24-A M.R.S. § 4320-T — ME Code / Title 24-A / Chapter 56-A / Section 4320-T
24-A §4320-T. Implementation of federal mental health parity laws (WHOLE SECTION TEXT EFFECTIVE UNTIL 4/30/28) (WHOLE SECTION TEXT REPEALED 4/30/28) (REALLOCATED FROM TITLE 24-A, SECTION 4320-R)
Status: repealed

(CONTAINS TEXT WITH VARYING EFFECTIVE DATES)

(WHOLE SECTION TEXT EFFECTIVE UNTIL 4/30/28)

(WHOLE SECTION TEXT REPEALED 4/30/28)

(REALLOCATED FROM TITLE 24-A, SECTION 4320-R)

1. Nonquantitative treatment limitation; definition. For the purposes of this section, "nonquantitative treatment limitation" means a limitation that is not expressed numerically but otherwise limits the scope or duration of benefits for treatment. [PL 2021, c. 638, §4 (NEW); RR 2021, c. 2, Pt. A, §80 (RAL).]

2. Compliance with federal mental health parity laws. A carrier offering a health plan in this State providing health coverage for mental health and substance use disorder services pursuant to sections 2749‑C, 2842, 2843, 4234‑A and 4320‑D and Title 24, sections 2325‑A and 2329 must meet the requirements of the federal Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 and any amendments to, and any federal guidance or regulations relevant to, that Act, including 45 Code of Federal Regulations, Sections 146.136, 147.136, 147.160 and 156.115(a)(3). [PL 2021, c. 638, §4 (NEW); RR 2021, c. 2, Pt. A, §80 (RAL).]

3. Implementation of federal mental health parity laws. The superintendent shall implement and enforce applicable provisions of the federal Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, and any amendments to and federal guidance or regulations relevant to that Act, including 45 Code of Federal Regulations, Sections 146.136, 147.136, 147.160 and 156.115(a)(3), by: A. Proactively ensuring compliance by insurers, health maintenance organizations and nonprofit hospital or medical service organizations that execute, deliver, issue for delivery, continue or renew individual policies or individual and group health care contracts; [PL 2021, c. 638, §4 (NEW); RR 2021, c. 2, Pt. A, §80 (RAL).] B. Evaluating all consumer or provider complaints regarding mental health and substance use disorder coverage for possible parity violations; [PL 2021, c. 638, §4 (NEW); RR 2021, c. 2, Pt. A, §80 (RAL).] C. Performing parity compliance market conduct examinations of carriers that execute, deliver, issue for delivery, continue or renew individual policies or individual and group health care contracts, particularly market conduct examinations that focus on nonquantitative treatment limitations, including, but not limited to, prior authorization, concurrent review, retrospective review, step therapy, network admission standards, reimbursement rates and geographic restrictions; and [PL 2021, c. 638, §4 (NEW); RR 2021, c. 2, Pt. A, §80 (RAL).] D. Requesting that carriers submit comparative analyses during the form review process demonstrating how they design and apply nonquantitative treatment limitation, both as written and in operation, for mental health and substance use disorder benefits as compared to how they design and apply nonquantitative treatment limitation, as written and in operation, for medical and surgical benefits. [PL 2021, c. 638, §4 (NEW); RR 2021, c. 2, Pt. A, §80 (RAL).] The superintendent may adopt rules, as authorized under section 212, as may be necessary to effectuate any provisions of the federal Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 that relate to the business of insurance. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A. [PL 2021, c. 638, §4 (NEW); RR 2021, c. 2, Pt. A, §80 (RAL).]

4. Reports to superintendent. As part of the report submitted to the superintendent, and subsequently reported by the superintendent to the Legislature, pursuant to section 2749‑C, subsection 4, section 2843, subsection 7, section 4234‑A, subsection 10 and Title 24, section 2325‑A, subsection 8, a carrier shall submit the following information to the superintendent: A. A description of the process used to develop or select the medically necessary health care criteria for mental health and substance use disorder benefits and the process used to develop or select the medically necessary health care criteria for medical and surgical benefits; [PL 2021, c. 638, §4 (NEW); RR 2021, c. 2, Pt. A, §80 (RAL).] B. Identification of all nonquantitative treatment limitations that are applied to mental health and substance use disorder benefits and medical and surgical benefits within each classification of benefits. The report must include information demonstrating that each nonquantitative treatment limitation that applies to mental health and substance use disorder benefits also applies to medical and surgical benefits within any classification of benefits; and [PL 2021, c. 638, §4 (NEW); RR 2021, c. 2, Pt. A, §80 (RAL).] C. The results of an analysis that demonstrate that for the medically necessary health care criteria described in paragraph A and for each nonquantitative treatment limitation identified in paragraph B, as written and in operation, the processes, strategies, evidentiary standards or other factors used in applying the medically necessary health care criteria and each nonquantitative treatment limitation to mental health and substance use disorder benefits within each classification of benefits are comparable to, and are applied no more stringently than, the processes, strategies, evidentiary standards or other factors used in applying the medically necessary health care criteria and each nonquantitative treatment limitation to medical and surgical benefits within the corresponding classification of benefits. At a minimum, the results of the analysis must: (1) Identify the factors used to determine that a nonquantitative treatment limitation applies to a benefit, including factors that were considered but rejected; (2) Identify and define the specific evidentiary standards used to define the factors and any other evidence relied upon in designing each nonquantitative treatment limitation; (3) Identify and describe the comparative analyses, including the results of the analyses, used to determine that the processes and strategies used to design each nonquantitative treatment limitation, as written, for mental health and substance use disorder benefits are comparable to, and are applied no more stringently than, the processes and strategies used to design each nonquantitative treatment limitation, as written, for medical and surgical benefits; (4) Identify and describe the comparative analyses, including the results of the analyses, used to determine that the processes and strategies used to apply each nonquantitative treatment limitation, in operation, for mental health and substance use disorder benefits are comparable to, and applied no more stringently than, the processes and strategies used to apply each nonquantitative treatment limitation, in operation, for medical and surgical benefits; and (5) Disclose the specific findings and conclusions reached by the insurer that the results of the analyses in this paragraph indicate that the carrier is in compliance with this section and the federal Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 and its implementing and related regulations, including 45 Code of Federal Regulations, Sections 146.136, 147.136, 147.160 and 156.115(a)(3). [PL 2021, c. 638, §4 (NEW); RR 2021, c. 2, Pt. A, §80 (RAL).] Information submitted by a carrier to the superintendent pursuant to this subsection is public information in accordance with section 216, except for information that a carrier requests be designated as confidential and the superintendent has determined is proprietary information. For the purposes of this subsection, "proprietary information" means information that is a trade secret or business or financial information the disclosure of which would impair the competitive position of a carrier or that would result in significant detriment to a carrier if the information were made available to the public. [PL 2021, c. 638, §4 (NEW); RR 2021, c. 2, Pt. A, §80 (RAL).]

5. Repeal. This section is repealed April 30, 2028. [PL 2021, c. 638, §4 (NEW); RR 2021, c. 2, Pt. A, §80 (RAL).]
24-A M.R.S. § 957 — ME Code / Title 24-A / Chapter 11 / Section 957
24-A §957. Deficiency reserve
Status: in_force

If the gross premium charged by any life insurer on any policy or contract which is subject to section 953, subsection 2 , is less than the valuation net premium for the policy or contract calculated by the method used in calculating the reserve thereon, but using the minimum valuation standards of mortality and rate of interest, the minimum reserve required for that policy or contract shall be the greater of either the reserve calculated according to the mortality table, rate of interest and method actually used for that policy or contract, or the reserve calculated by the method actually used for that policy or contract, but using the minimum valuation standards of mortality and rate of interest and replacing the valuation net premium by the actual gross premium in each contract year for which the valuation net premium exceeds the actual gross premium. The minimum valuation standards of mortality and rate of interest referred to in this section are those standards stated in sections 953 and 953‑A . [PL 1983, c. 346, §7 (AMD).]

For any life insurance policy issued on or after January 1, 1987, for which the gross premium in the first policy year exceeds that of the 2nd year and for which no comparable additional benefit is provided in the first year for that excess and that provides an endowment benefit or a cash surrender value or a combination thereof in an amount greater than that excess premium, the foregoing provisions of this section must be applied as if the method actually used in calculating the reserve for that policy were the method described in section 954 , ignoring the 2nd paragraph of section 954 . The minimum reserve at each policy anniversary of such a policy is the greater of the minimum reserve calculated in accordance with section 954, including the 2nd paragraph of that section, and the minimum reserve calculated in accordance with this section. [PL 2011, c. 420, Pt. A, §22 (AMD).]
24-A M.R.S. § 2729 — ME Code / Title 24-A / Chapter 33 / Section 2729
24-A §2729. Renewability
Status: in_force

Health insurance policies, other than accident insurance only policies, in which the insurer reserves the right to refuse renewal on an individual basis, shall provide in substance in a provision thereof or in an endorsement thereon or rider attached thereto that subject to the right to terminate the policy upon nonpayment of premium when due, such right to refuse renewal may not be exercised so as to take effect before the renewal date occurring on, or after and nearest, each policy anniversary (or in the case of lapse and reinstatement, at the renewal date occurring on, or after and nearest, each anniversary of the last reinstatement), and that any refusal of renewal shall be without prejudice to any claim originating while the policy is in force. The parenthetic reference to lapse and reinstatement may be omitted at the insurer's option. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2837-E — ME Code / Title 24-A / Chapter 35 / Section 2837-E
24-A §2837-E. Coverage for Pap tests
Status: in_force

All group health insurance policies, contracts and certificates must provide coverage for screening Pap tests recommended by a physician. [PL 2003, c. 517, Pt. A, §7 (AMD); PL 2003, c. 517, Pt. A, §13 (AFF).]
24-A M.R.S. § 2860-A — ME Code / Title 24-A / Chapter 37 / Section 2860-A
24-A §2860-A. Commissions
Status: in_force

A commission not exceeding 5% of credit life and health insurance premiums, as set forth by rules adopted by the superintendent, may be paid to any creditor who is a licensed credit insurance agent. This section does not prohibit fees paid to a lender for handling or processing credit life or health insurance not exceeding 10% of prima facie premiums as set forth by rules adopted by the superintendent. [PL 1993, c. 645, Pt. B, §6 (AMD).]
24-A M.R.S. § 3703 — ME Code / Title 24-A / Chapter 52 / Section 3703
24-A §3703. Establishment
Status: in_force

The Maine Employers' Mutual Insurance Company is established as an assessable domestic mutual insurance company subject to all the requirements and standards of this Title that are applicable to cash plan insurers unless specifically exempted from or which are clearly inconsistent with the provisions contained in this chapter. Notwithstanding any other law to the contrary, the company's authority to operate is limited as follows. [PL 1991, c. 885, Pt. C, §3 (AMD).]

1. Workers' compensation. The company shall provide workers' compensation insurance and employers' liability insurance incidental to and written in connection with workers' compensation coverage to employers in this State. The company may provide employment practices liability insurance incidental to and written in connection with workers' compensation coverage for employers if the employment practices liability insurance is provided as an endorsement to workers' compensation coverage approved by the superintendent and is provided under terms and conditions, including reinsurance protection, approved by the superintendent. Rates for employment practices liability insurance are subject to chapter 25 . The company may not write other lines of insurance. The company may reinsure workers' compensation and employers' liability insurance written by other insurers that are covering out-of-state employees of Maine-based employers that are insured by the company. For the purpose of providing insurance to Maine-based employers operating in other states, the company may apply to appropriate regulatory authorities in those states for authority to write workers' compensation, employers' liability and employment practices liability insurance for Maine-based employers' operations in those states. The company may form or acquire subsidiary insurers in other states that are authorized to write only workers' compensation insurance, employers' liability insurance and employment practices liability insurance as long as such coverage is incidental to and written in connection with workers' compensation coverage. The superintendent may authorize a subsidiary insurer formed or acquired by the company to write workers' compensation, employers' liability and employment practices liability insurance in this State as long as such coverage is incidental to and written in connection with coverage in the state in which the insured's principal place of business is located. The superintendent may not authorize a subsidiary insurer formed or acquired by the company to write any other line of insurance in this State. [PL 2009, c. 32, §1 (AMD).]

2. Exclusion from guaranty funds. The company and its policyholders are exempt from participation and may not join or contribute financially to, nor be entitled to the protection of, any plan, pool, association or guaranty or insolvency fund authorized or required by this Title. [PL 1991, c. 615, Pt. D, §1 (NEW).]

3. Initial board of directors. [PL 1991, c. 885, Pt. C, §3 (RP).]

4. Incorporation. [PL 1997, c. 661, §4 (RP).]

5. Composition of the board. The board consists of up to 9 members. Six members must be officers, directors, employees, partners or members of policyholders who purchase workers' compensation coverage from the Maine Employers' Mutual Insurance Company. Two members must be persons who represent the public interest of the company and must be appointed by the Governor within 30 days after a new board member is authorized or a vacancy occurs, subject to review and comment by the joint standing committee of the Legislature having jurisdiction over banking and insurance matters. The designated committee shall complete its review within 15 days of the Governor's written notice of appointment. If the designated committee fails to act within the required 15 days, then the appointees put forward by the Governor become the required board members. One member must be an at-large policyholder member elected by the board. The remaining board member is the president and chief executive officer who shall serve on the board of directors while employed as president and chief executive officer. The reduction in the number of board members from 13 to 9 must be done by attrition. The first 4 appointments to expire after September 1, 1998 may not be filled. A member of the board may not be a lobbyist required to be registered with the Commission on Governmental Ethics and Election Practices, a service provider to the workers' compensation system or a representative of a service provider to the workers' compensation system. [PL 2005, c. 683, Pt. B, §19 (AMD).]

6. Terms. A full term on the board of directors is 3 years. An individual may not serve more than 4 consecutive full terms as a director, except for the president and chief executive officer. All members shall serve for the terms provided and until their successors are appointed or elected and qualified. [PL 2011, c. 105, §1 (AMD).]

7. Corporate governance. The board of directors shall adopt bylaws consistent with section 3359 . The bylaws must provide a schedule of meetings and rules specifically relating to the conduct of meetings and voting procedures. [PL 1997, c. 661, §6 (AMD).]

8. Annual report. In addition to any other reports required by this Title, the company shall submit an annual report to the Governor and to the joint standing committee of the Legislature having jurisdiction over insurance matters that discloses the business transacted by the company during the previous year and states the resources and liabilities of the company together with other pertinent information considered appropriate by the board. The report must contain, at a minimum, a summary of the latest annual statement filing required to be filed under this Title with the Superintendent of Insurance prepared on a basis of statutory accounting precepts. Any variations between the annual statement and the annual report must be reconciled to clearly show variances and the basis for any different values. [RR 1993, c. 1, §64 (COR).]

9. Nominating committee. The board shall create a nominating committee. The nominating committee shall present to the board nominees for the at-large and the policyholder board member positions. [PL 1997, c. 661, §6 (AMD).]
24-A M.R.S. § 3202 — ME Code / Title 24-A / Chapter 45 / Section 3202
24-A §3202. Closing protection letters
Status: in_force

1. Title insurer may issue closing or settlement protection. A title insurer may issue closing or settlement protection on a form of closing protection letter approved by the superintendent pursuant to section 2412 . Only a buyer, borrower or lender that is a party to a transaction in which a title insurance policy will be issued by or on behalf of the title insurer issuing the closing or settlement protection is eligible to receive the benefit of closing or settlement protection. Closing or settlement protection issued pursuant to this subsection must benefit each buyer, borrower and lender that is a party to the transaction for which that closing or settlement protection is issued. [PL 2013, c. 233, §1 (NEW).]

2. Indemnity. The closing or settlement protection issued pursuant to subsection 1 may indemnify a buyer, borrower or lender against loss because of one of the following acts of a policy-issuing title insurance agent or other settlement service provider under the terms and conditions of the closing protection letter as issued by the title insurer: A. Theft or misappropriation of settlement funds in connection with a transaction, but only to the extent that the theft relates to the status of the title to an insured interest in land or to the validity, enforceability and priority of the lien of the mortgage on an insured interest in land; and [PL 2013, c. 233, §1 (NEW).] B. Failure to comply with the written closing instructions when agreed to by the settlement agent or title agent, but only to the extent that the failure to comply with the instructions relates to the status of the title to an insured interest in land or the validity, enforceability and priority of the lien of the mortgage on an insured interest in land. [PL 2013, c. 233, §1 (NEW).] [PL 2013, c. 233, §1 (NEW).]

3. Fee. The fee charged by a title insurer for closing or settlement protection coverage must be filed with the superintendent pursuant to section 2304‑A . The fee may not be subject to any agreement requiring a division of fees or premiums collected on behalf of the title insurer. A title insurer may charge only one fee for a closing or settlement protection letter for the protection of all parties receiving the benefit of closing or settlement protection in connection with the real property transaction giving rise to the issuance of the closing or settlement protection letter. [PL 2013, c. 233, §1 (NEW).]

4. Provision of other protection prohibited. Except as provided in this section, a title insurer may not provide any protection that purports to indemnify against improper acts or omissions of a person with regard to settlement or closing services. [PL 2013, c. 233, §1 (NEW).]
24-A M.R.S. § 9 — ME Code / Title 24-A / Chapter 1 / Section 9
24-A §9. "Transacting insurance" defined
Status: in_force

In addition to other aspects of insurance operations to which provisions of this Title by their terms apply, "transact" with respect to a business of insurance includes any of the following, whether by mail or any other means: [PL 1969, c. 132, §1 (NEW).]

1. Solicitation or inducement; [PL 1969, c. 132, §1 (NEW).]

2. Negotiations; [PL 1969, c. 132, §1 (NEW).]

3. Effectuation of a contract of insurance; [PL 1969, c. 132, §1 (NEW).]

4. Transaction of matters subsequent to effectuation and arising out of such a contract. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2482 — ME Code / Title 24-A / Chapter 28 / Section 2482
24-A §2482. Review of commission decisions regarding filings --  Article 11
Status: in_force

1. Appeal to review panel appointed by commission. Not later than 30 days after the commission has given notice of a disapproved product or advertisement filed with the commission, the insurer or 3rd-party filer whose filing was disapproved may appeal the determination to a review panel appointed by the commission. The commission shall promulgate rules to establish procedures for appointing a review panel and provide for notice and hearing. An allegation that the commission, in disapproving a product or advertisement filed with the commission, acted arbitrarily, capriciously or in a manner that is an abuse of discretion or otherwise not in accordance with the law is subject to judicial review in accordance with section 2474, subsection 4 . [PL 2023, c. 405, Pt. A, §86 (AMD).]

2. Commission may monitor, review and reconsider. The commission has authority to monitor, review and reconsider products and advertisements subsequent to their filing or approval upon a finding that the product does not meet the relevant uniform standard. Where appropriate, the commission may withdraw or modify its approval after proper notice and hearing, subject to the appeal process in subsection 1 . [PL 2003, c. 680, §1 (NEW).]
24-A M.R.S. § 3860 — ME Code / Title 24-A / Chapter 53 / Section 3860
24-A §3860. Attorney's bond
Status: in_force

1. Concurrently with the filing of the declaration provided for in section 3856 , the attorney of a domestic reciprocal insurer shall file with the superintendent a bond in favor of this State for the benefit of all persons damaged as a result of breach by the attorney of the conditions of attorney's bond as set forth in subsection 2 . The bond must be executed by the attorney and by an authorized corporate surety, and is subject to the superintendent's approval. [RR 2021, c. 1, Pt. B, §312 (COR).]

2. The bond must be in the penal sum of $25,000, aggregate in form, conditioned that the attorney will faithfully account for all moneys and other property of the insurer coming into the attorney's hands, and that the attorney will not withdraw or appropriate to the attorney's own use from the funds of the insurer, any moneys or property to which the attorney is not entitled under the power of attorney. [RR 2021, c. 1, Pt. B, §313 (COR).]

3. The bond shall provide that it is not subject to cancellation unless 30 days' advance notice in writing of cancellation is given both the attorney and the superintendent. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 4238 — ME Code / Title 24-A / Chapter 56 / Section 4238
24-A §4238. Medical food coverage for inborn error of metabolism
Status: in_force

1. Inborn error of metabolism; special modified low-protein food product. As used in this section, "inborn error of metabolism" means a genetically determined biochemical disorder in which a specific enzyme defect produces a metabolic block that may have pathogenic consequences at birth or later in life. As used in this section, "special modified low-protein food product" means food formulated to reduce the protein content to less than one gram of protein per serving and does not include foods naturally low in protein. [PL 1995, c. 369, §4 (NEW).]

2. Required coverage. All health maintenance organization individual and group contracts must provide coverage for metabolic formula and special modified low-protein food products that have been prescribed by a licensed physician for a person with an inborn error of metabolism. The contracts must reimburse: A. For metabolic formula; and [PL 1995, c. 369, §4 (NEW).] B. Up to $3,000 per year for special modified low-protein food products. [PL 1995, c. 369, §4 (NEW).] [PL 1995, c. 369, §4 (NEW).]

3. Application. The requirements of this section apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 1996. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 1995, c. 369, §4 (NEW).]
24-A M.R.S. § 1133 — ME Code / Title 24-A / Chapter 13 / Section 1133
24-A §1133. Time limit for disposal of real estate
Status: in_force

1. Except as stated in subsection 2 , or unless the insurer elects to hold the real estate as an investment under section 1125, subsection 1, paragraph G : A. An insurer shall dispose of real estate acquired under section 1125, subsection 1, paragraph A , within 5 years after it has ceased to be necessary for the convenient accommodation of the insurer in the transaction of its business. [PL 1969, c. 132, §1 (NEW).] B. An insurer shall dispose of real estate acquired under section 1125, subsection 1, paragraphs B , C or E , within 5 years after the date of acquisition, unless used or to be used for the insurer's accommodation under section 1125, subsection 1, paragraph A . [PL 1969, c. 132, §1 (NEW).] [PL 1969, c. 132, §1 (NEW).]

2. Upon proof satisfactory to the superintendent that the interests of the insurer will suffer materially by the forced sale thereof, the superintendent may by order grant a reasonable extension of the period, as specified in such order, within which the insurer shall dispose of any particular parcel of such real estate. [RR 2021, c. 1, Pt. B, §189 (COR).]
24-A M.R.S. § 4255 — ME Code / Title 24-A / Chapter 56 / Section 4255
24-A §4255. Coverage for hearing aids (REALLOCATED FROM TITLE 24-A, SECTION 4253)
Status: in_force

(REALLOCATED FROM TITLE 24-A, SECTION 4253)

1. Hearing aid; definition. For purposes of this section, "hearing aid" means a nonexperimental, wearable instrument or device designed for the ear and offered for the purpose of aiding or compensating for impaired human hearing, excluding batteries and cords and other assistive listening devices, including, but not limited to, frequency modulation systems. [PL 2007, c. 695, Pt. A, §30 (RAL).]

2. Required coverage. All health maintenance organization individual and group health insurance contracts must provide coverage for the purchase of a hearing aid for each hearing-impaired ear for an individual covered under the policy, contract or certificate in accordance with the following requirements. A. The hearing loss must be documented by a physician or audiologist licensed pursuant to Title 32, chapter 137 . [PL 2015, c. 494, Pt. A, §30 (AMD).] B. The hearing aid must be purchased in accordance with federal and state laws, regulations and rules for the sale and dispensing of hearing aids. [PL 2019, c. 418, §5 (AMD); PL 2019, c. 418, §7 (AFF).] C. The policy, contract or certificate may limit coverage to $3,000 per hearing aid for each hearing-impaired ear every 36 months. [PL 2019, c. 418, §5 (AMD); PL 2019, c. 418, §7 (AFF).] [PL 2019, c. 418, §5 (AMD); PL 2019, c. 418, §7 (AFF).]

3. Application of coverage. [PL 2019, c. 418, §6 (RP); PL 2019, c. 418, §7 (AFF).]

4. Limits; coinsurance; deductibles. Except as otherwise provided in this section, any contract that provides coverage for services under this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section. [PL 2007, c. 695, Pt. A, §30 (RAL).]
24-A M.R.S. § 1902 — ME Code / Title 24-A / Chapter 18 / Section 1902
24-A §1902. License required
Status: in_force

A person may not act as or profess to be an administrator after August 1, 1990, unless licensed under this chapter. An administrator doing business in this State on August 1, 1990, shall apply for a license by November 1, 1990. In addition to any other penalty that may be imposed for violation of this Title, any person violating this section shall, upon conviction, be punished by a fine of not less than $100 nor more than $1,000 or by imprisonment for less than one year, or both. [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]

An administrator licensed under this chapter on or before December 31, 2003 shall submit information by March 21, 2004 as to the types of business conducted by that administrator in this State on a form prescribed by the superintendent. [PL 2003, c. 469, Pt. E, §3 (NEW).]
24-A M.R.S. § 2157 — ME Code / Title 24-A / Chapter 23 / Section 2157
24-A §2157. Defamation
Status: in_force

No person shall make, publish, disseminate, or circulate, directly or indirectly, or aid, abet or encourage the making, publishing, disseminating or circulating of any oral or written statement or any pamphlet, circular, article or literature which is false, or maliciously critical of or derogatory to an insurer, or of an organization proposing to become an insurer, and which is calculated to injure any person engaged or proposing to engage in the business of insurance. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 1413 — ME Code / Title 24-A / Chapter 16 / Section 1413
24-A §1413. License requirement for business entities
Status: in_force

1. License required. A business entity, whether it has a location in this State or not, must be licensed as an insurance producer, adjuster or consultant business entity in order to authorize individual licensees to act on the entity's behalf by engaging in insurance producer, adjuster or consultant activities or in order to use the name of the business entity in insurance-related advertising in the State. A business entity has no authority to act on its own without an individual licensee. A license authority held by an individual licensee employed by a business entity does not transfer to other employees within that business entity. Licensure of a nonresident business entity does not depend upon the entity's maintaining a business entity license in another state. Business entity licensees are subject to the standards of section 407, subsection 2 , when applicable, and section 408, subsections 1 and 4 . [PL 2001, c. 259, §14 (AMD).]

2. Officers; directors; members; partners. A business entity shall notify the superintendent of its members, directors, officers or partners, and of all executive officers and directors of entities owning and individuals owning, directly or indirectly, 51% or more of the outstanding voting securities of the applicant, within 14 days of a request for such information by the superintendent. [PL 2011, c. 554, §3 (AMD).]

3. Responsible person. Each officer or director of a corporation, each officer and member of a limited liability company and each partner of a partnership who is acting as an insurance producer, adjuster or consultant shall obtain an insurance producer, adjuster, or consultant license. Officers, members and partners do not have to be individually licensed if they are not engaging in producer activities, are not acting as consultants or adjusters and are not being compensated based upon the volume of insurance business transacted. At least one individual licensee must be designated responsible for the business entity's compliance with the insurance laws and rules of this State. The responsible person shall ensure that every individual acting in the name of the entity does not act beyond the scope of that individual's license. The designated responsible person for each business entity shall maintain a list of all current home addresses and home telephone numbers for each individual designated to act in the name of the entity. The business entity shall notify the superintendent, within 14 days of every change of the designated licensed person responsible for the entity's compliance with laws and rules of this State. The designated responsible person is responsible for all correspondence with the business entity from the superintendent. If the responsible person in a business entity loses that person's license, the business entity license terminates if a new person is not designated as responsible for the business entity within 14 days. [PL 2001, c. 259, §14 (AMD).]

4. Authority. Whenever a business entity changes the individuals designated to act in the name of the entity, the entity shall notify the superintendent within 30 days of those changes. [PL 2001, c. 259, §14 (AMD).]

5. Resident branch offices. A resident business entity establishing more than one place of business in this State must procure a business entity branch registration for each location within the State. A resident branch office is any office location other than the location of the licensed business entity that regularly conducts insurance business or that is advertised as a location where the public may contact the business entity or its employees concerning insurance services. An office location that meets this definition that is itself a separate legal entity from the licensed business entity must obtain a separate business entity license and can not be registered as a branch office. The licensed person designated as responsible for the business entity is responsible for all branch locations. [PL 2001, c. 259, §14 (AMD).]

6. Nonresident branch locations. A nonresident business entity doing business in this State shall procure a business entity license for its principal location and a branch office registration for each location doing business in the State. The licensed person designated as responsible for the business entity is responsible for all such branch locations. [PL 2001, c. 259, §14 (AMD).]

7. Applications. [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF); MRSA T. 24-A §1413, sub-§7 (RP).]

8. Motor vehicle rental company. A rental company that primarily provides rental of motor vehicles to the public under a rental agreement that includes travel, baggage, liability or other related insurance coverage purchased by an individual in connection with and incidental to the rental of a motor vehicle, whether at the rental office or by preselection of coverage by the individual, shall obtain a limited insurance producer license under this chapter, and at least one employee at each office of the rental company located in the State shall obtain a limited insurance producer license. [PL 1999, c. 270, §3 (NEW).]

9. Equipment rental company. A rental company as defined in section 3043, subsection 1, paragraph C that solicits or sells insurance in connection with and incidental to the rental of covered rental equipment as defined in section 3043, subsection 1, paragraph B shall obtain a limited insurance producer license under this chapter, and at least one employee at each office of the rental company located in the State shall obtain a limited insurance producer license. [PL 2015, c. 77, §1 (NEW).]
24-A M.R.S. § 3302 — ME Code / Title 24-A / Chapter 47 / Section 3302
24-A §3302. Insurers to be organized under this Title
Status: in_force

All domestic stock and mutual legal reserve insurers hereafter organized shall be organized under the provisions of this Title, and not otherwise. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 1157 — ME Code / Title 24-A / Chapter 13-A / Section 1157
24-A §1157. Investment in subsidiaries
Status: in_force

1. Investment or acquisition. Subject to the limitations contained in subsection 5 , an insurer may invest in, or otherwise acquire, subsidiaries engaged or organized to engage in any businesses lawful under the laws of the jurisdictions in which those subsidiaries are organized. [PL 1987, c. 399, §14 (NEW).]

2. Authorization. Except as provided in section 1153, subsection 3 , investments in subsidiaries authorized by this section may not be authorized under any other section of this chapter. [PL 1987, c. 399, §14 (NEW).]

3. Superintendent; order of disposition. At any time after the acquisition by the insurer of any subsidiary, other than a holding company engaged solely in the ownership or control of other subsidiaries, or a subsidiary referred to in subsection 5, paragraph B , subparagraph (1) or (2), the superintendent may order its disposition if the superintendent finds, after notice and an opportunity to be heard, that its continued retention is materially adverse to the interests of the insurer's policyholders. The insurer has at least 36 months to effect the disposition. If that disposition is not so effected, the subsidiary may not thereafter be allowed as an asset of the insurer. [RR 2021, c. 2, Pt. A, §69 (COR).]

4. Name. The name of any subsidiary may not be such as to mislead or deceive the public. [PL 1987, c. 399, §14 (NEW).]

5. Limitations. Subject to the exceptions in paragraph B , investments in subsidiaries of an insurer are limited as follows. A. Except with the approval of the superintendent, that insurer may not make, directly or indirectly, an investment in any subsidiary if that investment would bring the aggregate net cost of investments in all subsidiaries to an amount in excess of the lesser of 10% of the insurer's total admitted assets or 50% of the insurer's surplus as regards policyholders or if that investment would bring the aggregate net investment in that subsidiary to an amount in excess of 2% of those total admitted assets. [PL 1993, c. 313, §29 (AMD).] B. Investments made directly or indirectly in the following subsidiaries are not subject to the limitations contained in paragraph A or in section 1155 or 1156 , nor are these investments to be counted in determining compliance with those limitations: (1) Subsidiaries, all of whose stock is owned by one or more insurers, engaged or organized to engage exclusively in the ownership or management of assets authorized under this chapter as investments for the insurer; (2) Subsidiaries engaged or organized to engage in the kinds of business in which the insurer may engage, provided that the aggregate net cost of the insurer's investments in all such subsidiaries may not exceed 50% of its surplus as to policyholders; and (3) A subsidiary that is a depository institution, or any company that controls such an institution, that is subject to the federal Gramm-Leach-Bliley Act, Sections 104(c) and 306(2), 113 Stat. 1338, as long as the insurer's total investment in all such subsidiaries does not exceed 5% of the insurer's admitted assets. An investment described in section 3415 is not considered as an investment in a subsidiary in determining compliance with the limitations of this subsection. [PL 1999, c. 715, §14 (AMD).] C. Subject to paragraph B , the "net cost of investment" is defined to be the sum of: The total money or other consideration expended and obligations assumed in the acquisition or formation of a subsidiary, including all organizational expenses and contributions to capital and surplus of that subsidiary; and all amounts expended in acquiring additional common stock, preferred stock, debt obligations and other securities, and all contributions to the capital or surplus, of a subsidiary subsequent to its acquisition or formation; less returns of capital, repayments of principal and any other payments reducing the investment in the subsidiary. [PL 1987, c. 399, §14 (NEW).] D. Investments made or acquired by subsidiaries referred to in paragraph B , subparagraph (1) are considered to be made or acquired directly by the insurer, pro rata, in the case of a subsidiary not wholly owned and, to such extent, are subject to all the provisions and limitations on the making of investments specified in this chapter with respect to investments by the insurer; must be valued in accordance with the provisions of section 901‑A and any other applicable provisions of this Title and any applicable rules adopted by the superintendent; and must be located pursuant to section 3408 . Those subsidiaries are subject to examination by the superintendent under section 221, subsection 1 and section 222, subsection 1‑A . [PL 2013, c. 238, Pt. A, §31 (AMD); PL 2013, c. 238, Pt. A, §34 (AFF).] E. There shall be excluded from all computations under paragraph A any investment by an insurer in any subsidiary, or by one subsidiary in another subsidiary, to the extent that such investment is reinvested in another subsidiary, but amounts so reinvested shall thereafter be included in such computations unless further excluded or exempted by this chapter. [PL 1987, c. 399, §14 (NEW).] [PL 2013, c. 238, Pt. A, §31 (AMD); PL 2013, c. 238, Pt. A, §34 (AFF).]

6. Valuation of subsidiary stock. In determining the financial condition of an insurer, all investments made directly or indirectly in the stock of its subsidiaries must be valued in accordance with section 901‑A and any rules adopted under that section. [PL 2001, c. 72, §16 (AMD).]

7. Application of law. Except as provided in section 1155 , investments in subsidiaries made pursuant to this section are not subject to any other restrictions or prohibitions contained in this chapter. [PL 1987, c. 399, §14 (NEW).]
24-A M.R.S. § 4221 — ME Code / Title 24-A / Chapter 56 / Section 4221
24-A §4221. Penalties and enforcement
Status: in_force

1. The superintendent may levy an administrative penalty in an amount not less than $100 nor more than $500, if reasonable notice in writing is given of the intent to levy the penalty and the health maintenance organization has a reasonable time within which to remedy the defect in its operations that gave rise to the penalty citation. The superintendent may augment this penalty by an amount equal to the sum that the superintendent calculates to be the damages suffered by enrollees or other members of the public. [RR 2021, c. 1, Pt. B, §349 (COR).]

2. If the superintendent or the Commissioner of Health and Human Services shall for any reason have cause to believe that any violation of this chapter has occurred or is threatened, the superintendent or Commissioner of Health and Human Services may give notice to the health maintenance organization and to the representatives, or other persons who appear to be involved in such suspected violation, to arrange a conference with the alleged violators or their authorized representatives for the purpose of attempting to ascertain the facts relating to such suspected violation and, in the event it appears that any violation has occurred or is threatened, to arrive at an adequate and effective means of correcting or preventing such violation. Proceedings under this subsection shall not be governed by any formal procedural requirements and may be conducted in such manner as the superintendent or the Commissioner of Health and Human Services may deem appropriate under the circumstances. [PL 1975, c. 503 (NEW); PL 2003, c. 689, Pt. B, §7 (REV).]

3. The superintendent may issue an order directing a health maintenance organization or a representative of a health maintenance organization to cease and desist from engaging in any act or practice in violation of this chapter. Within 10 days after service of the order of cease and desist, the respondent may request a hearing on the question of whether acts or practices in violation of this chapter have occurred. [PL 1975, c. 503 (NEW).]

4. In the case of any violation under this chapter, if the superintendent elects not to issue a cease and desist order, or in the event of noncompliance with a cease and desist order issued pursuant to this section, the superintendent may apply to the Superior Court to issue an injunction restraining the company in whole or in part from proceeding further with its business, or the superintendent may apply for an order of the court to command performance consistent with contractual obligations of the health maintenance organization. [RR 2021, c. 1, Pt. B, §350 (COR).]
24 M.R.S. § 2321-B — ME Code / Title 24 / Chapter 19 / Section 2321-B
24 §2321-B. Appropriate level of subscriber reserves
Status: in_force

The superintendent may adopt rules establishing the appropriate level of subscriber reserves. Rules adopted pursuant to this section are routine technical rules as defined in Title 5, chapter 375, subchapter II‑A . [PL 1997, c. 344, §7 (NEW).]
24-A M.R.S. § 4249 — ME Code / Title 24-A / Chapter 56 / Section 4249
24-A §4249. Mandated offer of domestic partner benefits
Status: in_force

1. Definition. [PL 2021, c. 567, §37 (RP).]

2. Mandated offer of domestic partner benefits. All individual or group policies or contracts issued by any health maintenance organization operating pursuant to this chapter must make available to an individual or group policyholder the option for additional benefits for the domestic partner of an enrollee or member, at appropriate rates and under the same terms and conditions as those benefits or options for benefits are provided to spouses of married enrollees or members covered under a health maintenance organization individual or group contract. [PL 2001, c. 347, §4 (NEW); PL 2001, c. 347, §5 (AFF).]

3. Financial dependency. Financial dependency of a domestic partner on the enrollee or member may not be required as a condition for eligibility for coverage. [PL 2001, c. 347, §4 (NEW); PL 2001, c. 347, §5 (AFF).]

4. Evidence of domestic partnership. As a condition of eligibility for coverage, a health maintenance organization or group policyholder may require an enrollee or member and the enrollee's or member's domestic partner to sign an affidavit attesting that the enrollee or member and enrollee's or member's domestic partner meet the definition of domestic partner under Title 1, section 72, subsection 2‑C and to show documentation of joint ownership or occupancy of real property, such as a joint deed, joint mortgage or a joint lease, or the existence of a joint credit card, joint bank account or powers of attorney in which each domestic partner is authorized to act for the other. [PL 2021, c. 567, §38 (AMD).]

5. Preexisting conditions. A domestic partner is subject to the same provisions on coverage of preexisting conditions as any spouse or dependent of an enrollee or member. [PL 2001, c. 347, §4 (NEW); PL 2001, c. 347, §5 (AFF).]

6. Termination of domestic partner benefits. A health maintenance organization may terminate coverage in accordance with other applicable provisions of this Title for the domestic partner of an enrollee or member upon notification by the enrollee or member that the domestic partner relationship has terminated. [PL 2021, c. 567, §39 (AMD).]

7. Construction. This section does not prohibit a health maintenance organization from negotiating a policy providing domestic partner benefits to a policyholder that does not comply with the requirements of this section. [PL 2001, c. 347, §4 (NEW); PL 2001, c. 347, §5 (AFF).]

Revisor's Note: §4249. Coverage for general anesthesia for dentistry (As enacted by PL 2001, c. 423, §4 and affected by §5 is REALLOCATED TO TITLE 24-A, SECTION 4251)

Revisor's Note: §4249. Coverage for hospice care services (As enacted by PL 2001, c. 358, Pt. LL, §4 and affected by §5 is REALLOCATED TO TITLE 24-A, SECTION 4250)
24-A M.R.S. § 3629 — ME Code / Title 24-A / Chapter 51 / Section 3629
24-A §3629. Other provisions applicable
Status: in_force

The following chapters and provisions of this Title, where and to the extent not inconsistent with this chapter and the reasonable implications thereof, also apply as to domestic mutual assessment insurers which are subject to this chapter: [PL 1969, c. 132, §1 (NEW).]

1. Chapter 1 (general definitions and provisions). [PL 1969, c. 132, §1 (NEW).]

2. Chapter 3 (the insurance superintendent), except that an insurer transacting insurance only on the assessment plan shall not be subject to section 228 (examination expense), and shall not be required to pay the expense of examination of the insurer. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

3. Chapter 5 (authorization of insurers and general requirements), except that the following sections or provisions shall not apply: A. Section 410 (capital funds required); [PL 1969, c. 132, §1 (NEW).] B. Section 411 (insuring combinations without additional capital funds); [PL 1969, c. 132, §1 (NEW).] C. Section 413 (application for certificate of authority), to the extent that payment is required of a fee for application for or issuance of a certificate of authority of an insurer transacting insurance on the assessment plan only; [PL 1969, c. 132, §1 (NEW).] D. Section 415 (continuance, expiration, reinstatement of certificate of authority), to the extent that payment of fee for continuance of certificate of authority is required of an insurer transacting insurance on the assessment plan only; and [PL 1969, c. 132, §1 (NEW).] E. Section 423 (annual statement), to the extent that payment of a fee for filing the annual statement is required of an insurer transacting insurance on the assessment plan only. [PL 1969, c. 132, §1 (NEW).] [PL 1969, c. 132, §1 (NEW).]

4. Chapter 7 (fees and taxes), except as otherwise expressly provided in this chapter, and that no fee shall be charged for the certificate of authority of an insurer transacting insurance on the assessment plan only. [PL 1969, c. 132, §1 (NEW).]

5. Chapter 9 (kinds of insurance), except the following sections: A. Section 702 ("life insurance" defined); [PL 1969, c. 132, §1 (NEW).] B. Section 709 ("title insurance" defined); and [PL 1969, c. 132, §1 (NEW).] C. Section 721 (limits of risk). [PL 1969, c. 132, §1 (NEW).] [PL 1969, c. 132, §1 (NEW).]

6. [PL 2001, c. 72, §17 (RP).]

6-A. Section 901‑A (statutory accounting principles); [PL 2001, c. 72, §18 (NEW).]

7. Chapter 13 (investments). [PL 1969, c. 132, §1 (NEW).]

8. Chapter 15 (administration of deposits). [PL 1969, c. 132, §1 (NEW).]

9. Chapter 16 ; [PL 1997, c. 457, §46 (AMD); PL 1997, c. 457, §55 (AFF).]

10. Chapter 23 (trade practices and frauds). [PL 1969, c. 132, §1 (NEW).]

11. Chapter 25 (rates and rating organizations), except as provided in such chapter 25 . [PL 1969, c. 132, §1 (NEW).]

12. Chapter 27 (the insurance contract); except that section 2415 (charter, bylaw provisions) shall not apply as to insurance written on the mutual assessment plan. [PL 1969, c. 132, §1 (NEW).]

13. Chapter 39 (casualty insurance contracts). [PL 1969, c. 132, §1 (NEW).]

14. Chapter 41 (property insurance contracts). [PL 1969, c. 132, §1 (NEW).]

15. Chapter 43 (surety insurance contracts). [PL 1969, c. 132, §1 (NEW).]

16. Chapter 47 (organization, corporate powers, procedures of domestic legal reserve stock and mutual insurers), except as to the following sections: A. Sections 3352 to 3358 (initial qualification, qualifying applications for insurance, guaranty capital, and related subjects); and [PL 1969, c. 132, §1 (NEW).] B. Sections 3364 to 3367 (provisions relative to contingent liability and nonassessable policies). [PL 1969, c. 132, §1 (NEW).] [PL 1969, c. 132, §1 (NEW).]

17. Chapter 49 (continuity of management). [PL 1969, c. 132, §1 (NEW).]

18. Chapter 57 (delinquent insurers; rehabilitation and liquidation). [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2865 — ME Code / Title 24-A / Chapter 37 / Section 2865
24-A §2865. Rulemaking
Status: in_force

The superintendent may adopt rules establishing specific requirements and procedures for consumer credit insurance policies, certificates of coverage and rates, consistent with the purposes of this chapter. These rules may specify additional types of consumer credit insurance that may be issued on an individual basis or, pursuant to chapter 40‑A , on a group basis. Rules adopted pursuant to this section are routine technical rules as defined by Title 5, chapter 375, subchapter II‑A . [PL 2001, c. 138, §15 (NEW).]
24-A M.R.S. § 4309-A — ME Code / Title 24-A / Chapter 56-A / Section 4309-A
24-A §4309-A. Compliance with the Affordable Care Act
Status: in_force

1. Carriers. A carrier shall comply with all applicable requirements of the federal Affordable Care Act. [PL 2011, c. 364, §30 (NEW).]

2. Superintendent. The superintendent may enforce and administer this section through all powers provided under this Title and Title 24 . The superintendent may adopt and amend rules, establish standards and enforce federal statutes and regulations in order to carry out the purposes of the federal Affordable Care Act. Rules or amendments adopted pursuant to this subsection, including amendments to major substantive rules, are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2011, c. 364, §30 (NEW).]
24-A M.R.S. § 2387-A — ME Code / Title 24-A / Chapter 25 / Section 2387-A
24-A §2387-A. Public Advocate
Status: in_force

1. Participation and duties. The Public Advocate shall represent the interests of insureds and policyholders in matters under this subchapter within the jurisdiction of the superintendent, including, but not limited to: A. Rate filings under this chapter; [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).] B. Rulemaking; [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).] C. Petitions by insurers to terminate license authority, or withdrawal plans submitted pursuant to section 415‑A ; [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).] D. Proceedings by the superintendent concerning the reasonableness and adequacy of the service provided by any insurer; [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).] E. Proceedings by the superintendent concerning the reasonableness and adequacy of the rates charged by any insurer; and [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).] F. Proceedings instituted by the superintendent concerning an insurer's license authority. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).] The Public Advocate has the same right to request data as any other party before the superintendent and may petition the superintendent, for good cause shown, to be allowed such other information as may be necessary to carry out the purposes of this section. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

2. Petition. The Public Advocate has the right to request that the superintendent investigate the reasonableness of the service provided by, or the rates charged by, insurers. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

3. Expert witnesses. The Public Advocate may employ witnesses and pay appropriate compensation and expenses to employ such witnesses. The funds for expert witnesses are available as indicated in section 2386 . [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

4. Appeal from superintendent's orders. The Public Advocate has the same rights of appeal from the superintendent's orders or decisions to which the Public Advocate has been a party as other parties. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

5. Application. This section applies to any proceeding under former section 2367 or section 2386‑A for policy years 1988 through 1992 and for any other proceeding initiated prior to January 1, 1993 or any continuation or appeal of a proceeding initiated prior to January 1, 1993. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]
24-A M.R.S. § 6402 — ME Code / Title 24-A / Chapter 77 / Section 6402
24-A §6402. Definitions
Status: in_force

As used in this Act, unless the context otherwise indicates, the following terms have the following meanings. [PL 1991, c. 828, §33 (NEW).]

1. Accredited state. "Accredited state" means a state in which the insurance department or regulatory agency has qualified as meeting the minimum financial regulatory standards promulgated and established by the National Association of Insurance Commissioners. [PL 1991, c. 828, §33 (NEW).]

2. Broker. [PL 2017, c. 169, Pt. E, §2 (RP).]

3. Control or controlled. "Control" or "controlled" has the same meaning as set out in section 222, subsection 2, paragraph B . [PL 1991, c. 828, §33 (NEW).]

4. Controlling producer. "Controlling producer" means a producer who directly or indirectly controls an insurer. [PL 2017, c. 169, Pt. E, §3 (AMD).]

5. Controlled insurer. "Controlled insurer" means a licensed property or casualty insurer that is controlled directly or indirectly by a producer. [PL 2017, c. 169, Pt. E, §4 (AMD).]

6. Licensed property or casualty insurer. "Licensed property or casualty insurer" means any person licensed to transact a property or casualty insurance business, or both, in this State with the exception of: A. [PL 2017, c. 169, Pt. E, §5 (RP).] B. A residual market pool or joint underwriting authority or association; or [PL 2017, c. 169, Pt. E, §5 (AMD).] C. A special purpose reinsurance vehicle holding a limited certificate of authority under section 782 or a captive insurance company, other than a risk retention group, licensed under section 6702 . [PL 2017, c. 169, Pt. E, §5 (AMD).] [PL 2017, c. 169, Pt. E, §5 (AMD).]

7. Producer. "Producer" means an insurance producer licensed or required to be licensed pursuant to chapter 16 or a person holding or required to hold a comparable license in another state where a licensed property or casualty insurer does business. [PL 2017, c. 169, Pt. E, §6 (AMD).]

8. Subproducer. "Subproducer" means a producer who, for shared commission or other recompense, places business with a controlled insurer through a controlling producer. [PL 2017, c. 169, Pt. E, §7 (AMD).]
24-A M.R.S. § 6907 — ME Code / Title 24-A / Chapter 87 / Section 6907
24-A §6907. Confidential records
Status: in_force

Except as provided in subsections 1 , 2 and 3 , information obtained by Dirigo Health under this chapter is a public record within the meaning of Title 1, chapter 13, subchapter 1 . [PL 2005, c. 615, §2 (AMD).]

1. Financial information. Any personally identifiable financial information, supporting data or tax return of any person obtained by Dirigo Health under this chapter is confidential. [PL 2023, c. 123, §5 (AMD).]

2. Health information. Health information obtained by Dirigo Health under this chapter that is covered by the federal Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, 110 Stat. 1936 or information covered by chapter 24 or Title 22, section 1711‑C is confidential. [PL 2023, c. 123, §6 (AMD).]

3. Practitioner-specific quality data. The confidentiality of practitioner-specific quality data is determined according to this subsection. A. Practitioner-specific quality data is confidential and may not be disclosed by the Maine Quality Forum prior to a determination of accuracy and completeness made under paragraph B . [PL 2005, c. 615, §3 (NEW).] B. Practitioner-specific quality data is not confidential after a determination of its accuracy and completeness is made by the Director of the Maine Quality Forum or a designee. [PL 2005, c. 615, §3 (NEW).] [PL 2005, c. 615, §3 (NEW).]
24-A M.R.S. § 3553 — ME Code / Title 24-A / Chapter 49 / Section 3553
24-A §3553. Emergency bylaws
Status: in_force

1. With the approval of the superintendent, any domestic organization may, at any time, adopt, in the same manner as in the case of ordinary bylaws, emergency bylaws to become operative during a period of acute emergency. Emergency bylaws may contain provisions with respect to the number of directors capable of acting which shall constitute its board, the number of such directors which shall constitute a quorum at a meeting of the board, the number of votes necessary for action by such board, the manner in which vacancies on the board shall be filled, the line of succession of its officers, and the interim management of the affairs of the insurance organization; such provisions, if approved by the superintendent, need not comply with the requirement of the charter of such domestic organization or of the insurance or incorporation laws of this State. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

2. Section 3554 and section 3555, subsections 2 to 6 shall not be applicable during a period of acute emergency to any domestic organization operating in accordance with and under emergency bylaws theretofore approved by the superintendent. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 7702 — ME Code / Title 24-A / Chapter 101 / Section 7702
24-A §7702. Home Resiliency Program
Status: in_force

1. Program established. The Home Resiliency Program is established within and under the direction of the bureau to provide grants to homeowners for the purpose of performing home resiliency projects. [PL 2025, c. 33, Pt. A, §1 (NEW).]

2. Home Resiliency Fund. The Home Resiliency Fund is established as a nonlapsing Other Special Revenue Funds account administered by the bureau for the purposes of funding the program. The bureau may transfer available balances from other bureau accounts to the fund, and the fund may receive money from any gift, grant, contribution, legislative appropriation, allocation or transfer or bond proceeds. The money in the fund may be used only for the purpose of awarding grants under the program and paying the costs of the administration of the program. [PL 2025, c. 33, Pt. A, §1 (NEW).]

3. Program administration. The bureau may contract with other entities for the administration of the program and other services, including, but not limited to: A. Promotion of the program, including the creation and maintenance of a publicly accessible website containing information about the program; [PL 2025, c. 33, Pt. A, §1 (NEW).] B. Development of an application form; [PL 2025, c. 33, Pt. A, §1 (NEW).] C. Verification of applicant eligibility; [PL 2025, c. 33, Pt. A, §1 (NEW).] D. Determination and distribution of grants; [PL 2025, c. 33, Pt. A, §1 (NEW).] E. Establishment of standards for project completion, including contractor approval; [PL 2025, c. 33, Pt. A, §1 (NEW).] F. Verification of project completion; [PL 2025, c. 33, Pt. A, §1 (NEW).] G. Development of a mechanism for the return of unused grant money; [PL 2025, c. 33, Pt. A, §1 (NEW).] H. Development of a list of home resiliency projects that would be eligible for a grant; and [PL 2025, c. 33, Pt. A, §1 (NEW).] I. Development of standards to be used to determine whether a home resiliency project has been completed satisfactorily. [PL 2025, c. 33, Pt. A, §1 (NEW).] [PL 2025, c. 33, Pt. A, §1 (NEW).]

4. Program eligibility. An individual is eligible for a grant if the individual: A. Has not previously received a grant under the program; [PL 2025, c. 33, Pt. A, §1 (NEW).] B. Submits an application on a form approved by the administrator; [PL 2025, c. 33, Pt. A, §1 (NEW).] C. In the application submitted under paragraph B , designates a home resiliency project from the list approved pursuant to subsection 5 to be performed on a home: (1) Owned by the applicant; (2) In which the applicant resides as the applicant's permanent residence; and (3) That was not the subject of a previous home resiliency project; and [PL 2025, c. 33, Pt. A, §1 (NEW).] D. Submits all information regarding the individual, the individual's home and the proposed home resiliency project as required by the bureau and the administrator. [PL 2025, c. 33, Pt. A, §1 (NEW).] [PL 2025, c. 33, Pt. A, §1 (NEW).]

5. Home resiliency projects; list. The bureau and the administrator of the project shall approve a list of prospective projects eligible for grants under the program. The administrator shall publish the list of approved prospective home resiliency projects in the promotional materials for the program and on the publicly accessible website maintained to promote the program. [PL 2025, c. 33, Pt. A, §1 (NEW).]

6. Grant determination. The bureau may establish 2 or more tiers of eligibility based on factors that reflect the income or financial means of the applicant. The bureau shall set maximum grant amounts and, if income or financial means tiers are established, shall set the maximum grant amounts for each tier. The administrator shall make grants under the program to eligible persons. The administrator shall review applications in the order in which they are received. An application is considered received when all required information has been submitted. The administrator shall award grants under the program until funds in the fund are exhausted. [PL 2025, c. 33, Pt. A, §1 (NEW).]

7. Post-grant verification. The recipient of a grant under the program shall provide to the administrator information that is required by the administrator and that is sufficient to allow the administrator to verify that the home resiliency project has been completed within the standards developed under subsection 3 for home resiliency project completion within 2 years of the grant. The recipient of a grant shall return to the administrator any funds provided to the recipient but not used for the approved project. [PL 2025, c. 33, Pt. A, §1 (NEW).]

8. No private right of action. This chapter does not provide an express or implied private right of action. [PL 2025, c. 33, Pt. A, §1 (NEW).]

9. Rulemaking. The superintendent may adopt rules necessary to implement the program. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2025, c. 33, Pt. A, §1 (NEW).]
24-A M.R.S. § 2220 — ME Code / Title 24-A / Chapter 24 / Section 2220
24-A §2220. Rulemaking
Status: in_force

The superintendent may adopt rules to carry out the purposes of this chapter and the privacy protection provisions of the federal Gramm-Leach-Bliley Act, 15 United States Code, Section 6801 et seq. (1999). Rules adopted pursuant to this chapter are routine technical rules as defined by Title 5, chapter 375, subchapter II‑A . [PL 2001, c. 262, Pt. C, §3 (AMD).]
24-A M.R.S. § 4120 — ME Code / Title 24-A / Chapter 55 / Section 4120
24-A §4120. Life benefit certificate provisions, standard and prohibited
Status: in_force

A life benefit certificate may not be delivered or issued for delivery in this State unless a copy of the form has been filed with the superintendent and approved by the superintendent as conforming to the requirements of this section and not inconsistent with any other provisions of law applicable thereto. For each such form filing, the society shall pay the superintendent a fee that must be the same as for an insurer, as provided in section 601 . A certificate is deemed approved unless disapproved by the superintendent within 60 days from the date of that filing. [RR 2021, c. 1, Pt. B, §328 (COR).]

1. The certificate shall contain in substance the following standard provisions or, in lieu thereof, provisions which are more favorable to the member: A. Title on the face and filing page of the certificate clearly and correctly describing its form; [PL 1969, c. 132, §1 (NEW).] B. A provision stating the amount of rates, premiums or other required contributions, by whatever name known, which are payable by the insured under the certificate; [PL 1969, c. 132, §1 (NEW).] C. A provision that the member is entitled to a grace period of not less than a full month, or 30 days at the option of the society, in which the payment of any premium after the first may be made. During such grace period the certificate shall continue in full force, but in case the certificate becomes a claim during the grace period before the overdue payment is made, the amount of such overdue payment or payments may be deducted in any settlement under the certificate; [PL 1969, c. 132, §1 (NEW).] D. A provision that the member shall be entitled to have the certificate reinstated at any time within 3 years from the due date of the premium in default, unless the certificate has been completely terminated through the application of a nonforfeiture benefit, cash surrender value or certificate loan, upon the production of evidence of insurability satisfactory to the society and the payment of all overdue premiums with interest at a rate not exceeding 6% per annum compounded annually, and the payment or reinstatement of any other indebtedness to the society upon the certificate with interest at a rate determined under the terms of the certificate in accordance with sections 2552 to 2554 ; [PL 1981, c. 188, §5 (AMD).] E. Except in the case of pure endowment, annuity or reversionary annuity contracts, reducing term insurance contracts, or contracts of term insurance of uniform amount of 15 years or less expiring before age 66, a provision that, in the event of default in payment of any premium after 3 full years' premiums have been paid or after premiums for a lesser period have been paid if the contract so provides, the society will grant, upon proper request not later than 60 days after the due date of the premium in default, a paid-up nonforfeiture benefit on the plan stipulated in the certificate, effective as of such due date, of such value as specified in this chapter. The certificate may provide, if the society's laws so specify or if the member shall so elect prior to the expiration of the grace period of any overdue premium, that default shall not occur so long as premiums can be paid under the provisions of an arrangement for automatic premium loan as may be set forth in the certificate; [PL 1969, c. 132, §1 (NEW).] F. A provision that one paid-up nonforfeiture benefit as specified in the certificate shall become effective automatically unless the member elects another available paid-up nonforfeiture benefit, not later than 60 days after the due date of the premium in default; [PL 1969, c. 132, §1 (NEW).] G. A statement of the mortality table and rate of interest used in determining all paid-up nonforfeiture benefits and cash surrender options available under the certificate, and a brief general statement of the method used in calculating such benefits; [PL 1969, c. 132, §1 (NEW).] H. A table showing in figures the value of every paid-up nonforfeiture benefit and cash surrender option available under the certificate for each certificate anniversary either during the first 20 certificate years or during the term of the certificate whichever is shorter; [PL 1969, c. 132, §1 (NEW).] I. A provision that the certificate shall be incontestable after it has been in force during the lifetime of the member for a period of 2 years from its date of issue except for nonpayment of premiums, violation of the provisions of the certificate relating to military, aviation or naval service and violation of the provisions relating to suspension or expulsion as substantially set forth in the certificate. At the option of the society, supplemental provisions relating to benefits in the event of temporary or permanent disability or hospitalization and provisions which grant additional insurance specifically against death by accident or accidental means may also be excepted. The certificate shall be incontestable on the ground of suicide after it has been in force during the lifetime of the member for a period of 2 years from date of issue. The certificate may provide, as to statements made to procure reinstatement, that the society shall have the right to contest a reinstated certificate within a period of 2 years from date of reinstatement with the same exceptions as herein provided; [PL 1969, c. 132, §1 (NEW).] J. A provision that in case the age or sex of the member or of any other person is considered in determining the premium and it is found at any time before final settlement under the certificate that the age or sex has been misstated, and the discrepancy and premium involved have not been adjusted, the amount payable shall be such as the premium would have purchased at the correct age and sex; but if the correct age or sex was not an insurable age or sex under the society's charter or laws, only the premiums paid to the society, less any payments previously made to the member, shall be returned or, at the option of the society, the amount payable under the certificate shall be such as the premium would have purchased at the correct age and sex according to the society's promulgated rates and any extension thereof based on actuarial principles; [PL 1969, c. 132, §1 (NEW).] K. A provision or provisions which recite fully, or which set forth the substance of, all sections of the charter, constitution, laws, rules or regulations of the society, in force at the time of issuance of the certificate, the violation of which will result in the termination of, or in the reduction of, the benefit or benefits payable under the certificate; and [PL 1969, c. 132, §1 (NEW).] L. If the constitution or laws of the society provide for expulsion or suspension of a member, any member so expelled or suspended, except for nonpayment of a premium or within the contestable period for material misrepresentations in such member's application for membership, must have the privilege of maintaining the member's insurance in force by continuing payment of the required premium. [RR 2015, c. 1, §30 (COR).] Any of the foregoing provisions or portions thereof not applicable by reason of the plan of insurance or because the certificate is an annuity certificate may to the extent inapplicable be omitted from the certificate. [RR 2015, c. 1, §30 (COR).]

2. No life benefit certificate may be delivered or issued for delivery in this State containing in substance any of the following provisions: A. Any provision limiting the time within which any action at law or in equity may be commenced to less than 2 years after the cause of action shall accrue; [PL 1969, c. 132, §1 (NEW).] B. Any provision by which the certificate shall purport to be issued or to take effect more than 6 months before the original application for the certificate was made, except in case of transfer from one form of certificate to another in connection with which the member is to receive credit for any reserve accumulation under the form of certificate from which the transfer is made; [PL 1989, c. 176, §7 (AMD).] C. Any provision for forfeiture of the certificate for failure to repay any loan thereon or to pay interest on such loan while the total indebtedness, including interest, is less than the loan value of the certificate; or [PL 1989, c. 176, §7 (AMD).] D. Any provision providing more restrictive coverage or excluding coverage for death resulting from Acquired Immune Deficiency Syndrome (AIDS), AIDS Related Complex (ARC) or HIV related diseases except this provision shall not apply to death by accident or accidental means. [PL 1989, c. 176, §7 (NEW).] [PL 1989, c. 176, §7 (AMD).]

3. The word "premiums" as used in this chapter means premiums, rates or other required contributions by whatever name known. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2472 — ME Code / Title 24-A / Chapter 28 / Section 2472
24-A §2472. Interstate Insurance Product Regulation Compact established; purposes
Status: in_force

1. Compact established. Pursuant to terms and conditions of this chapter, the State seeks to join with other states and establish the Interstate Insurance Product Regulation Compact, referred to in this chapter as "the compact," and thus become a member of the Interstate Insurance Product Regulation Commission. The superintendent is designated to serve as the representative of this State to the commission. [PL 2003, c. 680, §1 (NEW).]

2. Purposes. The purposes of this compact are, through means of joint and cooperative action among the compacting states: A. To promote and protect the interest of consumers of individual and group annuity, life, disability income and long-term care insurance products; [PL 2003, c. 680, §1 (NEW).] B. To develop uniform standards for insurance products covered under the compact; [PL 2003, c. 680, §1 (NEW).] C. To establish a central clearinghouse to receive and provide prompt review of insurance products covered under the compact and, in certain cases, advertisements related thereto, submitted by insurers authorized to do business in one or more compacting states; [PL 2003, c. 680, §1 (NEW).] D. To give appropriate regulatory approval to those product filings and advertisements satisfying the applicable uniform standard; [PL 2003, c. 680, §1 (NEW).] E. To improve coordination of regulatory resources and expertise between state insurance departments regarding the setting of uniform standards and review of insurance products covered under the compact; [PL 2003, c. 680, §1 (NEW).] F. To create the Interstate Insurance Product Regulation Commission; and [PL 2003, c. 680, §1 (NEW).] G. To perform these and such other related functions as may be consistent with the state regulation of the business of insurance. [PL 2003, c. 680, §1 (NEW).] [PL 2003, c. 680, §1 (NEW).]
24-A M.R.S. § 2434 — ME Code / Title 24-A / Chapter 27 / Section 2434
24-A §2434. Suits against foreign insurers
Status: in_force

Any person having a claim against any foreign insurer may bring a trustee action or any other appropriate action therefor in the courts of this State. Service of process upon such an insurer must be made as provided in section 421 . [PL 1997, c. 457, §43 (AMD).]
24-A M.R.S. § 2882 — ME Code / Title 24-A / Chapter 38 / Section 2882
24-A §2882. Insurers authorized to sell legal services insurance
Status: in_force

Upon application to an approval by the superintendent, an insurer incorporated by or under the laws of this State or any foreign or alien insurance company duly licensed to transact insurance in its state of domicile may make application for a certificate of authority to transact the business of legal services insurance, including reinsurance, in this State, if that company is authorized or qualified to be authorized to transact a health insurance business in this State. [PL 1983, c. 801, §11 (NEW).]
24-A M.R.S. § 2159-C — ME Code / Title 24-A / Chapter 23 / Section 2159-C
24-A §2159-C. Discrimination on the basis of genetic information or testing
Status: in_force

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Genetic characteristic" means any inherited gene or chromosome, or alteration of a gene or chromosome, that is scientifically or medically believed to predispose an individual to a disease, disorder or syndrome or to be associated with a statistically significant increased risk of development of a disease, disorder or syndrome. [PL 1997, c. 677, §2 (NEW).] B. "Genetic information" means the information concerning genes, gene products or inherited characteristics that may be obtained from an individual or family member. [PL 1997, c. 677, §2 (NEW).] C. "Genetic test" means a test for determining the presence or absence of an inherited genetic characteristic in an individual, including tests of nucleic acids, such as deoxyribonucleic acid, or DNA, ribonucleic acid, or RNA, or mitochondrial DNA, and tests of chromosomes or proteins in order to identify a predisposing genetic characteristic. [PL 1997, c. 677, §2 (NEW).] D. "Carrier" means an insurer, nonprofit hospital and medical service organization or health maintenance organization. [PL 2009, c. 244, Pt. D, §1 (NEW).] [PL 2009, c. 244, Pt. D, §1 (AMD).]

2. Discrimination in health, hospital and dental insurance. A carrier that issues individual or group hospital, health or dental insurance is subject to the requirements of this subsection. This subsection does not apply to accidental injury, specified disease, hospital indemnity, disability, long-term care and other limited benefit health insurance policies and contracts. A. A carrier may not discriminate against an individual or eligible dependent on the basis of genetic information or the refusal to submit to a genetic test or make available the results of a genetic test or on the basis that the individual or eligible dependent received a genetic test or genetic counseling in the issuance, withholding, extension or renewal of any hospital confinement or other health insurance, as defined by the superintendent, by rule, or in the fixing of the rates, terms or conditions for insurance, or in the issuance or acceptance of any application for insurance. [PL 2009, c. 244, Pt. D, §2 (NEW).] B. Except as provided in this paragraph, a carrier may not request or require an individual to undergo a genetic test. (1) Nothing in this subsection limits the authority of a health care professional who is providing health care services to an individual to request that that individual undergo a genetic test. (2) A carrier may request, but not require, that an individual undergo a genetic test if the conditions described in this subparagraph are met: (a) The request is made pursuant to research that complies with 45 Code of Federal Regulations, Part 46 or equivalent federal regulations and any applicable state or local laws, rules or regulations for the protection of human subjects in research; (b) The carrier clearly indicates to the individual to whom the request is made, or in the case of a minor child to the legal guardian of the individual, that compliance with the request is voluntary and noncompliance will have no effect on enrollment status or premium or contribution amounts; (c) Genetic information collected or acquired under this subparagraph is not used for purposes of determining eligibility for benefits, computing premium or contribution amounts, applying any preexisting condition exclusion or any other activities related to the creation, renewal or replacement of a health insurance contract; and (d) The carrier complies with all applicable federal laws and regulations. [PL 2009, c. 244, Pt. D, §2 (NEW).] C. A carrier may not request, require or purchase genetic information for purposes of determining eligibility for benefits, computing premium or contribution amounts, applying any preexisting condition exclusion or any other activities related to the creation, renewal or replacement of a health insurance contract. [PL 2009, c. 244, Pt. D, §2 (NEW).] D. A carrier may not request, require or purchase genetic information with respect to an individual prior to the individual's enrollment under the plan or coverage in connection with the enrollment. [PL 2009, c. 244, Pt. D, §2 (NEW).] E. If a carrier obtains genetic information incidental to the requesting, requiring or purchasing of other information concerning an individual, the request, requirement or purchase is not considered a violation of paragraph D if the request, requirement or purchase is not in violation of paragraph C . [PL 2009, c. 244, Pt. D, §2 (NEW).] F. A reference in this subsection to genetic information concerning an individual includes: (1) With respect to an individual who is a pregnant woman, genetic information of any fetus carried by that individual; and (2) With respect to an individual using an assisted reproductive technology, genetic information of any embryo legally held by the individual. [PL 2009, c. 244, Pt. D, §2 (NEW).] [PL 2009, c. 244, Pt. D, §2 (RPR).]

3. Discrimination in life, disability and long-term care insurance. An insurer may not make or permit any unfair discrimination against an individual in the application of genetic information or the results of a genetic test in the issuance, withholding, extension or renewal of an insurance policy for life, credit life, disability, long-term care, accidental injury, specified disease, hospital indemnity or credit accident insurance or an annuity. For the purposes of this subsection, "unfair discrimination" includes, but is not limited to, the application of the results of a genetic test in a manner that is not reasonably related to anticipated claims experience. A. If the superintendent has reason to believe that unfair discrimination has occurred and that a proceeding by the superintendent is in the interest of the public, the superintendent, in accordance with chapter 3 , shall serve upon the insurer a statement of the charges. Upon a determination that the practice or act of the insurer is in conflict with this subsection, the superintendent shall issue an order requiring the insurer to cease and desist from engaging in the practice or act and may order payment of a penalty consistent with the provisions of section 12‑A . [PL 1997, c. 677, §2 (NEW).] B. If, in the issuance, withholding, extension or renewal of an insurance policy covered by this subsection, an insurer uses the results of a genetic test in compliance with this subsection, the insurer shall notify the individual who is the subject of the genetic test that such a test is required and shall obtain the individual's authorization in accordance with the requirements of chapter 24 . If a genetic test is required, the insurer shall ensure that the individual states in writing whether the individual wishes to be informed of the test results and, if authorized by the individual, shall provide a copy of the test results, along with a written interpretation of the results by a qualified professional, to the individual or to a physician or other health care practitioner designated by the individual. [PL 1997, c. 677, §2 (NEW).] [PL 1997, c. 677, §2 (NEW).]

4. Use of information obtained through direct-to-consumer genetic testing. In connection with the issuance, withholding, extension or renewal of an insurance policy for life, credit life, disability, long-term care, accidental injury, specified disease, hospital indemnity or credit accident insurance or an annuity, an insurer may not request, require, purchase or use information obtained from an entity providing direct-to-consumer genetic testing without the informed written consent of the individual who has been tested. [PL 2019, c. 208, §1 (NEW).]
24-A M.R.S. § 2159-F — ME Code / Title 24-A / Chapter 23 / Section 2159-F
24-A §2159-F. Discrimination in medical malpractice insurance based solely on legally protected health care activity
Status: in_force

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Adverse action" means revocation, suspension or other disciplinary action against a health care professional's license. [PL 2023, c. 345, §1 (NEW).] B. [PL 2023, c. 648, Pt. E, §3 (RP).] C. "Aid and assist legally protected health care activity" and "aiding and assisting legally protected health care activity" have the same meanings as in Title 14, section 9002, subsection 1 . [PL 2023, c. 648, Pt. E, §3 (NEW).] D. "Legally protected health care activity" has the same meaning as in Title 14, section 9002, subsection 8 . [PL 2023, c. 648, Pt. E, §3 (NEW).] [PL 2023, c. 648, Pt. E, §3 (AMD).]

2. Discrimination prohibited. An insurer that provides medical malpractice insurance in this State may not refuse to issue or renew coverage, cancel or restrict coverage, impose any sanctions, fines, penalties or rate increases or require the payment of additional charges by a health care professional who engages in legally protected health care activity or aids and assists legally protected health care activity on the sole basis that the health care professional is acting in violation of another state's law related to legally protected health care activity or aiding and assisting legally protected health care activity or is subject to an adverse action against the health care professional's license in another state for a violation of that state's law related to legally protected health care activity or aiding and assisting legally protected health care activity. [PL 2023, c. 648, Pt. E, §3 (AMD).]

3. Action based on adverse action in another state prohibited. An insurer that provides medical malpractice insurance in this State may not refuse to issue or renew coverage, cancel or restrict coverage or require the payment of additional charges by a health care professional who engages in legally protected health care activity or aids and assists legally protected health care activity as a result of an adverse action against the health care professional's license in another state if the adverse action is solely based on a violation of the other state's law related to legally protected health care activity or aiding and assisting legally protected health care activity. [PL 2023, c. 648, Pt. E, §3 (AMD).]
24-A M.R.S. § 6454 — ME Code / Title 24-A / Chapter 79 / Section 6454
24-A §6454. Regulatory action level event
Status: in_force

1. Regulatory action level event; defined. "Regulatory action level event" means, with respect to any insurer, any of the following events: A. The filing of a risk-based capital report by the insurer that indicates that the insurer's total adjusted capital is greater than or equal to its authorized control level risk-based capital but less than its regulatory action level risk-based capital; [PL 1993, c. 634, Pt. A, §1 (NEW).] B. Provided the insurer does not challenge the adjusted risk-based capital report under section 6457 , the notification by the superintendent to an insurer of an adjusted risk-based capital report that indicates the event in paragraph A ; [PL 1993, c. 634, Pt. A, §1 (NEW).] C. If the insurer, under section 6457 , challenges an adjusted risk-based capital report that indicates the event in paragraph A , the notification by the superintendent to the insurer that the superintendent has, after a hearing, rejected the insurer's challenge; [PL 1993, c. 634, Pt. A, §1 (NEW).] D. The failure of the insurer to file a risk-based capital report by the filing date, unless the insurer has provided an explanation for the failure that is satisfactory to the superintendent and has cured the failure within 10 days after the filing date; [PL 1993, c. 634, Pt. A, §1 (NEW).] E. The failure of the insurer to submit a risk-based capital plan to the superintendent within the time period set forth in section 6453, subsection 3 ; [PL 1993, c. 634, Pt. A, §1 (NEW).] F. Provided the insurer has not challenged the determination under section 6457 , the notification by the superintendent to the insurer that: (1) The risk-based capital plan or revised risk-based capital plan submitted by the insurer is, in the judgment of the superintendent, unsatisfactory; and (2) The superintendent's finding unless vacated or stayed constitutes a regulatory action level event with respect to the insurer; [PL 1999, c. 113, §28 (AMD).] G. If the insurer, under section 6457 , challenges a determination by the superintendent under paragraph F , the notification by the superintendent to the insurer that the superintendent has, after a hearing, rejected that challenge; [PL 1993, c. 634, Pt. A, §1 (NEW).] H. Provided the insurer has not challenged the determination under section 6457 , the notification by the superintendent to the insurer that the insurer has failed to adhere to its risk-based capital plan or revised risk-based capital plan, but only if that failure has a substantial adverse effect on the ability of the insurer to eliminate the company action level event or regulatory action level event in accordance with its risk-based capital plan or revised risk-based capital plan and the superintendent has so stated in the notification; or [PL 1999, c. 113, §28 (AMD).] I. If the insurer, under section 6457 , challenges a determination by the superintendent under paragraph H , the notification by the superintendent to the insurer that the superintendent has, after a hearing, rejected the challenge unless the failure of the insurer to adhere to its risk-based capital plan or revised risk-based capital plan has no substantial adverse effect on the ability of the insurer to eliminate the company action level event or regulatory action level event with respect to the insurer. [PL 1999, c. 113, §28 (AMD).] [PL 1999, c. 113, §28 (AMD).]

2. Superintendent duties; regulatory action level event. When a regulatory action level event occurs, the superintendent shall: A. Require the insurer to submit a risk-based capital plan or, if applicable, a revised risk-based capital plan; [PL 1993, c. 634, Pt. A, §1 (NEW).] B. Perform such examination or analysis as the superintendent considers necessary of the assets, liabilities and operations of the insurer, including a review of its risk-based capital plan or revised risk-based capital plan; and [PL 1993, c. 634, Pt. A, §1 (NEW).] C. Subsequent to the examination or analysis, issue a corrective order specifying corrective actions that the superintendent considers necessary. [PL 1993, c. 634, Pt. A, §1 (NEW).] [PL 1993, c. 634, Pt. A, §1 (NEW).]

3. Determination of corrective actions. In determining corrective actions, the superintendent may take into account those factors that the superintendent considers relevant with respect to the insurer based upon the superintendent's examination or analysis of the assets, liabilities and operations of the insurer, including, but not limited to, the results of any sensitivity tests undertaken pursuant to the risk-based capital instructions. The risk-based capital plan or revised risk-based capital plan must be submitted: A. Within 45 days after the occurrence of the regulatory action level event; [PL 1993, c. 634, Pt. A, §1 (NEW).] B. If the insurer challenges an adjusted risk-based capital report under section 6457 and the challenge is not, in the judgment of the superintendent, frivolous, within 45 days after the notification to the insurer that the superintendent has, after a hearing, rejected the insurer's challenge; or [PL 1993, c. 634, Pt. A, §1 (NEW).] C. If the insurer challenges a revised risk-based capital plan under section 6457 , within 45 days after notification to the insurer that the superintendent has, after a hearing, rejected the insurer's challenge. [PL 1993, c. 634, Pt. A, §1 (NEW).] [PL 1993, c. 634, Pt. A, §1 (NEW).]

4. Consultants. The superintendent may retain actuaries, investment experts and other consultants as may be necessary in the judgment of the superintendent to review the insurer's risk-based capital plan or revised risk-based capital plan; examine or analyze the assets, liabilities and operations of the insurer; and formulate the corrective order with respect to the insurer. For insurers offering managed care plans as defined in section 4301‑A , the analysis of the insurer's operations may include an analysis of its contractual relationships with providers and the ability of the providers to fulfill their contractual obligations. The fees, costs and expenses relating to consultants must be borne by the affected insurer or such other party as directed by the superintendent. [RR 2001, c. 1, §38 (COR).]
24-A M.R.S. § 6603 — ME Code / Title 24-A / Chapter 81 / Section 6603
24-A §6603. General eligibility
Status: in_force

This section governs all multiple-employer welfare arrangements except for those offered by a registered employee leasing company complying with the requirements of section 6603‑A . [PL 1995, c. 618, §6 (NEW).]

1. Requirements for approval. To meet the requirements for approval and to maintain a multiple-employer welfare arrangement, an arrangement: A. Must be nonprofit; [PL 1993, c. 688, §1 (NEW).] B. Must be established by a trade association; industry association; association with employer members representing multiple trades, industries or professions; political subdivision of the State; religious organization; or professional association of employers or professionals that has a constitution or bylaws and that has been organized and maintained in good faith for a continuous period of one year for purposes other than that of obtaining or providing insurance; [PL 2019, c. 96, §2 (AMD).] C. Must be operated pursuant to a trust agreement by a board of trustees that has complete fiscal control over the arrangement and that is responsible for all operations of the arrangement. The trustees selected must be owners, partners, officers, directors or employees of one or more employers in the arrangement. A trustee may not be an owner, officer or employee of the administrator or service company of the arrangement. The trustees have the authority to approve applications of association members for participation in the arrangement and to contract with a licensed administrator or service company to administer the day-to-day affairs of the arrangement; [PL 2003, c. 374, §1 (AMD).] D. May not be offered, advertised or available to employers or other members of the public generally; [PL 2019, c. 96, §2 (AMD).] E. Must be operated in accordance with sound actuarial principles; [PL 1993, c. 688, §1 (NEW).] F. Must comply with the requirements of chapter 36 , governing continuity of health insurance coverage; [PL 1993, c. 688, §1 (NEW).] F-1. Must comply with the requirements of section 2809‑A, subsection 11 , concerning continued coverage in the event of an employee's being temporarily laid off or losing employment because of an injury or disease that the employee claims to be compensable under workers' compensation; [PL 2005, c. 121, Pt. A, §1 (NEW).] G. May not deny coverage to any otherwise eligible employer, employee or dependent on the basis of health status or claims experience; and [PL 1993, c. 688, §1 (NEW).] H. May issue only health care benefit plans that comply with the requirements of section 2808‑B with regard to rating practices, coverage for late enrollees and guaranteed renewal. An arrangement may not provide health care benefits that do not meet or exceed the requirements for mandated benefits applicable to comparable insured plans. [PL 2001, c. 410, Pt. A, §9 (AMD).] [PL 2019, c. 96, §2 (AMD).]

1-A. Eligibility based on geographic association. [PL 2019, c. 96, §3 (RP).]

2. Evidence of benefits; issuance to covered employee. The arrangement shall issue to each covered employee a contract, certificate, summary plan description or other evidence of the benefits and coverages provided. This evidence of the benefits and coverages provided must contain in boldface print in a conspicuous location the following statement: "The benefits and coverages described herein are provided through a trust fund established and funded by a group of employers." Arrangements in existence before October 1, 1993 that have previously issued benefit descriptions to employees may meet the disclosure requirements under this chapter by issuing to each employee additional written material necessary to meet the requirements of this subsection. [PL 1993, c. 688, §1 (NEW).]

3. Maintenance of specific excess insurance. Each arrangement shall maintain specific excess insurance with a retention level determined in accordance with sound actuarial principles and approved by the superintendent. The superintendent may also require the arrangement to purchase aggregate excess insurance. [PL 1993, c. 688, §1 (NEW).]

4. Maintenance of appropriate loss reserves. Each arrangement shall establish and maintain appropriate loss and loss expense reserves determined in accordance with sound actuarial principles and shall fund obligations by depositing assets that will yield in a time frame matching maturing liabilities of the arrangement sufficient funds to discharge claims and other expense payments. [PL 1993, c. 688, §1 (NEW).]

5. Funds held in trust. All funds of a multiple-employer welfare arrangement must be held in trust in this State in the name of the arrangement in a qualified financial institution by state or federally chartered financial institutions until such time as they are disbursed. [PL 2003, c. 374, §2 (AMD).]

6. Replacement of trustee. The superintendent may not grant or continue approval until the arrangement replaces any trustee found by the superintendent: A. To be incompetent, untrustworthy or financially irresponsible; [PL 1993, c. 688, §1 (NEW).] B. To be guilty of or to have pled guilty or no contest in any state or country to a criminal offense for which incarceration for one year or more may be imposed or for which incarceration of one year or more could be imposed had the offense occurred in this State, or that involves moral turpitude, dishonesty, false statement or misappropriation or conversion of property or funds; [PL 1993, c. 688, §1 (NEW).] C. To have had any type of insurance license revoked in this State or any other state; or [PL 1993, c. 688, §1 (NEW).] D. To have improperly manipulated assets, accounts or specific excess insurance or to have otherwise acted in bad faith. [PL 1993, c. 688, §1 (NEW).] [PL 1993, c. 688, §1 (NEW).]

7. Contracts available for inspection. To qualify for and retain approval to transact business, an arrangement must make all contracts with administrators or service companies available for inspection by the bureau initially and thereafter upon reasonable notice. [PL 1993, c. 688, §1 (NEW).]

8. Suspension or revocation of approval. Failure to maintain compliance with applicable eligibility or filing requirements established by this section is grounds for suspension or revocation of authority of an arrangement. However, with respect to deficiencies other than an impairment, the arrangement has 60 days after notification by the superintendent to take action necessary to correct the deficiency. [PL 1993, c. 688, §1 (NEW).]

9. Access to health care services. [PL 2011, c. 90, Pt. F, §8 (RP).]
24-A M.R.S. § 4381 — ME Code / Title 24-A / Chapter 57 / Section 4381
24-A §4381. Offsets
Status: in_force

1. In all cases of mutual debts or mutual credits between the insurer and another person in connection with any action or proceeding under this chapter, credits and debts must be set off and the balance only allowed or paid, except as provided in subsection 2 . [PL 2023, c. 405, Pt. A, §94 (AMD).]

2. An offset is not allowed in favor of a person if: A. The obligation of the insurer to the person would not at the date of the entry of any liquidation order or otherwise, as provided in section 4376 , entitle the person to share as a claimant in the assets of the insurer; [PL 2023, c. 405, Pt. A, §94 (AMD).] B. The obligation of the insurer to the person was purchased by or transferred to the person with a view of its being used as an offset; or [PL 2023, c. 405, Pt. A, §94 (AMD).] C. The obligation of the person is to pay an assessment levied against the members of a mutual insurer, or against the subscribers of a reciprocal insurer, or is to pay a balance upon the subscription to the capital stock of a stock insurer. [PL 2023, c. 405, Pt. A, §94 (AMD).] [PL 2023, c. 405, Pt. A, §94 (AMD).]
24-A M.R.S. § 4247 — ME Code / Title 24-A / Chapter 56 / Section 4247
24-A §4247. Coverage for contraceptives (REALLOCATED FROM TITLE 24-A, SECTION 4245)
Status: in_force

(REALLOCATED FROM TITLE 24-A, SECTION 4245)

1. Coverage requirements. All health maintenance organization individual and group health contracts that provide coverage for prescription drugs or outpatient medical services must provide coverage for all prescription contraceptives, nonprescription oral hormonal contraceptives and nonprescription emergency contraceptives approved by the federal Food and Drug Administration or for outpatient contraceptive services in accordance with the requirements of this section. For purposes of this section, "outpatient contraceptive services" means consultations, examinations, procedures and medical services provided on an outpatient basis and related to the use of contraceptive methods to prevent an unintended pregnancy. This section may not be construed to apply to prescription drugs or devices that are designed to terminate a pregnancy. [PL 2025, c. 445, §10 (AMD); PL 2025, c. 445, §14 (AFF).]

2. Exclusion for religious employer. A religious employer may request and a health maintenance organization shall grant an exclusion under the policy or contract for the coverage required by this section if the required coverage conflicts with the religious employer's bona fide religious beliefs and practices. A religious employer that obtains an exclusion under this subsection shall provide prospective insureds and those individuals insured under its policy written notice of the exclusion. This section may not be construed as authorizing a health maintenance organization to exclude coverage for prescription drugs prescribed for reasons other than contraceptive purposes or for prescription contraception that is necessary to preserve the life or health of a covered person. For the purposes of this section, "religious employer" means an employer that is a church, convention or association of churches or an elementary or secondary school that is controlled, operated or principally supported by a church or by a convention or association of churches as defined in 26 United States Code, Section 3121 (w) (3) (A) and that qualifies as a tax-exempt organization under 26 United States Code, Section 501(c) (3). [RR 1999, c. 1, §37 (RAL).]

3. Application. The requirements of this section apply to all individual and group policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 2003, c. 517, Pt. B, §27 (NEW).]

4. Coverage of contraceptive supplies. Coverage required under this section must include coverage for contraceptive supplies in accordance with the following requirements. For purposes of this section, "contraceptive supplies" means all contraceptive drugs, devices and products approved by the federal Food and Drug Administration to prevent an unwanted pregnancy, including nonprescription oral hormonal contraceptives and nonprescription emergency contraceptives. A. Coverage must be provided without any deductible, coinsurance, copayment or other cost-sharing requirement. [PL 2021, c. 609, §4 (AMD); PL 2021, c. 609, §5 (AFF).] B. If the federal Food and Drug Administration has approved one or more therapeutic equivalents of a contraceptive supply, a health maintenance organization is not required to cover all those therapeutically equivalent versions in accordance with this subsection, as long as at least one is covered without any deductible, coinsurance, copayment or other cost-sharing requirement in accordance with this subsection. [PL 2021, c. 609, §4 (AMD); PL 2021, c. 609, §5 (AFF).] C. [PL 2021, c. 609, §4 (RP); PL 2021, c. 609, §5 (AFF).] D. Coverage must be provided for the furnishing or dispensing of prescribed contraceptive supplies and nonprescription oral hormonal contraceptive supplies intended to last for a 12-month period, which may be furnished or dispensed all at once or over the course of the 12 months at the discretion of the health care provider for prescribed contraceptive supplies. [PL 2025, c. 445, §11 (AMD); PL 2025, c. 445, §14 (AFF).] E. A prescription is not required to obtain a nonprescription oral hormonal contraceptive or nonprescription emergency contraceptive. [PL 2025, c. 445, §11 (NEW); PL 2025, c. 445, §14 (AFF).] F. A health maintenance organization shall establish mechanisms to ensure that an enrollee who seeks coverage for a nonprescription oral hormonal contraceptive or nonprescription emergency contraceptive at a pharmacy has the option to obtain the nonprescription oral hormonal contraceptive or nonprescription emergency contraceptive at the point of sale without payment of any cost-sharing amount or to make the purchase at the pharmacy counter through an out-of-pocket payment at the point of sale and submit a claim for reimbursement to the health maintenance organization. [PL 2025, c. 445, §11 (NEW); PL 2025, c. 445, §14 (AFF).] G. The superintendent shall monitor compliance with the requirements for coverage of nonprescription oral hormonal contraceptives and nonprescription emergency contraceptives and any rules adopted in accordance with subsection 5, including any complaints or barriers to implementation. [PL 2025, c. 445, §11 (NEW); PL 2025, c. 445, §14 (AFF).] [PL 2025, c. 445, §11 (AMD); PL 2025, c. 445, §14 (AFF).]

5. Rules. The superintendent may adopt rules as necessary to implement the requirements of this section, including rules related to mechanisms to ensure coverage for nonprescription oral hormonal contraceptives and nonprescription emergency contraceptives and rules regarding notice to enrollees about how to access coverage for nonprescription oral hormonal contraceptives and nonprescription emergency contraceptives. Rules adopted pursuant to this subsection are routine technical rules as described in Title 5, chapter 375, subchapter 2‑A . [PL 2025, c. 445, §12 (NEW); PL 2025, c. 445, §14 (AFF).]
24 M.R.S. § 2332-K — ME Code / Title 24 / Chapter 19 / Section 2332-K
24 §2332-K. Coverage for services of certified nurse practitioners; certified midwives; certified nurse midwives (REALLOCATED FROM TITLE 24, SECTION 2332-J)
Status: in_force

(REALLOCATED FROM TITLE 24, SECTION 2332-J)

1. Required coverage for services upon referral of primary care provider. A nonprofit hospital or a medical service organization that issues individual and group health care contracts shall provide coverage under those contracts for services performed by a certified nurse practitioner, certified midwife or certified nurse midwife to a patient who is referred to the certified nurse practitioner, certified midwife or certified nurse midwife by a primary care provider when those services are within the lawful scope of practice of the certified nurse practitioner, certified midwife or certified nurse midwife. [PL 2021, c. 79, §1 (AMD); PL 2021, c. 79, §6 (AFF).]

2. Required coverage for self-referred services. With respect to individual and group health care contracts that do not require the selection of a primary care provider, a nonprofit hospital or medical service organization shall provide coverage under those contracts for services performed by a certified nurse practitioner, certified midwife or certified nurse midwife when those services are covered services and when they are within the lawful scope of practice of the certified nurse practitioner, certified midwife or certified nurse midwife. [PL 2021, c. 79, §1 (AMD); PL 2021, c. 79, §6 (AFF).]

3. Limits; coinsurance; deductibles. Any contract that provides coverage for services under this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section. [RR 1999, c. 1, §30 (RAL).]

4. Application. The requirements of this section apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 2003, c. 517, Pt. B, §8 (NEW).]
24-A M.R.S. § 6802-A — ME Code / Title 24-A / Chapter 85 / Section 6802-A
24-A §6802-A. Definitions
Status: in_force

As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 2003, c. 636, §5 (NEW).]

1. Advertising. "Advertising" means any written, electronic or printed communication or any communication by means of recorded telephone messages or transmitted on radio, television, the Internet or a similar communications medium, including film strips, motion pictures and videos, published, disseminated, circulated or placed before the public, directly or indirectly, for the purpose of creating an interest in or inducing a person to sell a life insurance policy pursuant to a settlement contract. [PL 2003, c. 636, §5 (NEW).]

2. Business of settlements. "Business of settlements" means any activity involved in, but not limited to, the offering, solicitation, negotiation, procurement, effectuation, purchasing, financing, monitoring, tracking, underwriting, selling, transferring, assigning, pledging, hypothecating or in any other manner engaging in the business of settlement contracts. [PL 2003, c. 636, §5 (NEW).]

3. Chronically ill. "Chronically ill" means: A. Being unable to perform at least 2 activities of daily living, including, but not limited to, eating, moving from one place to another, bathing, dressing, voiding the bladder, eliminating the bowel or maintaining continence; [PL 2003, c. 636, §5 (NEW).] B. Requiring substantial supervision to protect the individual from threats to health and safety due to severe cognitive impairment; or [PL 2003, c. 636, §5 (NEW).] C. Having a level of disability similar to that described in paragraph A , as determined by the United States Secretary of Health and Human Services. [PL 2003, c. 636, §5 (NEW).] [PL 2003, c. 636, §5 (NEW).]

4. Financing entity. "Financing entity" means an underwriter, placement agent, lender, purchaser of securities, purchaser of a policy or certificate from a settlement provider, credit enhancer or any entity that has a direct ownership in a policy or certificate that is the subject of a settlement contract: A. Whose principal activity related to the transaction is providing funds to effect the settlement or purchase of one or more purchased policies or to provide credit enhancement; and [PL 2003, c. 636, §5 (NEW).] B. Who has an agreement in writing with one or more licensed settlement providers to finance the acquisition of settlement contracts or to provide stop loss insurance. [PL 2003, c. 636, §5 (NEW).] "Financing entity" does not include a nonaccredited investor. [PL 2003, c. 636, §5 (NEW).]

5. Financing transaction. "Financing transaction" means any transaction in which a licensed settlement provider obtains financing for the purchase, acquisition, transfer or other assignment of one or more settlement contracts or policies acquired pursuant to a settlement contract or interests therein, including, without limitation, any secured or unsecured financing, securitization transaction or securities offering, either registered or exempt from registration under federal and state securities law, or otherwise sells, assigns, transfers, pledges, hypothecates or otherwise disposes of a settlement contract or policy acquired pursuant to a settlement contract or interest therein. [PL 2003, c. 636, §5 (NEW).]

6. Fraudulent viatical or life settlement act. "Fraudulent viatical or life settlement act" includes: A. Acts or omissions committed by any person who, knowingly or with intent to defraud, for the purpose of depriving another of property or for pecuniary gain, commits, or permits its employees or its agents to engage in, acts including: (1) Presenting, causing to be presented or preparing with knowledge or belief that it will be presented to or by a settlement provider, settlement producer, financing entity, insurer, insurance producer or any other person false material information, or concealing material information, as part of, in support of or concerning a fact material to one or more of the following: (a) An application for the issuance of a settlement contract or insurance policy; (b) The underwriting of a settlement contract or insurance policy; (c) A claim for payment or benefit pursuant to a settlement contract or insurance policy; (d) Premiums paid on an insurance policy; (e) Payments and changes in ownership or beneficiary made in accordance with the terms of a settlement contract or insurance policy; (f) The reinstatement or conversion of an insurance policy; (g) The solicitation, offer, effectuation or sale of a settlement contract or insurance policy; (h) The issuance of written evidence of a settlement contract or insurance policy; or (i) A financing transaction; (2) Employing any device, scheme or artifice to defraud related to policies acquired pursuant to a settlement contract; (3) Entering into stranger-originated life insurance; or (4) Failing to disclose to the insurer when requested by the insurer that the prospective insured has undergone a life expectancy evaluation by any person other than the insurer or its authorized representatives in connection with the issuance of a policy; [PL 2007, c. 543, §1 (AMD).] B. In the furtherance of a fraud or to prevent the detection of a fraud committing or permitting one's employees or agents to: (1) Remove, conceal, alter, destroy or sequester from the superintendent the assets or records of a licensee or other person engaged in the business of settlements; (2) Misrepresent or conceal the financial condition of a licensee, financing entity, insurer or other person; (3) Transact the business of settlements in violation of laws requiring a license, certificate of authority or other legal authority for the transaction of the business of settlements; or (4) File with the superintendent or the chief insurance regulatory official of another jurisdiction a document containing false information or otherwise concealing information about a material fact from the superintendent; [PL 2003, c. 636, §5 (NEW).] C. Embezzlement, theft, misappropriation or conversion of money, funds, premiums, credits or other property of a settlement provider, insurer, insured, viator, insurance policyowner or any other person engaged in the business of settlements or insurance; [PL 2003, c. 636, §5 (NEW).] D. Recklessly entering into, brokering or otherwise dealing in a settlement contract, the subject of which is a life insurance policy that was obtained by presenting false information concerning any fact material to the policy or by concealing, for the purpose of misleading another, information concerning any fact material to the policy, when the viator or the viator's agent intended to defraud the policy's issuer. For the purposes of this paragraph, "recklessly" means engaging in conduct in consciously and clearly unjustifiable disregard of a substantial likelihood of the existence of the relevant facts or risks, such disregard involving a gross deviation from acceptable standards of conduct; [PL 2009, c. 376, §1 (AMD).] E. Attempting to commit; assisting, aiding or abetting in the commission of; or conspiring to commit the acts or omissions specified in this subsection; [PL 2009, c. 376, §1 (AMD).] F. Engaging in any transaction, practice or course of business by a person who knows or reasonably should have known that the intent was to avoid the notice requirements of this chapter; [PL 2009, c. 376, §1 (NEW).] G. With respect to a settlement producer, knowingly soliciting an offer from, effectuating a life settlement contract with or making a sale to any settlement provider, financing entity or related provider trust that is controlling, controlled by or under common control with the producer, unless this relationship is disclosed to the viator; [PL 2009, c. 376, §1 (NEW).] H. With respect to a settlement provider, knowingly entering into a settlement contract if anything of value will be paid to a settlement producer controlling, controlled by or under common control with the provider or the financing entity or related provider trust that is involved in the settlement contract, unless this relationship is disclosed to the viator; and [PL 2009, c. 376, §1 (NEW).] I. Any statement or representation to the applicant or policyholder in connection with the sale or financing of a life insurance policy to the effect that the insurance is free or without cost to the policyholder for any period of time, unless free coverage is provided in the policy in the manner described. [PL 2009, c. 376, §1 (NEW).] [PL 2009, c. 376, §1 (AMD).]

6-A. Life expectancy evaluation. "Life expectancy evaluation" means any evaluation of the number of months the insured under the life insurance policy to be settled can be expected to live, or of the probability that the insured will live beyond a specified date, considering medical records and appropriate experiential data. [PL 2009, c. 376, §2 (AMD).]

7. Policy. "Policy" means an individual or group policy, group certificate, contract or arrangement of life insurance affecting the rights of a resident of this State or bearing a reasonable relation to this State, regardless of whether delivered or issued for delivery in this State. [PL 2003, c. 636, §5 (NEW).]

8. Related provider trust. "Related provider trust" means a titling trust or other trust established by a licensed settlement provider or a financing entity for the sole purpose of holding the ownership or beneficial interest in purchased policies in connection with a financing transaction. The trust must have a written agreement with the licensed settlement provider under which the licensed settlement provider is responsible for ensuring compliance with all statutory and regulatory requirements and under which the trust agrees to make all records and files related to settlement transactions available to the superintendent as if those records and files were maintained directly by the licensed settlement provider. [PL 2003, c. 636, §5 (NEW).]

9. Settlement contract. [PL 2007, c. 543, §3 (RP).]

9-A. Settlement contract. "Settlement contract" means an agreement between a viator and a settlement provider establishing the terms under which compensation or anything of value will be paid, which compensation or value is less than the expected death benefit of the insurance policy or certificate, in return for the viator's assignment, transfer, sale, devise or bequest of the death benefit or ownership of any portion of the insurance policy or certificate of insurance. "Settlement contract" includes the transfer for compensation or value of ownership or beneficial interest in a trust or other entity that owns such policy if the trust or other entity was formed or availed of for the principal purpose of acquiring one or more life insurance contracts, which life insurance contract insures the life of a person residing in this State. "Settlement contract" includes a premium finance loan made for a life insurance policy by a lender to a viator on or before the date of issuance of the policy when the viator or the insured receives on the date of the premium finance loan a guarantee of a future settlement value of the policy or when the viator or the insured agrees on the date of the premium finance loan to sell the policy or any portion of its death benefit on any date following the issuance of the policy. "Settlement contract" does not include: A. A policy loan or accelerated death benefit made by the insurer pursuant to the policy's terms; [PL 2007, c. 543, §4 (NEW).] B. A collateral assignment of a policy by the owner of the policy, unless the assignee knows or reasonably expects that the owner does not intend to repay the loan; [PL 2009, c. 376, §3 (AMD).] C. Loan proceeds that are used solely to pay: (1) Premiums for the policy; and (2) The costs of the loan, including, without limitation, interest, arrangement fees, utilization fees and similar fees, closing costs, legal fees and expenses, trustee fees and expenses and 3rd-party collateral provider fees and expenses, including fees payable to letter of credit issuers; [PL 2007, c. 543, §4 (NEW).] D. A loan made by a bank or other licensed financial institution in which the lender takes an interest in a life insurance policy solely to secure repayment of a loan or, if there is a default on the loan and the policy is transferred, the transfer of such a policy by the lender, as long as neither the default itself nor the transfer of the policy in connection with such default is pursuant to an agreement or understanding with any other person for the purpose of evading regulation under this chapter; [PL 2007, c. 543, §4 (NEW).] E. Unless the premium finance loan otherwise constitutes a settlement contract under this subsection, a loan made by a lender that does not violate Title 9‑A, Article 2 ; [PL 2007, c. 543, §4 (NEW).] F. An agreement in which all the parties are closely related to the insured by blood or law or have a lawful substantial economic interest in the continued life, health and bodily safety of the person insured or are trusts established primarily for the benefit of such parties; [PL 2007, c. 543, §4 (NEW).] G. Any designation, consent or agreement by an insured who is an employee of an employer in connection with the purchase by the employer, or by a trust established by the employer, of life insurance on the life of the employee; [PL 2007, c. 543, §4 (NEW).] H. A bona fide business succession planning arrangement: (1) Between shareholders in a corporation or between a corporation and one or more of its shareholders or one or more trusts established by its shareholders; (2) Between partners in a partnership or between a partnership and one or more of its partners or one or more trusts established by its partners; or (3) Between members in a limited liability company or between a limited liability company and one or more of its members or one or more trusts established by its members; [PL 2007, c. 543, §4 (NEW).] I. An agreement entered into by a service recipient, or a trust established by the service recipient, and a service provider, or a trust established by the service provider, who performs significant services for the service recipient's trade or business; or [PL 2007, c. 543, §4 (NEW).] J. Any contract, transaction or arrangement other than those set forth in paragraphs A to I exempted from the definition of "settlement contract" by the superintendent by rule based on a determination that the contract, transaction or arrangement is not of the type intended to be regulated by this chapter. Rules adopted pursuant to this paragraph are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2007, c. 543, §4 (NEW).] [PL 2009, c. 376, §3 (AMD).]

10. Settlement producer. "Settlement producer" means any person who has life insurance producer authority, who acts or aids in any manner in the soliciting of a settlement on behalf of a viator and for a fee, commission or other valuable consideration offers or attempts to negotiate settlement contracts between a viator and one or more settlement providers. "Settlement producer" does not include an attorney, accountant, financing entity or person exercising a power of attorney granted by the viator retained to represent the viator and whose compensation is paid solely by the viator without regard to whether the settlement is effected. "Settlement producer" does not include a credit union or an employer or association that makes its employees or members aware of settlement contracts. [PL 2009, c. 376, §4 (AMD).]

11. Settlement provider. "Settlement provider" means a person other than the viator that enters into or effectuates a settlement contract. "Settlement provider" does not include: A. A supervised lender, as defined in Title 9‑A, section 1‑301, subsection 39 , that takes an assignment of a life insurance policy as collateral for a loan; [PL 2003, c. 636, §5 (NEW).] B. The issuer of a life insurance policy providing accelerated benefits under section 2555 and pursuant to the contract; [PL 2003, c. 636, §5 (NEW).] C. An authorized or eligible insurer that provides stop-loss coverage to a settlement provider, purchaser, financing entity, special purpose entity or related provider trust; [PL 2003, c. 636, §5 (NEW).] D. A viator's friend or family member or other natural person who enters into no more than one agreement in a calendar year for the assignment, transfer, sale, devise or bequest of a life insurance policy for any value less than the expected death benefit; [PL 2003, c. 636, §5 (NEW).] E. A financing entity; [PL 2003, c. 636, §5 (NEW).] F. A special purpose entity; [PL 2003, c. 636, §5 (NEW).] G. A related provider trust; or [PL 2003, c. 636, §5 (NEW).] H. An accredited investor or qualified institutional buyer as defined respectively in Regulation D, Rule 501 and Rule 144A of the Federal Securities Act of 1933, as amended, and who acquires a policy from a settlement provider. [PL 2003, c. 636, §5 (NEW).] [PL 2003, c. 636, §5 (NEW).]

12. Special purpose entity. "Special purpose entity" means a corporation, partnership, trust, limited liability company or similar entity formed solely to provide either directly or indirectly access to institutional capital markets for a financing entity or licensed settlement provider. [PL 2003, c. 636, §5 (NEW).]

12-A. Stranger-originated life insurance. "Stranger-originated life insurance" means an act or practice to initiate a life insurance policy for the benefit of a person who, at the time of the origination of the policy, has no insurable interest in the insured. "Stranger-originated life insurance" includes, but is not limited to, cases in which life insurance is purchased with resources or guarantees from or through a person who, at the time of the inception of the policy, could not lawfully initiate the policy and when, at the time of policy inception, there is an arrangement or agreement to directly or indirectly transfer the ownership of the policy or the policy benefits to another person. "Stranger-originated life insurance" also includes the creation of a trust to give the appearance of insurable interest and the use of such a trust in order to initiate policies for investors in circumvention or violation of insurable interest laws and the prohibition against wagering on life. [PL 2009, c. 597, §1 (AMD).]

13. Terminally ill. "Terminally ill" means having an illness or sickness that can reasonably be expected to result in death within 24 months or less. [PL 2003, c. 636, §5 (NEW).]

14. Viator. "Viator" means a person who assigns, transfers, sells, devises or bequeaths or seeks to assign, transfer, sell, devise or bequeath a death benefit or ownership of a life insurance policy or certificate under a settlement contract. "Viator" does not include: A. A settlement provider licensed under this chapter; [PL 2003, c. 636, §5 (NEW).] B. An accredited investor or qualified institutional buyer as defined respectively in Regulation D, Rule 501 and Rule 144A of the Federal Securities Act of 1933, as amended; [PL 2003, c. 636, §5 (NEW).] C. A financing entity; [PL 2003, c. 636, §5 (NEW).] D. A special purpose entity; or [PL 2003, c. 636, §5 (NEW).] E. A related provider trust. [PL 2003, c. 636, §5 (NEW).] [PL 2003, c. 636, §5 (NEW).]
24-A M.R.S. § 4362 — ME Code / Title 24-A / Chapter 57 / Section 4362
24-A §4362. Injunctions
Status: in_force

1. Upon application by the superintendent for such an order to show cause, or at any time thereafter, the court may without notice issue an injunction restraining the insurer, its officers, directors, stockholders, members, subscribers, agents and all other persons from the transaction of its business or the waste or disposition of its property until the further order of the court. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

2. The court may at any time during a proceeding under this chapter issue such other injunctions or orders as may be deemed necessary to prevent interference with the superintendent or the proceeding, or waste of the assets of the insurer, or the commencement or prosecution of any actions, or the obtaining of preferences, judgments, attachments or other liens, or the making of any levy against the insurer or against its assets or any part thereof. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

3. Notwithstanding any other provision of law, no bond shall be required of the superintendent as a prerequisite for the issuance of any injunction or restraining order pursuant to this section. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

4. Notwithstanding subsections 1 , 2 or 3 or any provision of this chapter to the contrary, a person may not for more than 10 days be restrained, enjoined or prohibited from exercising or enforcing any right or cause of action under any pledge, security, credit, collateral, loan, advance, reimbursement, guarantee agreement or arrangement or any similar agreement, arrangement or other credit enhancement to which a federal home loan bank is a party. [PL 2025, c. 17, §3 (NEW).]

5. A federal home loan bank exercising its rights regarding collateral pledged by an insurer member of the federal home loan bank shall, within 7 days of receiving a redemption request made by the insurer member, repurchase the insurer member's outstanding capital stock in excess of the amount the insurer member must hold as a minimum investment. The federal home loan bank shall repurchase the excess outstanding capital stock only to the extent that the federal home loan bank determines in good faith that the repurchase is: A. Permissible under federal law, federal regulation and the federal home loan bank's capital plan; and [PL 2025, c. 17, §4 (NEW).] B. Consistent with the capital stock practices currently applicable to the federal home loan bank's entire membership. [PL 2025, c. 17, §4 (NEW).] [PL 2025, c. 17, §4 (NEW).]

6. No later than 10 days after the date of appointment of a receiver in a proceeding under this chapter involving an insurer member of a federal home loan bank, the federal home loan bank shall provide to the superintendent a process and a timeline for the following: A. The release of any collateral held by the federal home loan bank that exceeds the amount that is required to support the secured obligations of the insurer member and is remaining after any repayment of loans as determined under any applicable agreement between the federal home loan bank and the insurer member; [PL 2025, c. 17, §5 (NEW).] B. The release of any collateral of the insurer member remaining in the federal home loan bank's possession following repayment in full of all outstanding secured obligations of the insurer member; [PL 2025, c. 17, §5 (NEW).] C. The payment of fees owed by the insurer member and the operation, maintenance, closure or disposition of deposits and other accounts of the insurer member, as mutually agreed upon by the superintendent and the federal home loan bank; and [PL 2025, c. 17, §5 (NEW).] D. Any redemption or repurchase of federal home loan bank stock or excess stock of any class that the insurer member is required to own under any agreement between the federal home loan bank and the insurer member. [PL 2025, c. 17, §5 (NEW).] [PL 2025, c. 17, §5 (NEW).]

7. Upon the request of the superintendent in a proceeding under this chapter involving an insurer member of a federal home loan bank, the federal home loan bank shall provide to the superintendent any available option for the insurer member to renew or restructure a loan. In determining any available option, the federal home loan bank may consider market conditions, the terms of any loans outstanding to the insurer member, the applicable policies of the federal home loan bank and the federal laws and regulations applicable to the federal home loan bank. [PL 2025, c. 17, §6 (NEW).]
24-A M.R.S. § 4605-A — ME Code / Title 24-A / Chapter 62 / Section 4605-A
24-A §4605-A. Definitions
Status: in_force

As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).]

1. Account. "Account" means any one of the 3 accounts created under section 4606 . [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).]

2. Association. "Association" means the Maine Life and Health Insurance Guaranty Association created under section 4606 . [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).]

3. Authorized assessment. "Authorized assessment" or "authorized" when used in the context of assessments means that a resolution by the board of directors of the association has been passed whereby an assessment will be called immediately or in the future from member insurers for a specified amount; an assessment is authorized when the resolution is passed. [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).]

4. Benefit plan. "Benefit plan" means a specific employee, union or association of natural persons benefit plan. [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).]

5. Board of directors. "Board of directors" means the board of directors of the association. [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).]

6. Called assessment. "Called assessment" or "called" when used in the context of assessments means that a notice has been issued by the association to member insurers requiring that an authorized assessment be paid within the time frame set forth within the notice; an authorized assessment becomes a called assessment when notice is mailed by the association to member insurers. [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).]

7. Contractual obligation. "Contractual obligation" means an obligation under a policy or contract or certificate under a group policy or contract, or portion thereof, for which coverage is provided under section 4603 . [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).]

8. Covered policy or covered policy or contract. "Covered policy" or "covered policy or contract" means a policy or contract or portion of a policy or contract for which coverage is provided under section 4603 . [PL 2017, c. 382, §13 (AMD).]

9. Extra-contractual claims. "Extra-contractual claims" includes, for example, claims relating to bad faith in the payment of claims, punitive or exemplary damages or attorney's fees and costs. [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).]

10. Impaired insurer. "Impaired insurer" means a member insurer that, after the effective date of this section, is not an insolvent insurer and is placed under an order of rehabilitation or conservation by a court of competent jurisdiction. [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).]

11. Insolvent insurer. "Insolvent insurer" means a member insurer that, after the effective date of this section, is placed under an order of liquidation by a court of competent jurisdiction with a finding of insolvency. [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).]

12. Member insurer. "Member insurer" means an insurer or health maintenance organization that is licensed or that holds a certificate of authority to transact in this State any kind of insurance, annuity or health maintenance organization business for which coverage is provided under section 4603 and includes an insurer or health maintenance organization whose license or certificate of authority in this State may have been suspended, revoked, not renewed or voluntarily withdrawn, but does not include: A. A hospital or medical service organization, whether profit or nonprofit; [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).] B. [PL 2017, c. 382, §13 (RP).] C. A fraternal benefit society; [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).] D. A mandatory state pooling plan; [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).] E. A mutual assessment company or other person that operates on an assessment basis; [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).] F. An insurance exchange; [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).] G. An organization that has a certificate or license limited to the issuance of charitable gift annuities under this Title; or [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).] H. An entity similar to any of those listed in this subsection. [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).] [PL 2017, c. 382, §13 (AMD).]

13. Moody's Corporate Bond Yield Average. "Moody's Corporate Bond Yield Average" means the monthly average corporates as published by Moody's Investors Service, Inc., or any successor to that index. [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).]

14. Owner. "Owner" with respect to a policy or contract and "policyholder," "policy owner" and "contract owner" mean the person who is identified as the legal owner under the terms of the policy or contract or who is otherwise vested with legal title to the policy or contract through a valid assignment completed in accordance with the terms of the policy or contract and properly recorded as the owner on the books of the insurer. "Owner," "policyholder," "contract owner" and "policy owner" do not include persons with a mere beneficial interest in a policy or contract. [PL 2017, c. 382, §13 (AMD).]

15. Person. "Person" means an individual, corporation, limited liability company, partnership, association, governmental body or entity or voluntary organization. [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).]

16. Premiums. "Premiums" means amounts or considerations by whatever name called received on covered policies or contracts less returned premiums, considerations and deposits and less dividends and experience credits. "Premiums" does not include amounts or considerations received for policies or contracts or for the portions of policies or contracts for which coverage is not provided under section 4603 , except that assessable premiums may not be reduced on account of the provisions of section 4603 relating to interest limitations and relating to limitations with respect to one individual, one participant and one contract owner. "Premiums" does not include: A. Premiums on an unallocated annuity contract; or [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).] B. With respect to multiple nongroup policies of life insurance owned by one owner, whether the policy owner is an individual, firm, corporation or other person, and whether the persons insured are officers, managers, employees or other persons, premiums in excess of $5,000,000 with respect to these policies or contracts, regardless of the number of policies or contracts held by the owner. [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).] [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).]

17. Principal place of business. "Principal place of business" has the following meaning. A. "Principal place of business" of a plan sponsor or a person other than a natural person means the single state in which the natural persons who establish policy for the direction, control and coordination of the operations of the entity as a whole primarily exercise that function, determined by the association in its reasonable judgment by considering the following factors: (1) The state in which the primary executive and administrative headquarters of the entity is located; (2) The state in which the principal office of the chief executive officer of the entity is located; (3) The state in which the board of directors of the entity or similar governing body of the entity conducts the majority of its meetings; (4) The state in which the executive or management committee of the board of directors of the entity or similar governing body of the entity conducts the majority of its meetings; (5) The state from which the management of the overall operations of the entity is directed; and (6) In the case of a benefit plan sponsored by affiliated companies comprising a consolidated corporation, the state in which the holding company or controlling affiliate has its principal place of business as determined using the factors listed in subparagraphs (1) to (5). However, in the case of a plan sponsor, if more than 50% of the participants in the benefit plan are employed in a single state, that state is deemed to be the principal place of business of the plan sponsor. [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).] B. The principal place of business of a plan sponsor of a benefit plan is deemed to be the principal place of business of the association, committee, joint board of trustees or other similar group of representatives of the parties who establish or maintain the benefit plan, which, in lieu of a specific or clear designation of a principal place of business, is deemed to be the principal place of business of the employer or employee organization that has the largest investment in the benefit plan in question. [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).] [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).]

18. Receivership court. "Receivership court" means the court in the impaired or insolvent insurer's state having jurisdiction over the conservation, rehabilitation or liquidation of the insurer. [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).]

19. Resident. "Resident" means a person to whom a contractual obligation is owed and who resides in this State on the date of entry of a court order that determines a member insurer to be an impaired insurer or a court order that determines a member insurer to be an insolvent insurer, whichever occurs first. A person may be a resident of only one state, which in the case of a person other than a natural person is its principal place of business. Citizens of the United States that are either residents of foreign countries or residents of United States possessions, territories or protectorates that do not have an association similar to the association created by this chapter are deemed residents of the state of domicile of the insurer that issued the policies or contracts. [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).]

20. Structured settlement annuity. "Structured settlement annuity" means an annuity purchased in order to fund periodic payments for a plaintiff or other claimant in payment for or with respect to personal injury suffered by the plaintiff or other claimant. [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).]

21. State. "State" means a state, the District of Columbia, Puerto Rico or a United States possession, territory or protectorate. [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).]

22. Supplemental contract. "Supplemental contract" means a written agreement entered into for the distribution of proceeds under a life, health or annuity policy or contract. [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).]

23. Unallocated annuity contract. "Unallocated annuity contract" means an annuity contract or group annuity certificate that is not issued to and owned by an individual, except to the extent of any annuity benefits guaranteed to an individual by an insurer under the contract or certificate. [PL 2005, c. 346, §5 (NEW); PL 2005, c. 346, §16 (AFF).]
24-A M.R.S. § 6602 — ME Code / Title 24-A / Chapter 81 / Section 6602
24-A §6602. Scope
Status: in_force

1. Multiple-employer welfare arrangement; approval required. A person may not commence operations after January 1, 1995 of a multiple-employer welfare arrangement unless that arrangement is approved by the superintendent. A person may not operate after January 1, 1995 a multiple-employer welfare arrangement in existence before January 1, 1995 unless that arrangement has been submitted for approval in compliance with this chapter. [PL 1993, c. 688, §1 (NEW).]

2. Insurer authorized to transact health insurance. This chapter does not apply to a multiple-employer welfare arrangement that offers or provides benefits that are fully insured by an insurer authorized to transact health insurance in the State. [PL 1993, c. 688, §1 (NEW).]

3. Application. Section 6608 does not apply to a multiple-employer welfare arrangement that: A. Meets the general eligibility requirements of section 6603, subsection 1 ; [PL 1993, c. 688, §1 (NEW).] B. Is administered primarily from a principal place of business located within the State; and [PL 1993, c. 688, §1 (NEW).] C. Has provided employee health benefits for a continuous period since on or before January 1, 1984. [PL 1993, c. 688, §1 (NEW).] [PL 1993, c. 688, §1 (NEW).]

4. Application for approval; filing required. If a multiple-employer welfare arrangement does not satisfy the requirements of subsection 3 , the arrangement shall file with the superintendent within 60 days of the effective date of this subsection a complete application for authorization under section 6604 . [PL 1993, c. 688, §1 (NEW).]
24-A M.R.S. § 3358 — ME Code / Title 24-A / Chapter 47 / Section 3358
24-A §3358. Guaranty capital shares
Status: in_force

1. A mutual insurer formed to transact or transacting any kind of insurance has the right to provide for guaranty capital shares in its articles of incorporation. Outstanding guaranty capital shares at the par value take the place of a like amount of basic surplus otherwise required for authority to transact insurance. [PL 2013, c. 299, §9 (AMD).]

2. Shares of guaranty capital stock shall have a par value of $100 each, and shall be paid for in cash. Nothing in this Title shall be deemed to prohibit the sale of such shares at a price above such par value in order to provide the insurer with capital surplus. [PL 1969, c. 132, §1 (NEW).]

3. Only one class of such guaranty capital shares shall be provided for, and each such share outstanding shall have equal voting, dividend, retirement and other rights with every other such share. Each such share shall have one vote on matters coming to a vote at meetings of the insurer's shareholders and members. Policyholders of the insurer shall have the same voting rights as would exist in the absence of such guaranty capital. [PL 1969, c. 132, §1 (NEW).]

4. Noncumulative dividends, not exceeding in any one year 12% or lesser reasonable amount as determined by prevailing rates for loans of similar risk characteristics at the time the shares are issued, may be declared and paid by the insurer on outstanding guaranty capital shares out of that portion of the insurer's expendable surplus representing net realized earnings from its operations; and may be so paid even though the amount of the insurer's expendable surplus is then less in amount than any prior total of expendable contributed, borrowed or paid-in surplus. Such a dividend may be paid in cash or in guaranty capital shares, or part in each. An amount equal to the par value of shares so distributed as dividend shall be transferred from the insurer's earned surplus account to its guaranty capital shares account. [PL 1981, c. 501, §44 (AMD).]

5. If the guaranty capital becomes impaired, the impairment shall be cured as provided in section 3423 (impairment of capital funds). [PL 1969, c. 132, §1 (NEW).]

6. The insurer shall retire and cancel the guaranty capital shares, in part and in whole as soon as is reasonably possible, out of expendable surplus resulting from net realized earnings from its operations, or out of surplus created through issuance of agreements authorized by section 3415 . The insurer shall retire and cancel the guaranty capital shares in their entirety when such retirement would, in the superintendent's opinion, leave the insurer with surplus as to policyholders reasonably adequate to enable it to continue to transact the kinds and volume of insurance business transacted. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

7. In any liquidation of the insurer, outstanding guaranty capital shares shall have the same rights and priority as to the insurer's assets as are possessed by the stockholders of a like stock insurer. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 6812 — ME Code / Title 24-A / Chapter 85 / Section 6812
24-A §6812. Insurance company practices
Status: in_force

1. Duty to provide information. In addition to the provisions in section 6809 , an insurance company that is licensed to do business in this State shall promptly respond to reasonable requests for policy information from a settlement provider or settlement producer upon the receipt of the following documents in the office of the insurance company: A. An authorization signed by the viator to release specified information regarding the policy or certificate to a named licensed settlement provider or settlement producer; and [PL 2003, c. 636, §13 (AMD).] B. A request in writing from the settlement provider or settlement producer for the specified policy or certificate information. [PL 2003, c. 636, §13 (AMD).] Requests for the following items related to the policy or certificate that is the subject of a settlement transaction are deemed to be reasonable: ownership of and death benefits under the policy or certificate; premium information on the policy or certificate; liens, assignments and additional benefits; waiver of premium; and ownership and assignment provisions. The information provided must be the most recent information on file. By rule, the superintendent may specify additional criteria for information requests deemed reasonable under this section by a settlement provider. [PL 2003, c. 636, §13 (AMD).]

2. Conversion of group insurance. An issuer or 3rd-party administrator of a group life insurance policy shall promptly issue an individual conversion policy if the conversion is being requested for the purpose of entering into a settlement contract. For the purposes of this section, issuance of such a policy is deemed timely if it meets relevant standards for timeliness under chapter 23 . This subsection may not be construed to create any new conversion rights not already granted by the policy or certificate being acquired pursuant to a settlement contract. [PL 2003, c. 636, §13 (AMD).]

3. Right to assign rights or benefits. Subsection 1 or 2 does not prohibit a viator under a group life insurance policy from assigning rights or benefits under the policy to a licensed settlement provider or converting the coverage to an individual life insurance policy. [PL 2003, c. 636, §13 (AMD).]

4. Assignment restrictions prohibited. A policy of group life insurance issued or in existence in this State that permits any assignment of a viator's rights may not restrict the viator from making assignments other than by gift. [PL 1997, c. 430, §1 (NEW); PL 1997, c. 430, §2 (AFF).]

5. Purchase of securities. This chapter does not require notice to the superintendent of, or restrict an insurance company from investing in, or participating in, or purchasing any securities issued in any transaction including without limitation any financing, securitization transaction or securities offering in which the licensed settlement provider sells, assigns, transfers, pledges, hypothecates or otherwise disposes of settlement contracts, policies acquired pursuant to settlement contracts or any interest therein. [PL 2003, c. 636, §13 (AMD).]

6. Protection of policyholder’s rights. An insurer may not engage in a transaction, act, practice or course of business or dealing that restricts, limits or impairs in any way the lawful transfer of ownership, change of beneficiary or assignment of a policy. This subsection does not prohibit a lawful contract provision granting irrevocable rights to a beneficiary or lawfully prohibiting assignment. [PL 2009, c. 376, §14 (NEW).]
24-A M.R.S. § 6808-A — ME Code / Title 24-A / Chapter 85 / Section 6808-A
24-A §6808-A. Contact with insured; additional disclosures
Status: in_force

1. Contact with insured. The insured may be contacted by either the settlement provider or its authorized representative for the purpose of determining the insured's health status. This contact is limited to once every 3 months if the insured has a life expectancy of more than one year and no more than once per month if the insured has a life expectancy of one year or less. [PL 2003, c. 636, §11 (NEW).]

2. Additional disclosures. A settlement provider shall provide the viator with at least the following disclosures no later than the date the settlement contract is signed by all parties. The disclosures must be conspicuously displayed in the settlement contract or in a separate document signed by the viator and the settlement provider or settlement producer and must provide the following information: A. The affiliation, if any, between the settlement provider and the issuer of the insurance policy to be acquired pursuant to a settlement contract; [PL 2003, c. 636, §11 (NEW).] B. The name, address and telephone number of the settlement provider; [PL 2003, c. 636, §11 (NEW).] C. If an insurance policy to be purchased has been issued as a joint policy or involves family riders or any coverage of a life other than the insured's under the policy to be purchased, information regarding the possible loss of coverage on the other lives under the policy and advice to consult with the viator's insurance producer or the insurer issuing the policy for advice on the proposed settlement; [PL 2003, c. 636, §11 (NEW).] D. The dollar amount of the current death benefit payable to the settlement provider under the policy or certificate. If known, the settlement provider shall also disclose the availability of any additional guaranteed insurance benefits, the dollar amount of any accidental death and dismemberment benefits under the policy or certificate and the settlement provider's interest in those benefits; [PL 2009, c. 376, §10 (AMD).] E. The name, business address and telephone number of the independent 3rd-party escrow agent and the fact that the viator may inspect or receive copies of the relevant escrow or trust agreements or documents; [PL 2009, c. 376, §10 (AMD).] F. A reconciliation of the settlement provider’s gross offer to the net amount to be received by the viator; [PL 2009, c. 376, §10 (NEW).] G. The identity of all persons compensated directly or indirectly by the settlement provider for the settlement contract, the amount of compensation paid to each and the method of calculating that compensation; [PL 2009, c. 376, §10 (NEW).] H. Notice that the insured may be contacted as permitted by subsection 1 for the purpose of determining the insured’s health; [PL 2009, c. 376, §10 (NEW).] I. An offer to disclose to the insured all life expectancy estimates obtained by the provider; and [PL 2009, c. 376, §10 (NEW).] J. Notice that complaints and inquiries may be brought to the attention of the superintendent. [PL 2009, c. 376, §10 (NEW).] [PL 2009, c. 376, §10 (AMD).]

2-A. Disclosure by settlement producers. A settlement producer shall provide the viator with at least the following disclosures no later than the date the settlement contract is signed by all parties. The disclosures must be conspicuously displayed in the settlement contract or in a separate document signed by the viator and the settlement producer and must provide the following information: A. Notice that a settlement producer must exclusively represent the viator, not the insurer or the settlement provider, and owes a fiduciary duty to the viator; [PL 2009, c. 376, §11 (NEW).] B. A description of all offers, counteroffers, acceptances and rejections relating to any proposed settlement of the policy; [PL 2009, c. 376, §11 (NEW).] C. If any other persons are compensated directly or indirectly by the settlement producer for the settlement contract, their identity, the amount of compensation paid to each and the method of calculating that compensation; and [PL 2009, c. 376, §11 (NEW).] D. Notice that complaints and inquiries may be brought to the attention of the superintendent. [PL 2009, c. 376, §11 (NEW).] [PL 2009, c. 376, §11 (NEW).]

3. Notice of change in ownership or beneficiary. If the settlement provider transfers ownership or changes the beneficiary of the insurance policy, the settlement provider shall communicate the change in ownership or beneficiary to the insured within 20 days after the change. [PL 2003, c. 636, §11 (NEW).]

4. Disclosure of policyowner’s rights. The superintendent shall develop an informational brochure to apprise consumers of their rights as owners of life insurance policies. The document must be made available at no cost to all insurance companies and life insurance producers and written in lay terms. A. The brochure must advise the consumer: (1) That life insurance is a critical part of a broader financial plan and that the consumer is encouraged, and has a right, to seek additional financial advice and opinions; (2) That possible alternatives to the lapse of the policy exist; and (3) Of the definitions of common industry terms. [PL 2009, c. 376, §12 (NEW).] B. The brochure must contain the following statement in large, bold or otherwise conspicuous typeface calculated to draw the eye: "Life insurance is a critical part of a broader financial plan. There are many options available, and you have the right to shop around and seek advice from different financial advisers in order to find the option best suited to your needs." [PL 2009, c. 376, §12 (NEW).] C. The brochure may include brief descriptions of common products available from settlement providers. These products must be described in general terms for informative purposes only and not identify any specific settlement provider. [PL 2009, c. 376, §12 (NEW).] D. If the insured under an individual life insurance policy is 60 years of age or older, or is known by the insurer to be terminally ill or chronically ill, the insurer shall send notice to the policyowner that there may be alternative transactions available, including a copy of the superintendent’s brochure, whenever: (1) The policyowner has requested the surrender of the policy in whole or in part; (2) The policyowner has requested an accelerated death benefit; (3) The insurer sends an initial notice that the policy may lapse; or (4) As the superintendent may require by rule. [PL 2009, c. 376, §12 (NEW).] [PL 2009, c. 376, §12 (NEW).]
24-A M.R.S. § 2756 — ME Code / Title 24-A / Chapter 33 / Section 2756
24-A §2756. Coverage for contraceptives
Status: in_force

1. Coverage requirements. All individual health policies and contracts, except accidental injury, specified disease, hospital indemnity, Medicare supplement, disability income, long-term care and other limited benefit health insurance policies and contracts, that provide coverage for prescription drugs or outpatient medical services must provide coverage for all prescription contraceptives, nonprescription oral hormonal contraceptives and nonprescription emergency contraceptives approved by the federal Food and Drug Administration or for outpatient contraceptive services in accordance with the requirements of this section. For purposes of this section, "outpatient contraceptive services" means consultations, examinations, procedures and medical services provided on an outpatient basis and related to the use of contraceptive methods to prevent an unintended pregnancy. This section may not be construed to apply to prescription drugs or devices that are designed to terminate a pregnancy. [PL 2025, c. 445, §4 (AMD); PL 2025, c. 445, §14 (AFF).]

2. Exclusion for religious employer. A religious employer may request and an insurer shall grant an exclusion under the policy or contract for the coverage required by this section if the required coverage conflicts with the religious employer's bona fide religious beliefs and practices. A religious employer that obtains an exclusion under this subsection shall provide prospective insureds and those individuals insured under its policy written notice of the exclusion. This section may not be construed as authorizing an insurer to exclude coverage for prescription drugs prescribed for reasons other than contraceptive purposes or for prescription contraception that is necessary to preserve the life or health of a covered person. For the purposes of this section, "religious employer" means an employer that is a church, convention or association of churches or an elementary or secondary school that is controlled, operated or principally supported by a church or by a convention or association of churches as defined in 26 United States Code, Section 3121 (w) (3) (A) and that qualifies as a tax-exempt organization under 26 United States Code, Section 501(c) (3). [PL 1999, c. 341, §2 (NEW); PL 1999, c. 341, §5 (AFF).]

3. Coverage of contraceptive supplies. Coverage required under this section must include coverage for contraceptive supplies in accordance with the following requirements. For purposes of this section, "contraceptive supplies" means all contraceptive drugs, devices and products approved by the federal Food and Drug Administration to prevent an unwanted pregnancy, including nonprescription oral hormonal contraceptives and nonprescription emergency contraceptives. A. Coverage must be provided without any deductible, coinsurance, copayment or other cost-sharing requirement. [PL 2021, c. 609, §2 (AMD); PL 2021, c. 609, §5 (AFF).] B. If the federal Food and Drug Administration has approved one or more therapeutic equivalents of a contraceptive supply, an insurer is not required to cover all those therapeutically equivalent versions in accordance with this subsection, as long as at least one is covered without any deductible, coinsurance, copayment or other cost-sharing requirement in accordance with this subsection. [PL 2021, c. 609, §2 (AMD); PL 2021, c. 609, §5 (AFF).] C. [PL 2021, c. 609, §2 (RP); PL 2021, c. 609, §5 (AFF).] D. Coverage must be provided for the furnishing or dispensing of prescribed contraceptive supplies and nonprescription oral hormonal contraceptive supplies intended to last for a 12-month period, which may be furnished or dispensed all at once or over the course of the 12 months at the discretion of the health care provider for prescribed contraceptive supplies. [PL 2025, c. 445, §5 (AMD); PL 2025, c. 445, §14 (AFF).] E. A prescription is not required to obtain a nonprescription oral hormonal contraceptive or nonprescription emergency contraceptive. [PL 2025, c. 445, §5 (NEW); PL 2025, c. 445, §14 (AFF).] F. An insurer shall establish mechanisms to ensure that an enrollee who seeks coverage for a nonprescription oral hormonal contraceptive or nonprescription emergency contraceptive at a pharmacy has the option to obtain the nonprescription oral hormonal contraceptive or nonprescription emergency contraceptive at the point of sale without payment of any cost-sharing amount or to make the purchase at the pharmacy counter through an out-of-pocket payment at the point of sale and submit a claim for reimbursement to the insurer. [PL 2025, c. 445, §5 (NEW); PL 2025, c. 445, §14 (AFF).] G. The superintendent shall monitor compliance with the requirements for coverage of nonprescription oral hormonal contraceptives and nonprescription emergency contraceptives and any rules adopted in accordance with subsection 4, including any complaints or barriers to implementation. [PL 2025, c. 445, §5 (NEW); PL 2025, c. 445, §14 (AFF).] [PL 2025, c. 445, §5 (AMD); PL 2025, c. 445, §14 (AFF).]

4. Rules. The superintendent may adopt rules as necessary to implement the requirements of this section, including rules related to mechanisms to ensure coverage for nonprescription oral hormonal contraceptives and nonprescription emergency contraceptives and rules regarding notice to enrollees about how to access coverage for nonprescription oral hormonal contraceptives and nonprescription emergency contraceptives. Rules adopted pursuant to this subsection are routine technical rules as described in Title 5, chapter 375, subchapter 2‑A . [PL 2025, c. 445, §6 (NEW); PL 2025, c. 445, §14 (AFF).]

Revisor's Note: §2756. Coverage for services of certified nurse practitioners; certified nurse midwives (As enacted by PL 1999, c. 396, §2 and affected by §7 is REALLOCATED TO TITLE 24-A, SECTION 2757)

Revisor's Note: §2756. Coverage for services provided by registered nurse first assistants (As enacted by PL 1999, c. 412, §2 is REALLOCATED TO TITLE 24-A, SECTION 2758)
24-A M.R.S. § 7302 — ME Code / Title 24-A / Chapter 93 / Section 7302
24-A §7302. Definitions
Status: in_force

As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 2015, c. 279, §1 (NEW).]

1. Digital network. "Digital network" means any online-enabled application, software, website or system offered or used by a transportation network company that enables the provision of prearranged rides by transportation network company drivers. [PL 2015, c. 279, §1 (NEW).]

2. Personal vehicle. "Personal vehicle" means a vehicle that: A. Is used by a transportation network company driver; [PL 2015, c. 279, §1 (NEW).] B. Is owned, leased or otherwise authorized for use by the transportation network company driver; and [PL 2015, c. 279, §1 (NEW).] C. Is not a taxicab, as defined in Title 29‑A, section 101, subsection 79 , a limousine, as defined in Title 29‑A, section 101, subsection 32 or for-hire transportation as defined in Title 29‑A, section 101, subsection 25 . [PL 2015, c. 279, §1 (NEW).] [PL 2015, c. 279, §1 (NEW).]

3. Prearranged ride. "Prearranged ride" means transportation provided by a transportation network company driver to a transportation network company rider, beginning when the driver accepts a transportation request through a digital network and ending when the rider departs from the driver's personal vehicle. "Prearranged ride" does not include transportation provided using a taxi, limousine or other for-hire vehicle or transportation through a shared-expense carpool or vanpool arrangement that does not generate income or profit or accept a transportation request through a digital network. [PL 2015, c. 279, §1 (NEW).]

4. Transportation network company. "Transportation network company" means a corporation, partnership, sole proprietorship or other entity operating in the State that uses a digital network to connect transportation network company riders to transportation network company drivers who provide prearranged rides. "Transportation network company" does not include a transportation broker arranging nonemergency medical transportation for Medicaid or Medicare members pursuant to a contract with the State or a managed care organization. [PL 2015, c. 279, §1 (NEW).]

5. Transportation network company driver; driver. "Transportation network company driver" or "driver" means an individual who: A. Receives information regarding potential passengers and related services from a transportation network company in exchange for payment of a fee to the transportation network company; and [PL 2015, c. 279, §1 (NEW).] B. Uses a personal vehicle to offer or provide prearranged rides to a transportation network company rider in return for compensation or payment of a fee. [PL 2015, c. 279, §1 (NEW).] [PL 2015, c. 279, §1 (NEW).]

6. Transportation network company rider; rider. "Transportation network company rider" or "rider" means an individual or person who uses a transportation network company's digital network to connect with a transportation network company driver for a ride between locations chosen by the rider. [PL 2015, c. 279, §1 (NEW).]
24-A M.R.S. § 6460 — ME Code / Title 24-A / Chapter 79 / Section 6460
24-A §6460. Foreign insurers
Status: in_force

1. Submission of risk-based capital report. Upon the written request of the superintendent, a foreign insurer shall submit to the superintendent a risk-based capital report as of the end of the previous calendar year by the later of: A. The date a risk-based capital report would be required to be filed by a domestic insurer under this chapter; or [PL 1993, c. 634, Pt. A, §1 (NEW).] B. Fifteen days after the request is received by the foreign insurer. [PL 1993, c. 634, Pt. A, §1 (NEW).] At the written request of the superintendent, a foreign insurer shall promptly submit to the superintendent a copy of any risk-based capital plan that is filed with the insurance superintendent of any other state. [PL 1993, c. 634, Pt. A, §1 (NEW).]

2. Risk-based capital plan. When a company action level event, regulatory action level event or authorized control level event with respect to a foreign insurer occurs, as determined under laws governing risk-based capital applicable in the state of domicile of the insurer, or, if no such risk-based capital provision is in force in that state, under the provisions of this chapter, if the insurance superintendent of the state of domicile of the foreign insurer fails to require the foreign insurer to file a risk-based capital plan in the manner specified under the laws governing risk-based capital in that state, or, if no such risk-based capital provision is in force in that state, under this chapter, the superintendent may require the foreign insurer to file a risk-based capital plan with the superintendent. In this event, the failure of the foreign insurer to file a risk-based capital plan with the superintendent is grounds to order the insurer to desist from writing new insurance business in this State. [PL 2017, c. 169, Pt. F, §4 (AMD).]

3. Mandatory control level event. When a mandatory control level event with respect to any foreign insurer occurs, if a domiciliary receiver has not been appointed with respect to the foreign insurer under the rehabilitation and liquidation statute applicable in the state of domicile of the foreign insurer, the superintendent may make application to the Superior Court under chapter 57 with respect to the liquidation of property of foreign insurers in this State, and the occurrence of the mandatory control level event is considered adequate grounds for the application. [PL 1993, c. 634, Pt. A, §1 (NEW).]
24-A M.R.S. § 5071 — ME Code / Title 24-A / Chapter 68-A / Section 5071
24-A §5071. Scope
Status: in_force

This chapter applies to long-term care insurance policies or certificates delivered or issued for delivery in this State on or after January 1, 2000, except it does not apply to certificates issued under policies issued in other states to employer groups as described in section 2804 and labor union groups as described in section 2805 . This chapter is not intended to supersede the obligations of entities subject to this chapter to comply with the substance of other applicable insurance laws to the extent that these laws are not inconsistent with the requirements of this chapter, except that laws and rules designed and intended to apply to Medicare supplement insurance may not be applied to long-term care insurance. Notwithstanding this chapter, any product advertised, marketed or offered as long-term care insurance is subject to this chapter. [PL 1999, c. 292, §2 (NEW).]
24-A M.R.S. § 1441 — ME Code / Title 24-A / Chapter 16 / Section 1441
24-A §1441. Applicability
Status: in_force

1. Licensed resident producers. [PL 1997, c. 592, §39 (RP).]

1-A. Licensed producers. This subchapter applies to licensed resident and nonresident producers. [PL 1997, c. 592, §40 (NEW).]
24-A M.R.S. § 4234-A — ME Code / Title 24-A / Chapter 56 / Section 4234-A
24-A §4234-A. Mental health services coverage
Status: in_force

1. Findings. The Legislature finds that: A. Mental illness affects nearly 170,000 people of this State each year, resulting in anguish, grief, desperation, fear, isolation and a sense of hopelessness of significant levels among victims and families; [PL 1995, c. 407, §10 (NEW).] B. Consequences of mental illness include the expenditure of millions of dollars of public funds for treatment and losses of millions of dollars by businesses in the State in accidents, absenteeism, nonproductivity and turnover. Excessive stress and anxiety and other forms of mental illness clearly contribute to general health problems and costs; [PL 1995, c. 407, §10 (NEW).] C. Typical health coverage in this State discriminates against mental illness, the victims and affected families with nonexistent or limited benefits compared to provisions for other illnesses; and [PL 1995, c. 407, §10 (NEW).] D. Experience in this State and several other states demonstrates that the risk of mental illness can be insured at reasonable cost and with adequate controls on quality and utilization of treatment. [PL 1995, c. 407, §10 (NEW).] [PL 1995, c. 407, §10 (NEW).]

2. Policy and purpose. The Legislature declares that it is the policy of this State to: A. Promote equitable and nondiscriminatory health coverage benefits for all forms of illness including mental and emotional disorders that are of significant consequence to the health of people of the State and that can be treated in a cost-effective manner; [PL 1995, c. 407, §10 (NEW).] B. Ensure that victims of mental and other illnesses have access to and choice of appropriate treatment at the earliest point of illness in the least restrictive settings; [PL 1995, c. 407, §10 (NEW).] C. Ensure that costs of treatment of mental illness are supported through an equitable combination of public and private responsibilities; and [PL 1995, c. 407, §10 (NEW).] D. Ensure that the Legislature reasonably exercises its legal responsibility for insurance policy in this State by prescribing types of illnesses and treatment for which benefits must be provided. [PL 1995, c. 407, §10 (NEW).] [PL 1995, c. 407, §10 (NEW).]

3. Definitions. For purposes of this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Day treatment services" includes psychoeducational, physiological, psychological and psychosocial concepts, techniques and processes necessary to maintain or develop functional skills of clients, provided to individuals and groups for periods of more than 2 hours but less than 24 hours a day. [PL 1995, c. 407, §10 (NEW).] A-1. "Diagnostic and Statistical Manual" means the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, published by the American Psychiatric Association. [PL 2003, c. 20, Pt. VV, §16 (NEW); PL 2003, c. 20, Pt. VV, §25 (AFF).] A-2. "Home health care services" means those services rendered by a licensed provider of mental health services to provide medically necessary health care to a person suffering from a mental illness in the person's place of residence if: (1) Hospitalization or confinement in a residential treatment facility would otherwise have been required if home health care services were not provided; (2) Hospitalization or confinement in a residential treatment facility is not required as an antecedent to the provision of home health care services; and (3) The services are prescribed in writing by a licensed allopathic or osteopathic physician or a licensed psychologist who is trained and has received a doctorate in psychology specializing in the evaluation and treatment of mental illness. [PL 2003, c. 20, Pt. VV, §16 (NEW); PL 2003, c. 20, Pt. VV, §25 (AFF).] A-3. "Evidence-based practices" means clinically sound and scientifically based policies, practices and programs that reflect expert consensus on the prevention, treatment and recovery science, including, but not limited to, policies, practices and programs published and disseminated by the Substance Abuse and Mental Health Services Administration and the Title IV-E Prevention Services Clearinghouse within the United States Department of Health and Human Services, the What Works Clearinghouse within the United States Department of Education, Institute of Education Sciences and the California Evidence-Based Clearinghouse for Child Welfare within the California Department of Social Services, Office of Child Abuse Prevention. [PL 2021, c. 595, §7 (NEW).] B. "Inpatient services" includes a range of physiological, psychological and other intervention concepts, techniques and processes used in a community mental health psychiatric inpatient unit, general hospital psychiatric unit or psychiatric hospital licensed by the Department of Human Services or in an accredited public hospital to restore psychosocial functioning sufficient to allow maintenance and support of the client in a less restrictive setting. [PL 1995, c. 407, §10 (NEW).] B-1. "Medically necessary health care" has the same meaning as in section 4301‑A, subsection 10‑A . [PL 2003, c. 20, Pt. VV, §17 (NEW); PL 2003, c. 20, Pt. VV, §25 (AFF).] C. "Outpatient services" includes screening, evaluation, consultations, diagnosis and treatment involving use of psychoeducational, physiological, psychological and psychosocial evaluative and interventive concepts, techniques and processes provided to individuals and groups. [PL 1995, c. 407, §10 (NEW).] D. "Person suffering from a mental illness" means a person whose psychobiological processes are impaired severely enough to manifest problems in the area of social, psychological or biological functioning. Such a person has a disorder of thought, mood, perception, orientation or memory that impairs judgment, behavior, capacity to recognize or ability to cope with the ordinary demands of life. The person manifests an impaired capacity to maintain acceptable levels of functioning in the area of intellect, emotion or physical well-being. [PL 2003, c. 20, Pt. VV, §18 (AMD); PL 2003, c. 20, Pt. VV, §25 (AFF).] E. "Provider" means an individual included in section 2744, subsection 1 , a licensed physician, an accredited public hospital or psychiatric hospital or a community agency licensed at the comprehensive service level by the Department of Health and Human Services. All agency or institutional providers named in this paragraph shall ensure that services are supervised by a psychiatrist or licensed psychologist. [PL 1999, c. 256, Pt. O, §3 (AMD); PL 2001, c. 354, §3 (AMD); PL 2003, c. 689, Pt. B, §6 (REV).] [PL 2021, c. 595, §7 (AMD).]

4. Requirement. Every health maintenance organization that issues individual or group health care contracts providing coverage to residents of this State shall provide benefits as required in this section to any subscriber or other person covered under those contracts for conditions arising from mental illness. [PL 2003, c. 20, Pt. VV, §19 (AMD); PL 2003, c. 20, Pt. VV, §25 (AFF).]

5. Services. Each individual or group contract must provide for medically necessary health care for a person suffering from mental illness. Medically necessary health care includes, but is not limited to, the following services for a person suffering from a mental illness: A. Inpatient services; [PL 1995, c. 407, §10 (NEW).] B. Day treatment services; [PL 2003, c. 20, Pt. VV, §19 (AMD); PL 2003, c. 20, Pt. VV, §25 (AFF).] C. Outpatient services; and [PL 2003, c. 20, Pt. VV, §19 (AMD); PL 2003, c. 20, Pt. VV, §25 (AFF).] D. Home health care services. [PL 2003, c. 20, Pt. VV, §19 (NEW); PL 2003, c. 20, Pt. VV, §25 (AFF).] [PL 2003, c. 20, Pt. VV, §19 (AMD); PL 2003, c. 20, Pt. VV, §25 (AFF).]

6. Coverage for treatment of certain mental illnesses. Coverage for medical treatment for mental illnesses listed in paragraph A‑1 is subject to this subsection. A. [PL 2003, c. 20, Pt. VV, §20 (RP); PL 2003, c. 20, Pt. VV, §25 (AFF).] A-1. All individual and group contracts must provide, at a minimum, benefits according to paragraph B , subparagraph (1) for a person receiving medical treatment for any of the following categories of mental illness as defined in the Diagnostic and Statistical Manual, except for those designated as "V" codes in the Diagnostic and Statistical Manual: (1) Psychotic disorders, including schizophrenia; (2) Dissociative disorders; (3) Mood disorders; (4) Anxiety disorders; (5) Personality disorders; (6) Paraphilias; (7) Attention deficit and disruptive behavior disorders; (8) Pervasive developmental disorders; (9) Tic disorders; (10) Eating disorders, including bulimia and anorexia; and (11) Substance use disorders. For the purposes of this paragraph, the mental illness must be diagnosed by a licensed allopathic or osteopathic physician or a licensed psychologist who is trained and has received a doctorate in psychology specializing in the evaluation and treatment of mental illness. [PL 2019, c. 5, Pt. D, §3 (AMD).] B. All policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State must provide benefits that meet the requirements of this paragraph. (1) The contracts must provide benefits for the treatment and diagnosis of mental illnesses under terms and conditions that are no less extensive than the benefits provided for medical treatment for physical illnesses. (2) At the request of a reimbursing health maintenance organization, a provider of medical treatment for mental illness shall furnish data substantiating that initial or continued treatment is medically necessary health care. When making the determination of whether treatment is medically necessary health care, the provider shall use the same criteria for medical treatment for mental illness as for medical treatment for physical illness under the group contract. An insurer may not deny treatment for mental health services that use evidence-based practices and are determined to be medically necessary health care for an individual 21 years of age or younger. (3) If benefits and coverage for the treatment of physical illness are provided on an expense-incurred basis, the benefits and coverage required under this subsection may be delivered separately under a managed care system. (4) A policy or contract may not have separate maximums for physical illness and mental illness, separate deductibles and coinsurance amounts for physical illness and mental illness, separate out-of-pocket limits in a benefit period of not more than 12 months for physical illness and mental illness or separate office visit limits for physical illness and mental illness. (5) A health benefit plan may not impose a limitation on coverage or benefits for mental illness unless that same limitation is also imposed on the coverage and benefits for physical illness covered under the policy or contract. (6) Copayments required under a policy or contract for benefits and coverage for mental illness must be actuarially equivalent to any coinsurance requirements or, if there are no coinsurance requirements, may not be greater than any copayment or coinsurance required under the policy or contract for a benefit or coverage for a physical illness. (7) For the purposes of this section, a medication management visit associated with a mental illness must be covered in the same manner as a medication management visit for the treatment of a physical illness and may not be counted in the calculation of any maximum outpatient treatment visit limits. [PL 2021, c. 595, §8 (AMD).] [PL 2021, c. 595, §8 (AMD).]

7. Mandated offer of coverage for certain mental illnesses. [PL 2019, c. 5, Pt. D, §4 (RP).]

8. Contracts; providers. A health maintenance organization incorporated under this chapter shall allow providers, pursuant to sections 2744 and 2835 , to contract for and receive payment, subject to the health maintenance organization's credentialling policy, for the provision of mental health services within the scope of the provider's licensure. [PL 2003, c. 65, §3 (AMD); PL 2003, c. 65, §5 (AFF).]

8-A. Mental health services provided by counseling professionals. A health maintenance organization that issues individual or group health care contracts providing coverage for mental health services shall offer coverage for those services when performed by a counseling professional who is licensed by the State pursuant to Title 32, chapter 119 to assess and treat interpersonal and intrapersonal problems, has at least a master's degree in counseling or a related field from an accredited educational institution and has been employed as counselor for at least 2 years. Any contract providing coverage for the services of counseling professionals pursuant to this subsection may be subject to any reasonable limitations, maximum benefits, coinsurance, deductibles or exclusion provisions applicable to overall benefits under the contract. [PL 2003, c. 20, Pt. VV, §23 (AMD); PL 2003, c. 20, Pt. VV, §25 (AFF).]

9. Limits; coinsurance; deductibles. A policy or contract that provides coverage for the services required by this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section. [PL 1995, c. 407, §10 (NEW).]

10. Reports to the superintendent. Every health maintenance organization subject to this section shall report its experience for each calendar year to the superintendent no later than April 30th of the following year. The report must be in a form prescribed by the superintendent and include the amount of claims paid in this State for the services required by this section and the total amount of claims paid in this State for individual and group health care contracts, both separated according to those paid for inpatient, day treatment and outpatient services. The superintendent shall compile this data for all health maintenance organizations in an annual report. [PL 1995, c. 407, §10 (NEW).]

11. Application. Except as otherwise provided, the requirements of this section apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. Contracts entered into with the State Government or the Federal Government to service Medicaid or Medicare populations may limit the services provided under such contracts consistent with the terms of those contracts if mental health services are provided to these populations by other means. [PL 2003, c. 20, Pt. VV, §24 (AMD); PL 2003, c. 20, Pt. VV, §25 (AFF).]
24-A M.R.S. § 4116 — ME Code / Title 24-A / Chapter 55 / Section 4116
24-A §4116. Nonforfeiture benefits, cash surrender values, certificate loans and other options
Status: in_force

A society may grant paid-up nonforfeiture benefits, cash surrender values, certificate loans and such other options as its laws may permit. As to certificates issued on and after January 1, 1970 a society shall grant at least one paid-up nonforfeiture benefit; except in the case of pure endowment, annuity or reversionary annuity contracts, reducing term insurance contracts or contracts of term insurance of uniform amount of 15 years or less expiring before age 66. [PL 1973, c. 625, §153 (AMD).]

In the case of certificates other than those for which reserves are computed on the Commissioners 1941 Standard Ordinary Mortality Table, the Commissioners 1941 Standard Industrial Table, the Commissioners 1958 Standard Ordinary Mortality Table, or such later tables as authorized for use by domestic life insurers, the value of every paid-up nonforfeiture benefit and the amount of any cash surrender value, loan or other option granted shall not be less than the excess, if any, of 1 over 2 as follows: [PL 1987, c. 606, §1 (AMD).]

1. The reserve under the certificate determined on the basis specified in the certificate; and [PL 1969, c. 132, §1 (NEW).]

2. The sum of any indebtedness to the society on the certificate, including interest due and accrued, and a surrender charge equal to 2 1/2% of the face amount of the certificate, which, in the case of insurance on the lives of children, shall be the ultimate face amount of the certificate, if death benefits provided therein are graded. [PL 1969, c. 132, §1 (NEW).]

However, in the case of certificates issued on a substandard basis or in the case of certificates, the reserves for which are computed upon the American Men Ultimate Table of Mortality, the term of any extended insurance benefit granted including accompanying pure endowment, if any, may be computed upon the rates of mortality not greater than 130% of those shown by the mortality table specified in the certificate for the computation of the reserve. [PL 1969, c. 132, §1 (NEW).]

In the case of certificates for which reserves are computed on the Commissioners 1941 Standard Ordinary Mortality Table, the Commissioners 1941 Standard Industrial Table, the Commissioners 1958 Standard Ordinary Mortality Table, or such later tables as authorized for use by domestic life insurers, every paid-up nonforfeiture benefit and the amount of any cash surrender value, loan or other option granted shall not be less than the corresponding amount ascertained in accordance with the provisions of the laws of this State applicable to life insurers issuing policies containing like insurance benefits based upon such tables. [PL 1987, c. 606, §1 (AMD).]
24-A M.R.S. § 2108 — ME Code / Title 24-A / Chapter 21 / Section 2108
24-A §2108. Attorney fees
Status: in_force

In any such action against an unauthorized insurer, if the insurer has failed for 30 days after demand prior to the commencement of the action to make payment in accordance with the terms of the contract, and it appears to the court that such refusal was vexatious and without reasonable cause, the court shall allow to the plaintiff a reasonable attorney fee and include such fee in any judgment that may be rendered in such action, and in no event shall such fee be less than $100. Failure of an insurer to defend any such action shall be deemed prima facie evidence that its failure to make payment was vexatious and without reasonable cause. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2765 — ME Code / Title 24-A / Chapter 33 / Section 2765
24-A §2765. Coverage for services provided by independent practice dental hygienist or dental hygienist
Status: in_force

1. Services provided by independent practice dental hygienist or dental hygienist. An insurer that issues individual dental insurance or health insurance that includes coverage for dental services shall provide coverage for dental services performed by an independent practice dental hygienist or dental hygienist licensed under Title 32, chapter 143 when those services are covered services under the contract and when they are within the lawful scope of practice of the independent practice dental hygienist or dental hygienist. [PL 2025, c. 478, §3 (AMD).]

2. Limits; coinsurance; deductibles. A contract that provides coverage for the services required by this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section. [PL 2009, c. 307, §2 (NEW); PL 2009, c. 307, §6 (AFF).]

3. Coordination of benefits with dental insurance. If an enrollee eligible for coverage under this section is eligible for coverage under a dental insurance policy or contract and a health insurance policy or contract, the insurer providing dental insurance is the primary payer responsible for charges under subsection 1 and the insurer providing individual health insurance is the secondary payer. [PL 2009, c. 307, §2 (NEW); PL 2009, c. 307, §6 (AFF).]

4. Application. The requirements of this section apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 2009, c. 307, §2 (NEW); PL 2009, c. 307, §6 (AFF).]