CHAPTER 570
S.P. 622 - L.D. 1804
An Act to Improve the Accessibility and Affordability of Health Care Benefits in the State
Be it enacted by the People of the State of Maine as follows:
Sec. 1. 24-A MRSA §6603, sub-§1, ¶¶B and D, as enacted by PL 1993, c. 688, §1, are amended to read:
B. Must Except for those associations meeting the criteria of subsection 1-A, must be established by a trade association, industry association, political subdivision of the State, religious organization or professional association of employers or professionals that has a constitution or bylaws and that has been organized and maintained in good faith for a continuous period of one year for purposes other than that of obtaining or providing insurance;
D. May not be offered, advertised or available to employers or other members of the public generally, except as allowed under subsection 1-A;
Sec. 2. 24-A MRSA §6603, sub-§1-A is enacted to read:
1-A. Eligibility based on geographic association. To meet the requirements for approval and to maintain a multiple-employer welfare arrangement, an arrangement based on geographic association:
A. Must be established by an association with a principal office in a location within a 40-mile radius of the principal place of business of eligible employers;
B. Must permit eligibility for an employer that has employed an average of 100 or fewer full-time employees during the preceding calendar year, more of whom are employed in this State than any other state, and for an employer that is a licensed nonprofit hospital if the employer or hospital is located within a 40-mile radius of the association;
C. May establish eligibility standards for membership in the association, except that an association may not deny eligibility to an otherwise eligible employer or hospital on the basis of health status or claims experience; and
D. Must meet the requirements for approval in subsection 1, except as provided in subsection 1, paragraphs B and D.
Sec. 3. 24-A MRSA §6611, sub-§2, as enacted by PL 1993, c. 688, §1, is amended to read:
2. Actuarial report. At least once every 2 years each arrangement must have a report prepared by an actuary who is an associate or fellow of the Society of Actuaries and the American Academy of Actuaries as to the actuarial soundness of the arrangement. After an arrangement has filed 2 actuarial reports pursuant to this subsection, an arrangement may request that the superintendent grant a waiver of the filing requirement to the arrangement. The If required, the report must be filed with the superintendent. The report must consist of at least the following:
A. An assessment of the adequacy of contribution rates in meeting the level of benefits provided and changes, if any, needed in the contribution rates to achieve or preserve a level of funding adequate to enable payment of the benefit amounts provided under the arrangement, which must include a valuation of present assets, valued in accordance with insurance accounting precepts, and prospective assets and liabilities of the plan and the extent of unfunded accrued liabilities;
B. A plan and schedule to amortize any unfunded liabilities and a description of actions taken to reduce unfunded liabilities;
C. A description and explanation of actuarial assumptions;
D. A comparative review illustrating the level of funds available to the arrangement from rates, investment income and other sources realized over the period covered by the report indicating the assumptions used;
E. A certification by the actuary that the report is complete and accurate and that in the actuary's opinion the techniques and assumptions used are reasonable, make good and sufficient provision to meet the obligations of the arrangement and meet the requirements and intent of this chapter; and
F. Other factors or statements as may be reasonably required by the superintendent in order to determine the actuarial soundness of the plan.
Effective July 25, 2002, unless otherwise indicated.
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