| | |
employers, not to exceed 500 covered lives, to be known | | as the "target risk pool"; |
|
| | | (2)__An affordable benefit design; |
|
| | | (3)__A premium structure sufficient to cover the | | actuarially determined costs of comprehensive health | | care services; |
|
| | | (4)__Premium subsidies or a sliding premium schedule | | for uninsured individuals funded, in part, through a | | waiver of the premium tax; |
|
| | | (5)__Community preventive care and wellness programs; | | and |
|
| | | (6)__Reinsurance for catastrophic individual claims and | | claims beyond a specified aggregate limit. |
|
| | | 3.__Project oversight.__The Superintendent of Insurance in | | conjunction with the Commissioner of Human Services shall oversee | | the implementation of the project by the Mount Desert Island | | Community Health Plan or its successor organization. |
|
| | | 4.__Fund established.__The Community Health Plan Demonstration | | Project Guaranty Fund is established for the purpose of covering | | potential losses, which may be from reimbursement of claims that | | are in excess of income from premiums but not covered by | | reinsurance, incurred by the target risk pool during a defined 3- | | year benefit period of the project.__The money in the fund may | | not lapse but must be carried forward for the purposes identified | | in this section.__After final reconciliation of claims at the end | | of the 3-year benefit period, any unexpended funds of the fund | | must lapse to the General Fund. |
|
| | | 5.__Exemption.__This project is exempt from the provisions of | | other chapters of this Title and Title 22, Title 24-A and Title | | 36. |
|
| | | 6.__Assistance.__The Superintendent of Insurance may provide | | technical assistance to the Mount Desert Island Community Health | | Plan or its successor organization with respect to premium | | structure, benefit design, reinsurance and other issues related | | to the project.__The Department of Human Services may provide | | technical assistance to the Mount Desert Island Community Health | | Plan or its successor organization with respect to health quality | | and outcome evaluation, community outreach and prevention | | strategies and other issues related to the project. |
|
| | | 7.__Duration.__The project terminates January 1, 2004. |
|
|