Banking and Insurance

Pennsylvania Senate Bill 1439 tightens oversight of the state's health insurance exchange by requiring insurers to provide documentary proof of residency and legal status for every enrollee. The bill mandates that the exchange authority respond to insurer requests to cancel policies within one business day and make a final decision within five business days. Additionally, it requires the creation of an Office of Fraud Prevention within 180 days to investigate complaints, standardize reporting forms, and ensure staff receive annual anti-fraud training. The exchange authority must also submit an annual report to state legislators detailing fraud statistics, financial impacts, and implemented procedures.

Senate Bill 738 amends the Older Adults Protective Services Act to create new requirements for financial institutions concerning the financial exploitation of older adults. It mandates that financial institution employees report suspected financial exploitation to a designated representative within two business days. If the representative finds reasonable cause, they must then report the suspected exploitation to the Department of Aging or an area agency on aging. This bill aims to establish a structured reporting system within financial institutions to protect older adults.

SB 1409 amends Pennsylvania's Insurance Company Law to establish specific rules for how health insurers handle mental health treatments. The bill creates new definitions for "behavioral health crisis" and "serious mental illness," which includes conditions like schizophrenia, bipolar disorder, and major depression. Under these new rules, insurers can only require patients to try one alternative drug before approving a prescribed medication for serious mental illnesses, and they cannot require prior authorization or step therapy for drugs used during a behavioral health crisis if those drugs are FDA-approved and evidence-based. These changes will apply to new insurance policies starting January 1, 2027.

HB 1123 updates Pennsylvania's 1921 Insurance Company Law to require casualty insurance policies to cover colorectal cancer screening without cost-sharing. This affects insured residents in Pennsylvania who need preventive screenings, ensuring they face no copays or deductibles for this specific health service. The key provision mandates insurers to include coverage for colon cancer screenings as a standard benefit under casualty insurance policies. The bill passed final passage on October 29, 2025, and is now pending implementation under the Banking & Insurance committee. This change directly removes financial barriers for early detection of colorectal cancer through existing insurance coverage.

This bill establishes a formal regulatory framework in Pennsylvania for shared equity agreements, which are financial contracts where a provider gives a homeowner money in exchange for a stake in the property's future value. It directly affects financial institutions and investors offering these nonrecourse loans, requiring them to obtain a license from the Department of Banking and Securities to operate legally. The legislation defines specific terms like "shared equity provider" and outlines the duties of the state department to oversee these transactions, while also setting penalties for noncompliance. By creating new chapters in the state statutes, the bill aims to bring transparency and oversight to this growing area of residential finance without altering existing reverse mortgage rules.