Pennsylvania Code
Title 28 - HEALTH AND SAFETY
Part I - General Health
Chapter 9 - MANAGED CARE ORGANIZATIONS
Subchapter H - AVAILABILITY AND ACCESS
Section 9.676 - Enrollee rights

Universal Citation: 28 PA Code ยง 9.676

Current through Register Vol. 54, No. 44, November 2, 2024

(a) A plan shall have a written policy that shall state the plan's commitment to treating an enrollee in a manner that respects the enrollee's rights and shall include the plan's expectations of a member's responsibilities.

(b) An HMO shall offer to each enrollee, who becomes ineligible to continue as a part of a group subscriber agreement, a nongroup subscription agreement offering the same level of benefits as are available to a group subscriber.

(c) An HMO may not expel or refuse to reenroll an enrollee solely because of the enrollee's health care needs, nor refuse to enroll individual subscribers of a group on the basis of health status or health care needs of the individuals.

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