LD 335
pg. 3
Page 2 of 3 An Act To Clarify the Definition of "Eligible Group" in Small Group Health Insu... LD 335 Title Page
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LR 1319
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must submit an affidavit stating that all employees meet
the criteria in this subparagraph and that the
documentation and forms required under this subparagraph
will be provided to the carrier when payroll records
become available, when ownership distribution forms
become available or the first renewal date of the
coverage, whichever date is earlier. A false affidavit or
misrepresentation on an affidavit submitted by an
employer may result in the loss of group coverage and
repayment of claims paid. This subparagraph may not be
construed to prohibit a carrier from recognizing an
employer as an eligible group if the employer has not
produced the documentation required in this subparagraph.

 
This subparagraph applies only to an employer applying
for group health insurance coverage as a 2-person group
on or after October 1, 2001.

 
Sec. 2. 24-A MRSA §4346, sub-§1, ¶G, as enacted by PL 2001, c. 708, §3,
is amended to read:

 
G. "Small employer" means an eligible group as defined in
section 2808-B, subsection 1, paragraph D a person, firm,
corporation, partnership, association or subgroup engaged
actively in a business that employed an average of 50 or
fewer eligible employees during the preceding calendar year.

 
SUMMARY

 
This bill clarifies the definition of "eligible group" as it
applies to small group health plans by specifying that a majority
of the employees in the group must be employed in the State.
This bill also changes a cross-reference in the Maine Consumer
Choice Health Plan to maintain the current definition of
"eligible group."


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