| | | A. Dirigo Health may contract with health insurance | | carriers licensed to sell health insurance in this State or | | other private or public third-party administrators to | provide Dirigo Health Insurance Program coverage. In | | addition: |
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| | | (1) Dirigo Health shall issue requests for proposals | | from health insurance carriers; |
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| | | (2) Dirigo Health may include quality improvement, | | disease prevention, disease management and cost- | | containment provisions in the contracts with | | participating health insurance carriers or may arrange | | for the provision of such services through contracts | | with other entities; |
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| | | (3) Dirigo Health shall require participating health | | insurance carriers to offer a benefit plan identical to | the Dirigo Health Insurance Program, for which no | | Dirigo Health subsidies are available, in the general | | small group market; |
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| | | (4) Dirigo Health shall make payments to participating | | health insurance carriers under a Dirigo Health | Insurance Program contract to provide Dirigo Health | Insurance Program benefits to plan enrollees not | | enrolled in MaineCare; |
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| | | (5) Dirigo Health may set allowable rates for | | administration and underwriting gains for the Dirigo | Health Insurance Program; |
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| | | (6) Dirigo Health may administer continuation benefits | | for eligible individuals from employers with 20 or more | | employees who have purchased health insurance coverage | | through Dirigo Health for the duration of their | | eligibility periods for continuation benefits pursuant | | to the federal Consolidated Omnibus Budget | | Reconciliation Act, Public Law 99-272, Title X, Private | | Health Insurance Coverage, Sections 10001 to 10003; and |
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| | | (7) Dirigo Health may administer or contract to | | administer the United States Internal Revenue Code of | | 1986, Section 125 plans for employers and employees | | participating in Dirigo Health, including medical | | expense reimbursement accounts and dependent care | | reimbursement accounts. |
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| | | B. Dirigo Health shall contract with eligible businesses seeking | | assistance from Dirigo Health in arranging for |
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