LD 1168
pg. 18
Page 17 of 20 An Act To Reduce Individual Health Insurance Premiums Page 19 of 20
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LR 790
Item 1

 
inconsistent with this chapter and that evidence that a person is
unable to obtain coverage substantially similar to coverage that
may be obtained by a person who is considered a standard risk.__
Rules adopted pursuant to this subsection are routine technical
rules as defined in Title 5, chapter 375, subchapter 2-A.

 
2.__Change of domicile.__The board shall develop standards for
eligibility for coverage by the association for a natural person
who changes domicile to this State and who at the time domicile
is established in this State is insured by an organization
similar to the association.__The eligible maximum lifetime
benefits for that covered person may not exceed the lifetime
benefits available through the association less any benefits
already received from a similar organization in the former
domiciliary state.

 
3.__Eligibility without application.__The board shall develop
a list of medical or health conditions that make a person
eligible for plan coverage without applying for health insurance
under subsection 1.__A person who can demonstrate the existence
or history of any medical or health conditions on the list
developed by the board is not required to provide the evidence
specified in subsection 1. The board may amend the list from time
to time as appropriate.

 
4.__Exclusions from eligibility.__A person is not eligible for
coverage under the plan if:

 
A.__The person has or obtains health insurance coverage
substantially similar to or more comprehensive than a plan
policy or is eligible to have such coverage if the person
elects to obtain it, except that:

 
(1)__A covered person may maintain other coverage for
the period of time the person is satisfying a
preexisting condition waiting period under a plan
policy; and

 
(2)__A covered person may maintain plan coverage for
the period of time the person is satisfying a
preexisting condition waiting period under another
health insurance policy intended to replace the plan
policy;

 
B.__The person is eligible for employer-sponsored health
coverage, including continuation of group coverage as either
an employee or a dependent;

 
C.__The person is determined eligible for health care
benefits under the MaineCare program pursuant to Title 22;


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