LD 1239
pg. 5
Page 4 of 15 An Act Concerning Universal Health Insurance Page 6 of 15
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LR 186
Item 1

 
2.__Carrier.__"Carrier" has the same meaning as in section
4301, subsection 1.

 
3.__Enrollee.__"Enrollee" means a person enrolled in the
plan.

 
4.__Fund.__"Fund" means the Maine Universal Health Care
Fund.

 
5.__Plan.__"Plan" means the Maine Universal Health Care
Plan.

 
6.__Provider.__"Provider" means any person, organization,
corporation or association that provides health care services
and products and is authorized to provide those services and
products under the laws of this State.

 
7.__Resident.__"Resident" means a person who resides within
the State.

 
§4163.__Maine Universal Health Care Plan established

 
The Maine Universal Health Care Plan is established to
provide universal access to high-quality, affordable health
care for the people of this State.__The plan must offer health
care coverage beginning January 1, 2004 and be administered
and overseen by the agency in accordance with this chapter
that includes the purchase of reinsurance or stop loss
coverage from a reinsurer licensed to do business in this
State.__The plan may be administered through a self-insured
arrangement or through a contract with a carrier licensed to
do business in this State.

 
1. Eligibility.__Residents of the State are eligible to
receive covered health care services under the plan in
accordance with the requirements of this section. The agency
shall adopt rules regarding certification of eligibility for
the plan, application for a plan card and membership in the
plan.__The rules must provide for at least the following.

 
A.__Each resident of the State is eligible and may become
an enrollee if the agency certifies that the resident has
provided evidence of coverage under a primary health care
policy offered pursuant to section 2736-C, subsection 8-A,
section 2808-B, subsection 8-A and section 4315 and
approved by the superintendent or under a medical savings
account established pursuant to federal or state law.

 
B.__Eligibility may extend to an enrollee's spouse and
dependents if the evidence of coverage under a primary
health care policy demonstrates coverage for the
enrollee's spouse and dependents.


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