LD 1507
pg. 9
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LR 1913
Item 1

 
 
PART H

 
Sec. H-1. 24-A MRSA §1951, sub-§2, as corrected by RR 2001, c. 2, Pt.
B, §42 and affected by §58, is amended to read:

 
2. Private purchasing alliance. "Private purchasing
alliance" or "alliance" means a corporation licensed pursuant to
this section established under former Title 13-A, Title 13-B or
Title 13-C to provide health insurance to its members through one
or more participating carriers.

 
Sec. H-2. 24-A MRSA §1952, as enacted by PL 1995, c. 673, Pt. A,
§3, is amended to read:

 
§1952. Licensure

 
A person or entity private purchasing alliance may not market,
sell, offer or arrange for a package of one or more health
benefit plans underwritten by 2 one or more carriers without
first being licensed by the superintendent. The superintendent
shall specify by rule standards and procedures for the issuance
and renewal of licenses 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.

 
Sec. H-3. 24-A MRSA §2736-C, sub-§5, as enacted by PL 1993, c. 477,
Pt. C, §1 and affected by Pt. F, §1, is amended to read:

 
5. Loss ratios. For all policies and certificates issued on
or after the effective date of this section, the superintendent
shall disapprove any premium rates filed by any carrier, whether
initial or revised, for an individual health policy unless it is
anticipated that the aggregate benefits estimated to be paid
under all the individual health policies maintained in force by
the carrier for the period for which coverage is to be provided
will return to policyholders at least 65% of the aggregate
premiums collected for those policies, as determined in
accordance with accepted actuarial principles and practices and
on the basis of incurred claims experience and earned premiums.

 
Sec. H-4. 24-A MRSA §2747, sub-§1, as enacted by PL 1981, c. 205, §2,
is amended to read:

 
1. Any insurer denying medical expense reimbursement benefits
on any of the grounds specified in subsection 2 for a


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