LD 1611
pg. 62
Page 61 of 73 PUBLIC Law Chapter 469 Page 63 of 73
Download Chapter Text
LR 2137
Item 1

 
practices are in accordance with generally accepted actuarial
principles and with the applicable actuarial standards of practice
as promulgated by an actuarial standards board.__The filing must
also certify that the carrier has included in its experience any
savings offset payments or recovery of those savings offset
payments consistent with section 6913. The filing also must state
the number of policyholders, certificate holders and dependents, as
of the close of the preceding calendar year, enrolled in large
group health insurance plans offered by the carrier. A filing and
supporting information are public records except as provided by
Title 1, section 402, subsection 3.

 
3.__Documentation.__Every carrier shall maintain at its
principal place of business a complete and detailed description
of its rating practices, including information and documentation
that demonstrates that its rating methods and practices are in
accordance with generally accepted actuarial principles and with
the applicable actuarial standards of practice as promulgated by
an actuarial standards board.

 
Sec. E-18. 24-A MRSA §4203, sub-§3, ¶S, as amended by PL 1997, c. 370,
Pt. F, §1, is further amended to read:

 
S. A list of the names and addresses of all physicians and
facilities with which the health maintenance organization
has or will have agreements. If products are offered that
pay full benefits only when providers within a subset of the
contracted physicians or facilities are utilized, a list of
the providers in that limited network must be included, as
well as a list of the geographic areas where the products
are offered. This paragraph may not be construed to
prohibit a health maintenance organization from offering a
health plan that includes financial provisions designed to
encourage members to use designated providers in a network
in accordance with section 4303, subsection 1, paragraph A.

 
Sec. E-19. 24-A MRSA §4207, sub-§5, as repealed and replaced by PL
1993, c. 645, Pt. A, §6, is amended to read:

 
5. A schedule or an amendment to a schedule of charge for
enrollee health coverage for health care services may not be used
by any health maintenance organization unless it complies with
section 2736, 2808-B or 2839, whichever is applicable.

 
Sec. E-20. 24-A MRSA §4303, sub-§1, as amended by PL 1999, c. 742, §6,
is further amended to read:

 
1. Demonstration of adequate access to providers. A Except
as provided in paragraph A, a carrier offering a managed care
plan shall provide to its members reasonable access to


Page 61 of 73 Top of Page Page 63 of 73
Related Pages
  Search Bill Text Legislative Information
Bill Directory Search
Bill
Status
Session Information
119th Legislature Bills Maine Legislature

Office of Legislative Information
100 State House Station
Augusta, ME 04333
voice: (207) 287-1692
fax: (207) 287-1580
tty: (207) 287-6826
Word Viewer for Windows Disclaimer