PA HB618

Prohibits health insurers from denying coverage, charging higher premiums, or excluding benefits based on preexisting conditions or health factors including health status, medical history, genetic information, disability, or conditions arising from domestic violence

Limits premium rate variations in the individual and small group markets to only family size, geographic area, age (maximum 3:1 ratio for adults), and tobacco use (maximum 1.5:1 ratio)

Requires insurers to treat all enrollees in the individual market and small group market as members of single risk pools, excluding grandfathered health plans

Establishes penalties for violations including license suspension/revocation, fines up to $5,000 per violation ($10,000 for willful violations), with aggregate caps of $500,000 per insurer and $100,000 for other persons per calendar year

Structured as a contingency measure that takes full effect only if federal ACA protections (42 U.S.C. § 300gg, 300gg-3, 300gg-4, or 18032(c)) are repealed, invalidated by courts, or unenforced by the executive branch