| | 1-B. Notification of availability of individual coverage. An | insurer must provide forms to group policyholders and certificate | holders as required in subsection 1-A for the purpose of | informing terminating group members of their right to purchase | any individual health plan available in this State. An adequate | supply of forms must be provided to each group policyholder when | the policy is issued and at least annually thereafter. The | superintendent may prescribe the content of the form by routine | technical rule pursuant to Title 5, chapter 375, subchapter II-A | 2-A. The form must include at least the following: |
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| A. A statement that all state residents not eligible for | Medicare have a right to purchase any individual health plan | available in this State; |
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| B. A statement that in order to avoid a gap in coverage, | the individual should apply for individual coverage prior to | termination of group coverage; |
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| C. A statement that if more than 90 days pass between the | time the group coverage ends and the time individual | coverage begins, the individual coverage may exclude | preexisting conditions for one year; and |
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| D. A statement that information concerning individual | coverage is available from the Bureau of Insurance. The | bureau's toll-free telephone number must also be provided. |
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| | Sec. 5. 24-A MRSA §4209, sub-§6, as enacted by PL 1995, c. 189, §3 and | affected by §4, is amended to read: |
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| | 6. Notification of cancellation. A health maintenance | organization must provide by first class mail at least 10 days' | prior notification of cancellation for nonpayment of enrollment | charges according to this section. The notice must include the | date of cancellation of coverage and the time period for | exercising contract conversion rights. Notification is not | required when the insurer has received written notice from the | group contract holder that replacement coverage has been | obtained. |
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| A. Notice must be mailed to the group contract holder or | subgroup sponsor. |
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| B. At the time of notification under paragraph A, notice | must be mailed to the individual enrollee at: |
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| (1) The last address provided by the group contract | holder to the health maintenance organization; or |
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