LD 1577
pg. 6
Page 5 of 20 PUBLIC Law Chapter 400 Page 7 of 20
Download Chapter Text
LR 1479
Item 1

 
insurance carriers.__Except for the carriers and 3rd-party
administrators that are specifically excluded in subsection 2, each
health insurance carrier, 3rd-party administrator and employee
benefit excess insurance carrier shall pay a savings offset
payment. The following provisions govern savings offset payments.

 
A. The board shall calculate savings offset payments as a
percentage of paid claims, as defined by the board pursuant
to subsection 10. The board shall make reasonable efforts to
ensure that paid claims are counted only once with respect
to any savings offset payment. The board may verify each
health insurance carrier's, 3rd-party administrator's and
employee benefit excess insurance carrier's savings offset
payment based on annual statements and other reports the
board determines to be necessary.

 
B. Maximum savings offset payments are as follows:

 
(1) For health insurance carriers, the savings offset
payment may not exceed 4.0% of annual paid claims for
health care on policies issued pursuant to the laws of
this State that insure residents of this State;

 
(2) For 3rd-party administrators, the savings offset
payment may not exceed 4.0% of annual paid claims for
health care for residents of this State; and

 
(3) For employee benefit excess insurance carriers, the
savings offset payment may not exceed 4.0% of annual
paid claims on employee benefit excess insurance
policies, as defined in section 707, subsection 1,
paragraph C-1, issued pursuant to the laws of this
State that insure residents of this State.

 
C.__A health insurance and employee benefit excess insurance
carrier may not be required to pay a savings offset payment
on policies or contracts insuring federal employees.

 
D. Savings offset payments apply to claims paid for plan
years beginning on or after January 1, 2006.

 
E. Savings offset payments may not begin until 12 months
after Dirigo Health begins providing health insurance
coverage;

 
F. Savings offset payments must be made quarterly and are
due not less than 60 days after the close of the quarter and

 
with a minimum of 30 days' written notice by Dirigo Health to
health insurance carriers, employee benefit excess


Page 5 of 20 Top of Page Page 7 of 20
Related Pages
  Search Bill Text Legislative Information
Bill Directory Search
Bill
Status
Session Information
119th Legislature Bills Maine Legislature

Office of Legislative Information
100 State House Station
Augusta, ME 04333
voice: (207) 287-1692
fax: (207) 287-1580
tty: (207) 287-6826
Word Viewer for Windows Disclaimer