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Centers for Disease Control and Prevention guidelines in | effect on the year of issuance or renewal of the policy. |
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| E.__If approved by the superintendent, the policy may | include provisions with financial incentives encouraging a | policyholder to receive health care services at a center | of excellence or other high-quality provider designated by | the carrier based on objective quality indicators. |
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| Rules adopted pursuant to this subsection are routine | technical rules as defined in Title 5, chapter 375, subchapter | 2-A. |
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| | Sec. A-2. 24-A MRSA §2808-B, sub-§8-A is enacted to read: |
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| | 8-A. Primary health care policy.__All carriers offering | small group health plans in this State shall offer a primary | health care policy, referred to in this subsection as "the | policy".__The superintendent shall adopt rules that define the | benefit design for the policy in accordance with the | following. |
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| A. The policy must provide coverage that emphasizes | primary and preventive care, including, but not limited | to, well-adult and well-child visits and health | screenings. |
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| B. The annual maximum limit payable on the policy per | member covered under the small group health plan, | including dependents, must be determined as follows: |
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| (1)__For a member whose income is between 100% and | 200% of the federal nonfarm income federal poverty | level, the annual maximum limit payable on the policy | is $2,000 per member covered under the policy; |
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| (2) For a member whose income is between 200% and | 300% of the federal nonfarm income federal poverty | level, the annual maximum limit payable on the policy | is $5,000 per member covered under the policy; |
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| (3) For a member whose income is between 300% and | 400% of the federal nonfarm income federal poverty | level, the annual maximum limit payable on the policy | is $10,000 per member covered under the policy; and |
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| (4) For a member whose income is above 400% of the | federal nonfarm income federal poverty level, the | annual maximum limit payable on the policy is $25,000 | per member covered under the policy. |
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