LD 905
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LR 1598
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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:

 
A. A statement that all state residents not eligible for
Medicare have a right to purchase any individual health plan
available in this State;

 
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;

 
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

 
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.

 
Sec. 5. 24-A MRSA §4209, sub-§6, as enacted by PL 1995, c. 189, §3 and
affected by §4, is amended to read:

 
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.

 
A. Notice must be mailed to the group contract holder or
subgroup sponsor.

 
B. At the time of notification under paragraph A, notice
must be mailed to the individual enrollee at:

 
(1) The last address provided by the group contract
holder to the health maintenance organization; or


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