LD 1611
pg. 19
Page 18 of 47 An Act To Provide Affordable Health Insurance to Small Businesses and Individua... Page 20 of 47
Download Bill Text
LR 2137
Item 1

 
5.__Notification of subsidy. Dirigo Health shall notify
applicants in writing of their eligibility and approved level of
subsidy.

 
§6919.__Intragovernmental transfer

 
Starting July 1, 2004, Dirigo Health shall transfer to a
special dedicated, nonlapsing revenue account administered by the
agency of State Government that administers MaineCare for the
purpose of providing a state match for federal Medicaid dollars.__
Dirigo Health shall annually set the amount of contribution.__The
transfer may not include money collected as a recovery in section
6920.

 
§6920.__Recovery against insurers

 
1.__Recovery.__For the purpose of providing the funds
necessary to carry out the powers and duties of Dirigo Health,
the board shall assess, starting April 1, 2004, health insurance
carriers, reinsurance carriers and 3rd-party administrators, not
including carriers and 3rd-party administrators with respect to
Medicare supplemental insurance, long-term care insurance and
disease-specific insurance, at such a time and for such amounts
as the board finds necessary.__Recovery payments must be made
quarterly and are due not less than 30 days after written notice
to the member insurers and must accrue interest at 12% per annum
on and after the due date.

 
2.__Maximum recovery payments.__Each health insurance carrier
must be assessed an amount not to exceed 4.1% of annual health
insurance premiums of persons insured or reinsured by the
insurer.__An insurer may not be assessed on policies or contracts
insuring federal or state employees.

 
3.__Determination of recovery payment.__The board shall make
reasonable efforts to ensure that premium revenue associated with
each covered person is counted only once with respect to any
recovery payment.__For that purpose, the board shall require each
health insurance carrier that obtains excess or stop loss
insurance to include in its gross premium revenue that revenue
associated with all individuals whose coverage is insured, in
whole or in part, through excess or stop loss coverage.__The
board shall allow a health insurance carrier to exclude from its
gross premium revenue that revenue associated with covered
persons who have been counted by the primary insurer or by the
primary reinsurer or primary excess or stop loss insurer for the
purpose of determining its recovery payment under this
subsection.__The board may verify each insurer's recovery payment
based on annual statements and other reports determined to be
necessary by the board.__The board may use any reasonable method


Page 18 of 47 Top of Page Page 20 of 47