LD 1496
pg. 12
Page 11 of 41 An Act To Reduce Maine's Health Insurance Rates and Expand Consumer Choice ... Page 13 of 41
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LR 541
Item 1

 
solvency of the association and the administrative expenses of the
plan.

 
6.__Audit.__The association must be audited at least every 3
years. A copy of the audit must be provided to the superintendent
and to the joint standing committee of the Legislature having
jurisdiction over health insurance matters.

 
§3907.__Selection of plan administrator

 
1.__Selection of plan administrator.__The board shall select
an insurer or 3rd-party administrator, through a competitive
bidding process, to administer the plan.__The board shall
evaluate bids submitted under this subsection based on criteria
established by the board, including:

 
A.__The insurer's proven ability to handle large group
accident and health insurance;

 
B.__The efficiency of the insurer's claims-paying
procedures; and

 
C.__An estimate of total charges for administering the plan.

 
2.__Contract with plan administrator.__The plan administrator
selected pursuant to subsection 1 serves for a period of 3 years
pursuant to a contract with the association.__At least one year
prior to the expiration of that 3-year period of service, the
board shall invite all insurers, including the current plan
administrator, to submit bids to serve as the plan administrator
for the succeeding 3-year period.__The board shall select the
plan administrator for the succeeding period at least 6 months
prior to the ending of the 3-year period.

 
3.__Duties of plan administrator.__The plan administrator
selected pursuant to subsection 1 shall:

 
A.__Perform all eligibility and administrative claims-
payment functions relating to the plan;

 
B.__Pay a producer's referral fee as established by the
board to each producer that refers an applicant to the plan,
if the applicant's application is accepted.__The selling or
marketing of the plan is not limited to the plan
administrator or its producers.__The plan administrator
shall pay the referral fees from funds received as premiums
for the plan;

 
C.__Establish a premium billing procedure for collection of
premiums from insured persons.__Billings must be made
periodically as determined by the board;


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