Pennsylvania Code
Title 31 - INSURANCE
Part VIII - Miscellaneous Provisions
Chapter 150 - UNIFORM HEALTH INSURANCE CLAIM FORM-STATEMENT OF POLICY
Section 150.2 - Additional information requests

As required by Article XII of The Insurance Company Law of 1921 (40 P. S. §§ 991.1201-991.1205), the uniform health insurance claim form shall contain blank spaces for additional information requests. An insurer or the Department of Public Welfare may request Insurance Departmental approval of additional information to be printed in the blank spaces on the uniform health insurance claim form, and on subsequent pages, if necessary. The requests will be published in the Pennsylvania Bulletin for public comment. The Insurance Department will review the requests in accordance with the procedures under 2 Pa.C.S. (relating to administrative law and procedure). The requests will be deemed approved by the Insurance Department if not disapproved within 60 days after receipt of the request.