LD 1545
pg. 4
Page 3 of 9 An Act To Establish a Cooperative Approach to Health Care Coverage Page 5 of 9
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LR 16
Item 1

 
individuals participating in Dirigo Health, including
medical expense reimbursement accounts and dependent care
reimbursement accounts. ; and

 
(8)__Dirigo Health shall administer or contract to
administer individual health savings accounts for
individuals participating in Dirigo Health.

 
Sec. A-14. 24-A MRSA §6910, sub-§4, ¶¶B and C, as enacted by PL 2003, c.
469, Pt. A, §8, are repealed.

 
Sec. A-15. 24-A MRSA §6910, sub-§4, ¶D is enacted to read:

 
D.__Dirigo Health may not establish an out-of-pocket
maximum, including deductibles, copayments and coinsurance,
that exceeds 10% of an individual's adjusted gross income.

 
Sec. A-16. 24-A MRSA §6910, sub-§5, ¶¶A and B, as enacted by PL 2003, c.
469, Pt. A, §8, are amended to read:

 
A. Dirigo Health shall publicize the availability of Dirigo
Health Insurance to businesses, self-employed individuals
and others eligible to enroll in Dirigo Health Insurance.

 
B. Dirigo Health shall screen all eligible individuals and
employees for eligibility for subsidies under section 6912
and eligibility enrollee hardship funds under section 6912-A
or for MaineCare. To facilitate the screening and referral
process, Dirigo Health shall provide a single application
form for Dirigo Health and MaineCare. The application
materials must inform applicants of subsidies available
through Dirigo Health and of the additional coverage
available through MaineCare. It must allow an applicant to
choose on the application form to apply or not to apply for
MaineCare or for a subsidy enrollee hardship funds. It must
allow an applicant to provide household financial
information necessary to determine eligibility for MaineCare
or a subsidy enrollee hardship funds. Except when the
applicant has declined to apply for MaineCare or a subsidy
enrollee hardship funds, an application must be treated as
an application for Dirigo Health, for a subsidy enrollee
hardship funds and for MaineCare. MaineCare must shall make
the final determination of eligibility for MaineCare.

 
Sec. A-17. 24-A MRSA §6912, as enacted by PL 2003, c. 469, Pt. A,
§8, is repealed.

 
Sec. A-18. 24-A MRSA §6912-A is enacted to read:


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