An Act To Authorize the Health Care Choice Compact To Permit the Purchase of Health Insurance from New Hampshire
Be it enacted by the People of the State of Maine as follows:
Sec. 1. 24-A MRSA §405, sub-§6, as enacted by PL 1969, c. 132, §1, is amended to read:
6. Any suit or action by the duly constituted receiver, rehabilitator or liquidator of the insurer, or of the insurer's assignee or successor, under laws similar to those contained in chapter 57 (delinquency proceedings; rehabilitation and liquidation). ; or
Sec. 2. 24-A MRSA §405, sub-§7 is enacted to read:
7. Transactions pursuant to individual health insurance covering residents of this State written by a New Hampshire insurer or health maintenance organization pursuant to the Health Care Choice Compact established in section 405-A if the superintendent certifies that the New Hampshire insurer or health maintenance organization meets the requirements of section 405-A.
Sec. 3. 24-A MRSA §405-A is enacted to read:
§ 405-A. Health Care Choice Compact for individual health insurance
1. Health Care Choice Compact established. Pursuant to the federal Patient Protection and Affordable Care Act, Public Law 111-148, Section 1333, the State is authorized to join with New Hampshire to establish the Health Care Choice Compact to permit the sale of individual health insurance in this State by a New Hampshire insurer or health maintenance organization in accordance with the requirements of this section. As used in this section, "New Hampshire insurer or health maintenance organization" means an insurer or health maintenance organization that holds a valid certificate of authority to transact individual health insurance in New Hampshire.
2. Certification of New Hampshire insurers or health maintenance organizations. A New Hampshire insurer or health maintenance organization may not transact individual health insurance in this State by mail, the Internet or otherwise unless the superintendent has issued a certification that the New Hampshire insurer or health maintenance organization has met the requirements of this subsection. The superintendent shall issue a certification or deny certification within 30 days of a request.
A. A policy, contract or certificate of individual health insurance offered for sale in this State by a New Hampshire insurer or health maintenance organization must comply with the applicable individual health insurance laws in New Hampshire and must be actively marketed in that state.
B. A New Hampshire insurer or health maintenance organization shall meet the requirements of section 4302 for reporting plan information with respect to individual health plans offered for sale in this State and disclose to prospective enrollees how the health plans differ from individual health plans offered by domestic insurers in a format approved by the superintendent within 90 days of the effective date of this section. Health plan policies and applications for coverage must contain the following disclosure statement or a substantially similar statement: "This policy is issued by a New Hampshire insurer or health maintenance organization and is governed by the laws and rules of (New Hampshire insurer's or health maintenance organization's state of domicile). This policy may not be subject to all the insurance laws and rules of the State of Maine, including coverage of certain health care services or benefits mandated by Maine law. Before purchasing this policy, you should carefully review the terms and conditions of coverage under this policy, including any exclusions or limitations of coverage."
C. A New Hampshire insurer or health maintenance organization shall meet the requirements of section 4303, subsection 4 for grievance procedures with respect to health plans offered for sale in this State.
D. A New Hampshire insurer or health maintenance organization shall meet the requirements of chapter 56-A for provider network adequacy with respect to health plans offered for sale in this State.
E. A New Hampshire insurer or health maintenance organization shall meet the requirements of chapter 27 with respect to rates for individual health plans offered for sale in this State.
F. A New Hampshire insurer or health maintenance organization shall designate an agent for receiving service of legal documents and process in the manner provided in this title.
G. A New Hampshire insurer or health maintenance organization shall meet the requirements of this Title with respect to allowing the superintendent access to records of the New Hampshire insurer or health maintenance organization.
3. Unfair trade practices. The provisions of chapter 23 apply to a New Hampshire insurer or health maintenance organization permitted to transact individual health insurance under this section or section 405.
4. Compliance with court orders. A New Hampshire insurer or health maintenance organization shall comply with lawful orders from courts of competent jurisdiction issued in a voluntary dissolution proceeding or in response to a petition for an injunction by the superintendent asserting that the New Hampshire insurer or health maintenance organization is in a hazardous financial condition.
5. Exemption from other requirements. Except as expressly provided in this section, the requirements of this Title do not apply to a New Hampshire insurer or health maintenance organization permitted to transact individual health insurance under this section.
6. Effective date. The Health Care Choice Compact under subsection 1 becomes effective and binding upon the approval of the Secretary of the United States Department of Health and Human Services after legislative enactment by this State and New Hampshire except that an individual health insurance policy, contract or certificate may not be offered for sale in this State pursuant to this section before January 1, 2016.
summary
This bill authorizes the Health Care Choice Compact with New Hampshire pursuant to the federal Patient Protection and Affordable Care Act to allow insurers and health maintenance organizations authorized to transact individual health insurance in New Hampshire to offer their individual health plans for sale in this State. The bill requires New Hampshire insurers and health maintenance organizations to meet certain requirements of Maine law, including requirements for rating, provider network adequacy, disclosure, reporting and grievance procedures. The bill provides that the Health Care Choice Compact becomes effective and binding upon the approval of the Secretary of the United States Department of Health and Human Services after legislative enactment in New Hampshire and this State except that individual health insurance policies, contracts and certificates may not be offered for sale pursuant to the compact before January 1, 2016.