MRS Title 24-A, §405-B. DOMESTIC INSURERS OR LICENSED HEALTH MAINTENANCE ORGANIZATION; INDIVIDUAL
HEALTH INSURANCE APPROVED IN OTHER STATES
Generated
10.30.2023
§405-B. Domestic insurers or licensed health maintenance organization;
individual health insurance approved in other states
| 1
§405-B. Domestic insurers or licensed health maintenance organization; individual health
insurance approved in other states
Notwithstanding any other provision of this Title, a domestic insurer or licensed health maintenance
organization authorized to transact individual health insurance in this State may offer for sale in this
State an individual health plan duly authorized for sale in Connecticut, Massachusetts, New Hampshire,
Rhode Island or Vermont by a parent or corporate affiliate of the domestic insurer or licensed health
maintenance organization if the following requirements are met. [PL 2013, c. 388, Pt. B, §3 (AMD).]
1. Certificate of authority from state of domicile. The parent or corporate affiliate of the
domestic insurer or licensed health maintenance organization must hold a valid certificate of authority
to transact individual health insurance in the state of domicile of the parent or corporate affiliate.
[PL 2011, c. 90, Pt. C, §4 (NEW).]
2. Compliance with laws of state of domicile. A policy, contract or certificate of individual
health insurance offered for sale in this State by the domestic insurer or licensed health maintenance
organization must comply with the applicable individual health insurance laws in the state of domicile
of the parent or corporate affiliate and must be actively marketed in that state.
[PL 2011, c. 90, Pt. C, §4 (NEW).]
3. Disclosure and reporting. The domestic insurer or licensed health maintenance organization
shall meet the requirements of section 4302 for reporting plan information with respect to individual
health plans offered for sale in this State and disclose to prospective enrollees how the individual health
plans of the parent or corporate affiliate differ from individual health plans offered by other domestic
insurers or licensed health maintenance organizations in a format approved by the superintendent.
Health plan policies and applications for coverage must contain the following disclosure statement or
a substantially similar statement on the face page of the policy or application in a type size of at least
14 points and font that is easily readable by a person with average eyesight: "This policy is issued by
a domestic insurer or licensed health maintenance organization but is governed by the laws and rules
of (state of domicile of parent or corporate affiliate of domestic insurer or licensed health maintenance
organization), which is the state of domicile of the parent or corporate affiliate of the domestic insurer
or licensed health maintenance organization. This policy may not be subject to all the insurance laws
and rules of the State of Maine, including coverage of certain health care services or benefits mandated
by Maine law. Before purchasing this policy, you should carefully review the terms and conditions of
coverage under this policy, including any exclusions or limitations of coverage."
[PL 2013, c. 388, Pt. B, §4 (AMD).]
4. Grievance procedures. The domestic insurer or licensed health maintenance organization shall
meet the requirements of section 4303, subsection 4 for grievance procedures with respect to health
plans offered for sale in this State.
[PL 2011, c. 90, Pt. C, §4 (NEW).]
5. Sale of policies. A domestic insurer or licensed health maintenance organization may not offer
an individual health plan for sale in this State pursuant to this section before January 1, 2014.
[PL 2011, c. 90, Pt. C, §4 (NEW).]
SECTION HISTORY
PL 2011, c. 90, Pt. C, §4 (NEW). PL 2013, c. 388, Pt. B, §§3, 4 (AMD).
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All copyrights and other rights to statutory text are reserved by the State of Maine. The text included in this publication reflects
changes made through the First Regular and First Special Session of the 131st Maine Legislature and is current through November
MRS Title 24-A, §405-B. DOMESTIC INSURERS OR LICENSED HEALTH MAINTENANCE ORGANIZATION; INDIVIDUAL
HEALTH INSURANCE APPROVED IN OTHER STATES
2 |
§405-B. Domestic insurers or licensed health maintenance organization;
individual health insurance approved in other states
Generated
10.30.2023
1. 2023. The text is subject to change without notice. It is a version that has not been officially certified by the Secretary of State.
Refer to the Maine Revised Statutes Annotated and supplements for certified text.
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