LD 394
pg. 20
Page 19 of 21 An Act To Create a High-risk Pool in the Health Insurance Market Page 21 of 21
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LR 516
Item 1

 
B. The member insurer is able to determine through the use
of individual health statements, claims history or any
reasonable means that at the time the person applied for
insurance coverage with the member insurer, the covered
person was diagnosed with one of the following medical
conditions: acquired immune deficiency syndrome, angina
pectoris, ascites, chemical dependency cirrhosis of the
liver, coronary occlusion, cystic fibrosis, Friedreich's
ataxia, hemophilia, Hodgkin's disease, Huntington's chorea,
juvenile diabetes, leukemia, metastatic cancer, motor or
sensory aphasia, multiple sclerosis, muscular dystrophy,
myasthenia gravis, myotonia, heart disease causing open
heart surgery, Parkinson's disease, polycystic kidney,
psychotic disorders, quadriplegia, stroke, syringomyelia or
Wilson's disease.

 
2. Rules.__The superintendent may adopt rules to facilitate
payment to a carrier pursuant to this section. Rules adopted
pursuant to this subsection are routine technical rules as
defined in Title 5, chapter 375, subchapter 2-A.

 
Sec. 13. Application for federal grant. Within 30 days of the effective
date of this Act, the Superintendent of Insurance shall submit an
application to the federal Department of Health and Human
Services, Health Resources and Services Administration for a
federal seed grant to support the creation and initial operation
of the Comprehensive Health Insurance Risk Pool Association
established in the Maine Revised Statutes, Title 24-A, chapter
54.

 
Sec. 14. Study of reinsurance. The Comprehensive Health Insurance Risk
Pool Association established pursuant to the Maine Revised
Statutes, Title 24-A, section 3904 shall conduct a study of the
possibility of offering a reinsurance pool for the small group
medical insurance market in order to spread the cost of high-risk
individuals for the small group medical insurance market. The
study must address the cost of the reinsurance pool, potential
funding mechanisms and the effectiveness of a reinsurance pool.
The association may address any other issues regarding a
reinsurance pool that it determines are relevant in the study.
The association shall submit its report to the joint standing
committee of the Legislature having jurisdiction over health
insurance matters by March 1, 2007.

 
Sec. 15. Effective date. Those sections of this Act that repeal the
Maine Revised Statutes, Title 24-A, section 2736-C, subsection 3,
paragraphs A and C and that amend Title 24-A, section 2736-C,
subsection 3, paragraph D and subsection 9 take effect October 1,
2005.


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