An Act providing for health care insurance coverage protections; imposing duties on the Insurance Department and the Insurance Commissioner; and imposing penalties.
HB 535 bans Pennsylvania health insurers from setting annual or lifetime dollar limits on core health benefits for enrollees, whether services are provided by in-network or out-of-network providers. It applies to all individual and group health insurance policies (excluding specific types like Medicare supplements or dental/vision-only plans) and prohibits limits on benefits that were already covered without such caps in 2025 policies. The Insurance Department can enforce this through fines up to $5,000 per violation (or $10,000 for willful violations), with annual caps of $500,000 for insurers. The law does not require coverage of specific benefits but eliminates existing dollar limit practices for covered services.
Bill status
passed
3 of 5 stages cleared
Introduction
Feb 2025
Committee Review
Mar 2025
House Passage
Mar 2025
Senate Passage
Governor
Introduced Feb 10, 2025
Last action Mar 25, 2025
Floor votes · House Mar 25, 2025
How they voted
121–81
Passed
Total votes 202
Mar 25, 2025
D
Democratic101
100% Yea
R
Republican101
80% Nay
Vote distribution
All Yea
All Nay
Mixed
No data
Full legislative history
Actions timeline
Total actions
10
Key actions
3
Committee
5
Mar 25, 2025
Committee
Referred to Banking & Insurance
upper
Mar 25, 2025
Lower · Passed
Third consideration and final passage
lower
Mar 25, 2025
Lower · Passed
Re-reported as committed
lower
Mar 24, 2025
Committee
Re-committed to Appropriations
lower
Mar 17, 2025
Lower · Passed
Reported as committed
lower
Feb 10, 2025
Committee
Referred to Insurance
lower
1 primary · 27 co-sponsors
Sponsors
Role
Legislator
Party
State
District
P
Dan Frankel
DDemocratic
Co
Arvind Venkat
DDemocratic
Co
Ben Sanchez
DDemocratic
Co
Bob Merski
DDemocratic
Co
Carol Hill-Evans
DDemocratic
Co
Chris Pielli
DDemocratic
Co
Dan Deasy
DDemocratic
Co
Dan Williams
DDemocratic
Co
Emily Kinkead
DDemocratic
Co
Gina Curry
DDemocratic
Co
Heather Boyd
DDemocratic
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