LD 1496
pg. 18
Page 17 of 41 An Act To Reduce Maine's Health Insurance Rates and Expand Consumer Choice ... Page 19 of 41
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LR 541
Item 1

 
C.__The person previously terminated plan coverage, unless
12 months have elapsed since the person's last termination;

 
D.__The person has met the lifetime maximum benefit amount
under the plan of $3,000,000;

 
E.__The person is an inmate or resident of a public
institution; or

 
F.__The person's premiums are paid for or reimbursed under
any government-sponsored program or by any government agency
or health care provider, except as an otherwise qualifying
full-time employee, or dependent thereof, of a government
agency or health care provider.

 
5.__Termination of coverage.__The coverage of any person
ceases:

 
A.__On the date a person is no longer a resident;

 
B.__Upon the death of the covered person;

 
C.__On the date state law requires cancellation of the
policy; or

 
D.__At the option of the association, 30 days after the
association makes any inquiry concerning the person's
eligibility or place of residence to which the person does
not reply.

 
The coverage of any person who ceases to meet the eligibility
requirements of this section may be terminated immediately.

 
6.__Unfair trade practice.__It constitutes an unfair trade
practice for any insurer, producer, employer or 3rd-party
administrator to refer an individual employee or a dependent of
an individual employee to the association, or to arrange for an
individual employee or a dependent of an individual employee to
apply to the plan, for the purpose of separating such an employee
or dependent from a group health benefits plan provided in
connection with the employee's employment.

 
§3912.__Actions against association or member insurers based upon

 
joint or collective actions

 
Participation in the association, the establishment of rates,
forms or procedures or any other joint or collective action
required by this chapter may not be the basis of any legal action
or criminal or civil liability or penalty against the association
or a member insurer.


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