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annual out-of-pocket payments for covered health care | | expenses reach $6,000. When the $6,000 annual limit is met, | | the coinsurance amount must be reduced to 5% on any | | additional expenses. |
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| | | B.__A carrier may not enroll an employee or member in an | | alternate plan as described in this section if the | | employee or member has any other supplemental insurance | | coverage for the payment of the deductibles and | | coinsurance associated with the alternate plan except as | | provided in section 2808-D, subsection 2. |
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| | | C. The superintendent shall adopt rules to further define | | the plan required by this subsection. Rules adopted | | pursuant to this subsection are routine technical rules as | | defined in Title 5, chapter 375, subchapter 2-A. |
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| | | Sec. 3. 24-A MRSA §§2808-C and 2808-D are enacted to read: |
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| | | §2808-C.__Mandatory options in all group health coverage plans |
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| | | 1.__Mandatory offer.__All carriers offering group health | | plans in this State shall offer, at the time of offering and | | renewing a health plan, an alternate version of that plan in | | accordance with the requirements of this subsection and any | | rules adopted by the superintendent pursuant to this section.__ | | The alternate version of each plan must provide the identical | | coverages of the primary plan, except that additional | | deductibles and coinsurance payments must be required in the | | alternate plan as described in this subsection. |
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| | | A.__The alternate plan must include an annual deductible | | of $3,000.__The alternate plan must include a 20% | | coinsurance payment on health care expenses above $3,000 | | until the annual out-of-pocket payments for covered health | | care expenses reach $6,000.__When the $6,000 annual limit | | is met, the coinsurance amount must be reduced to 5% on | | any additional expenses. |
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| | | B.__A carrier may not enroll an employee or member in an | | alternate plan as described in this section if the | | employee or member has any other supplemental insurance | | coverage for the payment of the deductibles and | | coinsurance associated with the alternate plan, except as | | provided in section 2808-D, subsection 2. |
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| | | 2.__Rulemaking.__The superintendent shall adopt rules to | | further define the plan required by subsection 1. Rules | | adopted pursuant to this section are routine technical rules | | as defined in Title 5, chapter 375, subchapter 2-A. |
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