Public Law, Chapter 466, Part D, 123rd Legislature, First Regular Session

Chapter 466 H.P. 1338 - L.D. 1904

PART D

Sec. D-1. 24-A MRSA §222, sub-§6, as enacted by PL 1975, c. 356, §1, is amended to read:

6. Information as to tender offeror. If the person required to file the statement referred to in subsection 4 4-A is a partnership, limited partnership, syndicate or other group, the superintendent may require that the information called for by subsection 4 shall 4-A must be given with respect to each partner of such partnership or limited partnership, each member of such syndicate or group and each person who controls such partner or member. If the person required to file the statement referred to in subsection 4 4-A is a corporation, the superintendent may require that the information called for thereby shall must be given with respect to such corporation and each officer and director thereof and each person who is directly or indirectly the beneficial owner of more than 10% of the outstanding securities of such corporation.

Sec. D-2. 24-A MRSA §222, sub-§7, ¶D, as amended by PL 1983, c. 394, §2, is further amended to read:

D. Violation

(1) Failure to file the statement required under subsection 4 shall constitute 4-A constitutes a violation of this chapter.

(2) Effectuation of or any attempt to effectuate an acquisition of, control of or merger with a domestic insurer within 30 days of the filing of the statement required by subsection 4 4-A, prior to the superintendent's decision if a hearing is held or after disapproval of such acquisition of control or merger by the superintendent shall constitute constitutes a violation of this chapter.

Sec. D-3. 24-A MRSA §222, sub-§14, ¶A, as enacted by PL 1975, c. 356, §1, is amended to read:

A. Any person who willfully violates any of the provisions of this section, or the rules and regulations promulgated by the superintendent under authority thereof, or any person who willfully, in a filing pursuant to subsection 4 4-A or a registration pursuant to subsection 8, paragraph B, makes any untrue statement of a material fact or omits to state any material fact required to be stated therein or necessary to make the statements therein not misleading, shall must upon conviction be fined not more than $1,000 or imprisoned not more than 3 years, or both;

Sec. D-4. 24-A MRSA §707, sub-§1, ¶C-1, as amended by PL 1991, c. 872, §2, is further amended to read:

C-1. Employee benefit excess insurance. Insurance, protecting an employer against higher than expected obligations under an employee benefit plan, at retention levels that do not have the effect of making the plan an insured plan. Reinsurance provided to employers that self-insure their workers' compensation exposures pursuant to Title 39 39-A, section 23 403 does not constitute employee benefit excess insurance. The transaction of employee benefit excess insurance does not constitute the conduct of the business of reinsurance;

Sec. D-5. 24-A MRSA §2008, sub-§5, as amended by PL 1997, c. 592, §55, is further amended to read:

5. Any producer with surplus lines authority who knowingly or negligently issues a false certificate of insurance or who fails promptly to notify the insured of any material change with respect to such insurance by delivery to the insured of a substitute certificate as provided in subsection 3, upon conviction, is subject to the penalty provided by section 12 12-A or to any greater applicable penalty otherwise provided by law.

Sec. D-6. 24-A MRSA §2302, sub-§2, ¶A, as enacted by PL 1969, c. 132, §1, is amended to read:

A. Reinsurance, except joint reinsurance as provided in section 2322 2322-A;

Sec. D-7. 24-A MRSA §4204, sub-§2-A, ¶D, as amended by PL 2001, c. 72, §19, is further amended to read:

D. The health maintenance organization is financially responsible, complies with the minimum surplus requirements of this section 4204-A and, among other factors, can reasonably be expected to meet its obligations to enrollees and prospective enrollees.

(1) In a determination of minimum surplus requirements, the following terms have the following meanings.

(a) "Admitted assets" means assets recognized by the superintendent pursuant to section 901-A. For purposes of this chapter, the asset value is that contained in the annual statement of the corporation as of December 31st of the year preceding the making of the investment or contained in any audited financial report, as defined in section 221-A, of more current origin.

(b) "Reserves" means those reserves held by corporations subject to this chapter for the protection of subscribers. For purposes of this chapter, the reserve value is that contained in the annual statement of the corporation as of December 31st of the preceding year or any audited financial report, as defined in section 221-A, of more current origin.

(2) In making the determination whether the health maintenance organization is financially responsible, the superintendent may also consider:

(a) The financial soundness of the health maintenance organization's arrangements for health care services and the schedule of charges used;

(b) The adequacy of working capital;

(c) Any agreement with an insurer, a nonprofit hospital or medical service corporation, a government or any other organization for insuring or providing the payment of the cost of health care services or the provision for automatic applicability of an alternative coverage in the event of discontinuance of the plan;

(d) Any agreement with providers for the provision of health care services that contains a covenant consistent with subsection 6; and

(e) Any arrangements for insurance coverage or an adequate plan for self-insurance to respond to claims for injuries arising out of the furnishing of health care services.

Public Laws

123rd Legislature

First Regular Session

Chapter 466

H.P. 1338 - L.D. 1904