LD 1545
pg. 3
Page 2 of 9 An Act To Establish a Cooperative Approach to Health Care Coverage Page 4 of 9
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LR 16
Item 1

 
Title is compatible with an individual health savings account
as authorized under federal law and any supplemental benefits
the board wishes to make available; and

 
Sec. A-13. 24-A MRSA §6910, sub-§4, ķA, as enacted by PL 2003, c. 469,
Pt. A, §8, is amended to read:

 
A. Dirigo Health may contract with health insurance
carriers licensed to sell health insurance in this State or
other private or public third-party 3rd-party administrators
to provide Dirigo Health Insurance. In addition:

 
(1) Dirigo Health shall issue requests for proposals
from health insurance carriers;

 
(2) Dirigo Health may include quality improvement,
disease prevention, disease management and cost-
containment provisions in the contracts with
participating health insurance carriers or may arrange
for the provision of such services through contracts
with other entities;

 
(3) Dirigo Health shall require participating health
insurance carriers to offer a benefit plan identical to
Dirigo Health Insurance, for which no Dirigo Health
subsidies are available, in the general small group
market;

 
(4) Dirigo Health shall make payments to participating
health insurance carriers under a Dirigo Health
Insurance contract to provide Dirigo Health Insurance
benefits to plan enrollees not enrolled in MaineCare;

 
(5) Dirigo Health may set allowable rates for
administration and underwriting gains for Dirigo Health
Insurance;

 
(6) Dirigo Health may administer continuation benefits
for eligible individuals from employers with 20 or more
employees who have purchased health insurance coverage
through Dirigo Health for the duration of their
eligibility periods for continuation benefits pursuant
to the federal Consolidated Omnibus Budget
Reconciliation Act, Public Law 99-272, Title X, Private
Health Insurance Coverage, Sections 10001 to 10003; and

 
(7) Dirigo Health may administer or contract to administer the
United States Internal Revenue Code of 1986, Section 125 plans
for employers and employees


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