CHAPTER 131
H.P. 1388 - L.D. 1865
Resolve, Regarding Legislative Review of Chapter 755: Health Insurance Classifications, Disclosure and Minimum Standards, a Major Substantive Rule of the Department of Professional and Financial Regulation, Bureau of Insurance
Emergency preamble. Whereas, Acts and resolves of the Legislature do not become effective until 90 days after adjournment unless enacted as emergencies; and
Whereas, the Maine Revised Statutes, Title 5, chapter 375, subchapter 2-A requires legislative authorization before major substantive agency rules may be finally adopted by the agency; and
Whereas, the above-named major substantive rule has been submitted to the Legislature for review; and
Whereas, immediate enactment of this resolve is necessary to record the Legislature's position on final adoption of the rule; and
Whereas, in the judgment of the Legislature, these facts create an emergency within the meaning of the Constitution of Maine and require the following legislation as immediately necessary for the preservation of the public peace, health and safety; now, therefore, be it
Sec. 1. Adoption. Resolved: That final adoption of Chapter 755: Health Insurance Classifications, Disclosure and Minimum Standards, a provisionally adopted major substantive rule of the Department of Professional and Financial Regulation, Bureau of Insurance that has been submitted to the Legislature for review pursuant to the Maine Revised Statutes, Title 5, chapter 375, subchapter 2-A is authorized only if the following changes are made.
1. In Section 4(K) with regard to the definition of preexisting condition, the look-back period for a preexisting condition is changed from 12 months to 24 months.
2. In Section 5(A) with regard to prohibited policy provisions, language is added to clarify that that section is not intended to restrict the use of elimination periods for disability income benefits.
3. In Section 6(A) with regard to minimum standards for health insurance benefits generally, language is added to permit an insurer to void or contest a policy or deny claims for a sickness first manifested before the effective date of the policy that was fraudulently not disclosed or fraudulently misrepresented in an application for coverage.
4. In Section 6(A)(8) with regard to minimum standards for health insurance benefits generally, the maximum time period between the date of an accident and the date of loss is shortened from 180 days to 90 days for accidental death and dismemberment benefits and from 90 days to 30 days for disability coverage.
5. In Section 6(H) with regard to minimum standards for individual disability income protection coverage, the maximum elimination period is changed from 365 days to 730 days in cases of coverage having a benefit period of more than 2 years, and the shortest permissible maximum benefit period is changed from 6 months to 3 months.
6. In Section 6(J)(2)(c) with regard to specified disease coverage, language is added to provide an exception for lump-sum benefits based on diagnosis of a specified disease.
7. In Section 6(J)(4) and Section 6(J)(5) with regard to specified disease coverage, language is added to permit the Superintendent of Insurance to approve different minimum benefits for cancer coverage on an expense-incurred basis or a per diem indemnity basis if the superintendent determines that the minimum benefits are in the interest of the consumer.
Emergency clause. In view of the emergency cited in the preamble, this resolve takes effect when approved.
Effective April 14, 2004.
| Revisor of Statutes Homepage | Subject Index | Search | 121st Laws of Maine | Maine Legislature |
