LD 1507
pg. 3
Page 2 of 14 PUBLIC Law Chapter 428 Page 4 of 14
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LR 1913
Item 1

 
(b) The superintendent shall find that the
replacement is in the best interests of the
policyholders; and

 
(c) The carrier shall provide notice to the
policyholder and, if a group policy, to the
insureds at least 90 days before replacement; or

 
H. In renewing a large group policy in accordance with this
section, a carrier may modify the coverage, terms and
conditions of the policy consistent with other applicable
provisions of state and federal laws as long as the
modifications are applied uniformly to all policyholders of
the same product. This paragraph does not apply to
individual or small group policies.; or

 
Sec. A-2. 24-A MRSA §2850-B, sub-§3, ķI is enacted to read:

 
I.__In renewing an individual or small group policy in
accordance with this section, a carrier may make minor
modifications to the coverage, terms and conditions of the
policy consistent with other applicable provisions of state
and federal laws as long as the modifications meet the
conditions specified in this paragraph and are applied
uniformly to all policyholders of the same product.__
Modifications not meeting the requirements in this paragraph
are considered a discontinuance of the product pursuant to
paragraph G.

 
(1)__A modification pursuant to this paragraph must be
approved by the superintendent. The superintendent
shall approve the modification if it meets the
requirements of this section.

 
(2)__A change in a requirement for eligibility is not a
minor modification pursuant to this paragraph if the
change results in the exclusion of a class or category
of enrollees currently covered.

 
(3)__Benefit modifications required by law are deemed
minor modifications for purposes of this paragraph.

 
(4)__Benefit modifications other than modifications
required by law are minor modifications only if they
meet the requirements of this subparagraph. For
purposes of this subparagraph, changes in conditions or
requirements specified in the policy, such as
preauthorization requirements, are considered benefit
modifications.


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