| | A private purchasing alliance may not market, sell, offer or | arrange for a package of one or more health benefit plans | underwritten by 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. Dirigo Health, as established in | chapter 87, is exempt from the licensure requirements of this | section as an independent executive agency of the State. |
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| | Sec. E-9. 24-A MRSA §2736, sub-§3, ¶B, as enacted by PL 1997, c. 344, | §8, is amended to read: |
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| B. The insurer must demonstrate in accordance with | generally accepted actuarial principles and practices | consistently applied that, as of a date no more than 210 | days prior to the filing, the ratios of benefits incurred to | premiums earned for those products average no less than 80% | for the previous 12-month period. For the purposes of this | calculation, any savings offset payments paid pursuant to | section 6913 must be treated as incurred claims. |
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| | Sec. E-10. 24-A MRSA §2736, sub-§4, ¶C, as enacted by PL 1997, c. 344, | §8, is amended to read: |
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| C. In any hearing conducted under this subsection, the | Bureau of Insurance and any party asserting that the rates | are excessive have the burden of establishing that the rates | are excessive. The burden of proving that rates are | adequate and, not unfairly discriminatory and in compliance | with the requirements of section 6913 remains with the | insurer. |
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| | Sec. E-11. 24-A MRSA §2736-A, as repealed and replaced by PL 1979, | c. 558, §8, is amended to read: |
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| | If at any time the superintendent has reason to believe that a | filing does not meet the requirements that rates shall not be | excessive, inadequate or, unfairly discriminatory or not in | compliance with section 6913 or that the filing violates any of | the provisions of chapter 23, he the superintendent shall cause a | hearing to be held. |
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