PENNSYLVANIA, January 22 - contract, certificate or plan issued by an insurer that provides

medical or health care coverage on an annual basis to an

individual other than in connection with a group.

"Insurer." An entity that offers, issues or renews an

individual or group health insurance policy that provides

medical or health care coverage by a health care facility or

licensed health care provider and that is governed under any of

the following:

(1) The act of May 17, 1921 (P.L.682, No.284), known as

The Insurance Company Law of 1921, including section 630 and

Article XXIV thereof.

(2) The act of December 29, 1972 (P.L.1701, No.364),

known as the Health Maintenance Organization Act.

(3) 40 Pa.C.S. Ch. 61 (relating to hospital plan

corporations).

(4) 40 Pa.C.S. Ch. 63 (relating to professional health

services plan corporations).

"Out-of-network provider." A provider who does not contract

with an insurer to provide health care services to an enrollee

under a health insurance policy.

Section 3. Limitation on annual and lifetime limits.

(a) Limits.--Except as otherwise provided in this section,

an insurer offering, issuing or renewing an individual or group

health insurance policy may not establish, on either an annual

or lifetime basis, a limit on the dollar value of any core

benefit for an enrollee, whether provided by an in-network

provider or out-of-network provider.

(b) Core benefit.--For purposes of this section, a core

benefit shall include:

(1) A benefit for which no annual or lifetime per

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