LD 1496
pg. 2
Page 1 of 41 An Act To Reduce Maine's Health Insurance Rates and Expand Consumer Choice ... Page 3 of 41
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LR 541
Item 1

 
D. Notwithstanding paragraph A, carriers Carriers offering
supplemental coverage for the Civilian Health and Medical
Program for the Uniformed Services, CHAMPUS, are not
required to issue this coverage if the applicant for
insurance does not have CHAMPUS coverage.

 
Sec. A-10. 24-A MRSA §2736-C, sub-§6, ķA, as amended by PL 1995, c.
332, Pt. K, §1, is further amended to read:

 
A. Each carrier must actively market individual health plan
coverage, including any standardized plans defined pursuant
to subsection 8, to individuals in this State.

 
Sec. A-11. 24-A MRSA §2736-C, sub-§8, as amended by PL 1999, c. 256,
Pt. D, §2, is further amended to read:

 
8. Authority of superintendent. The superintendent may by
rule define one or more standardized individual health plans that
must may be offered by all carriers offering individual health
plans in the State, other than carriers offering only CHAMPUS
supplemental coverage.

 
Sec. A-12. 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;


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