| | | Health insurance carriers that seek to qualify to provide | | Dirigo Health Insurance must also qualify as health plans in | | Medicaid. |
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| | | 4.__Contracting authority.__Dirigo Health has contracting | | authority and powers to administer Dirigo Health Insurance as set | | out in this subsection. |
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| | | A.__Dirigo Health may contract with health insurance | | carriers licensed to sell health insurance in this State or | | other private or public third-party administrators to | | provide Dirigo Health Insurance.__In addition: |
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| | | (1)__Dirigo Health shall issue requests for proposals | | from health insurance carriers; |
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| | | (2)__Dirigo Health may include quality improvement, | | disease prevention, disease management and cost- | | containment provisions in the contracts with | | participating health insurance carriers or may arrange | | for the provision of such services through contracts | | with other entities; |
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| | | (3)__Dirigo Health shall require participating health | | insurance carriers to offer a benefit plan identical to | | Dirigo Health Insurance, for which no Dirigo Health | | subsidies are available, in the general small group | | market; |
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| | | (4)__Dirigo Health shall make payments to participating | | health insurance carriers under a Dirigo Health | | Insurance contract to provide Dirigo Health Insurance | | benefits to plan enrollees not enrolled in MaineCare; |
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| | | (5)__Dirigo Health may set allowable rates for | | administration and underwriting gains for Dirigo Health | | Insurance; |
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| | | (6)__Dirigo Health may administer continuation benefits | | for eligible individuals from employers with 20 or more | | employees who have purchased health insurance coverage | | through Dirigo Health for the duration of their | | eligibility periods for continuation benefits pursuant | | to the federal Consolidated Omnibus Budget | | Reconciliation Act, Public Law 99-272, Title X, Private | | Health Insurance Coverage, Sections 10001 to 10003; and |
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| | | (7)__Dirigo Health may administer or contract to administer the | | United States Internal Revenue Code of 1986, Section 125 plans | | for employers and employees |
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