LD 1496
pg. 25
Page 24 of 41 An Act To Reduce Maine's Health Insurance Rates and Expand Consumer Choice ... Page 26 of 41
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LR 541
Item 1

 
(8)__Coverage issued as a supplement to liability
insurance;

 
(9)__Workers' compensation;

 
(10)__Automobile medical payment; or

 
(11)__Insurance under which benefits are payable with
or without regard to fault and that is required
statutorily to be contained in any liability insurance
policy or equivalent self-insurance.

 
3.__Small group health plans subject to this section.__The
following small group health plans are subject to this section.

 
A.__Except as provided in this paragraph, this section
applies to any small group health plan that provides
coverage to one or more employees of a small employer.

 
B.__This section does not apply to individual health plans
that are subject to section 2736-C.

 
4.__Premium rates.__Premium rates for small group health plans
are subject to the following provisions.

 
A.__The index rate for a rating period for any class of
business may not exceed the index rate for any other class
of business by more than 20%.__This paragraph does not apply
to a class of business if any of the following apply:

 
(1)__The class of business is one for which the carrier
does not reject, and never has rejected, small
employers included within the carrier's definition of
employers eligible for the class of business or
otherwise eligible employees and dependents who enroll
on a timely basis, based upon their claims experience
or health status;

 
(2)__The carrier does not involuntarily transfer, and
never has involuntarily transferred, a health benefit
plan into or out of the class of business; and

 
(3)__The class of business is available for purchase.

 
B.__For a class of business, the premium rate charged during
a rating period to small employers with similar case
characteristics for the same or similar coverage, or the
rates that could be charged to such employers under the
rating system for that class of business, may not vary from
the index rate by more than 25% of the index rate.


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