| | | Sec. B-18. 24-A MRSA §4207, sub-§5, as amended by PL 2003, c. 469, Pt. | | E, §19, is further amended to read: |
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| | | 5. A schedule or an amendment to a schedule of charge for | | enrollee health coverage for health care services may not be used | | by any health maintenance organization unless it complies with | section 2736, 2808-B |
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| | | Sec. B-19. 24-A MRSA §4210, sub-§1, as amended by PL 1995, c. 332, Pt. | | O, §4, is further amended to read: |
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| | | 1. After a health maintenance organization has been in | | operation 24 months, it shall have an annual open enrollment | | period of at least one month during which it accepts enrollees up | | to the limits of its capacity, as determined by the health | | maintenance organization, in the order in which they apply for | | enrollment. To the extent not inconsistent with the requirements | of chapter 36 and sections 2736-C and 2808-B | | by section 4222-B, subsection 3, a health maintenance | | organization may apply to the superintendent for authorization to | | impose such underwriting restrictions upon enrollment as are | | necessary to preserve its financial stability, to prevent | | excessive adverse selection by prospective enrollees or to avoid | | unreasonably high or unmarketable charges for enrollee coverage | | for health care services. The superintendent shall approve or | | deny the application within 10 days of the receipt of that | | application from the health maintenance organization. |
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| | | Sec. B-20. 24-A MRSA §4212, sub-§2, ¶C, as enacted by PL 1995, c. 332, | | Pt. O, §6, is amended to read: |
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| | | C. When the provisions of the State's community rating law | | are applicable, as provided by section 2736-C, subsection 3, | paragraph B and section 2808-B, subsection 4, paragraph B | | or |
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| | | Sec. B-21. 24-A MRSA §4222-B, sub-§3, as enacted by PL 1995, c. 332, | | Pt. O, §8, is amended to read: |
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| | | 3. The requirements of sections 2736-C and 2808-B, | community rating law, | | except that a health maintenance organization is not required to | | offer coverage or accept applications from an eligible group or | | individual located outside the health maintenance organization's | | approved service area. |
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| | | Sec. B-22. 24-A MRSA §4346, sub-§1, ¶D, as enacted by PL 2001, c. 708, | | §3, is amended to read: |
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| | | D. "Eligible employee" or "employee" means an individual | | who: |
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