LD 1190
pg. 16
Page 15 of 18 An Act To Create the Comprehensive Health Insurance Risk Pool Association Page 17 of 18
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LR 436
Item 1

 
(2)__A person may maintain plan coverage for the
period of time the person is satisfying a preexisting
condition waiting period under another health
insurance policy intended to replace the plan policy;

 
B.__The person is determined eligible for health care
benefits under the MaineCare program pursuant to Title 22;

 
C.__The person previously terminated plan coverage, unless
12 months have elapsed since the person's last
termination;

 
D.__The person has met the lifetime maximum benefit amount
under the plan of $1,000,000;

 
E.__The person is an inmate or resident of a public
institution; or

 
F.__The person's premiums are paid for or reimbursed under
any government-sponsored program or by any government
agency or health care provider, except as an otherwise
qualifying full-time employee, or dependent thereof, of a
government agency or health care provider.

 
5.__Termination of coverage.__The coverage of any person
ceases:

 
A.__On the date a person is no longer a resident;

 
B.__Upon the death of the covered person;

 
I.C.__On the date state law requires cancellation of the
policy; or

 
D.__At the option of the association, 30 days after the
association makes any inquiry concerning the person's
eligibility or place of residence to which the person does
not reply.

 
The coverage of any person who ceases to meet the eligibility
requirements of this section may be terminated immediately.

 
6.__Unfair trade practice.__It constitutes an unfair trade
practice for any insurer, insurance producer, employer or 3rd-
party administrator to refer an individual employee or a
dependent of an individual employee to the association, or to
arrange for an individual employee or a dependent of an
individual employee to apply to the plan, for the purpose of
separating such an employee or dependent from a group health
benefits plan provided in connection with the employee's
employment.


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