| for private purchasing alliances. A rule may require an | application fee of not more than $400 and an annual license fee | of not more than $100. A license may not be issued until the | rulemaking required by this chapter has been undertaken and all | required rules are in effect. Dirigo Health, as established in | chapter 87, is exempt from the licensure requirements of this | section as an instrumentality of the State. |
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| | Sec. D-6. 24-A MRSA §2436, sub-§2-A, as enacted by PL 2001, c. 569, | §1, is amended to read: |
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| | 2-A. For purposes of this section, an "undisputed claim" | means a timely claim for payment of covered health care expenses | under a policy or certificate providing health care coverage that | is submitted to an insurer on in the insurer's standard claim | form electronic data format using the most current published | procedural codes with all the required fields completed with | correct and complete information in accordance with the insurer's | published claims filing requirements. This subsection applies | only to a policy or certificate of a health plan as defined in | section 4301-A, subsection 7. |
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| | Sec. D-7. 24-A MRSA §2736-C, sub-§2, ¶B-1 is enacted to read: |
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| B-1.__In no instance may a rate reflect the cost to the | individual health carrier of the recovery amount applied in | accordance with section 6920. |
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| | Sec. D-8. 24-A MRSA §2808-B, sub-§§2-A to 2-C are enacted to read: |
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| | 2-A.__Rate filings.__A carrier offering small group health | plans shall file with the superintendent every rate, rating | formula and classification of risks and every modification of any | formula or classification that it proposes to use.__Every filing | must state the effective date of the filing.__Every filing must | be made not less than 60 days in advance of the stated effective | date, unless the 60-day requirement is waived by the | superintendent. |
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| | 2-B.__Rate review and hearings.__Except as provided in | subsection 2-C, rate filings are subject to this subsection. |
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| A.__The effective date may be suspended by the | superintendent for a period of time not to exceed 30 days.__ | In the case of a filing that meets the criteria in paragraph | E, the superintendent may suspend the effective date for a | longer period not to exceed 30 days from the date the |
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