| | |
Bureau of Insurance that has been submitted to the Legislature for | | review pursuant to the Maine Revised Statutes, Title 5, chapter | | 375, subchapter 2-A is authorized only if the following changes are | | made. |
|
| | | 1. In Section 4(K) with regard to the definition of | | preexisting condition, the look-back period for a preexisting | | condition is changed from 12 months to 24 months. |
|
| | | 2. In Section 5(A) with regard to prohibited policy | | provisions, language is added to clarify that that section is not | | intended to restrict the use of elimination periods for | | disability income benefits. |
|
| | | 3. In Section 6(A) with regard to minimum standards for | | health insurance benefits generally, language is added to permit | | an insurer to void or contest a policy or deny claims for a | | sickness first manifested before the effective date of the policy | | that was fraudulently not disclosed or fraudulently | | misrepresented in an application for coverage. |
|
| | | 4. In Section 6(A)(8) with regard to minimum standards for | | health insurance benefits generally, the maximum time period | | between the date of an accident and the date of loss is shortened | | from 180 days to 90 days for accidental death and dismemberment | | benefits and from 90 days to 30 days for disability coverage. |
|
| | | 5. In Section 6(H) with regard to minimum standards for | | individual disability income protection coverage, the maximum | | elimination period is changed from 365 days to 730 days in cases | | of coverage having a benefit period of more than 2 years, and the | | shortest permissible maximum benefit period is changed from 6 | | months to 3 months. |
|
| | | 6. In Section 6(J)(2)(c) with regard to specified disease | | coverage, language is added to provide an exception for lump-sum | | benefits based on diagnosis of a specified disease. |
|
| | | 7. In Section 6(J)(4) and Section 6(J)(5) with regard to | | specified disease coverage, language is added to permit the | | Superintendent of Insurance to approve different minimum benefits | | for cancer coverage on an expense-incurred basis or a per diem | | indemnity basis if the superintendent determines that the minimum | | benefits are in the interest of the consumer. |
|
| | | Emergency clause. In view of the emergency cited in the preamble, | | this resolve takes effect when approved. |
|
| | | Effective April 14, 2004. |
|
|