Sec. 1. 24-A MRSA §2808-B, sub-§8-A is enacted to read:

8-A.__Catastrophic health plan.__The superintendent shall by rule define a catastrophic health plan that may be offered by all carriers offering small group health plans in the State.__An association group organized pursuant to section 2805-A or a trustee group organized pursuant to section 2806 may offer the catastrophic health plan to its subgroups.__As used in this section, "catastrophic health plan" means a plan that provides benefits for medical emergencies, serious illness and hospitalization only and that is exempt from the requirements for mandated coverage for specific health services and specific diseases and for certain providers of health services under Title 24 and this Title applicable to small group health plans.__A catastrophic health plan may not provide coverage for preventive care or annual exams.__A catastrophic health plan must impose a deductible of $1500 or higher. The premium rate charged by the carrier for the catastrophic health plan may not exceed 80% of the corresponding premium rate charged by that carrier for the basic plan required to be offered by carriers pursuant to subsection 8.

SUMMARY

This bill allows carriers in the small group market to offer a catastrophic health plan defined by the Superintendent of Insurance. For purposes of the bill, a catastrophic health plan is a plan that provides benefits for medical emergencies, serious illness and hospitalization only and that is exempt from the requirements for mandated coverage. The bill prohibits a catastrophic health plan from providing coverage for preventive care or annual exams and requires a deductible to be imposed of $1500 or higher. The bill also requires that the premium rate charged by the carrier for a catastrophic plan may not exceed 80% of the premium rate charged by that carrier for the basic plan required by the Department of Professional and Financial Regulation, Bureau of Insurance, Rule Chapter 750.