LD 1496
pg. 26
Page 25 of 41 An Act To Reduce Maine's Health Insurance Rates and Expand Consumer Choice ... Page 27 of 41
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LR 541
Item 1

 
C.__The percentage increase in the premium rate charged to a
small employer for a new rating period may not exceed the
sum of the following:

 
(1)__The percentage change in the new business premium
rate measured from the first day of the prior rating
period to the first day of the new rating period. In
the case of a class of business for which the small
group carrier is not issuing new policies, the carrier
shall use the percentage change in the base premium
rate;

 
(2)__An adjustment, not to exceed 15% annually and
adjusted pro rata for rating periods of less than one
year, due to the claim experience, health status or
duration of coverage or the employees or dependents of
the small employer as determined from the carrier's
rate manual for the class of business; and

 
(3)__Any adjustment due to change in coverage or change
in the case characteristics of the small employer as
determined from the carrier's rate manual for the class
of business.

 
D.__In the case of health benefit plans issued prior to the
effective date of this section, a premium rate for a rating
period may exceed the ranges described in paragraphs A or B
for a period of 5 years following the effective date of this
section. In that case, the percentage increase in the
premium rate charged to a small employer in such a class of
business for a new rating period may not exceed the sum of
the following:

 
(1)__The percentage change in the new business premium
rate measured from the first day of the prior rating
period to the first day of the new rating period. In
the case of a class of business for which the small
group carrier is not issuing new policies, the carrier
shall use the percentage change in the base premium
rate; and

 
(2)__Any adjustment due to change in coverage or change
in the case characteristics of the small employer as
determined from the carrier's rate manual for the class
of business.

 
E.__This section is not intended to affect the use by a
small group carrier of legitimate rating factors other than
claims experience, health status or duration of coverage in
the determination of premium rates. A small group carrier
shall apply rating factors, including case characteristics,
consistently with respect to all small employers in a class
of business.


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