|
Insurance through Dirigo Health.__"Plan enrollee" includes an | eligible employee who is eligible to enroll in MaineCare. |
|
| | 14.__Provider.__"Provider" means any person, organization, | corporation or association that provides health care services and | products and is authorized to provide those services and products | under the laws of this State. |
|
| | 15.__Reinsurance or reinsurer.__"Reinsurance" and "reinsurer" | have the same meanings as in section 741. |
|
| | 16.__Resident.__"Resident" has the same meaning as in section | 2736-C, subsection 1, paragraph C-2. |
|
| | 17.__Subsidy.__"Subsidy" means a subsidy as described in | section 6912. |
|
| | 18.__Third-party administrator.__"Third-party administrator" | means any person who, on behalf of any person who establishes a | health insurance plan covering residents, receives or collects | charges, contributions or premiums for or settles claims on | residents in connection with any type of health benefit provided | in or as an alternative to insurance as defined by section 704, | other than: |
|
| A. Any person listed in section 1901, subsection 1, | paragraphs A to C and paragraphs E to O; or |
|
| B. Any person who provides those services in connection with | a group health plan sponsored by an agricultural cooperative | association located outside of this State that provides | heath insurance coverage to members and employees of | agricultural cooperative associations located within this | State. |
|
| | 19.__Unemployed individual.__"Unemployed individual" means an | individual who does not work more than 20 hours a week for any | single employer. |
|
| §6904.__Board of Directors of Dirigo Health |
|
| | Dirigo Health operates under the supervision of a Board of | Directors established in accordance with this section. |
|
| | 1.__Appointments.__The board consists of 5 voting members and | 3 ex officio, nonvoting members as follows. |
|
| A.__The 5 voting members of the board must be appointed by the | Governor, subject to review by the joint standing |
|
|