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affidavit from the producer affirming the | producer's belief that the employer qualifies | as an eligible group for coverage. |
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| In determining if a new business or a business that | adds an owner or a new employee to payroll during the | course of a year qualifies as an eligible group for 2- | person coverage under this subparagraph, the employer | must submit an affidavit stating that all employees | meet the criteria in this subparagraph and that the | documentation and forms required under this | subparagraph will be provided to the carrier when | payroll records become available, when ownership | distribution forms become available or the first | renewal date of the coverage, whichever date is | earlier. A false affidavit or misrepresentation on an | affidavit submitted by an employer may result in the | loss of group coverage and repayment of claims paid. | This subparagraph may not be construed to prohibit a | carrier from recognizing an employer as an eligible | group if the employer has not produced the | documentation required in this subparagraph. |
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| This subparagraph applies only to an employer applying | for group health insurance coverage as a 2-person group | on or after October 1, 2001. |
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| | Sec. H-6. 24-A MRSA §4331, sub-§4, as enacted by PL 1999, c. 609, §20, | is amended to read: |
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| | 4. Downstream risk arrangement. "Downstream risk arrangement" | means any compensation an arrangement between that transfers | insurance risk from a carrier and to a downstream entity that may | directly or indirectly have the effect of reducing or limiting | services furnished to enrollees of the carrier. |
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| | Sec. H-7. 24-A MRSA §5011, sub-§2, as enacted by PL 1991, c. 740, §13, | is amended to read: |
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| | 2. Discounts. Issuers that do not vary rates for a | standardized plan based on age, gender, health status, claims | experience, policy duration, industry or occupation, and that do | not refuse issue of that plan to any individual or group based on | health status, may provide discounts on that plan to individuals | who purchase coverage during their initial period of eligibility | for enrollment in Medicare Part A by reason of age B at or after | 65 years of age, subject to approval by the superintendent. The | superintendent may adopt rules governing the appropriate use of | discounts. |
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