LD 1496
pg. 22
Page 21 of 41 An Act To Reduce Maine's Health Insurance Rates and Expand Consumer Choice ... Page 23 of 41
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LR 541
Item 1

 
Sec. B-11. 24-A MRSA §2808-B, as amended by PL 2003, c. 469, Pt. E,
§§14 to 16, is repealed.

 
Sec. B-12. 24-A MRSA §2808-C is enacted to read:

 
§2808-C.__Small group health plans

 
1.__Purpose.__The purpose of this section is to promote the
availability of health insurance coverage to small employers, to
prevent abusive rating practices, to require disclosure of rating
practices to purchasers of small group health plans, to establish
standards for continuity of coverage__for small employers and
their covered employees and to improve the efficiency and
fairness of the small group market.

 
2.__Definitions.__As used in this section, unless the context
otherwise indicates, the following terms have the following
meanings.

 
A.__"Actuarial certification" means a written statement by a
member of the American Academy of Actuaries or other
individual acceptable to the superintendent that a carrier
offering small group health plans is in compliance with the
provisions of subsection 4 based on the person's examination
and review of the carrier's appropriate records and the
actuarial assumptions and methods used by the carrier to
establish premium rates for its small group health plans.

 
B.__"Base premium rate" means, for each class of business as
to a rating period, the lowest premium rate charged or which
could have been charged under a rating system for that class
of business by a small group carrier to small employers with
similar case characteristics for health plans with the same
or similar coverage.

 
C.__"Carrier" means any insurance company, nonprofit
hospital and medical service organization or health
maintenance organization authorized to issue small group
health plans in this State.__For the purposes of this
section, carriers that are affiliated companies or that are
eligible to file consolidated tax returns are treated as one
carrier and any restrictions or limitations imposed by this
section apply as if all small group health plans delivered
or issued for delivery in this State by affiliated carriers
were issued by one carrier.__For purposes of this section,
health maintenance organizations are treated as separate
organizations from affiliated insurance companies and
nonprofit hospital and medical service organizations.


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