LD 1611
pg. 7
Page 6 of 47 An Act To Provide Affordable Health Insurance to Small Businesses and Individua... Page 8 of 47
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LR 2137
Item 1

 
12.__Plan enrollee.__"Plan enrollee" means an eligible individual
or eligible employee who enrolls in Dirigo Health Insurance through
Dirigo Health.__"Plan enrollee" includes an eligible employee who
is eligible to enroll in MaineCare.

 
13.__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.

 
14.__Reinsurance or reinsurer.__"Reinsurance" and "reinsurer"
have the same meanings as in section 741.

 
15.__Resident.__"Resident" means a person who is legally
domiciled in this State and has been for at least 60 days and has
a Maine driver's license, is registered to vote in this State or
meets other criteria established by Dirigo Health.

 
16.__Subsidy.__"Subsidy" means a subsidy as described in
section 6918.

 
17.__Third-party administrator.__"Third-party administrator"
means any person who, on behalf of any person who establishes a
health insurance plan covering residents, receives or collects
charges, contributions or premiums for or settles claims on
residents in connection with any type of health benefit provided
in or as an alternative to insurance as defined by section 704,
other than any person listed in section 1901, subsection 1,
paragraphs A to O.

 
18.__Unemployed individual.__"Unemployed individual" means an
individual who does not work more than 15 hours a week for any
single employer.

 
§6907.__Board of Directors of Dirigo Health

 
1.__Establishment; appointments.__The Board of Directors of
Dirigo Health is established and comprises 5 voting members and 3
ex officio, nonvoting members.

 
A.__The 5 voting members of the board must be appointed by
the Governor, subject to review by the joint standing
committee of the Legislature having jurisdiction over health
insurance matters and confirmation by the Senate.

 
B.__Ex officio, nonvoting members of the board must include:

 
(1)__The Commissioner of Professional and Financial
Regulation or the commissioner's designee;


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