SUMMARY

This bill creates the Maine Health Insurance High-risk Pool Association for the individual health insurance market. It is based on a similar high-risk pool established by the State of New Hampshire. The purpose of the association is to spread the health care costs of high-risk individuals among all health insurers. The bill funds the high-risk pool through an assessment on insurers. An individual insured through the high-risk pool may be charged a premium of up to 150% of the average premium rates charged by carriers for similar health insurance plans. Eligibility for the high-risk pool does not extend to those covered under a group health insurance policy.

The bill also broadens the community rating laws to allow carriers to vary premiums on the basis of age within a maximum rate differential on a ratio of 4 to one and on the basis of health status and tobacco use within a maximum rate differential on a ratio of 1.5 to one. The bill also removes the guaranteed issuance requirement for individual health plans, effective October 1, 2005.