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Regulation31 Pa. Code § 152.16

Preexisting condition limitation.

Pennsylvania · PAID
First seen July 21, 2026 · last checked July 21, 2026
Version history
v1fetched Jul 21, 2026b9a53daaa90a
Full text
Public law · full text
1
A risk-assuming preferred provider organization which is not a licensed insurer may not use a policy or contract which contains a preexisting condition limitation which is more restrictive than the following: a preexisting condition is a disease or physical condition for which medical advice or treatment has been received within 90 days immediately prior to becoming covered under the preferred provider arrangement. The condition is covered after the individual has been covered for more than 12 months under the group contract.