| 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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