LD 1168
pg. 3
Page 2 of 20 An Act To Reduce Individual Health Insurance Premiums Page 4 of 20
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LR 790
Item 1

 
Sec. 8. 24-A MRSA §2736-C, sub-§3, ķE is enacted to read:

 
E.__An individual may not be denied health insurance due to
age or gender.__This paragraph may not be construed to
require a carrier to actively market health insurance to an
individual 65 years of age or older.

 
Sec. 9. 24-A MRSA §2736-C, sub-§9, as enacted by PL 1995, c. 570, §7,
is amended to read:

 
9. Exemption for certain associations. The superintendent
may exempt a group health insurance policy or group nonprofit
hospital or medical service corporation contract issued to an
association group, organized pursuant to section 2805-A, from the
requirements of subsection 3, paragraph A; subsection 6,
paragraph A; and subsection 8 if:

 
A. Issuance and renewal of coverage under the policy or
contract is guaranteed to all members of the association who
are residents of this State and to their dependents;

 
B. Rates for the association comply with the premium rate
requirements of subsection 2 or are established on a
nationwide basis and substantially comply with the purposes
of this section, except that exempted associations may be
rated separately from the carrier's other individual health
plans, if any;

 
C. The group's anticipated loss ratio, as defined in
subsection 5, is at least 75%;

 
D. The association's membership criteria do not include
age, health status, medical utilization history or any other
factor with a similar purpose or effect;

 
E. The association's group health plan is not marketed to
the general public;

 
F. The association does not allow insurance agents or
brokers to market association memberships, accept
applications for memberships or enroll members, except when
the association is an association of insurance agents or
brokers organized under section 2805-A;

 
G. Insurance is provided as an incidental benefit of
association membership and the primary purposes of the
association do not include group buying or mass marketing of
insurance or other goods and services; and


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