LD 1611
pg. 16
Page 15 of 47 An Act To Provide Affordable Health Insurance to Small Businesses and Individua... Page 17 of 47
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LR 2137
Item 1

 
(4)__Dirigo Health shall require participating
employers to certify that at least 75% of their
employees are enrolled in Dirigo Health Insurance, are
enrolled in the MaineCare program or receive health
care benefits through another creditable health plan.

 
(5)__Dirigo Health shall reduce the payment amounts for
plan enrollees eligible for a subsidy under section
6918 accordingly.__Dirigo Health shall return any
payments made by plan enrollees also enrolled in
MaineCare to those enrollees.

 
(6)__Dirigo Health shall require participating
employers to pass on any subsidy in section 6918 to the
plan enrollee qualifying for the subsidy, up to the
amount of payments made by the plan enrollee.

 
(7)__Dirigo Health may establish other criteria for
participation.

 
(8)__Dirigo Health may limit the number of
participating employers.

 
C.__Dirigo Health may permit eligible individuals to
purchase Dirigo Health Insurance for themselves and their
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 may collect payments from eligible
individuals participating in Dirigo Health Insurance to
cover the cost of:

 
(a)__Enrollment in Dirigo Health Insurance for
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 reduce the payment amounts for
individuals eligible for a subsidy under section 6918
accordingly.


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