LD 1496
pg. 28
Page 27 of 41 An Act To Reduce Maine's Health Insurance Rates and Expand Consumer Choice ... Page 29 of 41
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LR 541
Item 1

 
A carrier that denies coverage in accordance with this
subparagraph may not enroll individuals residing within
the service area subject to denial of coverage, or groups
or subgroups within that area for a period of 180 days
after the date of the first denial of coverage.

 
7.__Disclosure of rating practices and renewability
provisions.__Each small group carrier shall disclose the
following in the sales and marketing materials provided to small
employers:

 
A.__The extent to which premium rates for a specific small
employer are established or adjusted due to the claims
experience, health status or duration of coverage of the
employees and dependents of the small employer;

 
B.__The ability of the carrier to change premium rates and
rating factors, including case characteristics, that may
affect changes in premium rates;

 
C.__A description of the class of business in which the
small employer is or will be included, including the
applicable grouping of plans; and

 
D.__The small employer's rights regarding renewal of the
small group health plan.

 
8.__Maintenance of records.__A small group carrier shall
maintain at its principal place of business a complete and
detailed description of its rating practices and renewal
underwriting practices, including information and documentation
that demonstrate that its rating methods and practices are based
upon commonly accepted actuarial assumptions and are in
accordance with sound actuarial principles. On or before March
1st annually, a carrier shall file with the superintendent an
actuarial certification that the carrier is in compliance with
this section and that the rating methods of the carrier are
actuarially sound. A copy of the certification must be retained
by the carrier at its principal place of business. A carrier
shall also make the information and documentation required in
this subsection available to the superintendent upon request.__
The information provided to the superintendent pursuant to this
subsection is proprietary and must be kept confidential by the
superintendent. The information may not be disclosed except as
agreed to by the carrier or as ordered by a court of competent
jurisdiction.

 
9.__Discretion of superintendent.__The superintendent may
suspend all or any part of subsection 4 as to the premium rates
applicable to one or more small employers for one or more rating


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