Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 54 Pa.B. 6234 (September 28, 2024).

31 Pa. Code § 243.4. Reporting requirements for self-insurance plans.

§ 243.4. Reporting requirements for self-insurance plans.

 A health care provider with an approved self-insurance plan shall report to the Commissioner not later than 6 months following the end of the hospital’s fiscal year the experience of the prior fiscal year. The reports shall include the following:

   (1)  A certificate of acceptable audit of the self-insurance trust fund by a certified public accountant (CPA) and a copy of the CPA report.

   (2)  A balance sheet, an income and expense exhibit and other financial exhibits which the Commissioner may require.

   (3)  A comprehensive report of the risk management program of the self-insurance plan. A provider may substitute the proof of current 3-year accreditation by the Joint Commission on Accreditation of Hospitals and the current Department of Health audit showing a satisfactory status in place of the comprehensive report.

   (4)  Other information as the Commissioner may reasonably request.

Authority

   The provisions of this §  243.4 amended under The Insurance Department Act of 1921 (40 P. S. § §  1—321); The Insurance Company Law of 1921 (40 P. S. § §  341—991); and sections 206, 506, 1501 and 1502 of The Administrative Code of 1929 (71 P. S. § §  66, 186, 411 and 412); and the Health Care Services Malpractice Act (40 P. S. § §  1301.101—1301.1006).

Source

   The provisions of this §  243.4 adopted July 1, 1977, effective July 2, 1977, 7 Pa.B. 1816; renumbered February 9, 1979, 9 Pa.B. 498; amended September 18, 1987, effective November 18, 1987, 17 Pa.B. 3742. Immediately preceding text appears at serial page (39845).

Cross References

   This section cited in 31 Pa. Code §  243.3 (relating to standards for self-insurance plans).



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