Pennsylvania HB 1796: An Act providing for confidentiality in certain communications between insurers and protected individuals.

Bill Text

PRINTER'S NO. 2209
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 1796
Session of
2025
INTRODUCED BY GUZMAN, HOWARD, CEPEDA-FREYTIZ, RIVERA, HILL-
EVANS, SANCHEZ AND K.HARRIS, AUGUST 10, 2025
REFERRED TO COMMITTEE ON INSURANCE, AUGUST 11, 2025
AN ACT
Providing for confidentiality in certain communications between
insurers and protected individuals.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Short title.
This act shall be known and may be cited as the Confidential
Insurance Communications Protection Act.
Section 2. Legislative findings.
The General Assembly finds and declares as follows:
(1) Survivors of domestic violence and others at risk
may face serious threats to their safety and privacy when
insurance communications disclose sensitive information to
abusers or unintended parties.
(2) To protect access to medical and behavioral health
services, confidentiality in insurance communications must be
guaranteed.
Section 3. Definitions.
The following words and phrases when used in this act shall
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have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Confidential communication." A written, electronic or
verbal communication from an insurer, including an explanation
of benefits, claims notification, billing statement or
appointment reminder.
"Insurer." An entity authorized to issue health insurance
policies or administer health plans in this Commonwealth.
"Protected individual." A person covered under a health
insurance policy who has provided a written request for
confidentiality due to fear of endangerment.
Section 4. Confidential communication requests.
(a) Right of protected individuals.--A protected individual
may submit a written request to the insurer for confidential
communications. The request must:
(1) State that disclosure of health information could
endanger the protected individual.
(2) Specify the desired alternative communication
method, such as:
(i) a mailing address different from that of the
policyholder;
(ii) a secure email address; or
(iii) a private telephone number.
(b) Duty of insurer.--Not later than 10 business days after
receipt of a request under subsection (a), the insurer shall
accommodate the request and may not require documentation of
abuse beyond the protected individual's attestation.
Section 5. Nondisclosure requirement.
An insurer may not:
(1) Disclose the existence or nature of a confidential
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communication request to the primary policyholder or a third
party.
(2) Refuse coverage or deny benefits based on a
confidentiality request.
(3) Require a protected individual to obtain
authorization from the policyholder.
Section 6. Enforcement.
Failure to comply with this act shall constitute a violation
of the act of July 22, 1974 (P.L.589, No.205), known as the
Unfair Insurance Practices Act, and may subject the insurer to
administrative penalties, including fines and corrective action
orders, issued by the Insurance Department.
Section 7. Effective date.
This act shall take effect in 120 days.
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