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Telehealth Insurance in Pennsylvania

Pennsylvania’s 2024 Act 42 requires covered plans to cover services through telemedicine on the same basis as in person when the service is otherwise covered and technology meets privacy and security law. The Act does not require payment to out-of-network providers, and it preserves the in-person standard-of-care limit. 1,2

What Is Virtual Care And Telehealth?

Telehealth liability can cover claims arising from remote health care, such as a video visit or remote monitoring. If you provide care online, match the quote to your clinicians, services and patient locations; cyber and in-person risks need separate review. Read the national Virtual care and telehealth guide.

What to Watch for in Pennsylvania

  • Pennsylvania Patient Location Determines the Rules

    The Act does not require payment to out-of-network providers, and it preserves the in-person standard-of-care limit. Record where the patient is at each encounter and ask whether the policy covers services delivered under that state-specific rule. 2

  • Keep Telehealth Within Pennsylvania Practice Rules

    Pennsylvania’s 2024 Act 42 requires covered plans to cover services through telemedicine on the same basis as in person when the service is otherwise covered and technology meets privacy and security law. Ask the broker to confirm the professional-liability policy covers the modalities and services your clinicians use in {n}. 1

  • Confirm Pennsylvania Plan Payment Conditions

    Pennsylvania’s 2024 Act 42 requires covered plans to cover services through telemedicine on the same basis as in person when the service is otherwise covered and technology meets privacy and security law. Verify network, authorization, and covered-service conditions before relying on payment for remote encounters. 1,2

Who Regulates Insurance in Pennsylvania

Pennsylvania Insurance Department

The Pennsylvania Insurance Department publishes state tools to check licensed producers, agencies, and insurers, and its Consumer Services Online portal accepts complaints about insurers, agents, brokers, and public adjusters. The department also oversees Pennsylvania insurance business and consumer services. 3,4,5

Surplus-lines tax and stamping office

Reported tax rate: 3% of gross premium (2% for eligible surplus-lines risk retention groups) Pennsylvania charges 3% of gross surplus-lines premiums (2% for an eligible surplus-lines risk-retention group); the tax is in addition to premium, is borne by the insured, and is collected by the producer. For multistate risks, the 2025 Revenue instructions say all gross premiums are taxable when Pennsylvania is the home state, while Insurance Company Law §1621(d) says tax is levied only on premium reasonably ascribable to Pennsylvania risk; confirm allocation with your producer or the state. Surplus-lines coverage is excluded from the guaranty association, and qualifying large risks or exempt commercial purchasers may use distinct no-search routes, with the ECP route requiring disclosure and written request. 6,7,8,9

Providers With Documented State Licenses

No provider in Spot’s research documents both a state license record and this coverage line. This does not establish that providers are unlicensed. Check the regulator’s license lookup and confirm availability with a provider when requesting a quote.

Questions to Ask Before You Buy in Pennsylvania

  1. Does our professional-liability policy cover the telehealth modalities we use with patients in Pennsylvania?
  2. How should we document Pennsylvania patient location, consent, and required in-person follow-up?
  3. Which Pennsylvania plan rules or network terms affect reimbursement for these services?

Virtual Care And Telehealth in Pennsylvania: FAQ

Do clinicians need authorization to provide telehealth to patients in Pennsylvania? 2

Yes. The Act does not require payment to out-of-network providers, and it preserves the in-person standard-of-care limit. 2

Does Pennsylvania require health plans to cover telehealth? 1

Usually, when the service is otherwise covered and meets the state’s applicable clinical and plan conditions. Pennsylvania’s 2024 Act 42 requires covered plans to cover services through telemedicine on the same basis as in person when the service is otherwise covered and technology meets privacy and security law. 1

Virtual Care And Telehealth in Other States

Other Coverage in Pennsylvania

Sources

  1. Act 42 of 2024, Insurance Code. Act 42 of 2024; § 4803(a), (b), (c): coverage and HIPAA-compliant technology. Accessed 2026-09-29.
  2. Pennsylvania Department of State, Telemedicine FAQs. Pennsylvania Department of State; Question 3: Medical Assistance coverage and provider enrollment. Accessed 2026-09-29.
  3. pennsylvania insurance regulator. State insurance regulator; PID official agency page and the search/consumer-help service map. Accessed 2026-09-28.
  4. Pennsylvania Insurance Industry Search Tool Library. State insurance regulator; PID identifies consumer Sircon and detailed individual, business-entity, and company search tools. Accessed 2026-09-28.
  5. File a Complaint with Your Insurance Company, Agent, Broker, or Public Adjuster. State insurance regulator; PID directs insurance complaints and questions to its Consumer Services Online portal. Accessed 2026-09-28.
  6. RCT-123 Gross Premiums Tax - Surplus Lines Agents (2025). Pennsylvania Department of Revenue; Instructions p. 4, imposition/base/rate: 3% on gross premiums; insured bears tax, producer collects/remits; RRG exception 2% per statute. Accessed 2026-09-28.
  7. Insurance Company Law, §1621. Pennsylvania General Assembly; Subsection (d): multi-state tax is levied only on premium reasonably ascribable to Pennsylvania risk. This differs from the 2025 RCT-123 instructions, which state all gross premiums taxable if PA is home state; see source tax. Accessed 2026-09-28.
  8. Insurance Department Act, surplus-lines notice provision. Pennsylvania General Assembly; Policy legend: insurer is not licensed and surplus-lines insurance is NOT covered by Pennsylvania Insurance Guaranty Association. Accessed 2026-09-28.
  9. Pennsylvania Insurance Company Law §§1604 and 1610 (40 P.S. §§991.1604, 991.1610). Pennsylvania General Assembly; Act 28 of 2011 §1610(a), (a.1): large-risk criteria and ECP disclosure followed by written request exempt from diligent-search requirements. Accessed 2026-09-28.
  10. Licenses. At-Bay; Current producer introduction and state table; At-Bay Insurance Services LLC; P&C and surplus-lines identifiers. Accessed 2026-09-21.
  11. Licenses and Carriers. Coalition; Licenses and Carriers, re-read 22 September 2026: Insurance Licenses table for Coalition Insurance Solutions, Inc., national producer number 18419475, with producer and surplus-lines numbers for all 50 states and DC including California 0L76155, Georgia 196479, Texas 2199630 and 2205589, Pennsylvania 815731 and 817452, Colorado 539028 and Wisconsin 3000108852. Insurance Carriers table naming, with NAIC numbers, Allianz Underwriters Insurance Company 36420, Arch Specialty Insurance Company 21199, Ascot Specialty Insurance Company 45055, Ascot Insurance Company 23752, Aspen Specialty Insurance Company 10717, Chaucer Insurance Company DAC, Coalition Insurance Company 29530, Fireman's Fund Indemnity Corporation 11380, Fortegra Specialty Insurance Company 16823, Lloyd's of London, MSIG Specialty Insurance USA Inc. 34886, MS Transverse Specialty Insurance Company 41807, Steadfast Insurance Company 26387, Vantage Risk Specialty Insurance Company 16275 and Zurich American Insurance Company 16535. Accessed 2026-09-22.
  12. Insurance Producer Licenses. Corgi Insurance; Current complete Insurance Producer Licenses table for Corgi Insurance Services, Inc.; 50 rows covering 49 states and DC (DC 3003091619); no New Mexico row; no NPN or as-of date shown. Accessed 2026-09-28.
  13. About Hiscox US Insurance. Hiscox; Hiscox Insurance Company Inc. NAIC 10200 as Chicago, IL domiciled insurer admitted or licensed in all 50 states and D.C.; Hiscox Inc. as general agent and Lloyd’s coverholder for Syndicates 33 and 3624; surplus-lines placements through licensed surplus-lines brokers; A.M. Best rating statement. Accessed 2026-09-16.
  14. Licenses. ERGO NEXT Insurance; Current entity-by-state license table reopened 28 September 2026: 50 rows under Next First Insurance Agency, Inc., including Washington, DC; New York rows instead list Next Insurance Services PC-1423070 and AP Intego BR-1198885. Accessed 2026-09-28.
  15. Insurance Licenses by State. TechInsurance; Current state table; identifies TechInsurance as a division of Specialty Program Group LLC d/b/a SPG Insurance Solutions; lists DC 3000041536 and labels Rhode Island “Individual licenses,” without an agency license number. Accessed 2026-09-28.
  16. Licenses. Vouch; Effective 16 January 2025: Vouch Specialty Insurance Services, LLC, NPN 19926463; P&C table (50 states and DC); surplus-lines table includes Idaho 870820; footnote says Georgia and Idaho do not issue agency-level surplus-lines licenses; Idaho retained as producer-only due to conflict. Accessed 2026-09-15.

Updated .

This guide is informational and does not determine whether a policy is available or meets your needs. Editorial policy. To suggest a correction, contact Spot with a supporting source.

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