the policy or contract, if the eligible person pays the premium and is not being covered under the policy or contract pursuant to continuation of benefits provisions applicable under Federal or State law. The term does not include a certificate issued under a policy or contmct issued to a tnjst, or to the tnjstees of a fund, which tnjst or fund is established or adopted by two or more employers, by one or more labor unions or similar employee organizations, or by one or more employers and one or more labor unions or similar employee organizations, to insure employees of the employers or members of the unions or organizations. "Licensed producer." As defined in section 701 of the act of May 17, 1921 (p.l.789, No.285), known as The Insurance Department Act of "Member." A camer that is a member of the Individual Health Coverage Program under this chapter. "Modified community rating." A rating system in which the premium for all persons covered by a contract is foldlulated based on the experience of all persons covered by that contract, without regard to age, sex, occupation and geographical location, but which may differ by health status. The term applies to contracts and policies issued prior to the effective date of this chapter which are subject to section 516. "Net earned premium." The premiums earned in this Commonwealth on health benefits plans, less return premiums thereon and dividends paid or credited to policy or contract holders on the health benefits plan business. The term includes the aggregate premiums earned on the camer's insured group and individual business and health maintenance organization business, including premiums from any Medicare or Medicaid contracts with the Federal or State government, but shall not include any C'Jtccss or stop-loss coverage issued by a camer in connection with any self-insured health benefits plan, or Medicare supplement policies or contracts. "Open enrollment" The offering of an individual health benefits plan to any eligible person on a guaranteed issue basis, pursuant to procedures established by the board of directors of the Individual Health Coverage Program. "Plan of operation." The plan of operation of the Individual Health Coverage Program adopted by the board under this chapter. "Preexisting condition." A condition that, during a specified period of not more than six months immediately preceding the effective date of coverage, had manifested itself in such a manner as would cause an ordinarily prudent person to seek medical advice, diagnosis, care or treatment, or for which medical advice, diagnosis, care or treatment was recommended or received as to that condition or as to a pregnancy existing on the effective date of coverage. "Progmm." The Individual Health Coverage Progmm established under this chapter. Section 502. Individual health benefits plans required. (a) Plans required to be offered.-no Iater than 180 days after the effective date of this chapter, a camer shall, as a condition of issuing health benefits plans in this Commonwealth, offer individual health benefits plans. The plans shall be offered on an open enrollment, community-rated basis, pursuant to the provisions of this chapter, except that a camer shall be deemed to have satisfied its obligation to provide the individual health benefits plans by paying an assessment or receiving an exemption pursuant to section 509. (b) Choice of plans.-a camer shall offer to an eligible person a choice of five individual health benefits plans, any of which may contain provisions for managed care. One plan shall be a basic health benefits plan, one plan shall be a managed care plan and three plans shall include enhanced benefits ofproportionally increasing actuarial value. A canier may elect to convert any individual contract or policy forms in force on the effective date of this chapter to any of the five benefit plans, except that the camer may not convert more than 25% of C'Jtisting contracts or policies each year, and the replacement plan shall be of no less actuarial value than the policy or contract being replaced. Notwithstanding the provisions of this subsection to the contraly, at any time after three years after the effective date of this chapter, the board, by regulation, may reduce the number of plans required to be offered by a camer. Notwithstanding the provisions of this subsection to the contraly, a health maintenance organization which is a qualified health maintenance organization pursuant to the Health Maintenance Organization Act of 1973 (Public Law , 42 U.S.C. 300e et seq.) shall be permitted to offer a basic health benefits plan in accordance with the provisions of that law in lieu of the five plans required under this subsection. (c) Benefits of plan.- (1) A basic health benefits plan shall provide, at a minimum, the following: (i) Inpatient hospital services. (ii) Emergency outpatient hospital services. (iii) Routine and emergency physician services, including those provided in health clinics but excluding those provided in nursing care or intermediate care facilities. (iv) Prenatal, delivcl}' and postpartum care. (v) Laboratory and diagnostic X-ray services. (vi) X-ray, radium and radioactive isotope therapy. (vii) Services of a nurse midwife. (viii) Home health services in cases where it is determined that the coverage of such services is cost effective. (ix) Ambulatory and institutional services. (x) Drugs or biologicals that are provided as part of any inpatient hospital services. (2) Notwithstanding the provisions of this subsection or any other law to the contraly, a camer may, with the approval of the board, modify the coverage provided for under paragraph (1) or provide alternative benefits or services from those required by this subsection if they are within the intent of this chapter or if the board changes the benefits included in the basic health benefits plan. (3) A contract or policy for a basic health benefits plan provided for in this section may contain or provide for coinsurance or deductibles, or both, except that no deductible shall be payable in excess of a total of $250 by an individual or $500 by a family unit during any benefit year, and no coinsurance shall be payable in excess of a total of $500 by an individual or by a family unit during any benefit year. Any person previously covered under a group or individual health benefits plan may apply deductibles paid under the previous plan to annual limits under the basic health benefits plan. (4) Notwithstanding the provisions of paragraph (3) or any other law to the contraly, a carrier may provide for increased deductibles or coinsurance for a basic health benefits plan if approved by the board or if the board increases deductibles or coinsurance included in the basic health benefits plan. (d) Application.-Every group conversion contract or policy issued after the effective date of this chapter shall be issued pursuant to this section, except that this requirement shall not apply to any group conversion contract or policy in which a portion of the premium is chargeable to or subsidized by the group policy from which the conversion is made. (e) Contingency.-If all five of the individual health benefits plans are not established by the board by January 1, 1997, a carrier may phase in the offering of the five health benefits plans by offering each health benefits plan as it is established by the board. However,

7 1996 LEGISLATIVE JOURNAL - SENATE 2579 once the board establishes all five plans, the camer shall be required to offer the five plans in accordance with this chapter. Section 503. Guarantee of coverage and renewal of policy. An individual health benefits plan issued pmsuant to section 502 is subject to the following provisions: (1) The health benefits plan shall guarantee coverage for an eligible person and his dependents on a community-rated basis. (2) A health benefits plan shall be renewable with respect to an eligible person and his dependents at the option of the policy or contract holder except under the following circumstances: (i) nonpayment of the required premiums by the policy or contract holder, (ii) fraud or misrepresentation by the policy or contract holder, including equitable fraud, with respect to coverage of eligible individuals or their dependents; (iii) termination of eligibility of the policy or contract holder; or (iv) cancellation or amendment by the board of the specific individual health benefits plan. Section 504. Duties of board. (a) Board to establish policy and contract forms and benefit levels.-the board shall establish the policy and contract forms and benefit levels to be made available by all camers for the policies required to be issued pmsuant to section 502. The board shall provide the commissioner with an infoiulational filing of the policy and contract forms and benefit levels it establishes. (b) Cost containment measures.-the individual health benefits plans established by the board may include cost containment measures such as, but not limited to: (1) utilization review of health care services, including review of medical necessity of hospital and physician services; (2) case management benefit alternatives; (3) selective contracting with hospitals, physicians and other health care providers; (4) reasonable benefit differentials applicable to participating and nonparticipating providers; and (5) other managed-care provisions. (c) Limitation on coverage for preexisting conditions.-an individual health benefits plan offered pursuant to section 502 shall contain a limitation of no more than six months on coverage for preexisting conditions, except that the limitation shall not apply to an individual who has, under a prior group or individual health benefits plan, with no intervening lapse in coverage, been treated or diagnosed by a physician for a condition under that plan or satisfied the preexisting condition limitation, if any, under the prior plan. (d) Rider packages.-in addition to the five standard individual health benefits plans provided for in section 502, the board may develop up to five rider packages. Premium rates for the rider packages shall be determined in accordance with section 506. (e) Certification of plans.-after the board's establishment of the individual health benefits plans required pursuant to section 502, and notwithstanding any law to the contrary, a camer shall file the policy or contract forms with the board and certify to the board that the health benefits plans to be used by the callier are in substantial compliance with the provisions in the corresponding board-approved plans. The certification shall be signed by the chief executive officer of the callier. Upon receipt by the board of the certification, the certified plans may be used until the board, after notice and hearing, disapproves their continued use. Section 505. Exceptions to required coverage. (a) Health maintenance organizations.-a health maintenance organization shall not be required to offer coverage to or accept an applicant pmsuant to this chapter if the applicant is not geographically located in the health maintenance organization's approved service area or if the health maintenance organization does not have the capacity in its facilities to enroll additional members. H the health maintenance organization does not have the capacity in its facilities for additional individual enrollees, it also shall not offer coverage to or accept any new group enrollees. (b) Potential of creating ~ impaired condition.-a canicr shall not be required to offer coverage or accept applications pursuant to this chapccr if the commissionc:'l" finds 1bat 1hc acceptance of applications would place the camer in a financially impaired condition. Section 506. Rates and filings. (a) Application for approval of discounted or reduced rates of payment to hospitals.-the board shall make application on behalfof all camers for approval of discounted or reduced rates ofpayment to hospitals for health care services provided under an individual health benefits plan under this chapter. (b) Government funding or discounts.-in addition to discounted or reduced rates of hospital payment, 1hc board shall make application on behalf of all camers for any other subsidies, discounts or funds that may be provided for under Federal or State law or regulation. A camer may include discounted or reduced rates of hospital payment and other subsidies or funds granted to 1hc board to reduce its panium rates for individual health benefits plans subject to this chapter. (c) Filing of full schedule of rates.-a clutier shall not issue individual health benefits plans on a new contract or policy fmm pmsuant to this chapter until an infmnatiooal fihng of a full schedule of rates which applies to the contract or policy fmm has been filed with the board. The board shall forward 1hc infonnational filing to the commissioner and the Attorney General. (d) Filing of rate changes.-a canier shall make an infounational filing with the board of any change in its rates for individual health benefits plans pursuant to section 502 prior to the date the rates become effective. The board shall file the informational filing with the commissioner and the Attorney General. H the camer has filed all information required by the board, the filing shall be deemed to be complete. (e) Anticipated loss ratio.- (1) Rates shall be formulated on contracts or policies required pmsuant to section 502 so that the anticipaled minjmum loss ratio for a contract or policy form shall not be less than 85% of the premium. The camer shall submit with its rate filing supporting data, as determined by the board, and a certification by a member of the American Academy of Actuaries, or other individuals acceptable to the board and to the commissioner, that the camer is in compliance with the provisions of this subsection. (2) Following the close of each calendar year, if the board determines that a camer's loss ratio was less than 85% for that calendar year, the camer shall be required to refund to policy or contract holders the difference between the amount of net earned premium it received that year and the amount that would have been necessary to achieve the 85% loss ratio. Section 507. Individual Health Coverage Program and board. (a) Program established.-1bere is hereby established the individual Health Coverage Program. All camers subject to the provisions of this chapter shall be members of the program. (b) Board.-Within 30 days of the effective date of this chapter, the commissioner shall give notice to all members of the time and place for the initial organizational meeting. which shall take place within 60 days of the effective date of this chapter. The governing body of the program shall be a board which shall consist of nine representatives. The commissioner or his designee shall serve as an ex officio member on the board. Four members of the board shall be appointed by the, with the advice and consent of the Senate, one of whom shall be a representative of an employer, appointed upon the recommendation of a business trade association, who is a person with experience in the management or administration of an employee health benefit plan; one of whom shall be a representative of organized labor, appointed upon the recommendation of the AFL CIO, who is a person with experience in the management or administration of an employee health benefit plan; and two of whom shall be consumers of a health benefits plan who are reflective of the population in this Commonwealth. Four board members who represent caniers shall be elected by the members, subject to the approval of the commissioner. To the extent there is an entity licensed in this Com-

8 2580 LEGISLATIVE JOURNAL - SENATE NOVEMBER 13, monwealtb that is willing to have a representative serve on the board, a representative from each of the following entities shall be elected: (1) A health service corporation. (2) A health maintenance organization. (3) A mutual health insurer of this Commonwealth. (4) A foreign health insurance company authorized to do business in this Commonwealth. In approving the selection of the eatrier representatives of the board, the commissioner shall assure that all members of the program are fairly represented. (c) Term of office.-initially, two of the 's appointees and two of the camer representatives shall serve for a term of three years, one of the 's appointees and one of the camer representatives shall serve for a term of two years, and one of the 's appointees and one of the camer representatives shall serve for a term of one year. Thereafter, all board members shall serve for a term of three years. Vacancies shall be filled in the same manner as the original appointments. (d) Initial camer members.-h the initial camer representatives to the board are not elected at the organizational meeting, the commissioner shall appoint those members to the initial board within 15 days of the organizational meeting. (e) Plan of operation.-witbin 90 days after the appointment of the initial board, the board shall submit to the commissioner a plan ofoperation and thereafter, any amendments to the plan necessuy or suitable to assure the fair, reasonable and equitable administration of the program. The commissioner may disapprove the plan of operation if the commissioner determines that it is not suitable to assure the fair, reasonable and equitable administration of the program and that it docs not provide for the sharing of program losses on an equitable and proportionate basis in accordance with section 509. The plan of operation or amendments thereto shall become effective unless disapproved in writing by the commissioner within 45 days of receipt by the commissioner. (f) Failure to submit plan of operation.-h the board fails to submit a suitable plan of operation within 90 days after its appointment, the commissioner shall adopt a temporuy plan of operation. The commissioner shall amend or rescind a temporuy plan adopted under this subsection at the time a plan of operation is submitted by the board. (g) Plan components.-the plan of operation shall establish procedures for: (1) The handling and accounting of assets and moneys of the program and an annual fiscal reporting to the commissioner. (2) Collecting assessments from members to provide for sharing program losses in accordance with the provisions of section 509 and administrative expenses incwred or estimated to be incwred during the period for which the assessment is made. (3) Approving the coverage, benefit levels and contract f011jls for individual health benefits plans in accordance with the provisions of section 502. (4) The imposition of an interest penalty for late payment of an assessment pursuant to section 509. (5) Any additional matters at the discretion of the board. (h) Appointment of insmance producer.-the board shall appoint a licensed producer to advise the board on issues related to sales of individual health benefits plans issued pursuant to this chapter. Section 508. Powers and authority of program and board. The program shall have the general powers and authority granted under the laws of this Commonwealth to insmance companies, health service corporations and health maintenance organizations licensed or approved to transact business in this Commonwealth, except that the program shall not have the power to issue health benefits plans directly to either groups or individuals. The board shall have the specific authority to: (1) Assess members their proportionate share of program losses and administrative expenses in accordance with the provisions of section 509 and make advance interim assessments, as may be reasonable and necessuy for organizational and reasonable operating expenses and estimated losses. An interim assessment shall be credited as an offset against any regular assessment due f01lowing the close of the fiscal year. (2) Establish rules, conditions and procedures pertaining to the sharing of program losses and administrative expenses among the members of the program. (3) Review rate applications and form filings submitted by carriers in accordance with this chapter. (4) Define the provisions of individual health benefits plans in accordance with the requirements of this chapter. (5) Enter into contracts which are nccessuy or proper to cany out the provisions and purposes of this chapter. (6) Establish a procedure for the joint distribjtion of infonnation on individual health benefits plans issued pursuant to section 502. (7) Establish, at the board's discretion, standards for the application of a means test for individual health benefits plans issued pursuant to section 502. (8) Establish, at the board's discretion, reasonable guidelines for the purchase of new individual health benefits plans by persons who already are enrolled in or insured by another individual health benefits plan. (9) Establish minimum requirements for performance standards for camers that are reimbursed for losses submitted to the program and provide for performance audits from time to time. (10) Sue or be sued, including taking any legal actions necessmy or proper for recovely of an assessment for, on behalf of or against the program or a member. (11) Appoint from among its members appropriate legal, actuarial and other committees as necessuy to provide technical and other assistance in the operation of the program, in policy and other contract design and any other function within the authority of the program. (12) BolTOw money to effect the purposes of the program. Any notes or other evidence of indebtedness of the program not in default shall be legal invesbnents for caniers and may be canied as admitted assets. (13) Contract for an indepc;ndent actuuy and any other professional services the board deems necessuy to cany out its duties under this chapter. Section 509. Program losses; immunity; payments; and nongroup persons. (a) Equitable sharing of program losses.-the board shall establish procedures for the equitable sharing of program losses among all members in accordance with their total market share as follows: (1) (i) By March 1, 1997, and following the close of each calendar year thereafter, on a date established by the board: (A) every camer issuing health benefits plans in this Commonwealth shall file with the board its net earned premium for the preceding calendar year ending December 31; and (B) evely camer issuing individual health benefits plans in this Commonwealth shall file with the board the net earned premium on policies or contracts issued under section 502 and the claims paid and the administrative expenses attributable to those policies or contracts. H the claims paid and reasonable administrative expenses for that calendar year exceed the net earned premium and any investment income thereon, the amount of the excess shall be the net paid loss for the camer that shall be reimbursable under this chapter. For the purposes of this subparagraph, "reasonable administrative expenses" shall be actual expenses or a maximum of 25% of premium, whichever amount is less. (ii) Every member shall be liable for an assessment to reimburse carners issuing individual health benefits plans in this Commonwealth which sustain net paid losses for the previous year, unless the member has received an exemption from the board under subsection (d) and has written a minimum number of nongroup persons as provided for in that subsection. The assessment of each member shall be in the proportion that the net earned premium of the member for the calendar year preceding

9 1996 LEGISLATIVE JOURNAL - SENATE 2581 the assessment bears to the net earned premium of all members for the calendar year preceding the assessment. (2) A member that is financially impaired may seek from the commissioner a defennent in whole or in part from any assessment issued by the board. The commissioner may defer, in whole or in part, the assessment of the member if, in the opinion of the commissioner, the payment of the assessment would endanger the ability of the member to fulfill its contractual obligations. If an assessment against a member is defened in whole or in part, the amount by which the assessment is defened may be assessed against the other members in a manner consistent with the basis fur assessment set forth in this section. The member receiving the defennent shall remain liable to the program for the amount defened. (b) Immunity from liability.-the participation in the program as a member, the establishment of rates, fol1lls or procedures, or any other joint or collective action required by this chapter shall not be the basis of any legal action, criminal or civil liability, or penalty against the program, a member of the boaid or a member of the pr0 gram either jointly or separately except as otherwise provided in this chapter. (c) Payment of assessment.-payment of an assessment made under this section shall be a condition of issuing health benefits plans in this Commonwealth for a carrier. Failure to pay the assessment shall be grounds for forfeiture of a carrier's authorization to issue health benefits plans of any kind in this Commonwealth, as well as any other penalties pennitted by law. (d) Exemption and enrollment of nongroup persons under managed care or indemnity plan.- (I) Notwithstanding the provisions of this chapter to the contrary, a carrier may apply to the board, by a date established by the board, for an exemption from the assessment and reimbursement for losses provided for in this section. A camer which applies for an exemption shall agree to enroll or insure a minimum number of nongroup persons on an open enrollment community-rated basis, under a managed care or indemnity plan, as specified in this subsection, provided that any indemnity plan so issued confonns with sections 502 through 505 and 516. For the purposes of this subsection, nongroup persons include individually enrolled persons, conversion policies issued pursuant to this chapter, Medicare cost and risk lives and Medicaid recipients. In detemrining whether the canier meets the minimum number ofnongroup persons required pursuant to this subsection, the number of Medicaid recipients and Medicare cost and risk lives shall not exceed 50% of the total. (2) Notwithstanding the provisions of paragraph (1) to the contrary, a health maintenance organization qualified pursuant to the Health Maintenance Organization Act of 1973, (Public Law , 42 U.S.C. 300e et seq.) and tax exempt under section 501(c)(3) of the Internal Revenue Code of 1986 (Public Law ,26 U.S.C. 1 et seq.) may include up to one-third Medicaid recipients and up to one-third Medicare recipients in detennining whether it meets its minimum number. (3) The minimum number of nongroup persons, as detennined by the board, shall equal the total number of community-rated and modified community-rated, individually enrolled or insured persons, including Medicare cost and risk lives and enrolled Medicaid lives, of all carriers subject to this chapter as of the end of the calendar year, multiplied by the proportion that that carrier's net earned premium bears to the net earned premium of all camers for that calendar year, including those carriers that are exempt from the assessment. (4) Within 180 days after the effective date of this chapter and on or before March 1 of each year thereafter, every canier seeking an exemption pursuant to this subsection shall file with the boaid a statement of its net earned premium for the preceding calendar year. The board shall detennine each carrier's minimum number of nongroup persons in accordance with this subsection. (5) On or before March 1 of each year, every carrier that was granted an exemption for the preceding calendar year shall file with the board the number of nonplup persons, by category, enrolled or insured as of December 31 of the preceding calendar year. To the extent that the carrier has failed to enroll the minimum number of nongroup persons established by the board, the carrier shall be assessed by the board on a pro rata basis fir any diffi:iartial between the minimum number established by the board and the actual number enrolled or insured by the carrier. (6) A carrier that applies for the exemption shall be deemed to be in compliance with the requirements of this subsection if: (i) by the end of calendar year 1996, it has enrolled or insured at least 40% of the minimum number of nongroup persons required; (ii) by the end of calendar year 1997, it has enrolled or insured at least 75% of the minimum number of nongroup persons required; and (iii) by the end of calendar year 1998, it has enrolled or insured 100% of the minimum number of nongroup persons required. (7) Any carrier that writes both managed care and indemnity business that is granted an exemption pursuant to this subsection may satisfy its obligation to write a minimum number of nongroup persons by writing either managed care or indemnity business, or both. (e) Limitation.-Notwithstanding the provisions of this section to the contrary, no carrier shall be liable for an assessment to reimburse any canier pursq8dt to this section in an amount which exceeds 35% of the aggregate net paid losses of all carriers filing pursuant to subsection (a)(l)(i). To the extent that this limitation results in any unreimbursed paid losses to any carrier, the unreimbursed net paid losses shall be distributed among carriers: (1) which owe assessments pursuant to subsection (a)(l)(ii); (2) whose assessments do not exceed 35% of the aggregate net paid losses of all carriers; and (3) who have not received an exemption pursuant to subsection (d). For the pwposes of paragraph (3), a carrier shall be deemed to have received an exemption notwithstanding the fact that the carrier failed to enroll or insure the minimum number of nongroup persons IeqUin:d for that calendar year. Section 510. Statement of net paid losses and reimbursement. (a) Statement of net paid losses.-no later than March I, 1997, any carrier issuing individual health benefits plans in this Commonwealth shall file with the boaid a statement of any net paid losses for the calendar year ending December 31, 1996, as calculated pursuant to section 509, along with any supporting infonnation required by the board. (b) Reimbursement.-The losses filed pursuant to subsection (a) shall be reimburse4 in an amount up to $10,000,000 or 50% of the paid losses, whichever amount is less, to the carrier filing the losses. The assessment shall be made as a separate assessment from those required pursuant to section 509, but shall be assessed in the same manner and at the same time as the first assessment made after the effective date of this chapter as provided for in section 509, except that the canier filing for the reimbursement shall not be subject to an assessment under this section. Section 511. Detennination of caniers with disproportionate share of substandard risks and recommendations for remedial action. The board shall determine whether any carrier has a disproportionate share of substandard risks insured or enrolled under its individual health benefits plans and shall make recommendations to the and the General Assembly for remedial action to minimize the losses sustained by the carrier as a result of insuring these risks. Section 512. Sale of plan. A health benefits plan issued pursuant to section 502 may be sold through a licensed producer. Section 513. Rate filings. Notwithstanding the provisions of any other insmance law of this Commonwealth to the contrary, a health maintenance organization shall not be required to submit any rate filings with the commissioner

10 2582 LEGISLATIVE JOURNAL - SENATE NOVEMBER 13, for an individual health benefits plan that is subject to the provisions of this chapter, but shall be subject to the minimum loss ratio provisions of section 506. Section 514. Action by board. (a) General rule.-all actions adopted by the board shall be subject to the provisions of this section, notwithstanding any provisions of law to the contrary. (b) Notice requirements.- (1) Prior to the adoption of an action of the board, the board shall publish notice of its intended action in three newspapers of general ciiculation in this Commonwealth, and may publish the notice of intended action in any trade or professional publication which it deems necessary. The notice of intended action shall include procedures for obtaining a detailed description of the intended action and the time, place and manner by which interested persons may present their views. The board shall provide the notice of intended action and a detailed description of the intended action by mail, or otherwise, to affected trade and professional associations, camers subject to this chapter and such other interested persons or organizations which may request notification. The board shall foiward the notice of intended action and the detailed description of the intended action concmrently to the Legislative Reference Bureau for publication in the Pennsylvania Bulletin. (2) The board shall not charge any fee for placement upon the mailing list of associations, camers or other persons to be notified, but the board may charge a fee to an association, camer or other person nxplcsting a copy of the feltt of the intended action, which fee shall not be in excess of the actual cost of reproducing and mailing the copy. (3) A copy of the text of the intended action shall be available in the department (c) Public hearing.-the board shall hold a public hearing on the establishment and modification of health benefits plans, and the board may hold a public hearing on any other intended action. Notice of a hearing shall be given in the notice of intended action provided for in subsection (b). (d) Opportunity to comment in writing.- (1) Whether or not a public hearing is held, the board shall afford all interested persons an opportunity to ~mment in writing on the intended action. Written comments shall be submitted to the board within the time established by the board in the notice of intended action, which time shall not be less than 20 calendar days from the date of notice. (2) The board shall give due consideration to all comments received. Within a reasonable period of time following submission of the comments pursuant to this subsection, the board shall prepare for public distribution a report listing all parties who provided written submissions concerning the intended action, summarizing the content of the submissions and providing the board's response to the data, views and arguments contained in the submissions. A copy of the report shall be filed with the Legislative Reference Bureau for publication in the Pennsylvania Bulletin. (e) Final action.-the board may adopt the intended action immediately following the expiration of the public comment period provided in subsection (d) or the hearing provided for in subsection (c), whichever date is later. The final action adopted by the board shall be submitted for publication in the Pennsylvania Bulletin and shall be effective on the date of the submission or such later date as the board may establish. (f) Construction.-Nothing in this section shall be construed to prohibit the commissioner from adopting any role or regulation pmsuant to the act of July 31, 1968 (p.l.769, No.240), referred to as the Commonwealth Documents Law, or from taking any other action required or authorized by this chapter. (g) Definition.-As used in this section, the term "action" includes, but is not limited to: (1) The establishment and modification of health benefits plans. (2) Procedures and standards for the: (i) assessment of members and the apportionment thereof; (il) filing of policy forms; (iii) making of rate filings; (iv) evaluation of material submitted by caniers with respect to loss ratios; and (v) establishment of refunds to policy or contract holders. (3) The promulgation or modification of policy forms. The term shall not include the hearing and resolution of contested cases, personnel matters and applications for withdrawal or exemptions. Section 515. Prohibition. A camer shall not require an eligible person to purchase any other insurance coverage, including, but not limited to, life insurance, accident insurance or disability insurance, as a condition of or in conjunction with the purchase of a health benefits plan under this chapter. Section 516. Applicability; duplicative coverage; penalties; rates. (a) Plan issued on or after effective date of chapter.-an individual health benefits plan issued on or after the effective date of this chapter shall be subject to the provisions of this chapter. (b) Plans issued prior to effective date of chapter.- (1) An individual health benefits plan issued on an open enrollment, modified community-rated basis or community-rated basis prior to the effective date of this chapter shall not be subject to sections 502 through 506, unless otherwise specified therein. (2) An individual health benefits plan issued other than on an open enrollment basis prior to the effective date of this chapter shall not be subject to the provisions of this chapter, except that the plan shall be liable for assessments made pursuant to section 509. (3) A group conversion contract or policy issued prior to the effective date of this chapter that is not issued on a modified community-rated basis or community-rated basis shall not be subject to the provisions of this chapter, except that the contract or policy shall be liable for assessments made pursuant to section 509. (c) Duplicative coverage prohibited.-after the effective date of this chapter, an individual who is eligible to participate in a group health benefits plan that provides coverage for hospital or medical expenses shall not be covered by an individual health benefits plan which provides benefits for hospital and medical expenses that are the same or similar to coverage provided in the group health benefits plan, except that an individual who is eligible to participate in a group health benefits plan but is cmrently covered by an individual health benefits plan may continue to be covered by that plan until the first anniversary date of the group plan occurring on or after January 1, (d) Penalties.-Except as otherwise provided in subsection (c), after the effective date of this chapter, a person who is covered by an individual health benefits plan who is a participant in or is eligible to participate in a group health benefits plan that provides the same or similar coverages as the individual health benefits plan and a person, including an employer or insurance producer, who causes another person to be covered by an individual health benefits plan which person is a participant in or who is eligible to participate in a group health benefits plan that provides the same or similar coverages as the individual health benefits plan shall be subject to a fine by the commissioner in an amount not less than twice the annual premium paid for the individual health benefits plan, together with any other penalties permitted by law. (e) Rates.-Every individual health benefits plan issued prior to the effective date of this chapter shall be rated as follows: (1) No later than 180 days after the effective date of this chapter, the premium rate charged by a camer to the highest rated individual who purchased an individual health benefits plan prior to the effective date of this chapter shall not be greater than 150% of the premium rate charged to the lowest rated individual purchasing that same or a similar health benefits plan. (2) During the period July 1, 1997, to June 30, 1998, the premium rate charged by a cani.er to the highest rated individual who purchased an individual health benefits plan prior to the effective date of this chapter shall not be greater than 125% of the premium rate

11 1996 LEGISLATIVE JOURNAL - SENATE 2583 charged to the lowest rated individual purchasing that same or a similar health benefits plan. (3) On and after July 1, 1998, every individual health benefits plan which was issued before the effective date of this chapter shall be community rated upon the date of its renewal. (4) A carrier that issues an individual health benefits plan with modified community rating subject to the provisions of this subsection shall make an informational filing with the board whenever it adjusts or modifies its rates. CHAPTER 11 MISCELLANEOUS PROVISIONS Section Effective date. This act shall take effect as follows: (1) Chapter 3 shall take effect January 1, (2) This section shall take effect immediately. (3) The remainder of this act shall take effect in 60 days. On the question, Will the Senate agree to the amendment? The PRESIDENf pro tempore. The Chair recognizes the gentlewoman from Philadelphia, Senator Schwartz. Senator SCHWARlZ. Mr. President, just briefly, I want to explain the amendment to my colleagues. It introduces some changes and some market reforms to open up the market, the health insurance market, to individuals who are one of the groups that are fmding it most difficult to find affordable insurance in Pennsylvania. Many, many other States, Mr. President, have moved ahead to open up the marketplace to help enable individuals and small groups. My amendment only speaks to individuals, but other States have really wodced very bard to create opportunities for both individuals and small groups to fmd more affordable insurance. Mr. President, what this does is not involve any cost to the Commonwealth, to the State budget, but instead what it does is to require insurance companies to sell insurance. Right now we only require Blue Cross and Blue Shield to sell insurance to individuals, but it requires all insurance companies that sell health insurance in Pennsylvania to offer an individual plan. Actually it would be a standard plan. If they chose not to, they would have to pay a small surcharge into a fund to create a reinsurance pool to make it more affordable for all those companies which choose to offer individual policies. These would be community rated, they would be affordable, there would be a variety of plans available to individuals, and it would, Mr. President, create a new market for insurance companies and I think a fair market because it creates a reinsurance pool so catastrophic loss and insurance companies are, in fact, protected. So I think, Mr. President, it really does do something, an important something, in helping to create an affordable individual policy for millions of Pennsylvanians who now have no health insurance. We used to talk about a million Pennsylvanians without health insurance and then we talked about 1.2 million Pennsylvanians without ongoing health insurance, and as you know, Mr. President, we just increased that nuinber by an additional 220,000 people this past spring, so we now have almost 1.5 million Pennsylvanians who do not have access and do not have ongoing health insurance. I believe that we have an obligation to help the marketplace be able to offer health insurance to individuals. This is a pr0 gram that has been incredibly successful in New Jersey in offering health insurance to individuals. We have seen thousands of individuals be able to sign up in New Jersey. We, in fact, have seen the insurance companies in New Jersey be pleased that they have a new market that they can sell insurance to. It is something we ought to do, Mr. President. We have, and I have, criticized the General Assembly and the administration for not doing enough in opening up the marketplace and helping individuals be able to have private insurance, affordable insurance, health insurance. It is an issue that just because we stopped discussing it, it did not go away, Mr. President This is one step in helping to assure that at least some individuals, and potentially thousands of individuals, in Pennsylvania would have access to affordable health insurance through the private marketplace. It seems to me aimost--excuse the language here--a very Republican notion that we are helping the marketplace be able to create new markets for new customers and help customers be able to have access to those markets. I think it is a win-win situation for everyone, and I have raised the notion before. It is legislation that has been out there for people to look at for quite some time. I offer it as an amendment to this bill because it is incredibly relevant and timely for us to move ahead. Thank you, Mr. President gentleman from Centre, Senator Corman. Senator CORMAN. Mr. President, I rise to oppose this amendment. Its intent is to increase the availability of health insurance for individuals. However, this concept erodes the employer-based market with an end product that has more expensive options to individuals by decreasing the tax incentive and increasing the cost of coverage from the current tax rate. It adds a whole new layer of bureauaacy to an already overly bureaucratic system and establishes new government programs that will set rates and benefits. Mr. President, it completely ignores the trend toward making health insurance coverage more available, more affordable, and more useful to all of those who come from increased competition. You get more availability through increased competition and deaeased regulation, not the opposite. This amendment limits the competitors in the marketplace by requiring that all insurers offer five plans, both on an individual and on a group basis. And some insurance companies may not be able to offer five plans, so therefore they will not be able to market their products in Pennsylvania and hence we have reduced the market available for competition. The real measure of any legislation on health insurance is whether it improves the health insurance madret and the health insurance coverage that is offered in the market. This amendment does neither. The thrust of this amendment is to hurt the market through adding bureaucracy and complexity and by limiting the number of potential competitors to serve the employer and the employees. I urge my colleagues to join me in defeating this amendment.

12 2584 LEGISLATIVE JOURNAL - SENATE NOVEMBER 13, Thank you, Mr. President. The PRESIDENf pro tempore. The Chair recognizes the gentleman from Philadelphia, Senator Hughes. Senator lllighes. Mr. Presiden~ I just want to rise briefly, after listening to the current discussion, to urge my colleagues to support this particular amendment. We left a public health discussion earlier this year, Mr. Presiden~ that forced 225,000, 240,000 people off the Medical Assistance rolls and out into the general population with no folbldation for support for their Medical Assistance, for their medical coverage, and on top of that, we have created an environment where those providers, having been used to providing support for this population, are also doing without. I think the gentlewoman's amendment moves in a direction that would make an attemp~ a significant attemp~ to pick up the pace and get more coverage into individual hands, and especially in an environment where I think we need to be very concerned about the general health of the population of this Commonwealth. We were in a meeting of the Committee on Public Health and Welfare today where we interviewed the 's nominee for Physician General, Mr. Presiden~ and it is clear that we need an advocate in that position to talk about the general health of this population. One of the ways of doing that is making sure that there is appropriate coverage for all those who do not have coverage right now. In one short 6-month, 9-month period, I-year period, we will add to the rolls of the uninsured in this Commonwealth another 25 percen~ another 250,000 people. We need to find a way to pick them up. I think the concept of the gentlewoman from Philadelphia, Senator Schwartz, is an appropriate fashion, and I would request support for this amendment. LEGISLATIVE LEAVES The PRESIDENf pro tempore. The Chair recognizes the gentleman from Delaware, Senator Loeper. Senator WEPER. Mr. President, Senator Tomlinson has been called from the floor, and I request a temporary Capitol leave on his behalf, and also for Senator Tilghman. The PRESIDENf pro tempore. Senator Loeper has requested temporary Capitol leaves for Senator Tomlinson and Senator Ttlghman. Without objection, those leaves will be granted. The Chair recognizes the gentleman from Lackawanna, Senator Mellow. Senator MELLOW. Mr. Presiden~ I request temporary Capitol leaves for Senator Furno and Senator Tartaglione. The PRESIDENf pro tempore. Senator Mellow requests temporary Capitol leaves for Senator Fumo and Senator Tartaglione. Without objection, those leaves will be granted. And the question recurring, Will the Senate agree to the amendment? The PRESIDENf pro tempore. The Chair recognizes the gentlewoman from Philadelphia, Senator Schwartz. Senator SCHWARlZ. Mr. Presiden~ I will be brief, but it is actually somewhat discouraging to see my colleagues leave the floor when 1.5 million Pennsylvanians do not have access to health insurance. It is a subject that we should all care abou~ Mr. Presiden~ and' while it is lunchtime, I think it might be an issue we should attend to and not just say, well, let us not deal with it today, we are busy doing something else. But as to the points that were made by one of the previous speakers in concern about the fact of what this might or might not do to the marketplace, let me just give some specific figures on all of this. In the individual policy that this, the health insurance that would allow for the madcet changes and would allow for individuals that is modeled after New Jersey, these are somewhat old statistics, but already we have seen almost 150,000 individuals in New Jersey be able to buy health insurance. That is not insignificant. If we could see a couple hundred thousand people be able to afford health insurance in the individual marketplace, that would be something I think we could really be quite proud of and we ought to move ahead 00. In Pennsylvania, just to give some statistics on this, there was concern about what this might do to those who are employed. The fact is that 43 percent of those who do not have ongoing health insurance are employed full-time. It is expensive for employers to pay for health insurance. It is particularly expensive for small businesses to do so. If that is a concern of some of my colleagues, I would be happy for them to take a careful look at the legislation that I have that would change some of the marketplace to enable small businesses to be able to better afford to cover their employees. There are things we can do about that. The idea that what we should do about helping businesses be able to afford health insurance is not to help individuals get insurance makes no sense at all. It certainly does not make it less competitive. The idea is to help everyone be able to buy health insurance and to make it affordable for everyone - those who are employed, those who are employed by large businesses and small businesses, those who wolk part-time, those who are temporarily unemployed, and that is 17 percent of those without insmance. Another 17 to 18 perrent are employed parttime, and almost 23 perren~ Mr. Presiden~ are in fact not employed at all. They are either retired and not yet covered under Medicare, they are sometimes YOlBlger but not still covered by their parents' policies, and they are sometimes homemakers. I think that we actually need to do this. We ought to take it seriously, we ought to pass this legislation. Let the Insurance Department proceed with crafting a program tha~ in fac~ could work, Mr. Presiden~ for all of us, work for those who sell insurance, work for those who underwrite insurance, work for those who need health insurance, and help the providers who are providing setvices to people who cannot pay be able to get reimbursed for some of those services. Thank you, Mr. President. LEGISLATIVE LEAVES gentleman from Delaware, Senator Loeper. Senator LOEPER. Mr. Presiden~ Senator FIsher and Senator Shaffer have been called from the floor, and I request temporary Capitol leaves for them.

13 1996 LEGISLATIVE JOURNAL - SENATE 2S8S The PRESIDENf pro tempore. Senator Loeper requests temporary Capitol leaves for Senator Ftsber and Senator Shaffer. Without objection, those leaves are granted. And the question recurring, Will the Senate agree to the amendment? The yeas and nays were required by Senator SCHWARlZ and were as follows, viz: Afilerbach Andrezeski Belan Bodack Costa Armstrong Brightbill Corman Delp Fisher Gerlach Greenleaf FuDlO Hughes Kasunic LaValle Mellow Hart Heckler Holl Jubelirer Lemmond Loeper Less than a majority of the Senators having voted "aye," the question was determined in the negative. And the question recurring, Will the Senate agree to the bill on third consideration? It was agreed to. And the amendments made thereto having been printed as required by the Constitution, On the question, Shall the bill pass finally? LEGISLATIVE LEAVE CANCELLED The PRESIDENf pro tempore. The Chair notes the presence on the floor of Senator Tomlinson, and his temporary Capitol leave is cancelled. And the question recurring, Shall the bill pass finally? YEAS-20 Musto Q1»ake Porterfield Schwartz Stapleton NAYS-25 Madigan Mowery Peterson Piccola Punt Robbins Stewart Stout Tartaglione Wagner WiUiams Shaffer Thompson Tilghman Tomlinson U1iana Wenger gentleman from Centre, Senator Corman. Senator CORMAN. Mr. President, for a number of years now I have been strongly pushing an innovative health care idea that I believe has real potential when it comes to reducing costs, improving patient care, and giving consumers more choices in health care coverage. The idea is called medical savings accounts. And in a few short years it has gone from being the ugly duckling of the health care debate to being the belle of the ball, mostly because it makes good, common sense for consumers. Recently Congress approved the Health Insurance Portability and Accountability Act, and when they did they also included medical savings accounts with it. This act establishes a medical savings account program whereby companies could offer medi- cal savings accounts to their employees. These funds would be used for legitimate medical expenses and would be exempt from Federal income tax. Today we have a bill before 08 that would give the States such an option, permitting savings accounts established to fund individual health care coverage to be exempt from State taxes. I am here to ask for your support for House Bill No. 1468, for this is a critical step in making medical savings accounts available to self-employed and small bjsblesses in Pennsylvania. Now, the issue, Mr. President, is not sbould we have medical savings accounts, they do exist. The issue is whether to remove the 2.9 percent State income tax for the person who chooses to have a medical savings account. This legislation will treat that option the same as other options are treated by State tax laws, making them a reality for the consumer who wants greater freedom in choosing health care providers and greater control over their health care costs. Medical savings accounts are based on a very simple and logical theory, Mr. President. Consumers will make more effective and efficient decisions about how to spend their health care dollars if they are allowed to keep a larger share of what they have themselves. Through medical savings accounts, individuals and their employers can make regular tax-free deposits into medical savings accounts, which will be the property of the individual. They can draw upon that money without penalty to only pay for medical expenses. Money they do not spend will grow with interest, and they could use that money for medical expenses after retirement, or they can roll it into the same medical savings account and continue to accumulate health care funds or leave it as part of their estate. One of the biggest selling points is that medical savings accounts require consumers to directly handle payment of medical costs, thereby shifting the fiscal responsibility from government to the consumer. No additional bureaucracy, no expensive mandates, no interfering with the doctor/patient relationship. One supporter has described it as taking the power of the purse and shifting it to the patient. More and more advocates are calling for States to provide for tax exemptions for the medical savings accounts. Among the supporters of this new health are the Council of Affordable Health Insurance, the National Center for Policy Analysis, the Business Coalition for Affordable Health Care, and in addition, Mr. President, 18 other States have enacted a medical savings account law, those States being Arizona, Colorado, Idaho, D Unois, Indiana, Louisiana, Mississippi, Missouri, Montana, New Mexico, Ohio, Oklahoma, Utah, Vrrginia, Washington, West Vrrginia, Wisconsin, and I hope soon we can say Pennsylvania. Why should Pennsylvania join these other States in conferring tax-exempt status on medical savings accounts? Because we can all stand to gain when we lower health care costs and increase competition. One study found that medical savings accounts would save maybe $240 billion a year in health care spending and more than $55 billion in administrative costs. That is because when people spend their own money, Mr. President, rather than someone else's, they become more care-

14 LEGISLATIVE JOURNAL - SENATE NOVEMBER 13, ful consumers. And that, in tum, creates a more competitive, cost-conscious marketplace. Today we have a chance to give Pennsylvania consumers more conuol over their health care decisions. I believe we owe it to our State residents to join the many other States which have enabled their residents to establish tax-exempt medical savings accounts. It is a cost-effective, sensible approach to health care and focuses on the needs of the individual rather than inaease bureaucracy. Today I would encourage all of my colleagues to join me in passing this bill, House Bill No bank you, Mr. President. gentlewoman from Philadelphia, Senator Schwartz. Senator SCHWARTZ. Mr. President, I rise not to object to this bill, because 1JUthfully it is not a tenible idea, it is just an extremely limited idea, so I will vote for it But I think that we should understand what we are doing here, and what we are doing basically is allowing for tax exemption mostly for people who actually have a good bit of money to be able to manage their health care dollars a little bit differently. So what we are doing here is helping people who have the ability to make these kinds of decisions, who have enough income to be able to take this kind of risk. It really is geared towards the upper income levels of people who are willing to accept a very catastrophic coverage for insurance and this pot of money that their employers will put aside for them in order for them to make certain choices about how they use their health care dollars. Let me fu'st say that there are several problems with this. One is that it might encomage people to postpone the kind of health services that in fact are the cheapest and have the most cost savings in the long nm. So they might postpone the maybe expensive preventative service that they need, that checkup that they ought to have to see if they have some health problems. They may avoid that for a while in order to say, I better bang onto this money. So instead of finding the diabetes or the hemt condition or the hypertension at an early stage when it is highly treatable, you might postpone it in hopes that it will go away or maybe I will not have to deal with it this year or, more significantly, because some other medical expense comes up that is a higher priority. And for many of us, for example, our children are a high priority. So say, for example, that your child is an athlete and he broke his leg while he was playing football this season. Well, okay, you had to pay for that. Obviously you were not going to say, no, excuse me, I will wait wtil next year to take care of that or I will wait until it is cheaper. Then your other child needs braces. Do you say, well, maybe I should not go to the orthodontist with my child and pay for those braces, maybe I ought to wait because I might need this money for something else. Well, maybe you would make that choice. You are the consumer, you can make that choice. When we had hearings about this, it was suggested by our now U. S. Senator that it really is looking at health care a little bit like the way we shop for coats. His example was that maybe you do not have quite enough money to buy your winter coat now, it got awfully cold yesterday, but you do not have quite enough money, so let us wait for the sale. I am going to wait wtil the end of the season and I will wear last year's coat and get away with that Maybe that works for buying coats. It does not wolk if your child's coat does not fit them or they lost it at school and it is cold out. You might still have to go out and buy that coat. But, Mr. President, it really is not transferable to health care. It is not like you can say, that is right, I foluld a lump in my breast, but, you know, I am going to wait until there is a sale on lumpectomies, because really, after all, it is sort of expensive for me to go and I am going to shop around and wait to see what comes up in the spring because, after all, we do mammographies for free during May because it is Mother's Day. So, even though it is November, I think I will wait until May when I can get a free mammogram and not spend my medical savings account dollars on a mammogram right now. Now, you would be a careful consumer if you were looking at coats, but, Mr. President, you would be a foolish health care consumer not to get that mammography now instead of waiting until May. So while it sounds like a good idea at some level, the fact is, at a very practical level, it really will not work, particularly for modest-income families, particularly for families who may be tmfortunate enough to have a whole series of health problems happen to them, through no fault of their own, during 1 or 2 years. So, Mr. President, again, while I do not think it is so terrible, let me just end by making one other comment about something that the gentleman from Centre, Senator Corman, spoke about before. He said what is really good about this is that it is the individual rather than government telling you how to use your medical care dollars. Well, Mr. President, government does not tell you now how to use your medical care dollars. Your private insurance that either you buy or your employer buys tells you that. We have very little to say about that. On occasion we have said if you sell health insurance in this Commonwealth you have to include these kinds of services. It is true, we have said that, and I think that has been helpful on occasion, but, by and large, government does not conuol what health insurance is sold to your employer and whether it is even bought by your employer. Your employer can decide not to offer you health insurance and, obviously, you can decide not to buy it. So I do not think this is a question of let us get government out of your lives and let us give you control, this is about a few people potentially being able to make some decisions about the use of their dollars. For most of us, Mr. President, this is really not very useful, and I would suggest that there are a whole slew of other things we ought to do to make health insurarice more cost-effective, health care more affordable generally, and more accessible to all of us. Thank you, Mr. President. LEGISLATIVE LEAVES gentleman from Delaware, Senator Loeper.

15 1996 LEGISLATIVE JOURNAL - SENATE 2587 Senator WEPER. Mr. President, Senator Bell and Senator miana have been called from the floor, and I request temporary Capitol leaves on their behalf. The PRESIDENT pro tempore. Senator Loeper requests temporary Capitol leaves for Senator Bell and Senator UIiana. Without objection, their leaves are granted. The Chair recognizes the gentleman from Lackawanna, Senator Mellow. Senator MELLOW. Mr. President, I request a temporary Capitol leave for Senator Bodack. The PRESIDENT pro tempore. Senator Mellow requests a temporary Capitol leave for Senator Bodack. Without objection, that leave also is granted. And the question recurring, Sball the bill pass finally? The yeas and nays were taken agreeably to the provisions of the Constitution and were as follows, viz: YEAS-46 Afflerbach Gerlach Mellow Stapleton Andrezeski Greenleaf Mowery Stewart Armstrong Hart Musto Stout Belan Heckler O'Pake Tartaglione Bell Holl Petenon Thompson Bodack Hughes Piccola Tilghman Brightbill Jubelirer Porterfield Tomlinson Corman Kasunic Punt Uliana Costa LaValle RobiJins Wagner Delp Lemmond Schwartz Wenger Fisher Loeper Shaffer Williams Fumo Madigan NAYS-{) A constitutional majority of all the Senators having voted "aye," the question was determined in the affirmative. Ordered, That the Secretary of the Senate retwn said bill to the House of Representatives with information that the Senate has passed the same with amendments in which concurrence of the House is requested. BILLS OVER IN ORDER SB 1559 and lib Without objection, the bills were passed over in their order at the request of Senator WEPER. BILL ON THIRD CONSIDERATION AND FINAL PASSAGE lib 268S (Pr. No. 4125) --The Senate proceeded to consideration of the bill, entitled: An Act authorizing the release of Project 70 restrictions imposed on certain lands owned by the Adams-Croyle Recreation Authority and required for improvements to Croyle Township Road 352, Cambria County, in return for the imposition of Project 70 restrictions on certain lands being conveyed to the Adams-Croyle Recreation Authority. Considered the third time and agreed to, And the amendments made thereto having been printed as required by the Constitution, On the question, Shall the bill pass finally? The yeas and nays were taken agreeably to the provisions of the Constitution and were as follows, viz: YEAS-46 Afflerbach Gerlach Mellow Stapleton Andrezeski Greenleaf Mowery Stewart Armstrong Hart Musto Stout Belan Heckler 0'Pake Tartaglione Bell Holl Petenon Thompson Bodack Hughes Piccola Tilghman Brightbill Jubelirer Porterfield Tomlinson Corman Kasunic Punt Uliana Costa LaValle Robbins Wagner Delp Lemmond Schwartz Wenger Fisher Loeper Shaffer Williams Fumo Madigan NAYS-o A constitutional majority of all the Senators having voted "aye," the question was determined in the affirmative. Ordered, That the Secretary of the Senate retwn said bill to the House of Representatives with information that the Senate has passed the same with amendments in which concurrence of the House is requested. SECOND CONSIDERATION CALENDAR BILLS REREPORTED FROM COMMITTEE AS AMENDED OVER IN ORDER lib 774, SB 868 and lib Without objection, the bills were passed over in their order at the request of Senator WEPER. BILL REREPORTED FROM COMMITIEE AS AMENDED ON SECOND CONSIDERATION SB 1160 (Pr. No. 2382) - The Senate proceeded to consideration of the bill, entitled: An Act providing for review procedures pertaining to accident and health insurance f01dl and rate filings; providing penalties; and making repeals. Considered the second time and agreed to, Ordered, To be printed on the Calendar for third consideration. BILLS REREPORTED FROM COMMITIEE AS AMENDED OVER IN ORDER SB SB 1667, lib 1929 and lib Without 0bjection, the bills were passed over in their order at the request of Senator LOEPER. BILLS OVER IN ORDER lib 685, Sft 1404, SB 1405, Sft 1406, SB 1470, lib 1532 and SB Without objection, the bills were passed over in their order at the request of Senator WEPER.

16 2588 LEGISLATIVE JOURNAL - SENATE NOVEMBER 13, BllL REREFERRED SB 1628 (Pr. No. 2386) - The Senate proceeded to consideration of the bill, entitled: An Act amending TIt1c 75 (Vehicles) of the Pennsylvania Consolidated Statutes, further providing for driver's license revocation or suspension, for revocation of habitual offenders' drivers' licenses for driving ~ a suspended <r revoked license. and fer chemical ~ting to determine amount of alcohol or controlled substances; providing for driving under influence suspensions; and further providing for mns1*medt of license <r registration and fer driving under the influence of alcohol or a controlled substance. Upon motion of Senator LOEPER, and agreed to, the bill was rereferred to the Committee on Appropriations. BllLS OVER IN ORDER SB 16'72t SB 1673, SB 1674, SB 1675, SB 1676, lib 2118, lib 2295, lib 2312, lib 2313 and lib Without objection, the bills were passed over in their order at the request of Senator LOEPER. BllL ON SECOND CONSIDERATION HB 2511 (Pr. No. 3636) -- The Senate proceeded to consideration of the bill, entitled: An Act providing for volunteer health services; limiting liability of a volunteer license holder; and requiring reports. Considered the second time and agreed to, Ordered, To be printed on the Calendar for third consideration. BllL REREFERRED lib 2630 (Pr. No. 3576) -- The Senate proceeded to consideration of the bill, entitled: An Act amending the act of June 28, 1935 (p.l.477, No.193), refcitcd to as the Enforcement Officer Disability Benefits Law, extending benefits to certain employees of the Office of Attorney General. Upon motion of Senator LOEPER, and agreed to, the bill was rereferred to the Committee on Appropriations. EXECUTIVE NOMINATIONS EXECUTIVE SESSION Motion was made by Senator LOEPER, That the Senate do now resolve itself into Executive Session for the pmpose of considering certain nominations made by the. Which was agreed to. NOMINATIONS TAKEN FROM THE TABLE Senator LOEPER. Mr. President, I call from the table certain nominations and ask for their consideration. The Clerk read the nominations as follows: MEMBER OF TIlE STAlE BOARD OF ACCOUNTANCY June 28, 1996 the advice and consent of the Senate, John W. Kuhn, 2906 William Penn Highway, Easton 18045, Northampton County, Eighteenth Senatorial District, for reappointment as a member of the State Board of Accountancy, to serve for a tenn of fold' years and until his successor is appointed and qualified, but not longer than six months beyond that period. momas J. RIOOE MEMBER OF TIlE ANIMAL HEALTII AND DIAGNOSTIC COMMISSION September 23, 1996 the advice and consent of the Senate, David C. K:radel, D.VM., 1178 Fox Hill Road, State College 16803, Centre County, Thirty-fourth Senatorial District, for appoinbnent as a member of the Animal Health and Diagnostic Commission, to serve until October 3, 1999 and until his successor is appointed and qualified, bit not longer than six months beyond that period, vice Sherbyn Ostrich, V.M.D., Robesonia, resigned. momas J. RIOOE MEMBER OF TIlE BOARD OF TRUSTEES OF CLARKS SUMMIT STAlE HOSPITAL June 28, 1996 the advice and consent of the Senate, Joseph M. Cognetti, 238 Vassar Avenue, Clarks Green 18411, Lackawanna County, Twenty-second Senatorial District, for reappoinbnent as a member of the Board of Trustees of Clarks Summit State Hospital. to serve until the third Tuesday of January 1999, and until his successor is appointed and qualified. momas J. RIDGE MEMBER OF THE NAVIGATION COMMISSION FOR TIIE DELAWARE RIVER AND ITS NAVIGABLE TRIBUTARIES September 13, 1996 the advice and consent of the Senate, Joseph F. Bradley, 30 Stone Ridge Road, Thornton 19373, Delaware County, Ninth Senatorial District, for reappointment as a member of the Navigation Commis-

17 1996 LEGISLATIVE JOURNAL - SENATE 2589 sion for the Delaware RM::r and Its Navigable TribJtaries, to sene for a tam of four years and until his successor is appointed and qualificd. momas J. RIDGE MEMBER OF THE NAVIGATION COMMISSION FOR THE DELAWARE RIVER AND ITS NAVIGABLE lribufaries September 13, 1996 In confomrity with law, I have the honor hereby to nominate for the advice and consent of the Senate, Anthony H. MUITay, Esquire, 3035 Wmchester Avenue, Philadelphia 19136, Philadelphia County, FJft:h Senatorial District, for appointment as a member of the Navigation Commission for the Delaware River and Its Navigable Tributaries, to serve for a term. of four years and until his successor is appointed and qualified, vice David A. Franklin, Philadelphia, whose term. expired. momas J. RIDGE MEMBER OF THE HEALTH POLICY BOARD September 18, 1996 In confomrity with law, I have the honor hereby to nominate for the advice and consent of the Senate, Charles W. Pruitt, Jr., 300 Fox Chapel Road, Apartment 407, Pittsburgh 15238, Allegheny County, Thirty-eighth Senatorial District, for reappointment as a member of the Health Policy Board, to serve for a term. of three years and until his successor is appointed and qualified. momas J. RIDGE MEMBER OF THE HEALTH POLICY BOARD September 23, 1996 the advice and consent of the Senate, Kimberly A. Rankin. 541 Truce Road, New Providence 17560, Lancaster County, Thirteenth Senatorial District, for reappointment as a member of the Health Policy Board, to serve for a term of three years and until her successor is appointed and qualified. momas 1. RIDGE MEMBER OF THE HEALTH POLICY BOARD May 30,1996 the advice and consent of the Senate, Carl A. Sirio, M.D., 50 Quail Hill Road, Pittsbwgh 15238, Allegheny County, Thirty-eighth Senatorial District, for appointment as a member of the Health Policy Board, to sene for a tam of dm:e ~ and until his success<r is appointed and qualified, vice Peter A. Cognetti, M.D., Waverly, whose term. expired. momas J. RIDGE MEMBER OF THE PENNSYLVANIA HOUSING FINANCE AGENCY. August 26, 1996 In confomrity with law, I h!lve the honor hereby to nominate for the advice and consent of the Senate, Brenda R. Jefferson Jackson, 101 South Beckman DriVe, Philadelphia 19119, Philadelphia County, Fourth Senatorial District, for appointment as a member of the Pennsylvania Housing Fmance Agency, to serve until July 20, 2002, and until her successor is appointed and qualified, vice Daniel J. Milliron, Esquire, Altoona, whose term. expired. momas J. RIDGE MEMBER OF THE STAlE BOARD OF OSlEOPATHIC MEDICINE September 19, 1996 In confomrity with law, I have the honor hereby to nominate for the advice and consent of the Senate, Thomas R. Czarnecki, D.O., P. O. Box 4236, HmrisbUIg 17111, Dauphin County, Fifteenth Senatorial District, for appointment as a member of the State Board of Osteopathic Medicine, to serve for a tam of four years or until his successor is appointed and qualified, but not longer than six months beyond that period, vice Dennis M. Guest, D.O., Yardley, whose term. expired. momas J. RIDGE MEMBER OF THE STAlE BOARD OF EXAMINERS OF NURSING HOME ADMINIS1RATORS September 23, 1996 the advice and consent of the Senate, Romaine 1. Campenni, 23 East Sunrise Drive, Somerset Park, Pittston 18640, Luzerne County, fourteenth Senatorial District, for reappointment as a member of the State Board of Examiners of Nursing Home Administrators, to serve for a term of four years or until her successor is appointed and qualified but not longer than six months beyond that period. ' momas J. RIDGE MEMBER OF THE STATE BOARD OF EXAMINERS OF NURSING HOME ADMINISTRATORS June 5,1996

18 2590 LEGISLATIVE JOURNAL - SENATE NOVEMBER 13, the advice and consent of the Senate, Frederick D. Kessler, Esquire, 43 Marltet S1Jeet, Lewisburg 17837, Union County, Twenty-seventh Senatorial District, for appointment as a member of the State Board of Examiners of Nursing Home Administrators, to serve for a tenn of four years or until his successor is appointed and qualified, but not longer than six months beyond that period, vice Ronald H. Gabriel, McMmray, whose term expired. MEMBER OF TIIE STAlE BOARD OF EXAMINERS OF NURSING HOME ADMINISTRATORS September 10, 1996 the advice and consent of the Senate, Lawrence J. Tabas, Esquire (Public Member), 720 BI)'Il Mawr Avenue, Penn Valley 19072, Montgomery County, Seventeenth Senatorial District, for appointment as a member of the State Board of Examiners of Numing Home Administrators, to serve for a term of four years or until his successor is appointed and qualified, but not longer than six months beyond that period, vice Richard Cessar, Glenshaw, resigned. THOMAS 1. RIDGE MEMBER OF TIIE BOARD OF lruslees OF POLK CENIER August 27, 1996 In conformity with law, I have the honor hereby to nominate for the advice and consent of the Senate, George G. Thompson, Esquire, 953 Elk S1Jeet, Franklin 16365, Venango County, Twenty-first Senatorial District, for appointment as a member of the Board of Trustees of Polk Center, to serve until the third Tuesday of January 2001, and until his successor is appointed and qualified, vice George Scanlon, Franklin, whose telul expired. MEMBER OF TIIE PROFESSIONAL STANDARDS AND PRACI1CES COMMISSION September 19, 1996 the advice and consent of the Senate, Robert E. Ames, 129 Second S1Jeet, Coaldale 18218, Schuylkill County, Twenty-ninth Senatorial District, for appointment as a member of the Professional Standards and Practices Commission, to serve until the third Tuesday of January 1999 and until his successor is appointed and qualified, vice James W. Stevens, Berwyn, whose telul expired. THOMAS 1. RIDGE MEMBER OF TIIE PROFESSIONAL STANDARDS AND PRACTICES COMMISSION September 19, 1996 In confoimity with law, I have the honor hereby to nominate for the advice and consent of the Senate, Robert B. ColUlany, Ed.D., 1833 Douglas Drive, Carlisle 17013, Cumberland County, Thirty-first Senatorial District, for appointment as a member of the Professional Standards and Practices Commission, to serve until the third Tuesday of January 1999 and until his successor is appointed and qualified, vice Juan Cruz, Jr., Bethlehem, whose term expired. MEMBER OF TIIE STAlE REAL ESTAlE COMMISSION October 7, 1996 the advice and consent of the Senate, James E. Grandon, Jr., 901 Sleepy Hollow Lane, Mechanicsbmg 17055, Cumberland County, Thirty-first Senatorial District, for appointment as a member of the State Real Estate Commission, to serve for a telul of five years or until his successor is appointed and qualified, but not longer than six months beyond that period, vice Howard Hanna, Jr., Pittsbmgh, whose telul expired. MEMBER OF TIIE STAlE BOARD OF CERTIFIED REAL ESTAlE APPRAISERS September 19, 1996 the advice and consent of the Senate, David J. King, 339 Bicker Road, Cabot 16023, Butler County, Twenty-first Senatorial District, for reappointment as a member of the State Board of Certified Real Estate Appraisers, to serve for a tenn of four years and until his successor is appointed and qualified, but not longer than six months beyond that period. MEMBER OF TIIE STAlE BOARD OF EXAMINERS IN SPEECH-LANGUAGE AND HEARING June 28, 1996 In confoimity with law, I have the honor hereby to nominate for the advice and consent of the Senate, Kwan H. Won, MD., 135 Sample Bridge Road, Mechanicsbmg 17055, Cumberland County, Tbirtyfirst Senatorial District, for reappointment as a member of the State

19 1996 LEGISLATIVE JOURNAL - SENATE 2591 Board of Examiners in Speech-Language and Hearing, to serve for a term of three years and until his successor is appointed and qualified. MEMBER OF THE STAlE BOARD OF VElllCLE MANUFACTURERS, DEALERS AND SALESPERSONS September 18, 1996 the advice and consent of the Senate, C. Grant Miller, P. O. Box 41, Lock Haven 17745, Clinton County, Thirty-fourth Senatorial District, for appointment as a member of the State Board of Vehicle Manufactmers, Dealers and Salespersons, to serve for a term of four years and until his successor is appointed and qualified, but not longer than six months beyond that period, vice Edwin K. Galbreath, Jr., New Castle, whose tenn expired. MEMBER OF THE BOARD OF 1RUSTEES OF WERNERSVILLE STATE HOSPITAL September 10, 1996 the advice and consent of the Senate, Christine C. Brubaker, 22 Leaf Park, Lancaster 17603, Lancaster County, Thirteenth Senatorial District, for appointment as a member of the Board of Trustees of Wernersville State Hospital, to serve until the third Tuesday of January 2001, and until her successor is appointed and qualified, vice Douglas N. Howe, D.C., Pottsville, whose tenn expired. THOMAS 1. RIDGE MEMBER OF THE BOARD OF 1RUSTEES OF WERNERSVILLE STATE HOSPITAL June 28, 1996 the advice and consent of the Senate, Pattee J. Miller, 855 North Parle Road, Wyomissing 19610, Berks County, Forty-eighth Senatorial District, for reappointment as a member of the Board of Trustees of Wernersville State Hospital, to serve until the third Tuesday of January 1999, and until her successor is appointed and qualified. MEMBER OF THE LACKAWANNA COUNlY BOARD OF ASSISTANCE July 26, 1996 the advice and consent of the Senate, George A. Yavorek, Esquire (Republican), 321 Sproce Street, Scranton 18503, Lackawanna County, Twenty-second Senatorial District, for appointment as a member of the Lackawanna County Board of Assistance, to serve until December 31, 1996, and until his successor is appointed and qualified, vice Elizabeth Julia, Carbondale, whose tenn expired. MEMBER OF TIIE LUZERNE COUNfY BOARD OF ASSISTANCE June 18, 1996 the advice and consent of the Senate, Rose Tucker (Democrat), 129 Washington Street, Exeter 18643, Luzeme County, Fourteenth Sen~ rial District, for appointment as a member of the Luzerne County Board of Assistance, to serve until December 31, 1996, and until her successor is appointed and qualified, vice James A. Burns, Exeter, whose tenn expired. MEMBER OF THE NOR1HUMBERLAND COUNfY BOARD OF ASSISTANCE October 8, 1996 the advice and consent of the Senate, William R. Swinehart, Esquire (Republican), R. D. #1, Box 101, Dornsife 17823, Northumberland County, Twenty-seventh Senatorial District, for appointment as a member of the Northumberland County Board of Assistance, to serve until December 31, 1998, and until his successor is appointed and qualified, vice Brian L. Hendricks, Shamokin, whose tenn expired. DISTRICT JUSTICE September 19, 1996 the advice and consent of the Senate, Harold D. Kessler, 3330 Harrowgate Road, York 17402, York County, Thirteenth Senatorial District, for appointment as District Justice, in and for the County of York, Magisterial District , to serve until the first Monday of January 1998, vice Roy L. Lam, resigned. On the question, Will the Senate advise and consent to the nominations? The yeas and nays were required by Senator WEPER and were as follows, viz:

20 2592 LEGISLATIVE JOURNAL - SENATE NOVEMBER 13, YEAS-46 Aftlerbach Gerlach Mellow Stapleton Andrezc.slti Greenleaf Mowery Stewart Armstrong Hart Musto Stout BeIaD Heckler O'Pake Tartaglione Bell Holl Peterson Thompson Bodaclt Hughes Piccola Tdghman Brightbill lubelirer Porterfield Tomlinson Corman Kasunic Punt Uliana Costa lavalle Robbins Wagner Delp Lemmond Schwartz Wenger Fisher Loeper Shaffer Williams Furno Madigan NAYS-o A constitutional majority of all the Senators having voted "aye," the question was determined in the affumative. Ordered, That the be informed accordingly. EXECUTIVE SESSION RISES Senator LOEPER. Mr. President, I move that the Executive Session do now rise. The motion was agreed to. UNFINISHED BUSINESS REPORTS FROM COMMITTEE Senator MOWERY, from the Committee on Law and Justice, reported the following bills: BB 2257 (Pr. No. 4217) (Amended) An Act amending the act of April 12, 1951 (p.l.90, No.21), known as the Liquor Code, providing for an investigative unit and for records of importing distributors; and providing for distributors' and importing distributors' restrictions on sales of malt or brewed beverages, for prices of malt or brewed beverages, for Sunday sales of alcoholic beverages and for distribution of malt and brewed beverages. BB 2292 (Pr. No. 4218) (Amended) An Act amending the act of April 12, 1951 (p.l.90, No.21), known as the Liquor Code, further providing for identification cards and for special occasion pemrits; providing licenses for regional history centers; providing for multipwpose cultural and science facilities licenses; and further providing for advertising. DISCHARGE PETITIONS The PRESIDENf pro tempore laid before the Senate the following communications, which were read by the Clerk as follows: In the Senate, November 13, 1996 A PETITION To place before the Senate the nomination of Valerie Smith, as a member of the Health Policy Board. TO: The President Officer of the Senate: WE, The undersigned members of the Senate, pursuant to section 8 (b) of Article IV of the Constitution of Pennsylvania, do hereby request that you place the nomination of Valerie Smith, as a member of the Health Policy Board, before the entire Senate body for a vote, the nomination not having bcen voted upon within 15 legislative days: William J. Stewart Robert J. Mellow Leonard J. Bodack Michael A. O'Fake Patrick J. Stapleton In the Senate, November 13, 1996 A PETITION To place before the Senate the nomination of Paula Vitz, as a member of the State Board of Examiners in Speech-Language and Hearing. TO: The President Officer of the Senate: WE, The undersigned members of the Senate, pursuant to section 8 (b) of Article IV of the Constitution of Pennsylvania, do hereby request that you place the nomination of Paula Vitz, as a member of the State Board of Examiners in Speech-Language and Hearing, before the entire Senate Ixxly for a vote. the nomination not having been voted upon within 15 legislative days: William J. Stewart Robert J. Mellow Leonard J. Bodack Michael A. O'Pake Patrick J. Stapleton The PRESIDENf pro tempore. These communications will be laid on the table. CONGRATULATORY RESOLUTIONS The PRESIDENf pro tempore laid before the Senate the following resolutions, which were read, considered and adopted: Congratulations of the Senate were extended to the Indian American Association of Lehigh Valley by Senator Afilerbach. Congratulations of the Senate were extended to Delos D. Dobson by Senator Andrezeski. Congratulations of the Senate were extended to Mr. and Mrs. Richard IIDdebrand, Mr. and Mrs. Harold T. Rittenhouse, Sr., and to Mr. and Mrs. Robert Rothweiler by Senator Armstrong. Congratulations of the Senate were extended to Robert Joseph Grudowski by Senator Belan. Congratulations of the Senate were extended to West Chester University by Senator Bell. Congratulations of the Senate were extended to WLBR-FM Radio by Senator Brightbill. Congratulations of the Senate were extended to Mr. and Mrs. Raymond Musselman by Senator Delp. Congratulations of the Senate were extended to Helen Dietsch by Senator Greenleaf. Congratulations of the Senate were extended to Michael Regosch, Kurt Rieger and to Mark Walter Weber by Senator Heckler. Congratulations of the Senate were extended to Mr. and Mrs. Richard C. Fox by Senator Helfrick.

21 1996 LEGISLATIVE JOURNAL - SENATE 2593 Congratulations of the Senate were extended to Jeffrey Kelso, Kevin Donald Kerr, John Lewis Langsford III, Stephen Joseph Pasquini and to Ryan T. Pongras by Senator Holl. Congratulations of the Senate were extended to Reverend Maureen L. Davis by Senator Hughes. Congratulations of the Senate were extended to Mr. and Mrs. James Defibaugh by Senator Jubelirer. Congratulations of the Senate were extended to Larry A. Hill by Senator Kasunic. Congratulations of the Senate were extended to Jonathan Bradbury, Ruby Elston and to Elk Mountain VFW Post 8488 by Senator Lemmond. Congratulations of the Senate were extended to Mr. and Mrs. John Huboky by Senator Loeper. Congratulations of the Senate were extended to Congdon Bailey Post 8675, Veterans of Foreign Wars, of Troy by Senator Madigan. Congratulations of the Senate were extended to Samuel J. Sutton by Senator Mowery. Congratulations of the Senate were extended to Dr. Tim Marks and to Maureen O'Mara by Senator Peterson. Congratulations of the Senate were extended to Dr. and Mrs. Richard Guise, Mr. and Mrs. Bill Waidlich and to the Triple Crown Corporation of Harrisburg by Senator Piccola. Congratulations of the Senate were extended to St. John's Evangelical Lutheran Church of Boquet by Senator Porterfield. Congratulations of the Senate were extended to Mr. and Mrs. George E. Cunningham, Mr. and Mrs. Walter Hummel, Todd A. Naito and to Isaac Strausser by Senator Rhoades. Congratulations of the Senate were extended to James David Gould III by Senator Salvatore. Congratulations of the Senate were extended to Mr. and Mrs. Glenn Bryan, Mr. and Mrs. Charles Duespohl, Mr. and Mrs. Jack Vrrgili and to Jessica Henry by Senator Shaffer. Congratulations of the Senate were extended to John George and to Dr. Stephen M. Vak by Senator Stapleton. Congratulations of the Senate were extended to the Mann Older Adult Center of Philadelphia and to the Sultan Jihad Ahmad Scholarship Committee by Senator Tartaglione. Congratulations of the Senate were extended to Peter Bodenstab and to Helen Coates Herr by Senator Thompson. Congratulations of the Senate were extended to the Wtlliam Penn Foundation of Philadelphia by Senator Tilghman. Congratulations of the Senate were extended to The Pen Ryn School of Andalusia by Senator Tomlinson. Congratulations of the Senate were extended to Carl Smollinger, Animals in Distress of Catasauqua and to the Holy Ghost Church of West Easton by Senator Uliana. Congratulations of the Senate were extended to Pittsburgh Community Television, PClV, by Senator Wagner. BILLS ON FIRST CONSIDERATION Senator PORTERFIELD. Mr. President, I move that the Senate do now proceed to consideration of all bills reported from committees for the frrst time at today's Session. The motion was agreed to. The bills were as follows: SB 1662, SB 1720, HB 1782, HB 1988, HB 2065, HB 2210, lib 2257, lib 2292 HB 2595 and HB And said bills having been considered for the frrst time, Ordered, To be printed on the Calendar for second coosideration. COMMUNICATION FROM THE GOVERNOR NOMINATION REFERRED TO COMMI'I"I'EE The PRESIDENT pro tempore laid before the Senate the following communication in writing from Ills Excellency, the of the Commonwealth, which was read as follows and referred to the Committee on Rules and Executive Nominations: MEMBER OF TIlE PENNSYLVANIA LIQUOR CONIROL BOARD November 13, 1996 the advice and consent of the Senate, George F. McManus, 312 Glenn Road, Camp Hill 17011, Cumberland County, Thirty-first Senatorial District, for appointment as a member of the Pennsylvania Uquor Control Board, to serve until the third Thesday in May 2000, vice Oliver L. Slinker, Hanisburg, whose tedn expired. momas J. RIDGE HOUSE MESSAGE HOUSE CONCURS IN SENATE CONCURRENT RESOLUTION The Clerk of the House of Representatives informed the Senate that the House has concurred in resolution from the Senate, entitled: Weekly adjournment. RECESS Majority Leader, Senator Loeper. Senator WEPER. Mr. President, before we are ready to entertain a motion to adjown, I ooderstand that there is still a need for an off-the-floor meeting of the Committee on Environmental Resources and Energy, and I request that we have a very brief recess in order for that committee to meet in the Rules room at the rear of the Senate Chamber at this time. The PRESIDENT pro tempore. Would all Members of the Committee on Environmental Resources and Energy please report to the Rules room to the rear of the Senate Chamber for an immediate committee meeting. For that pmpose, the Senate will stand in recess.