| (4) Dirigo Health shall require participating | employers to certify that at least 75% of their | employees that work 30 hours or more per week and who | do not have other creditable coverage are enrolled in | Dirigo Health Insurance and that the employer group | otherwise meets the minimum participation requirements | specified by section 2808-B, subsection 4, paragraph A. |
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| (5) Dirigo Health shall reduce the payment amounts for | plan enrollees eligible for a subsidy under section | 6912 accordingly. Dirigo Health shall return any | payments made by plan enrollees also enrolled in | MaineCare to those enrollees. |
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| (6) Dirigo Health shall require participating | employers to pass on any subsidy in section 6912 to the | plan enrollee qualifying for the subsidy, up to the | amount of payments made by the plan enrollee. |
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| (7) Dirigo Health may establish other criteria for | participation. |
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| (8) Dirigo Health may limit the number of | participating employers. |
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| | Sec. B-26. 24-A MRSA §6913, sub-§9, as enacted by PL 2003, c. 469, Pt. | A, §8, is amended to read: |
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| | 9. Demonstration of offset. As provided in sections 2736-C, | 2808-B 2808-C and 2839-B, the claims experience used to determine | any filed premiums or rating formula must reasonably reflect, in | accordance with accepted actuarial standards, known changes and | offsets in payments by the carrier to health care providers in | this State, including any reduction or avoidance of bad debt and | charity care costs to health care providers in this State as a | result of the operation of Dirigo Health and any increased | enrollment due to an expansion in MaineCare eligibility occurring | after June 30, 2004 as determined by the board consistent with | subsection 1. |
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| | Sec. B-27. Effective date. This Part takes effect January 1, 2007. |
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| | Sec. C-1. 24-A MRSA §4205, sub-§1, śC, as enacted by PL 1975, c. 503, | is amended to read: |
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| C. The furnishing of health care services through providers | which that are under contract with or employed by the health |
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