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ERI DisclaimerPennsylvania - Compensation & Benefit Legislation
PENNSYLVANIA - AASHOWME
Demonstrates www.BenefitsReview.com™ site. Illustrates insurance carriers' coverage within the State.
PENNSYLVANIA - ADOPTED CHILD HEALTH CARE MANDATE
OBRA 1993 (Federal) requires group health plans to honor medical and child support orders. Also, plans must treat adopted children like biological children covered by the plan, and plans are precluded from applying pre-existing condition exclusions to an adopted child where no such exclusion applies to a newborn biological child. Health plans that covered the cost of pediatric vaccines as of May 1, 1993, and fail to continue that level of coverage, will be subject to an excise tax penalty applicable to plans that fail to meet the health care continuation coverage requirements under OBRA 1993.
Mandatory coverage of birth of adopted children is included in state's newborn health care mandate.
Preventive care for children: Yes, for immunization.
(Pennsylvania Stat. Ann. tit. 40 Sections 23-24.6-9, 27-18-27, 27-18-30, 27-38.1-1, 27-38.1-2, 27-38.1-3)
PENNSYLVANIA - ALCOHOLISM & DRUG ABUSE
Mandatory coverage.
Minimum yearly inpatient coverage: 30 days.
Minimum yearly outpatient coverage: 30 visits.
Minimum lifetime coverage: Inpatient: 90 days; outpatient: 120 days; 4 detoxification visits of up to 7 days.
(Pennsylvania Stat. Ann. tit. 40 Sections 908-2, 908-3, 908-4, 908-5)
PENNSYLVANIA - CAFETERIA PLAN TAX LAWS
State income tax, unemployment insurance tax on salary reduction: For purposes of Pennsylvania income taxes, salary reductions and any cash the employee has the option to receive must be counted as wages. Certain Pennsylvania municipalities, including Erie, Philadelphia, and Pittsburgh, also require employers to count cafeteria plan benefits as wages for purposes of local income taxes. For state Unemployment Insurance purposes, there are no specific cafeteria plan provisions, but employer contributions toward health and life insurance generally are nontaxable, even if provided under a cafeteria plan. Employee salary reductions for the purchase of group-term life insurance are taxable on a case-by-case basis.
PENNSYLVANIA - CONTINUATION OF COVERAGE CONVERSIONS
State reports no statutory requirements.
PENNSYLVANIA - COORDINATION OF BENEFITS
State reports no statutory requirements.
PENNSYLVANIA - COST-OF-LIVING
ERI's Relocation Assessor is a recommended source for U.S./Canadian cost-of-living data.
PENNSYLVANIA - DRUG TESTING AND EMPLOYEE ASSISTANCE BENEFITS
State has no statutory requirements.
PENNSYLVANIA - GROUP HEALTH CODE ADDITIONS (MANDATED)
Alcoholism and Drug Abuse Treatment: Group policies and contracts must cover costs of at least seven days of detoxification treatment per admission (a lifetime limit of four admissions for detoxification is permitted); 30 days per year of residential care (a lifetime limit of 90 days is permitted); and 30 outpatient visits per year (a lifetime limit of 120 visits is permitted). Two outpatient visits may be exchanged for one residential treatment day to increase residential treatment. (Pennsylvania Stat. Ann. tit. 40 Section 908.)
Conversion: Group policies on an expense incurred basis must provide conversion rights to employees whose coverage is terminated. (Pennsylvania Stat. Ann. tit. 40 Section 756.2(d).)
Mammography Screening: Group policies providing hospital or medical/surgical coverage must cover costs of mammography screening as described. (Pennsylvania Stat. Ann. tit. 40 Section 764c.)
Maternity: Group policies which provide maternity benefits must provide hospital coverage for a mother and her newborn baby for minimum of 48 hours following a vaginal birth and for a minimum of 96 hours following a Caesarean delivery. A shorter hospital stay for a mother and her baby may be allowed if any attending physician determines that they meet the medical criteria for early discharge. In cases of early post delivery hospital discharge, a mother and her newborn must receive one home health care visit within 48 hours after discharge by a licensed health care provider whose scope of practice includes postpartum care. Home health care visits must include parental education, breast and bottle feeding assistance, infant screening and clinical tests, and maternal and neonatal physical assessments. At a mother's option, she may visit the facility of the provider rather than accept a home health care visit. Policies must not include co-payments, co-insurance payments, or deductible amounts for post delivery home health care visits. (H1977, 1996)
Newborns: Policies must provide benefits for newborns from the moment of birth for injury of sickness including treatment of medically diagnosed congenital defects, birth abnormalities, and prematurity. (Pennsylvania Stat. Ann. tit. 40 Section 771.)
Outpatient Cancer Treatment: Policies covering cancer chemotherapy and approved hormone treatments and services must cover such treatment rendered by an outpatient department of a hospital or other medically appropriate treatment setting. (Pennsylvania Stat. Ann. tit. 40 Section 764b.)
Providers: Psychologists: Costs of services must be covered if the provider is licensed, the service is within the provider's scope of services, and the service is covered by the policy. (Pennsylvania Stat. Ann. tit. 40 Section 768.)
PENNSYLVANIA - GROUP HEALTH FOR SMALL EMPLOYERS
State reports no statutory requirements.
PENNSYLVANIA - GROUP LIFE CODE ADDITIONS
Employer required to pay part of premium: Yes.
Percent of employees who must elect coverage (if employees pay part of premium): No statutory requirements.
Percent of employees who must be covered if employer pays all of premium: 100%.
Minimum number of employees in group plan: 10.
Employer prohibited as beneficiary: Yes.
Grace period (days): 31.
Mandatory conversion: Yes.
Other provisions: None.
(Pennsylvania Stat. Ann. tit. 40 Sections 532.1, 532.2, 532.6)
PENNSYLVANIA - HOLIDAYS
January 1, Washington's Birthday (or 3rd Monday in February), Memorial Day (or last Monday in May), July 4, Labor Day (or 1st Monday in September), Veterans Day, and December 25 are state holidays in all 50 states and in the District of Columbia. Other holidays under State law include: Martin Luther King's birthday (or 3rd Monday in January), Columbus Day (or 2nd Monday in October), Thanksgiving. Other: Any day appointed by the Governor or President. If January 1, February 12, June 14, July 4, November 11, or December 25 falls on Sunday, following Monday is a holiday. (Pennsylvania Stat. Ann. tit. 44 Sections 11,16, 19.2, 22, 26-34, 36, 38, 40, 40.1, 40.2 40.3, 40.4, 40.7)
PENNSYLVANIA - IMMIGRATION (PREVAILING WAGE POLICY)
See U.S. Federal General Administrative Letter 1-2000
PENNSYLVANIA - JURY DUTY & WITNESS TIME OFF
Employer Restriction For Discharging Employee For Taking Leave For Jury Service: Yes, for service employers with 15 or more employees, or manufacturing employers with 40 or more employees.
Remedies and Penalties: Violator is guilty of a summary offense. Employee may bring civil action for lost wages, benefits, reinstatement, and reasonable attorney fees.
Other Requirements: Paid jury service from employer is not required. (Pennsylvania Stat. Ann. tit. 42, Section 4563.)
Employer Restriction For Discharging Employee For Taking Leave to be a Witness: Yes.
Remedies and Penalties: Violator is guilty of a summary offense. Employee may bring civil action for lost wages, benefits, reinstatement, and reasonable attorney fees.
Other Requirements: Paid witness service from employer is not required.
PENNSYLVANIA - LEAVES OF ABSENCE
State reports no statutory requirements.
See U.S. Federal Family and Medical Leave Act
PENNSYLVANIA - LONG TERM DISABILITY CODE ADDITIONS
State does not require employer to provide long term disability benefits; although many employers do in order to remain competitive in hiring/retention of employees.
See LEAVES OF ABSENCE (above), WORKERS' COMPENSATION (below) and U.S. Federal Americans With Disabilities Act
PENNSYLVANIA - MANDATED PROVIDERS
Optometrists, chiropractors, dentists, psychologists, podiatrists, nurse practitioners and midwives. Mandatory coverage for nursing services, osteopaths, and physical therapists. (Pennsylvania Stat. Ann. tit. 40, Sections 768, 1502, 1511, 3001, 3002, 3024)
PENNSYLVANIA - MENTAL HEALTH CARE
Mandatory coverage.
Minimum yearly inpatient coverage: 30 days
Minimum yearly outpatient coverage: 60 visits
Minimum lifetime coverage: No less than lifetime physical illness. (Pa. Stat. Ann. tit. 40, Section 764g)
PENNSYLVANIA - MINIMUM WAGE
Refer to the Federal minimum wage: $5.15 per hour (effective September 1, 1997).
Exemptions: Certain professionals, agriculture workers, domestics, and outside sales. Students (sub-minimum wage of 85%) and apprentices (sub-minimum wage of 85%) may be exempt by certificate;, handicapped workers in special environments may be exempt by certificate or license. (Pennsylvania Code Ann. tit. 43, Sections 333.104, 333.105)
PENNSYLVANIA - NEW HIRE REPORTING
Who is required to report: All employers.
Who must be reported: All employees.
Exempt from reporting: No exemptions.
Form(s) to file: Form provided by the State, or by W-4 with the additional required information. Information may transmitted electronically.
Filing deadline: Within 20 days of hire.
Employer information to be included: Name, address, EIN, name of employer’s representative, and telephone number.
Employee information to be included: Name, address, SSN, date of birth, and hire date.
Penalty for failure to report: $25 per employee not reported per month. $500 if failure is result of conspiracy between employer and employee.
(Pa. Stat. Ann. tit. 23, Section 4391, 4392, 4396)
PENNSYLVANIA - NEWBORN CARE MANDATE
Mandated coverage.
Preventive care for children: Yes, for immunizations. (Pennsylvania Stat. Ann. tit. 40 Sections 23-24.6-9, 27-18-27, 27-18-30, 27-38.1-1, 27-38.1-2, 27-38.1-3)
PENNSYLVANIA - PARENTAL LEAVE
See U.S. Federal Family and Medical Leave Act
PENNSYLVANIA - PRE-EXISTING CONDITIONS
State reports no statutory requirements.
See U.S. Federal Health Insurance Portability & Accountability Act
PENNSYLVANIA - PROTECTED CLASSIFICATIONS
Age: Yes, age 40 and over.
Race: Yes.
Color: Yes.
National Origin: Yes.
Ancestry: Yes.
Religion: Yes.
Sex: Yes.
Pregnancy: No specific law. State has expressed policy against discrimination.
Sexual Harassment: No specific law. State has expressed policy against discrimination.
(Pa. Const. art. I Section 28; Pa. Stat. Ann. tit. 43, Sections 952-955.)
PENNSYLVANIA - SALARY SURVEY
ERI's Salary Assessor is a recommended source for U.S./Canadian wages & salaries.
PENNSYLVANIA - SHORT TERM DISABILITY CODE ADDITIONS
State does not require employer or employee participation in short term disability plans.
PENNSYLVANIA - TERMINATION & SEVERANCE PAY
Date pay is due if employee is discharged: Payday.
Date due if employee resigns: Payday.
Severance: State reports no statutory requirements.
(Pennsylvania Stat. Ann. tit. 43, Sections 260.2a, 260:5; 15 Pennsylvania Cons. Stat. Ann. Section 2582)
PENNSYLVANIA - UNEMPLOYMENT TAX
Employer Contributions
Tax Rate (%)
Standard 5.4 - 9.2 (Varies by industry)
Maximum 9.2
Minimum 1.5
Voluntary Contribution Provision: Yes. Within 30 days of mailing notice, but within 120 days of start of contribution year.
(Pennsylvania Cons. Stat. Ann. tit. 48 Sections 766, 781.1, 781.8, 782, 784.)
PENNSYLVANIA - VACATION PAY
See Termination & Severance pay (above)
PENNSYLVANIA - VOTING TIME OFF
State reports no statutory requirements.
PENNSYLVANIA - WORKERS' COMPENSATION
Private Employers: Mandatory as to all employments. Executive officers may elect not to be covered. (Note: Executive officers are defined as individuals who have either ownership interest in a sub-chapter S corporation or at least 5% ownership interest in the sub-chapter S corporation.)
Public Employers: Mandatory as to all salaried public employments except elected officials.
Exceptions: Domestic or casual labor, outworker, farmer with 1 employee working less than 20 days a year of earns less than $150 a year. (Note: Outworker is person to whom articles are given for cleaning, repairing, etc., at home.)
Special Coverage Provisions: Voluntary as to casual and domestic service. (Note: Employers may be exempted from covering an employee whose religious sect prohibits benefits from insurance provided that the sect makes provisions for its members.)
(U.S. Chamber of Commerce, 1994 Analysis of Workers' Compensation Laws.)