LD 1611
pg. 15
Page 14 of 47 An Act To Provide Affordable Health Insurance to Small Businesses and Individua... Page 16 of 47
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LR 2137
Item 1

 
or may arrange for the provision of such services through
contracts with other entities;

 
(3)__Dirigo Health shall require participating health
insurance carriers to offer a benefit plan identical to
Dirigo Health Insurance, for which no Dirigo Health
subsidies are available, in the general small group
market;

 
(4)__Dirigo Health shall make payments to participating
health insurance carriers under a Dirigo Health
Insurance contract to provide Dirigo Health Insurance
benefits to plan enrollees not enrolled in MaineCare;
and

 
(5)__Dirigo Health may set allowable rates for
administration and underwriting gains for contracting
health insurance carriers.

 
B.__Dirigo Health shall contract with eligible businesses
seeking assistance from Dirigo Health in arranging for
health benefits coverage by Dirigo Health Insurance for
their employees and dependents as set out in this paragraph.

 
(1)__Dirigo Health may establish contract and other
reporting forms and procedures necessary for the
efficient administration of contracts.

 
(2)__Dirigo Health shall collect payments from
participating employers and plan enrollees to cover the
cost of:

 
(a)__Dirigo Health Insurance for enrolled
employees and dependents;

 
(b)__Dirigo Health's quality assurance, disease
management and cost-containment programs;

 
(c)__Dirigo Health's administrative services; and

 
(d)__Other health promotion costs.

 
(3)__Dirigo Health shall establish the minimum required
contribution levels, not to exceed 60%, to be paid by
employers toward the aggregate payment in subparagraph
(2) and establish an equivalent minimum amount to be
paid by employers for plan enrollees and their
dependents who are enrolled in MaineCare.


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