LD 1611
pg. 44
Page 43 of 47 An Act To Provide Affordable Health Insurance to Small Businesses and Individua... Page 45 of 47
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LR 2137
Item 1

 
plans as defined by section 2808-B must be filed in accordance
with that section.

 
Sec. D-10. 24-A MRSA §2839-B is enacted to read:

 
§2839-B.__Large group rates

 
1.__Application. This section applies to group health
insurance offered in the large group market as defined in section
2850-B, except insurance covering only accidental injury,
specified disease, hospital indemnity, dental, vision, disability
income, long-term care, Medicare supplement or other limited
benefit health insurance.

 
2.__Annual filing.__Every carrier offering group health
insurance specified in subsection 1 shall annually file with the
superintendent on or before April 30th a certification signed by
a member in good standing of the American Academy of Actuaries or
a successor organization that the carrier's rating methods and
practices are in accordance with generally accepted actuarial
principles and with the applicable actuarial standards of
practice as promulgated by an actuarial standards board.__The
filing must also certify that the carrier has not reflected cost
to the group health carrier of the recovery amount applied in
accordance with section 6920. The filing also must state the
number of policyholders and dependents, as of the close of the
preceding calendar year, enrolled in large group health insurance
plans offered by the carrier. A filing and supporting information
are public records except as provided by Title 1, section 402,
subsection 3.

 
3.__Documentation.__Every carrier shall maintain at its
principal place of business a complete and detailed description
of its rating practices, including information and documentation
that demonstrates that its rating methods and practices are in
accordance with generally accepted actuarial principles and with
the applicable actuarial standards of practice as promulgated by
an actuarial standards board.

 
Sec. D-11. 24-A MRSA §4207, sub-§5, as repealed and replaced by PL
1993, c. 645, Pt. A, §6, is amended to read:

 
5. A schedule or an amendment to a schedule of charge for
enrollee health coverage for health care services may not be used
by any health maintenance organization unless it complies with
section 2736, 2808-B or 2839, whichever is applicable.

 
Sec. D-12. Effective date. That section of this Part that amends the
Maine Revised Statutes, Title 24-A, section 2436, subsection 2-A
takes effect January 1, 2005.


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