Your State Government's Oversight of Health Insurance in Pennsylvania
The Government of the state of Pennsylvania is in charge of developing, implementing and managing insurance requirements and regulations applicable to insurance business in the state. In meeting this obligation, the State Government generally chooses to balance the needs of consumers with a business environment that promotes a robust financial growth rate. With regards to health insurance, the State Government must serve three major groups: consumers, insurance companies, and independent insurance brokers.
The Government's primary control factor for promoting a good health insurance system is the licensing and review of health insurance providers and brokers. For managing insurance providers, the State Government prepares basic standards for insurance products and performs routine financial statement reviews, ensuring that taxation regulations are met. For insurance brokers, the State Government sets professional and licensing qualifications, administers broker license tests and issues licenses, sets and reviews continuing education needs, and collects broker licensing fees. The State level Government is responsible for identifying and investigating insurance crimes and fraud, especially as it pertains to consumers or if it may harm the business environment of the state.
For insurance consumers, the State Government publishes guidelines for consumers to help residents understand their best health insurance choices. The State-level Government can also help consumers file insurance appeals with their insurance provider when there is a dispute over the insurance policy terms. Lastly, the State Government performs the work associated with managing the Federal Medicare program within the state where subsidized insurance is provided to children without health insurance and low income families, under-insured seniors, or self-employed individuals.