24-A M.R.S. § 4102 — ME Code / Title 24-A / Chapter 55 / Section 4102
24-A §4102. Lodge system defined
Status: in_force

A society having a supreme legislative or governing body and subordinate lodges or branches by whatever name known, into which members are elected, initiated or admitted in accordance with its constitution, laws, ritual and rules, which subordinate lodges or branches shall be required by the laws of the society to hold regular meetings at least once in each month, shall be deemed to be operating on the lodge system. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 6224 — ME Code / Title 24-A / Chapter 73 / Section 6224
24-A §6224. Removal of records or assets from the State
Status: in_force

No records or assets of the provider related to the organization of the facility and the provision of services under the continuing care agreement may be removed from this State by the provider, except that the superintendent may consent in writing to the removal of those records. [PL 1987, c. 482, §1 (NEW).]
24-A M.R.S. § 2519 — ME Code / Title 24-A / Chapter 29 / Section 2519
24-A §2519. Incontestability -- annuities
Status: in_force

If any statements, other than those relating to age, sex and identity are required as a condition to issuing an annuity or pure endowment contract, other than a reversionary, survivorship, or group annuity, and subject to section 2521 , there shall be a provision that the contract shall be incontestable after it has been in force during the lifetime of the person or of each of the persons as to whom such statements are required, for a period of 2 years from its date of issue, except for nonpayment of stipulated payments to the insurer; and at the option of the insurer such contract may also except any provisions relative to benefits in the event of disability and any provisions which grant insurance specifically against death by accident or accidental means. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 3602 — ME Code / Title 24-A / Chapter 51 / Section 3602
24-A §3602. Chapter exclusive
Status: in_force

Nothing in this Title shall either directly or indirectly apply to such mutual assessment insurers except as contained or referred to in this chapter. [PL 1969, c. 132, §1 (NEW).]
24 M.R.S. § 2318 — ME Code / Title 24 / Chapter 19 / Section 2318
24 §2318. Maternity benefits and dependent coverage
Status: repealed

1. Definitions. For the purposes of this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Dependent children" means children who are under 19 years of age and are children, stepchildren or adopted children of, or children placed for adoption with, the subscriber, member or spouse of the subscriber or member. [PL 1993, c. 666, Pt. A, §1 (NEW).] B. "Placed for adoption" means the assumption and retention of a legal obligation by a person for the total or partial support of a child in anticipation of adoption of the child. If the legal obligation ceases to exist, the child is no longer considered placed for adoption. [PL 1993, c. 666, Pt. A, §1 (NEW).] [PL 1993, c. 666, Pt. A, §1 (RPR).]

2. Maternity benefits. All individual or group contracts issued by any nonprofit hospital or medical service organization operating pursuant to this chapter must provide to unmarried subscribers or members and minor dependents of the subscribers or members the same minimum maternity benefits and the same option for additional maternity benefits, at appropriate rates and under the same terms and conditions as those benefits or options for benefits are provided to married subscribers or members. This requirement applies to all individual or group contracts issued or renewed after the effective date of this subsection. [PL 1991, c. 200, Pt. B, §1 (NEW).]

3. Coverage. All individual or group contracts issued in accordance with the requirements of this section must provide unmarried subscribers with the same benefits or option of benefits for dependent children as is extended to dependent children of married subscribers, at appropriate rates and under the same terms and conditions. [PL 1991, c. 200, Pt. B, §1 (NEW).]

4. Financial dependency. Financial dependency of dependent children on the subscriber or member or the spouse of the subscriber or member may not be required as a condition for eligibility for coverage. [PL 1991, c. 200, Pt. B, §1 (NEW).]

5. Adopted children. All individual or group contracts issued in accordance with the requirements of this section must provide the same benefits to dependent children placed for adoption with the subscriber or spouse of the subscriber under the same terms and conditions as apply to natural dependent children or stepchildren of the subscriber or spouse of the subscriber, irrespective of whether the adoption has become final. [PL 1993, c. 666, Pt. A, §2 (NEW).]

6. 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, §1 (NEW).] Revisor's Note: §2318. Newborn children coverage (REPEALED BY PL 1975, c. 700, §100)
24-A M.R.S. § 6806 — ME Code / Title 24-A / Chapter 85 / Section 6806
24-A §6806. Reporting requirements; confidentiality of information
Status: in_force

1. Annual report. A settlement provider licensee shall file with the superintendent by March 1st of each year an annual statement containing such information as the superintendent prescribes by rule, including information related to settlement transactions on policies settled within 5 years of policy issuance. The superintendent may not adopt any rule that requires the submission of information that permits the identification of a viator or relates to transactions when the viator is not a resident of this State. The superintendent may not request, collect or compile personal information that identifies any viator or insured except in connection with the investigation of a specific complaint and with the prior written permission of the viator or insured or the viator's or insured's estate or representative to collect that information. The annual statement required by this subsection and by rule of the superintendent is a public record within the meaning of Title 1, chapter 13, subchapter 1 . [PL 2017, c. 75, §1 (AMD).]

1-A. Fee for filing annual report. The fee for filing the annual report is the same as for an insurer as provided in section 601 . On or before July 1st of each year, the superintendent shall forward to each settlement provider an itemized bill for the amount due for the filing of the annual statement and the amount due for the certificate of authority annual fee. [PL 2003, c. 636, §9 (AMD).]

2. Privacy protection. Except as otherwise required or permitted by law, a settlement provider, settlement producer, insurance company, insurance producer, independent insurance producer, information bureau, rating company or any other person with actual knowledge of the identity of a viator, or of the insured if other than the viator, may not disclose that identity, or the insured's financial or medical information, to any other person unless the disclosure: A. Is necessary to effectuate a settlement contract between the viator and a settlement provider and the viator and the insured have provided prior written consent to the disclosure; [PL 2003, c. 636, §9 (AMD).] B. Is provided in response to an investigation or examination by the superintendent or any other government officer or agency pursuant to section 6807 ; [PL 2003, c. 636, §9 (AMD).] C. Is necessary to permit a financing entity, related provider trust or special purpose entity to finance the purchase of policies by a settlement provider and the viator and insured have provided prior written consent to the disclosure; [PL 2003, c. 636, §9 (AMD).] D. Is a term or condition to the transfer of a policy by one settlement provider to another settlement provider; [PL 2003, c. 636, §9 (NEW).] E. Is necessary to allow the settlement provider or insurance producer or an authorized representative to make contacts for the purpose of determining health status; or [PL 2003, c. 636, §9 (NEW).] F. Is required to purchase stop-loss coverage. [PL 2003, c. 636, §9 (NEW).] [PL 2003, c. 636, §9 (AMD).]

3. Sale or transfer. [PL 2003, c. 636, §9 (RP).]
24-A M.R.S. § 7604 — ME Code / Title 24-A / Chapter 99 / Section 7604
24-A §7604. Authority of self-storage providers
Status: in_force

1. Requirements for employees and authorized representatives of self-storage providers. An employee or authorized representative of a self-storage provider may sell or offer self-storage insurance to a customer and is not subject to licensure as an insurance producer under this chapter if: A. The self-storage provider obtains a limited lines license to authorize its employees or authorized representatives to sell or offer self-storage insurance pursuant to this section; [PL 2021, c. 676, Pt. A, §42 (NEW).] B. The insurer issuing the self-storage insurance either directly supervises or appoints a supervising entity to supervise the administration of the sale of insurance, including development of a training program for employees and authorized representatives of the self-storage providers. (1) The training must be delivered to all employees and authorized representatives of the self-storage provider who are directly engaged in the activity of selling or offering self-storage insurance. The training may be provided in electronic form. If the training is conducted in electronic form, the supervising entity shall implement a supplemental education program that is conducted and overseen by licensed employees of the supervising entity to supplement the electronic training. (2) Each employee and authorized representative must receive basic instruction about the self-storage insurance offered to customers and the disclosures required under section 7603, subsection 1 ; and [PL 2021, c. 676, Pt. A, §42 (NEW).] C. The employee or authorized representative of the self-storage provider does not advertise, represent or otherwise hold that employee or authorized representative out as other than a limited lines licensed insurance producer. [PL 2021, c. 676, Pt. A, §42 (NEW).] [PL 2021, c. 676, Pt. A, §42 (NEW).]

2. Charges. The charges for self-storage insurance coverage may be billed and collected by the self-storage provider. Any charge to the customer for coverage that is not included in the cost associated with the rental or lease of self-storage or related services must be separately itemized on the customer's bill. If the self-storage insurance coverage is included with the rental or lease of self-storage or related services, the self-storage provider shall clearly and conspicuously disclose to the customer that the self-storage insurance coverage is included with the rented or leased storage space. A self-storage provider billing and collecting charges for coverage is not required to maintain those funds in a segregated account as long as the self-storage provider is authorized by the insurer to hold such funds in an alternative manner and remits the funds to the supervising entity within 60 days of receipt. All funds received by a self-storage provider from a customer for the sale of self-storage insurance are considered funds held in trust by the self-storage provider in a fiduciary capacity for the benefit of the insurer. A self-storage provider may receive compensation for billing and collection services. [PL 2021, c. 676, Pt. A, §42 (NEW).]
24-A M.R.S. § 2833 — ME Code / Title 24-A / Chapter 35 / Section 2833
24-A §2833. Child coverage
Status: in_force

1. Definitions. For the purposes of this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Dependent children" means children who are under 19 years of age and are children, stepchildren or adopted children of, or children placed for adoption with, the certificate holder, member or spouse of the certificate holder or member. [PL 1993, c. 666, Pt. A, §5 (NEW).] B. "Placed for adoption" means the assumption and retention of a legal obligation by a person for the total or partial support of a child in anticipation of adoption of the child. If the legal obligation ceases to exist, the child is no longer considered placed for adoption. [PL 1993, c. 666, Pt. A, §5 (NEW).] [PL 1993, c. 666, Pt. A, §5 (RPR).]

2. Coverage. All group or blanket health insurance plans issued in accordance with the requirements of section 2832 must provide unmarried women certificate holders with the option of coverage of their children from the date of birth. A certificate holder who, pursuant to the laws of this State or any other state, has been adjudicated or has acknowledged the certificate holder to be the father of an illegitimate child must be given the option of coverage for that child from the date of the certificate holder's adjudication or acknowledgement of paternity. This optional coverage must be the same as that provided the children of a married certificate holder with family or dependent coverage. [RR 2021, c. 1, Pt. B, §248 (COR).]

3. Financial dependency. Financial dependency of dependent children on the certificate holder or the spouse of the certificate holder may not be required as a condition for eligibility for coverage. [PL 1991, c. 200, Pt. B, §4 (NEW).]

4. Adopted children. All group or blanket health insurance policies and certificates issued in accordance with the requirements of this section must provide the same benefits to dependent children placed for adoption with the certificate holder or spouse of the certificate holder under the same terms and conditions as apply to natural dependent children or stepchildren of the certificate holder, irrespective of whether the adoption has become final. [PL 1993, c. 666, Pt. A, §6 (NEW).]
24-A M.R.S. § 1259 — ME Code / Title 24-A / Chapter 15 / Section 1259
24-A §1259. Excess deposits
Status: in_force

1. If securities deposited by an insurer under this chapter are subject to material fluctuations in market value, the superintendent may, in the superintendent's discretion, require the insurer to deposit and maintain on deposit additional securities in amount reasonably necessary to assure that the deposit at all times has a market value of not less than the amount specified under the law by which the deposit is required. [RR 2021, c. 1, Pt. B, §198 (COR).]

2. An insurer may otherwise at its option deposit securities in amount exceeding its deposit required or otherwise permitted under this Title by not more than 20% of such required or permitted deposit, or $20,000, whichever is the larger amount, for the purpose of absorbing fluctuations in the value of securities deposited and to facilitate exchange and substitution of such securities. During the solvency of the insurer any such excess shall be released to the insurer upon its request. During the insolvency of the insurer, such excess deposit shall be released only as provided in section 1263, subsection 4 . [PL 1969, c. 177, §27 (AMD).]
24-A M.R.S. § 2155 — ME Code / Title 24-A / Chapter 23 / Section 2155
24-A §2155. "Twisting" prohibited
Status: in_force

No person shall make or issue, or cause to be made or issued, any written or oral statement misrepresenting or making incomplete comparisons as to the terms, conditions, or benefits contained in any policy for the purpose of inducing or attempting or tending to induce the policyholder to lapse, forfeit, borrow against, surrender, retain, exchange, modify, convert, or otherwise affect or dispose of any insurance policy. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 4375-A — ME Code / Title 24-A / Chapter 57 / Section 4375-A
24-A §4375-A. Voidable property transfers and liens
Status: in_force

1. Fraudulent transfers prior to petition. Fraudulent transfers prior to petition are governed by this subsection. A. A transfer made or suffered and an obligation incurred by an insurer within one year prior to the filing of a successful petition for rehabilitation or liquidation under this chapter is fraudulent as to then existing and future creditors if made or incurred without fair consideration, or with actual intent to hinder, delay or defraud either existing or future creditors. A transfer made or an obligation incurred by an insurer ordered to be rehabilitated or liquidated under this chapter that is fraudulent according to the terms of this section may be avoided by the receiver except as to a person who in good faith is a purchaser, lienor or obligee for a present fair equivalent value, but any purchaser, lienor or obligee who in good faith has given a consideration less than fair for such transfer, lien, or obligation may retain the property, lien or obligation as security for repayment. The court may, on due notice, order any such transfer or obligation to be preserved for the benefit of the estate, and in that event, the receiver succeeds to and may enforce the rights of the purchaser, lienor or obligee. [PL 1991, c. 828, §31 (NEW).] B. The determination of when a transfer is made is governed by the following rules. (1) A transfer of property other than real property is deemed to be made or suffered when it becomes so far perfected that no subsequent lien obtainable by legal or equitable proceedings on a simple contract may become superior to the rights of the transferee. (2) A transfer of real property is deemed to be made or suffered when it becomes so far perfected that no subsequent bona fide purchaser from the insurer may obtain rights superior to the rights of the transferee. (3) A transfer that creates an equitable lien may not be deemed to be perfected if there are available means by which a legal lien could be created. (4) Any transfer not perfected prior to the filing of a petition for liquidation is deemed to be made immediately before the filing of the successful petition. (5) A lien obtainable by legal or equitable proceedings upon a simple contract is one arising in the ordinary course of such proceedings upon the entry or docketing of a judgment or decree, or upon attachment, garnishment, execution, or like process, whether before, upon, or after judgment or decree and whether before or upon levy, but does not include liens that under applicable law are given a special priority over other liens that are prior in time. (6) A lien obtainable by legal or equitable proceedings may become superior to the rights of a transferee, or a purchaser may obtain rights superior to the rights of a transferee within the meaning of this paragraph if those consequences would follow only from the lien or purchase itself, or from the lien or purchase followed by any step wholly within the control of the respective lienholder or purchaser, with or without the aid of ministerial action by public officials, but not if any acts subsequent to the obtaining of the lien or subsequent to the purchase require the agreement or concurrence of any 3rd party or require any further judicial action or ruling. (7) The provisions of this paragraph apply whether or not there are or were creditors who might have obtained any liens or persons who might have become bona fide purchasers. [PL 1991, c. 828, §31 (NEW).] C. Any transaction of the insurer with a reinsurer is deemed fraudulent and may be avoided by the receiver under paragraph A if: (1) The transaction consists of the termination, adjustment or settlement of a reinsurance contract in which the reinsurer is released from any part of its duty to pay the originally specified share of losses that had occurred prior to the time of the transaction unless the reinsurer gives a present fair equivalent value for the release; and (2) Any part of the transaction takes place within one year prior to the date of filing of the petition through which the receivership is commenced. [PL 1991, c. 828, §31 (NEW).] D. A person receiving any property from the insurer or a benefit from possession or use of the property that is fraudulently transferred is personally liable for the value of the preference and shall account to the liquidator. [PL 1991, c. 828, §31 (NEW).] [PL 1991, c. 828, §31 (NEW).]

2. Fraudulent transfers after petition. Fraudulent transfers after petition are governed by this subsection. A. After a petition for rehabilitation or liquidation has been filed, a transfer of any of the real property of the insurer made to a person acting in good faith is valid against the receiver if made for a present fair equivalent value or, if the transfer was not made for a present fair equivalent value, then it is valid only to the extent of the present consideration actually paid for the property, for which amount the transferee has a lien on the property so transferred. Constructive notice of the commencement of a proceeding in rehabilitation or liquidation is deemed to be given upon the recording of a copy of the petition for or order of rehabilitation or liquidation with the register of deeds in the county where any real property in question is located. The exercise by a court of the United States or any state or jurisdiction to authorize or effect a judicial sale of real property of the insurer within any county in any state is not impaired by the pendency of such a proceeding unless the copy is recorded in the county prior to the consummation of the judicial sale. [PL 1991, c. 828, §31 (NEW).] B. After a petition for rehabilitation or liquidation has been filed and before either the receiver takes possession of the property of the insurer or an order of rehabilitation or liquidation is granted the following rules apply. (1) A transfer of any of the property of the insurer, other than real property, made to a person acting in good faith is valid against the receiver if made for a present fair equivalent value or, if not made for a present fair equivalent value, then the transfer is valid only to the extent of the present consideration actually paid, for which amount the transferee has a lien on the property so transferred. (2) A person acting in good faith who is indebted to the insurer or holding property of the insurer may pay the indebtedness or deliver the property or any part of the property to the insurer with the same effect as if the petition were not pending. (3) A person having actual knowledge of the pending rehabilitation or liquidation who effectuates a transfer of any of the property of the insurer or who benefits by the transfer is deemed not to act in good faith. (4) A person asserting the validity of a transfer under this section has the burden of proof. Except as elsewhere provided in this section, a transfer by or on behalf of the insurer after the date of the petition for liquidation by any person other than the liquidator is not valid against the liquidator. [PL 1991, c. 828, §31 (NEW).] C. A person receiving any property from the insurer or a benefit from possession or use of the property that is fraudulently transferred under this subsection is personally liable for the value of the preference and shall account to the liquidator. [PL 1991, c. 828, §31 (NEW).] [PL 1991, c. 828, §31 (NEW).]

3. Voidable preferences. Voidable preferences and liens are governed by this subsection. A. A preference is a transfer that is made or suffered by the insurer of any of the property of an insurer to or for the benefit of a creditor for or on account of an antecedent debt if the effect of the transfer may be to enable the creditor to obtain a greater percentage of this debt than another creditor of the same class would receive and the transfer is made within one year before the filing of a successful petition for liquidation under this chapter or, if a liquidation order is entered while the insurer is already subject to a rehabilitation order, if made or suffered within one year before the filing of the successful petition for rehabilitation or within 2 years before the filing of the successful petition for liquidation, whichever time is shorter. [PL 1991, c. 828, §31 (NEW).] B. Any preference may be avoided by the liquidator if: (1) The insurer was insolvent at the time of the transfer; (2) The transfer was made within 4 months before the filing of the petition; (3) The creditor receiving it or to be benefitted by it or the creditor's agent had reasonable cause to believe that the insurer was insolvent or was about to become insolvent when the transfer was made; or (4) The creditor receiving it was an officer of the insurer or any employee or attorney or other person who was in fact in a position of comparable influence with the insurer whether or not that person held such a position, or any shareholder holding directly or indirectly more than 5% of any class of any equity security issued by the insurer, or any other person, firm, corporation, association or aggregation of persons with whom the insurer did not deal at arm's length. [PL 1991, c. 828, §31 (NEW).] C. Where the preference is voidable, the liquidator may recover the property or its value if it has been converted from any person who received or converted the property, except that, where a bona fide purchaser or lienor has given less than fair equivalent value, that person is deemed to have a lien upon the property to the extent of the consideration actually given. When a preference by way of lien or security interest is voidable, the court may on due notice order the lien or title to be preserved for the benefit of the estate, in which event the lien or title passes to the liquidator. [PL 1991, c. 828, §31 (NEW).] D. The determination of when a transfer is made is governed by subsection 1, paragraph B . [PL 1991, c. 828, §31 (NEW).] E. A transfer of property for or on account of a new and contemporaneous consideration, which is considered under subsection 1, paragraph B to be made or suffered after the transfer because of delay in perfecting it, does not become a transfer for or on account of an antecedent debt if any acts required by the applicable law to be performed in order to perfect the transfer as against liens or bona fide purchasers' rights are performed within 21 days or any period expressly allowed by the law, whichever is less. A transfer to secure a future loan, if such a loan is actually made, or a transfer which becomes security for a future loan, has the same effect as a transfer for or on account of a new and contemporaneous consideration. [PL 1991, c. 828, §31 (NEW).] F. If any lien considered voidable under paragraph B is dissolved by the furnishing of a bond or other obligation, the surety that was indemnified directly or indirectly by the transfer of or the creation of a lien upon any property of an insurer before the filing of a petition under this chapter that results in a liquidation order, the indemnifying transfer or lien is also voidable. [PL 1991, c. 828, §31 (NEW).] G. The property affected by any lien considered voidable under this subsection must be discharged from the lien, and that property and any of the indemnifying property transferred to or for the benefit of a surety must pass to the liquidator; except that, the court may on due notice order a lien to be preserved for the benefit of the estate and the court may direct that a conveyance be executed as may be proper or adequate to evidence the title of the liquidator. [PL 1991, c. 828, §31 (NEW).] H. The court has summary jurisdiction of any proceeding by the liquidator to hear and determine the rights of any parties under this section. Reasonable notice of any hearing in the proceeding must be given to all parties in interest, including the obligee of a releasing bond or other like obligation. Where an order is entered for the recovery of indemnifying property in kind or for the avoidance of an indemnifying lien, the court, upon application of any party in interest, shall in the same proceeding ascertain the value of the property or lien. If the court finds that the value is less than the amount for which the property is held as indemnity or the amount of the lien, the transferee or lienholder may elect to retain the property or lien upon payment to the liquidator of its value as ascertained by the court within a reasonable time as fixed by the court. [PL 1991, c. 828, §31 (NEW).] I. The liability of the surety under a releasing bond or other like obligation must be discharged to the extent of the value of the indemnifying property recovered or the indemnifying lien nullified and avoided by the liquidator or, when the property is retained under paragraph H , to the extent of the amount paid to the liquidator. [PL 1991, c. 828, §31 (NEW).] J. If a creditor has been preferred and afterward in good faith gives the insurer further credit for property that becomes a part of the insurer's estate without security of any kind, the amount of the new credit remaining unpaid at the time of the petition may be set off against the preference that would otherwise be recoverable. [PL 1991, c. 828, §31 (NEW).] K. If, within 4 months before the filing of a successful petition for liquidation under this chapter or at any time in contemplation of a proceeding to liquidate an insurer, the insurer pays money or transfers property, directly or indirectly, to an attorney-at-law for services rendered or to be rendered, the transactions may be examined by the court on its own motion and must be examined by the court on petition of the liquidator and may be held valid only to the extent they are reasonable in amount as determined by the court. Any excess may be recovered by the liquidator for the benefit of the estate; except that, where the attorney is in a position of influence in the insurer or an affiliate of the insurer, payment of any money or the transfer of any property to the attorney for services rendered or to be rendered is governed by the provisions of paragraph B , subparagraph (4). [PL 1991, c. 828, §31 (NEW).] L. An officer, manager, employee, shareholder, member, subscriber, attorney or any other person acting on behalf of the insurer who knowingly participates in giving any preference when that person has reasonable cause to believe the insurer is or is about to become insolvent at the time of the preference is personally liable to the liquidator for the amount of the preference. If the transfer was made within 4 months before the date of filing of a successful petition for liquidation, a presumption arises that there was reasonable cause to believe the insurer was or was about to become insolvent. [PL 1991, c. 828, §31 (NEW).] M. A person receiving any property from the insurer or a benefit from possession or use of the property as a preference voidable under this subsection is personally liable for the value of that preference and shall account to the liquidator. [PL 1991, c. 828, §31 (NEW).] N. Nothing in this subsection prejudices any other claim by the liquidator against any person. [PL 1991, c. 828, §31 (NEW).] [PL 1991, c. 828, §31 (NEW).]

4. Claims of holders of void or voidable rights. Claims of holders of void or voidable rights are governed by this subsection. A. A claim of a creditor who has received or acquired a preference, lien, conveyance, transfer, assignment or encumbrance voidable under this section is not allowed unless the claimant surrenders the preference, lien, conveyance, transfer, assignment or encumbrance. If the avoidance is effected by a proceeding in which a final judgment is entered, the claim is not allowed unless the money is paid or the property is delivered to the liquidator within 30 days from the date of the entering of the final judgment; except that the court having jurisdiction over the liquidation may allow further time if there is an appeal or other continuation of the proceeding. [PL 1991, c. 828, §31 (NEW).] B. A claim allowable under paragraph A by reason of the avoidance, whether voluntary or involuntary, of a preference, lien, conveyance, transfer, assignment or encumbrance may be filed as an excused late filing if filed within 30 days from the date of the avoidance or within any further time allowed by the court under paragraph A . [PL 1991, c. 828, §31 (NEW).] [PL 1991, c. 828, §31 (NEW).]

5. Negotiable instruments. Nothing in this section impairs the negotiability of currency or negotiable instruments. [PL 1991, c. 828, §31 (NEW).]

6. Avoidance of transfers. Notwithstanding subsection 1 , 2 , 3 or 4 or any provision of this chapter to the contrary, a receiver, rehabilitator, liquidator or any other person may not: A. Avoid any transfer of or any obligation to transfer money or other property arising under or in connection with any pledge, security, credit, collateral, loan, advance, reimbursement or guarantee agreement or arrangement or any similar agreement, arrangement or other credit enhancement to which a federal home loan bank is a party that is made, incurred or assumed prior to or after the filing of a successful petition for rehabilitation or liquidation under this chapter, or otherwise would be subject to avoidance under this section, except the avoidance of a transfer under this section if the transfer was made with actual intent to hinder, delay or defraud the insurer, a receiver appointed for the insurer or an existing or future creditor; and [PL 2025, c. 17, §7 (NEW).] B. Avoid any preference arising under or in connection with any pledge, security, credit, collateral, loan, advance, reimbursement or 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, §7 (NEW).] [PL 2025, c. 17, §7 (NEW).]
24-A M.R.S. § 2695 — ME Code / Title 24-A / Chapter 32-A / Section 2695
24-A §2695. Disclosure requirements
Status: in_force

1. Outline of coverage. Except as provided in subsections 7 and 8 , an insurer shall deliver an outline of coverage to an applicant or enrollee in connection with the sale of individual health insurance, group health insurance, dental plans and vision care plans delivered or issued for delivery in this State. [PL 2001, c. 410, Pt. C, §1 (NEW).]

2. Sale through producer. If the sale of a policy described in subsection 1 occurs through a producer, the outline of coverage must be delivered to the applicant at the time of application or to the certificate holder at the time of enrollment. [PL 2001, c. 410, Pt. C, §1 (NEW).]

3. Sale through direct-response advertising. If the sale of a policy described in subsection 1 occurs through direct-response advertising, the outline of coverage must be delivered no later than in conjunction with the issuance of the policy or delivery of the certificate. [PL 2001, c. 410, Pt. C, §1 (NEW).]

4. Outline of coverage not delivered at time of application or enrollment. If the outline of coverage required in subsections 1 and 8 and in any rules adopted by the superintendent pursuant to this chapter is not delivered at the time of application or enrollment, the advertising materials delivered to the applicant or enrollee must contain all the information required in subsection 8 and in any rules adopted by the superintendent pursuant to this chapter. [PL 2001, c. 410, Pt. C, §1 (NEW).]

5. Outline of coverage delivered at time of application or enrollment. If the outline of coverage is delivered to the applicant or enrollee at the time of application or enrollment, the insurer must collect an acknowledgment of receipt or certificate of delivery of the outline of coverage and the insurer must maintain evidence of the delivery. [PL 2001, c. 410, Pt. C, §1 (NEW).]

6. Coverage issued on basis other than as applied for. If coverage is issued on a basis other than as applied for, an outline of coverage properly describing the coverage or contract actually issued must be delivered with the policy or certificate to the applicant or enrollee. [PL 2001, c. 410, Pt. C, §1 (NEW).]

7. Outline of coverage not required. An outline of coverage for group health insurance, a group dental plan or a group vision care plan is not required to be delivered to certificate holders if the certificate contains a brief description of: A. Benefits; [PL 2001, c. 410, Pt. C, §1 (NEW).] B. Provisions that exclude, eliminate, restrict, limit, delay or in any other manner operate to qualify payment of the benefits; [PL 2001, c. 410, Pt. C, §1 (NEW).] C. Renewability provisions; and [PL 2001, c. 410, Pt. C, §1 (NEW).] D. Notice requirements as provided in rules adopted pursuant to this chapter. [PL 2001, c. 410, Pt. C, §1 (NEW).] [PL 2001, c. 410, Pt. C, §1 (NEW).]

8. Superintendent shall prescribe format and content of outline of coverage. The superintendent shall prescribe the format and content of the outline of coverage required by subsection 1 . As used in this subsection, "format" means style, arrangement and overall appearance, including items such as the size, color and prominence of type and the arrangement of text and captions. The rules may exempt certain group policies from the requirement to deliver an outline of coverage to an applicant or enrollee. The outline of coverage must include: A. A statement identifying the applicable category or categories of coverage as prescribed in section 2694 ; [PL 2001, c. 410, Pt. C, §1 (NEW).] B. A description of the principal benefits and coverage provided; [PL 2001, c. 410, Pt. C, §1 (NEW).] C. A statement of exceptions, reductions and limitations; [PL 2001, c. 410, Pt. C, §1 (NEW).] D. A statement of renewal provisions, including any reservation by the insurer of a right to change premiums; and [PL 2001, c. 410, Pt. C, §1 (NEW).] E. A statement that the outline is a summary of the policy or certificate issued or applied for and that the policy or certificate should be consulted to determine governing policy provisions. [PL 2001, c. 410, Pt. C, §1 (NEW).] [PL 2001, c. 410, Pt. C, §1 (NEW).]

9. Notice must be delivered to all applicants eligible for Medicare. An insurer shall deliver the notice required under rules applicable to Medicare supplement insurance to all applicants eligible for Medicare. [PL 2001, c. 410, Pt. C, §1 (NEW).]
24-A M.R.S. § 4321 — ME Code / Title 24-A / Chapter 56-A / Section 4321
24-A §4321. Consumer Health Care Division
Status: in_force

1. Division established. The Consumer Health Care Division, referred to in this section as the "division," is established within the Bureau of Insurance. The division shall work in coordination with other bureau sections and staff to accomplish the duties set forth in subsection 4 . [PL 1997, c. 792, §3 (NEW).]

2. Director. The Director of the Consumer Health Care Division, referred to in this section as the "director," is the head of the Consumer Health Care Division. The director is appointed by the superintendent and is subject to the approval of the Commissioner of Professional and Financial Regulation. The director is subject to the Civil Service Law. [PL 2005, c. 294, §23 (AMD).]

3. Staff. The superintendent may hire or assign personnel as determined necessary to perform the duties of the division subject to the approval of the Commissioner of Professional and Financial Regulation and subject to the Civil Service Law. The personnel are supervised by the director in consultation with the superintendent. The qualifications of those personnel must reflect the needs and responsibilities relating to the division's duties under this subchapter. [PL 1997, c. 792, §3 (NEW).]

4. Duties. The duties of the division include: A. Providing access to the division through a toll-free number; [PL 1997, c. 792, §3 (NEW).] B. Providing information to consumers regarding health care plan options and obtaining health care coverage and services. The division may not make any specific recommendations regarding commercially offered products; [PL 1997, c. 792, §3 (NEW).] C. Assisting enrollees to understand their rights and responsibilities under health care plans; [PL 1997, c. 792, §3 (NEW).] D. Providing information to consumers on health care plan performance by distributing materials and utilizing existing resources relating to health care plan performance; [PL 1997, c. 792, §3 (NEW).] E. Providing assistance to enrollees with complaints relating to health care plans, when appropriate. The division may assist enrollees with quality-of-care complaints by coordinating with the appropriate state health professional licensing boards and other appropriate state and federal oversight bodies with authority over quality-of-care complaints. The division shall defer any issues of professional competence to the appropriate state health professional licensing boards; [PL 1997, c. 792, §3 (NEW).] F. Collecting and disseminating information regarding health care plans, quality assurance programs and quality improvement and coordinating information with other public entities or agencies involved in the delivery, funding or regulation of health care; [PL 1997, c. 792, §3 (NEW).] G. Acting as an information resource in the development of policies and programs that protect consumer interests and rights under health care plans by: (1) Analyzing, evaluating and monitoring the development and implementation of federal, state and local laws, regulations, rules and other governmental policies and actions that pertain to the health, safety, welfare and rights of health care consumers; and (2) Identifying practices and policies that may affect access to quality health care, including, but not limited to, practices relating to marketing of health care plans and accessibility of services and resources for under-served areas and vulnerable populations. The division may refer these issues to the appropriate state or federal regulatory agency with jurisdiction over these practices and policies; [PL 1997, c. 792, §3 (NEW).] H. Promoting coordination between the division and other organizations that assist consumers, including, but not limited to, legal assistance providers serving low-income health care consumers and other health care consumers, health insurance counseling assistance programs, the long-term care ombudsman program pursuant to Title 22, section 5106, subsection 11‑C and assistance programs for individuals with disabilities established under federal or state law; [PL 1997, c. 792, §3 (NEW).] I. Collecting and disseminating information regarding the activities of the division; [PL 1997, c. 792, §3 (NEW).] J. Submitting an annual report by January 1st of each year to the Commissioner of Professional and Financial Regulation, the Consumer Health Care Division Advisory Council and the joint standing committee of the Legislature having jurisdiction over insurance matters describing the activities carried out by the division in the year for which the report is prepared, analyzing the data available to the division and evaluating the problems experienced by consumers; and [PL 1997, c. 792, §3 (NEW).] K. Performing other duties as the superintendent may prescribe. [PL 1997, c. 792, §3 (NEW).] [PL 1997, c. 792, §3 (NEW).]
24-A M.R.S. § 2016 — ME Code / Title 24-A / Chapter 19 / Section 2016
24-A §2016. Periodic reports and tax payments
Status: in_force

1. Each producer with surplus lines authority shall maintain in the producer's office a monthly report showing the amount of insurance placed for any person or organization, the location of each risk, the gross premium charged, the name of each insurer with which the insurance was placed, the date and term of each insurance contract issued during the preceding month and any other pertinent information required by the superintendent. The report must show in the same detail each contract cancelled during the month covered by the report and the return premium on it. The monthly report must be made available to the superintendent for examination at the producer's office location at any time or by delivery to the bureau upon 5 days' notice by the superintendent. [PL 2007, c. 51, §6 (AMD).]

2. [PL 2011, c. 331, §5 (RP); PL 2011, c. 331, §§16, 17 (AFF).]
24-A M.R.S. § 1156 — ME Code / Title 24-A / Chapter 13-A / Section 1156
24-A §1156. Reserve and other investments
Status: in_force

1. Standard of care. When investing the assets of an insurer, the directors and officers of the insurer shall perform their duties in good faith and with that degree of care that an ordinarily prudent person in a like position would use under similar circumstances. [PL 1987, c. 399, §14 (NEW).]

2. Investment classes. Subject to section 1155 , the assets of an insurer may be invested in the following classes, subject to the percentage limitations contained in this subsection: A. Obligations issued, assumed, guaranteed or insured by the United States or by any state or by the District of Columbia, or any other governmental unit in the United States, its territories or possessions, or by any agency or instrumentality of any of those, provided that those obligations are by law payable, as to both principal and interest, from taxes upon all property or income within the jurisdiction of that governmental unit, or from adequate special revenues pledged or appropriated or otherwise by law required to be provided for the purpose of that payment, but not including special assessments on properties benefitted by local improvements unless adequate security is evidenced by the ratio of assessment to the value of those properties, or unless the obligation is additionally secured by an adequate guaranty fund required by law; [PL 1987, c. 399, §14 (NEW).] B. Obligations issued, assumed, guaranteed or accepted by domestic institutions or by trustees or receivers of those institutions, and preferred shares of any of those institutions, provided that without the prior approval of the superintendent, no domestic insurer may acquire any high-yield or medium grade obligations of any institution if: (1) The aggregate amount of all medium grade obligations and all high-yield obligations then held by the insurer exceeds 20% of its admitted assets; (2) The aggregate amount of all high-yield obligations then held by the insurer exceeds 10% of its admitted assets; (3) The aggregate amount of all high-yield obligations rated 5 or 6 by the Securities Valuation Office of the National Association of Insurance Commissioners or, if not valued by the National Association of Insurance Commissioners, rated the equivalent of 5 or 6 by Moody's Investors Service, Inc., Standard and Poor's Corporation, Fitch Investors Service, Inc. or Duff and Phelps, Inc., exceeds 3% of admitted assets; (4) The aggregate amount of all high-yield obligations rated 6 by the Securities Valuation Office of the National Association of Insurance Commissioners or, if not valued by the National Association of Insurance Commissioners, rated the equivalent of 6 by Moody's Investors Service, Inc., or rated D by Standard and Poor's Corporation, Fitch Investors Service, Inc., or Duff and Phelps, Inc., exceeds 1% of admitted assets; (5) The aggregate amount of medium grade obligations issued, guaranteed or insured by any one institution then held by the insurer exceeds 1/2 of 1% of its admitted assets; or (6) The aggregate amount of high-yield obligations issued, guaranteed or insured by any one institution then held by the insurer exceeds 1/2 of 1% of its admitted assets. [PL 1993, c. 313, §26 (RPR).] C. Obligations secured by liens on real property or interests in real property located within the United States and not eligible under paragraph A or B acquired directly or indirectly through limited partnership interests, general partnership interests, joint ventures, stock of an investment subsidiary or membership interests in a limited liability company, trust certificates or other similar instruments if, at the time of the acquisition, the obligation does not exceed: (1) Ninety percent of the fair market value of the real estate, if the mortgage loan is secured by a purchase money mortgage or like security received by the insurer upon disposition of the real estate; (2) Eighty percent of the fair market value of the real estate, if the mortgage loan requires immediate scheduled payment in periodic installments of principal and interest, has an amortization period of 30 years or less and requires periodic payments made no less frequently than annually. Each periodic payment must be sufficient to ensure that at all times the outstanding principal balance of the mortgage loan may not be greater than the outstanding principal balance that would be outstanding under a mortgage loan with the same original principal balance, with the same interest rate and requiring equal payments of principal and interest with the same frequency over the same amortization period. Mortgage loans that are otherwise permitted under this subparagraph may provide for a payment of the principal balance before the end of the period of amortization of the loan. For residential mortgage loans, the 80% limitation may be increased to 97% if acceptable private mortgage insurance has been obtained; or (3) Seventy-five percent of the fair market value of the real estate for mortgage loans that do not meet the requirements of subparagraph (1) or (2). A mortgage loan that is secured by other than a first lien may not be acquired under this paragraph unless the insurer is the holder of the first lien. For purposes of this paragraph, the amount of an obligation required to be included in the calculation of the loan-to-value ratio may be reduced to the extent the obligation is insured by the Federal Housing Administration or guaranteed by the Administrator of Veterans' Affairs, or their successors. A mortgage loan that is acquired under this paragraph and is restructured in a manner that meets the requirements of a restructured mortgage loan in accordance with the National Association of Insurance Commissioners accounting practices and procedures manual or successor publication continues to qualify as a mortgage loan under this paragraph. [PL 1999, c. 715, §12 (AMD).] D. Investments in real property or interests therein located in the United States, held directly or evidenced by partnership interests, stock of corporations, trust certificates or other instruments and acquired: (1) As an investment for the production of income or to be improved or developed for that investment purpose; or (2) For the convenient accommodation of the insurer's business. After giving effect to any of those types of investments, the aggregate amount of investments made under subparagraph (1) may not exceed 20% of the insurer's total admitted assets; the aggregate amount of investments made under subparagraph (2) may not exceed 10% of the insurer's total admitted assets; and the aggregate amount of investments made under this paragraph may not exceed 25% of the insurer's total admitted assets. Investments under subparagraph (1) in any single property, including improvements on that property, may not in the aggregate exceed 2% of the insurer's total admitted assets; [PL 1993, c. 313, §27 (AMD).] E. Investments in personal property or interests in that property located or used wholly or in part within the United States, held directly or evidenced by partnership interests, stock of corporations, trust certificates or other instruments, provided that, after giving effect to any investment of that type, the aggregate amount of those investments will not exceed 10% of the insurer's total admitted assets and provided that investments under this paragraph in any single item of personal property will not in the aggregate exceed 1% of the insurer's total admitted assets; [PL 1987, c. 399, §14 (NEW).] F. Investments, other than investments described in paragraph D or E and in addition to investments authorized by section 1157 , in common stock, partnership interests, trust certificates or other equity interests, other than preferred shares, of domestic institutions, provided that, after giving effect to any investment of that type under this paragraph, the aggregate amount of those investments will not exceed 20% of the insurer's total admitted assets; [PL 1987, c. 399, §14 (NEW).] F-1. Investment practices entered into under section 1153, subsection 4 or section 1160, subsection 6 ; [PL 2001, c. 471, Pt. D, §24 (NEW).] G. The following foreign investments in and investment practices with persons domiciled in foreign jurisdictions: (1) Canadian securities and investments substantially of the same classes as those eligible for investment under paragraphs A to F , but the aggregate amount of those investments that are held at any time by any insurer may not exceed 10% of total admitted assets, except when a greater amount is permitted pursuant to subparagraph (2), in which case this subparagraph is not applicable; (2) In the case of any insurer that is authorized to do business in a foreign country or possession of the United States or that has outstanding insurance, annuity or reinsurance contracts on lives or risks resident or located in a foreign country or possession of the United States, securities and investments in that foreign country or possession that are substantially of the same classes as those eligible for investment under paragraphs A to F, but the aggregate amount of such investments in a foreign country or a possession of the United States and of cash in the currency of that country or possession that is at any time held by that insurer may not, except as provided in paragraph H , exceed 1 1/2 times the amount of its reserves and other obligations under those contracts or the amount that that insurer is required by law to invest in that country or possession, whichever is greater; (3) Foreign investments in and foreign investment practices with persons domiciled in foreign jurisdictions that are substantially of the same classes as those eligible for investment under this chapter, if after giving effect to the investment or transaction: (a) The aggregate amount of foreign investments then held by the insurer and foreign investment practices then engaged in by the insurer under this subparagraph does not exceed 20% of its admitted assets; and (b) The aggregate amount of foreign investments then held by the insurer and foreign investment practices then engaged in by the insurer under this subparagraph in a single foreign jurisdiction does not exceed 10% of its admitted assets if the foreign jurisdiction has a sovereign debt rating of "1" from the Securities Valuation Office of the National Association of Insurance Commissioners or 3% of its admitted assets if the foreign jurisdiction has a sovereign debt rating other than "1" from the Securities Valuation Office of the National Association of Insurance Commissioners; and (4) Investments and investment practices denominated in foreign currencies whether or not they are foreign investments acquired or foreign investment practices engaged in pursuant to subparagraphs (1) or (3), or additional foreign currency exposure as a result of the termination or expiration of a hedging transaction with respect to investments or investment practices denominated in a foreign currency if: (a) The aggregate amount of investments then held by the insurer and investment practices then engaged in by the insurer under this subparagraph denominated in foreign currencies does not exceed 10% of its admitted assets; and (b) The aggregate amount of investments then held by the insurer and investment practices then engaged in by the insurer under this subparagraph denominated in the currency of a single foreign jurisdiction does not exceed 10% of its admitted assets if the foreign jurisdiction has a sovereign debt rating of "1" from the Securities Valuation Office of the National Association of Insurance Commissioners or 3% of its admitted assets if the foreign jurisdiction has a sovereign debt rating other than "1" from the Securities Valuation Office of the National Association of Insurance Commissioners. An investment or an investment practice is not considered denominated in a foreign currency if the insurer enters into one or more hedging transactions permitted under section 1153, subsection 4 to hedge the foreign currency exchange rate risk associated with such investment or investment practice; and [PL 1999, c. 715, §13 (AMD).] H. Investments that do not qualify or are not permitted under any other paragraph of this subsection; as long as: (1) After giving effect to any investment made under this paragraph, the aggregate amount of those investments does not exceed 14% of total admitted assets, except that investments made under this paragraph in institutions or property not located within the State may not exceed 10% of total admitted assets; and, if the insurer makes investments described in paragraphs A to G and elects to charge those investments against the quantitative limits in this paragraph instead of the quantitative limits in paragraphs A to G , then the aggregate amount invested under this paragraph in those types of investments may not exceed 5% of total admitted assets for any one of those types of investments; (2) Investments that are neither interest bearing nor income entitled are subject to all of the provisions of this paragraph; and the aggregate amount of those investments held at any one time may not exceed 3% of total admitted assets; (3) The investment limitations contained in this chapter, qualitative or otherwise, do not apply to loans or investments made or acquired under this paragraph, provided that no loan or investment made or acquired under this paragraph may be represented by any asset determined to be nonadmitted pursuant to section 901-A or rules adopted under that section; any loan or investment expressly prohibited under section 1160; or agents' balances, or amounts advanced to or owing by agents, except as to policy loans, mortgage loans and collateral loans to those agents otherwise authorized under this chapter; or (4) The insurer shall keep a separate record of all loans and investments made or acquired under this paragraph. Any such loan or investment that, subsequent to the date of making or acquisition, has attained the standard of eligibility and qualifies under any other provision of this chapter may be considered to have been made or acquired under and in compliance with that provision and may no longer be considered to have been made or acquired under this paragraph. [PL 2001, c. 471, Pt. A, §27 (AMD).] [PL 2001, c. 471, Pt. A, §27 (AMD); PL 2001, c. 471, Pt. D, §24 (AMD).]

3. Determination of eligibility. The eligibility of any investment under any paragraph of subsection 2 must be determined at the time of acquisition, except that investments qualified under subsection 2, paragraph H , may be requalified at a later date under another provision of this chapter, if the relevant conditions are satisfied at the time of such requalification. [PL 1993, c. 313, §28 (AMD).]
24-A M.R.S. § 2932 — ME Code / Title 24-A / Chapter 40 / Section 2932
24-A §2932. Definitions
Status: in_force

As used in this chapter, unless the context otherwise indicates, the following words shall have the following meanings. [PL 1973, c. 625, §146 (NEW).]

1. Casualty insurance. "Casualty insurance" means all contracts of insurance covered by section 707 . [PL 1973, c. 625, §146 (NEW).]

2. Mass marketing plan. "Mass marketing plan" means a method of selling property and casualty insurance wherein such insurance is offered to employees of particular employers or to members of particular associations or organizations or to persons grouped in other ways and the employer, association or organization has agreed to or otherwise affiliated itself with, or facilitated, the sale of such insurance to its employees or members and employees and includes without limitation such plans whether described as "mass merchandising," "group merchandising," "franchise merchandising" or "collective merchandising." [PL 1973, c. 625, §146 (NEW).]

3. Property insurance. "Property insurance" means all contracts of insurance covered by section 705 . [PL 1973, c. 625, §146 (NEW).]
24-A M.R.S. § 2829-A — ME Code / Title 24-A / Chapter 35 / Section 2829-A
24-A §2829-A. Disability benefit offsets
Status: in_force

1. Disclosure to persons eligible for coverage. For any policy or contract subject to this chapter that provides disability income benefits, if the benefits under that policy or contract are subject to reduction due to other sources of income, then the insurer shall include in any written enrollment material and certificate of coverage developed by the insurer that is intended to be distributed to persons eligible for coverage under the policy or contract a clear and conspicuous notice that accurately explains all types of other sources of income that may result in a reduction of the benefits payable under the policy or contract. The notice requirement under this section does not apply to an advertisement intended for the general public. [PL 2005, c. 42, §2 (NEW).]

2. Recovery of disability benefit overpayments. For claims filed after January 1, 2006, an insurer that is entitled to reduce disability income benefit payments when the insured receives income from other sources and that is entitled to recover overpayments through offsets against current payments to the insured may not recover such overpayments at a rate greater than 20% of the net benefit per benefit payment period unless: A. For policies applied for after September 13, 2003, the insurer has complied with the requirements of subsection 1 ; [PL 2005, c. 42, §2 (NEW).] B. The insurer effects the offset of benefits within 60 days of notice to the insurer, or such later date as the insurer begins paying benefits to the insured, that the insured is receiving or is entitled to receive income that may result in a reduction of benefits payable under the policy; [PL 2005, c. 42, §2 (NEW).] C. The overpayment did not result from the insurer's miscalculation of benefit reductions or the insurer's miscalculation of benefits payable under the policy; and [PL 2005, c. 42, §2 (NEW).] D. The insurer provided the insured with clear and conspicuous written notice that accurately explains to the insured all types of other sources of income that may result in a reduction of the benefits payable under the policy within 30 days of the date a claim for disability benefits was filed. [PL 2005, c. 42, §2 (NEW).] [PL 2005, c. 42, §2 (NEW).]
24 M.R.S. § 2306 — ME Code / Title 24 / Chapter 19 / Section 2306
24 §2306. Reports
Status: in_force

Every corporation organized under this chapter shall file in the office of the superintendent annual and quarterly financial statements substantially similar to those required of health insurers under Title 24‑A, sections 423 , 423‑A and 423‑D verified by at least 2 of the principal officers of that corporation. The statement must be on an annual or quarterly statement blank of the National Association of Insurance Commissioners for use by nonprofit hospital or medical service corporations, be prepared in accordance with the association's annual or quarterly statement instructions, follow practices and procedures prescribed by the association's accounting practices and procedures manual and be accompanied by any useful or necessary modification or adaptation and any additional information required by the superintendent. The superintendent may by rule or order require the filing of more frequent reports. [PL 2017, c. 169, Pt. A, §1 (AMD).]

A nonprofit hospital or medical service corporation that controls and operates a health maintenance organization as a division or line of business of the corporation shall file on a continuing basis any additional periodic financial reports required by Title 24‑A, section 4208 . [PL 2017, c. 169, Pt. A, §1 (AMD).]
24-A M.R.S. § 993 — ME Code / Title 24-A / Chapter 11 / Section 993
24-A §993. Actuarial opinion of reserves and supporting documentation
Status: in_force

1. Statement of actuarial opinion. Every property and casualty insurance company doing business for covered kinds of insurance in this State, unless otherwise exempted by the domiciliary commissioner, shall annually submit the opinion of an appointed qualified actuary entitled “Statement of Actuarial Opinion.” This opinion must be filed in accordance with the appropriate NAIC property and casualty annual statement instructions. [PL 2007, c. 281, §2 (NEW); PL 2007, c. 281, §3 (AFF).]

2. Actuarial opinion summary. An actuarial opinion summary is required pursuant to this subsection. A. Every property and casualty insurance company domiciled in this State that is required to submit a statement of actuarial opinion shall annually submit an actuarial opinion summary, written by the company’s appointed qualified actuary. This actuarial opinion summary must be filed in accordance with the appropriate NAIC property and casualty annual statement instructions and must be considered as a document supporting the actuarial opinion required in subsection 1 . [PL 2007, c. 281, §2 (NEW); PL 2007, c. 281, §3 (AFF).] B. A property and casualty insurance company licensed but not domiciled in this State shall provide an actuarial opinion summary upon request of the superintendent. [PL 2007, c. 281, §2 (NEW); PL 2007, c. 281, §3 (AFF).] [PL 2007, c. 281, §2 (NEW); PL 2007, c. 281, §3 (AFF).]

3. Actuarial report and work papers. An actuarial report is required pursuant to this subsection. A. An actuarial report and underlying work papers as required by the appropriate NAIC property and casualty annual statement instructions must be prepared to support each actuarial opinion. [PL 2007, c. 281, §2 (NEW); PL 2007, c. 281, §3 (AFF).] B. If a property and casualty insurance company fails to provide a supporting actuarial report or work papers at the request of the superintendent or the superintendent determines that the supporting actuarial report or work papers provided by the company are otherwise unacceptable to the superintendent, the superintendent may engage a qualified actuary at the expense of the company to review the opinion and the basis for the opinion and prepare the supporting actuarial report or work papers. [PL 2007, c. 281, §2 (NEW); PL 2007, c. 281, §3 (AFF).] [PL 2007, c. 281, §2 (NEW); PL 2007, c. 281, §3 (AFF).]

4. Liability. The appointed qualified actuary is not liable for damages to any person, other than the property and casualty insurance company and the superintendent, for any act, error, omission, decision or conduct with respect to the actuary's opinion, except in cases of fraud, willful misconduct or reckless disregard on the part of the actuary. [PL 2007, c. 281, §2 (NEW); PL 2007, c. 281, §3 (AFF).]
24-A M.R.S. § 6405 — ME Code / Title 24-A / Chapter 77 / Section 6405
24-A §6405. Disclosure
Status: in_force

Before the effective date of any policy placed with a controlled insurer by a controlling producer or a controlling producer's subproducer, the controlling producer shall deliver written notice to the prospective insured disclosing the relationship between the producer and the controlled insurer, except that if the business is placed through a subproducer who is not a controlling producer, the controlling producer shall retain and enforce a signed commitment from the subproducer that the subproducer is aware of the relationship between the insurer and the controlling producer and that the subproducer has notified or will notify the insured. [PL 2017, c. 169, Pt. E, §10 (AMD).]
24-A M.R.S. § 3418 — ME Code / Title 24-A / Chapter 47 / Section 3418
24-A §3418. Dividends to policyholders
Status: in_force

1. The directors of a domestic mutual insurer may from time to time apportion and pay or credit to its members dividends only out of that part of its accumulated surplus funds which represents net realized savings, net realized earnings and net realized capital gains, all in excess of the surplus required by law to be maintained by the insurer. [PL 1969, c. 132, §1 (NEW).]

2. A dividend otherwise proper may be payable out of such savings, earnings and gains even though the insurer's total surplus is then less than the aggregate of contributed surplus remaining unpaid by the insurer. [PL 1969, c. 132, §1 (NEW).]

3. A domestic stock insurer may pay dividends to holders of its participating policies out of any available surplus funds. [PL 1969, c. 132, §1 (NEW).]

4. No dividend shall be paid which is inequitable, or which unfairly discriminates as between classifications of policies or policies within the same classifications. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 4301-A — ME Code / Title 24-A / Chapter 56-A / Section 4301-A
24-A §4301-A. Definitions
Status: in_force

As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 1999, c. 742, §3 (NEW).]

1. Adverse health care treatment decision. "Adverse health care treatment decision" means a health care treatment decision made by or on behalf of a carrier offering or renewing a health plan denying in whole or in part payment for or provision of otherwise covered services requested by or on behalf of an enrollee. "Adverse health care treatment decision" includes a rescission determination and an initial coverage eligibility determination, consistent with the requirements of the federal Affordable Care Act, and a prior authorization determination in accordance with section 4304 . [PL 2023, c. 680, Pt. A, §1 (AMD); PL 2023, c. 680, Pt. A, §10 (AFF).]

1-A. Aids and assists legally protected health care activity. "Aids and assists legally protected health care activity" has the same meaning as in Title 14, section 9002, subsection 1 . [PL 2023, c. 648, Pt. E, §4 (NEW).]

2. Authorized representative. "Authorized representative" means: A. A person to whom an enrollee has given express written consent to represent the enrollee in an external review; [PL 1999, c. 742, §3 (NEW).] B. A person authorized by law to provide consent to request an external review for an enrollee; [PL 2023, c. 680, Pt. A, §2 (AMD); PL 2023, c. 680, Pt. A, §10 (AFF).] C. A family member of an enrollee or an enrollee's treating health care provider when the enrollee is unable to provide consent to request an external review; or [PL 2023, c. 680, Pt. A, §2 (AMD); PL 2023, c. 680, Pt. A, §10 (AFF).] D. A provider that is actively treating an enrollee. [PL 2023, c. 680, Pt. A, §2 (NEW); PL 2023, c. 680, Pt. A, §10 (AFF).] [PL 2023, c. 680, Pt. A, §2 (AMD); PL 2023, c. 680, Pt. A, §10 (AFF).]

2-A. Behavioral health care service. "Behavioral health care service" means a health care service or treatment to address mental health and substance use conditions. [PL 2023, c. 119, §1 (NEW); PL 2023, c. 119, §4 (AFF).]

3. Carrier. "Carrier" means: A. An insurance company licensed in accordance with this Title to provide health insurance; [PL 1999, c. 742, §3 (NEW).] B. A health maintenance organization licensed pursuant to chapter 56 ; [PL 1999, c. 742, §3 (NEW).] C. A preferred provider arrangement administrator registered pursuant to chapter 32 ; [PL 1999, c. 742, §3 (NEW).] D. A fraternal benefit society, as defined by section 4101 ; [PL 1999, c. 742, §3 (NEW).] E. A nonprofit hospital or medical service organization or health plan licensed pursuant to Title 24 ; [PL 1999, c. 742, §3 (NEW).] F. A multiple-employer welfare arrangement licensed pursuant to chapter 81 ; [PL 2011, c. 364, §21 (AMD).] G. A self-insured employer subject to state regulation as described in section 2848‑A ; or [PL 2011, c. 364, §21 (AMD).] H. Notwithstanding any other provision of this Title, an entity offering coverage in this State that is subject to the requirements of the federal Affordable Care Act. [PL 2011, c. 364, §22 (NEW).] An employer exempted from the applicability of this chapter under the federal Employee Retirement Income Security Act of 1974, 29 United States Code, Sections 1001 to 1461 (1988) is not considered a carrier. [PL 2011, c. 364, §§21, 22 (AMD).]

4. Clinical peer. "Clinical peer" means a physician or other licensed health care practitioner who holds a nonrestricted license in a state of the United States, is board certified in the same or similar specialty as typically manages the medical condition, procedure or treatment under review and whose compensation does not depend, directly or indirectly, upon the quantity, type or cost of the medical condition, procedure or treatment that the physician or other licensed health care practitioner approves or denies on behalf of a carrier. [PL 2019, c. 171, §1 (AMD).]

4-A. Emergency medical condition. "Emergency medical condition" means the sudden and, at the time, unexpected onset of a physical or mental health condition, including severe pain, manifesting itself by symptoms of sufficient severity, regardless of the final diagnosis that is given, that would lead a prudent layperson, possessing an average knowledge of medicine and health, to believe: A. That the absence of immediate medical attention for an individual could reasonably be expected to result in: (1) Placing the physical or mental health of the individual or, with respect to a pregnant woman, the health of the pregnant woman or her unborn child in serious jeopardy; (2) Serious impairment of a bodily function; or (3) Serious dysfunction of any organ or body part; or [PL 2019, c. 238, §1 (NEW).] B. With respect to a pregnant woman who is having contractions, that there is: (1) Inadequate time to effect a safe transfer of the woman to another hospital before delivery; or (2) A threat to the health or safety of the woman or unborn child if the woman were to be transferred to another hospital. [PL 2019, c. 238, §1 (NEW).] [PL 2019, c. 238, §1 (NEW).]

4-B. Emergency service. "Emergency service" means a health care item or service furnished or required to evaluate and treat an emergency medical condition that is provided in an emergency facility or setting. [PL 2019, c. 238, §1 (NEW).]

5. Enrollee. "Enrollee" means an individual who is enrolled in a health plan or a managed care plan. [PL 1999, c. 742, §3 (NEW).]

5-A. Gender-affirming health care services. "Gender-affirming health care services" has the same meaning as in Title 14, section 9002, subsection 4 . [PL 2023, c. 648, Pt. E, §5 (NEW).]

6. Health care treatment decision. "Health care treatment decision" means a decision regarding diagnosis, care or treatment when medical services are provided by a health plan, or a benefits decision involving determinations regarding medically necessary health care, preexisting condition determinations and determinations regarding experimental or investigational services. [PL 2001, c. 288, §1 (AMD).]

7. Health plan. "Health plan" means a plan offered or administered by a carrier that provides for the financing or delivery of health care services to persons enrolled in the plan, other than a plan that provides only accidental injury, specified disease, hospital indemnity, Medicare supplement, disability income, long-term care or other limited benefit coverage not subject to the requirements of the federal Affordable Care Act. A plan that is subject to the requirements of the federal Affordable Care Act and offered in this State by a carrier, including, but not limited to, a qualified health plan offered on an American Health Benefit Exchange or a SHOP Exchange established pursuant to the federal Affordable Care Act, is a health plan for purposes of this chapter. [PL 2011, c. 364, §23 (AMD).]

8. Independent review organization. "Independent review organization" means an entity that conducts independent external reviews of adverse health care treatment decisions. [PL 1999, c. 742, §3 (NEW).]

8-A. Legally protected health care activity. "Legally protected health care activity" has the same meaning as in Title 14, section 9002, subsection 8 . [PL 2023, c. 648, Pt. E, §6 (NEW).]

9. Managed care plan. "Managed care plan" means a plan offered or administered by a carrier that provides for the financing or delivery of health care services to persons enrolled in the plan through: A. Arrangements with selected providers to furnish health care services; and [PL 1999, c. 742, §3 (NEW).] B. Financial incentives for persons enrolled in the plan to use the participating providers and procedures provided for by the plan. [PL 1999, c. 742, §3 (NEW).] A return to work program developed for the management of workers' compensation claims may not be considered a managed care plan. [PL 1999, c. 742, §3 (NEW).]

10. Medically appropriate health care. [PL 2001, c. 288, §2 (RP).]

10-A. Medically necessary health care. "Medically necessary health care" means health care services or products provided to an enrollee for the purpose of preventing, diagnosing or treating an illness, injury or disease or the symptoms of an illness, injury or disease in a manner that is: A. Consistent with generally accepted standards of medical practice; [PL 2001, c. 288, §3 (NEW).] B. Clinically appropriate in terms of type, frequency, extent, site and duration; [PL 2001, c. 288, §3 (NEW).] C. Demonstrated through scientific evidence to be effective in improving health outcomes; [PL 2001, c. 288, §3 (NEW).] D. Representative of "best practices" in the medical profession; and [PL 2001, c. 288, §3 (NEW).] E. Not primarily for the convenience of the enrollee or physician or other health care practitioner. [PL 2001, c. 288, §3 (NEW).] [PL 2001, c. 288, §3 (NEW).]

11. Medical necessity. [PL 2001, c. 288, §4 (RP).]

12. Ordinary care. "Ordinary care" means, in the case of a carrier, the degree of care that a carrier of ordinary prudence would use under the same or similar circumstances. For a person who is an agent of a carrier, "ordinary care" means the degree of care that a person of ordinary prudence would use under the same or similar circumstances. [PL 1999, c. 742, §3 (NEW).]

13. Participating provider. "Participating provider" means a licensed or certified provider of health care services, including mental health services, or health care supplies that has entered into an agreement with a carrier to provide those services or supplies to an individual enrolled in a managed care plan. [PL 1999, c. 742, §3 (NEW).]

14. Peer-reviewed medical literature. "Peer-reviewed medical literature" means scientific studies published in at least 2 articles from major peer-reviewed medical journals that present supporting data that the proposed use of a drug or device is safe and effective. [PL 1999, c. 742, §3 (NEW).]

15. Plan sponsor. "Plan sponsor" means an employer, association, public agency or any other entity providing a health plan. [PL 1999, c. 742, §3 (NEW).]

16. Provider. "Provider" means a practitioner or facility licensed, accredited or certified to perform specified health care services consistent with state law. [PL 1999, c. 742, §3 (NEW).]

16-A. Provider profiling program. "Provider profiling program" means a program that uses provider data in order to rate or rank provider quality, cost or efficiency of care by the use of a grade, star, tier, rating or any other form of designation that provides an enrollee with an incentive to use a designated provider based on quality, cost or efficiency of care. [PL 2013, c. 383, §3 (AMD).]

17. Religious nonmedical provider. "Religious nonmedical provider" means a provider who provides only religious nonmedical treatment or religious nonmedical nursing care. [PL 1999, c. 742, §3 (NEW).]

17-A. Reproductive health care services. "Reproductive health care services" has the same meaning as in Title 14, section 9002, subsection 9 . [PL 2023, c. 648, Pt. E, §7 (NEW).]

18. Special condition. "Special condition" means a condition or disease that is life-threatening, degenerative or disabling and requires specialized medical care over a prolonged period of time. [PL 1999, c. 742, §3 (NEW).]

19. Specialist. "Specialist" means an appropriately licensed and credentialed health care provider with specialized training and clinical expertise. [PL 1999, c. 742, §3 (NEW).]

20. Standard reference compendia. "Standard reference compendia" means: A. The United States Pharmacopeia Drug Information or information published by its successor organization; or [PL 1999, c. 742, §3 (NEW).] B. The American Hospital Formulary Service Drug Information or information published by its successor organization. [PL 1999, c. 742, §3 (NEW).] [PL 1999, c. 742, §3 (NEW).]

21. Urgent care. "Urgent care" means health care or treatment provided in response to exigent circumstances. [PL 2023, c. 119, §2 (NEW); PL 2023, c. 119, §4 (AFF).]
24-A M.R.S. § 3003 — ME Code / Title 24-A / Chapter 41 / Section 3003
24-A §3003. Combination coverages
Status: in_force

Any policy or contract otherwise subject to section 3002 (standard fire policy required; exceptions), which includes either on an unspecified basis as to the coverage or for a single premium coverage against the peril of fire and substantial coverage against other perils need not comply with such provisions, provided: [PL 1969, c. 132, §1 (NEW).]

1. Such policy or contract shall afford coverage, with respect to the peril of fire, not less than the coverage afforded by such Maine standard fire policy; [PL 1969, c. 132, §1 (NEW).]

2. That such coverage as to the peril of fire shall be made subject without change to the same general provisions and stipulations as those of such standard fire policy; [PL 1969, c. 132, §1 (NEW).]

3. The provisions in relation to mortgagee interests and obligations in such standard fire policy shall be incorporated therein without change; [PL 1969, c. 132, §1 (NEW).]

4. Such policy or contract is complete as to all of its terms without reference to the standard form of fire insurance policy or any other policy; [PL 1969, c. 132, §1 (NEW).]

5. The superintendent is satisfied that such policy or contract complies with the provisions hereof. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 2902-D — ME Code / Title 24-A / Chapter 39 / Section 2902-D
24-A §2902-D. Family exclusions prohibited
Status: in_force

An insurer may not sell or renew a motor vehicle liability insurance policy on or after January 1, 1994 with a provision that excludes coverage for injury to the insured or any family member of the insured. [PL 1993, c. 69, §2 (NEW).]
24-A M.R.S. § 2854 — ME Code / Title 24-A / Chapter 37 / Section 2854
24-A §2854. Forms available
Status: in_force

Consumer credit insurance may be issued only in the following forms: [PL 2001, c. 138, §8 (AMD).]

1. Individual life. Individual policies of life insurance issued to debtors on the term plan; [PL 1969, c. 132, §1 (NEW).]

2. Individual accident and health. Individual policies of health insurance issued to debtors on a term plan, or disability benefit provisions in individual policies of credit life insurance; [PL 1969, c. 132, §1 (NEW).]

3. Group life. Group policies of life insurance issued to creditors providing insurance upon the lives of debtors on the term plan; [PL 1969, c. 132, §1 (NEW).]

4. Group accident and health. Group policies of health insurance issued to creditors on a term plan insuring debtors, or disability benefit provisions in group credit life insurance policies to provide such coverage; [PL 1969, c. 132, §1 (NEW).]

4-A. Individual credit property insurance. Individual policies of property insurance on property that is purchased on credit or pledged as collateral on a loan when the insurance is purchased by or issued to the debtor in connection with that loan or credit transaction; [PL 2001, c. 138, §8 (NEW).]

4-B. Group credit property insurance. Group policies of property insurance on property that is purchased on credit or pledged as collateral on a loan when the insurance is purchased by or issued to the debtor in connection with that loan or credit transaction; [PL 2001, c. 138, §8 (NEW).]

4-C. Individual credit involuntary unemployment insurance. Individual involuntary unemployment policies insuring a debtor pursuant to or in connection with a specific loan or other credit transaction but not including disability insurance policies; [PL 2001, c. 138, §8 (NEW).]

4-D. Group credit involuntary unemployment insurance. Group involuntary unemployment policies insuring a debtor pursuant to or in connection with a specific loan or other credit transaction but not including disability insurance policies; or [PL 2001, c. 138, §8 (NEW).]

5. Combination. A combination under subsections 1 and 2 , or under 3 and 4 . [PL 1969, c. 132, §1 (NEW).]

The superintendent may by rules adopted pursuant to section 2865 or chapter 40‑A designate other permissible types of consumer credit insurance. [PL 2001, c. 138, §8 (NEW).]
24-A M.R.S. § 2152-B — ME Code / Title 24-A / Chapter 23 / Section 2152-B
24-A §2152-B. Unfair solicitation methods
Status: in_force

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Cold lead advertising" means making use directly or indirectly of a method of marketing that fails to disclose in a conspicuous manner that a purpose of the marketing is insurance sales solicitation and that contact will be made by an insurance producer or insurance company. [PL 2007, c. 53, §1 (NEW).] B. "Medicare products" includes Medicare Part A, Medicare Part B, Medicare Part C, Medicare Part D, Medicare Advantage and Medicare supplement plans. [PL 2007, c. 53, §1 (NEW).] [PL 2007, c. 53, §1 (NEW).]

2. Unfair solicitation methods. It is an unfair trade practice under this chapter for an insurer or producer to: A. Sell, solicit or negotiate the purchase of health insurance in this State through the use of cold lead advertising; [PL 2007, c. 53, §1 (NEW).] B. Use an appointment that was made to discuss Medicare products or to solicit the sale of Medicare products in order to solicit sales of life insurance, health insurance or annuity products unless the consumer requests such solicitation and the products to be discussed are clearly identified to the consumer in writing at least 48 hours in advance of the appointment; [PL 2023, c. 243, §2 (AMD).] C. Solicit the sale of Medicare products door-to-door prior to receiving an invitation from a consumer; and [PL 2023, c. 243, §2 (AMD).] D. Use an advertisement, solicitation, informational brochure, mailer or other promotional material using the terms "Medicare," "Medicaid" or "MaineCare" that mimics or implies that it is an official document from a state or federal agency. [PL 2023, c. 243, §2 (NEW).] [PL 2023, c. 243, §2 (AMD).]
24-A M.R.S. § 475 — ME Code / Title 24-A / Chapter 5 / Section 475
24-A §475. "Insurer" defined
Status: in_force

The words "insurer" or "insurers" as used in this subchapter shall include corporations, interinsurers, associations, societies and orders as well as partnerships and individual agents representing such organizations. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 4304-A — ME Code / Title 24-A / Chapter 56-A / Section 4304-A
24-A §4304-A. Prior authorization for rehabilitative or habilitative services
Status: in_force

1. Prior authorization for new episode of care prohibited for 12 visits. A carrier may not require prior authorization for rehabilitative or habilitative services, including, but not limited to, physical therapy services, occupational therapy services or chiropractic services, for the first 12 visits of each new episode of care. For purposes of this subsection, "new episode of care" means treatment for a new condition or treatment for a recurring condition for which an enrollee has not been treated within the previous 90 days. [PL 2023, c. 275, §2 (NEW).]

2. Intent. This section does not limit the right of a carrier to deny a claim when an appropriate prospective or retrospective review concludes that the health care services or treatment rendered were not medically necessary. [PL 2023, c. 275, §2 (NEW).]
24-A M.R.S. § 1252 — ME Code / Title 24-A / Chapter 15 / Section 1252
24-A §1252. Purpose of deposit
Status: in_force

1. Deposits made in this State under section 412 (deposit requirement) shall be held in trust for the respective purposes stated in that section. [PL 1969, c. 132, §1 (NEW).]

2. A deposit made in this State by a domestic insurer transacting insurance in another state, province or country, and as required by the laws of such other state, province or country, shall be held for the protection of all the insurer's policyholders or all its policyholders and creditors or for such other purpose or purposes as may be specified pursuant to such laws. [PL 1969, c. 132, §1 (NEW).]

3. Deposits required under the retaliatory provision, section 428 , shall be held for such purposes as is required by such provision, and as specified by the superintendent's order requiring such deposit to be made. [PL 1969, c. 177, §25 (AMD); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 1402 — ME Code / Title 24-A / Chapter 16 / Section 1402
24-A §1402. Definitions
Status: in_force

As used in this chapter, unless the context otherwise indicates, the following words have the following meanings. [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).]

1. Adjuster. "Adjuster" means any individual who, as an independent contractor or as an employee of an independent contractor, or as an employee of another organization, for fee, commission or other compensation, investigates for, settles on behalf of and reports to an insurer, fraternal benefit society, workers' compensation self-insurer or insured relative to claims arising under the workers' compensation laws or other types of insurance contracts. "Adjuster" does not include: A. Attorneys admitted to practice in this State; [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] B. Property and casualty insurance adjusters who are employees of insurers or workers' compensation insurance adjusters who are employees of insurers; [PL 2017, c. 152, §1 (AMD); PL 2017, c. 152, §5 (AFF).] C. Licensed producers authorized by contract to settle and pay claims within a specified limit established by the insurer or fraternal benefit society not to exceed $10,000 or, temporarily under the same circumstance described in section 1475 , $20,000; [PL 2019, c. 591, §1 (AMD).] D. Persons excepted from licensure as adjusters pursuant to Title 5, section 1727‑A and persons acting as adjusters solely on behalf of the State or counties, cities and towns; [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] E. Persons adjusting only life and health insurance claims; [PL 2011, c. 554, §1 (AMD).] F. Adjuster trainees; or [PL 2011, c. 554, §1 (AMD).] G. An individual who satisfies the following with regard to portable electronic device insurance as defined under section 7001, subsection 6, paragraph A : (1) The individual collects claim information from, or furnishes claim information to, insureds or claimants and conducts data entry including entering data into an automated claims adjudication system; and (2) The individual is an employee of an adjuster licensed under this chapter or the adjuster's affiliate. No more than 25 individuals under the supervision of one licensed adjuster or insurance producer described under paragraph C may be exempt pursuant to this paragraph. For purposes of this paragraph, "automated claims adjudication system" means a preprogrammed computer system designed for the collection, data entry, calculation and final resolution of portable electronic device insurance claims that is used by an adjuster, insurance producer or supervised individual operating pursuant to this paragraph; complies with all claims payment requirements of the Maine Insurance Code; and is certified as compliant with this paragraph by a licensed adjuster that is an officer of a business entity licensed under this chapter. [RR 2011, c. 2, §29 (COR).] [PL 2019, c. 591, §1 (AMD).]

2. Adjuster trainee. "Adjuster trainee" means any individual with less than one year total experience handling loss claims under insurance contracts or the workers' compensation laws who is not licensed in this State as an adjuster and who is employed by and subject to the immediate personal supervision of an adjuster who is licensed in this State and who has been established in the business of adjusting for 3 years or more. [PL 1997, c. 592, §19 (AMD).]

3. Agency. [PL 2001, c. 259, §3 (RP).]

3-A. Business entity. "Business entity" means a corporation, association, partnership, limited liability company, limited liability partnership or other legal entity. [PL 2001, c. 259, §4 (NEW).]

4. Consultant. "Consultant" means any individual who, for a fee, advises or offers to advise any person insured or seeking insurance or named or to be named as beneficiary, or having or to have any interest in or insured under any property and casualty or life and health insurance contract or annuity contract, existing or proposed. A. "To advise" means to provide information relative to coverage, rights or interests under insurance or annuity contracts, or relative to the retention, exchange, surrender, exercise of rights or other disposition of insurance or annuity contracts. [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] B. [PL 1999, c. 225, §1 (RP).] C. [PL 1999, c. 225, §1 (RP).] D. "Consultant" does not include: (1) An attorney licensed to practice who is actively practicing law in this State; (2) An insurance actuary and member or associate of the Society of Actuaries or American Academy of Actuaries; (3) A public accountant certified under Title 32, chapter 113 or a certified public accountant who is certified under Title 32, chapter 113 and in active public practice; (4) A licensed insurance producer who receives a fee in lieu of a commission pursuant to section 1450 if the insurance producer receives a fee for the insurance transaction and not for other services provided; (5) A financial institution or a financial institution holding company if the insurance advice is given as part of its trust department rendering insurance advice in a fiduciary capacity; or (6) A person authorized to act as or on behalf of an investment advisor in accordance with Title 32, sections 16403 and 16404 to the extent such activities entail providing insurance advice incidental to financial planning advice. [RR 2021, c. 2, Pt. A, §70 (COR).] [RR 2021, c. 2, Pt. A, §70 (COR).]

5. Insurance producer. "Insurance producer" means a person required to be licensed under subchapter II‑A to sell, solicit or negotiate insurance. A. [PL 1997, c. 457, §23 (NEW); MRSA T. 24-A §1402, sub-§5, ¶A (RP).] [PL 2001, c. 259, §5 (RPR).]

6. Insurance producer activities. [PL 2001, c. 259, §6 (RP).]

7. License. "License" means a document issued by the superintendent authorizing a person to act as an insurance producer, adjuster or consultant for kinds of insurance specified in the document as authorized in this chapter. The license itself does not create any authority, actual, apparent or inherent, in the licensee to represent or commit any particular insurer, health maintenance organization, fraternal benefit society, nonprofit hospital or medical service organization, viatical settlement provider or risk retention group. [PL 1997, c. 592, §19 (AMD).]

8. Life and health consultant. "Life and health consultant" means a person licensed as a consultant to advise on life contracts, annuity contracts and health insurance contracts. [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).]

9. Limited insurance producer license. [PL 2001, c. 259, §7 (RP).]

9-A. Multiple peril crop insurance adjuster. “Multiple peril crop insurance adjuster” means a person who adjusts crop insurance claims under the federal crop insurance program administered by the United States Department of Agriculture. [PL 2009, c. 511, Pt. C, §2 (NEW).]

10. Nonresident. "Nonresident" means a person other than a resident of this State. [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).]

11. Property and casualty consultant. "Property and casualty consultant" means a person licensed as a consultant to advise on any one or more of the following kinds of insurance: A. Casualty insurance; [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] B. Property insurance; [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] C. Surety insurance; [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] D. Marine and transportation insurance; [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] E. Title insurance; or [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] F. Legal services insurance. [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).]

11-A. Property and casualty insurance adjuster. "Property and casualty insurance adjuster" means a person who adjusts property and casualty claims of any kind except for multiple peril crop insurance claims and workers' compensation claims. [PL 2017, c. 152, §2 (AMD); PL 2017, c. 152, §5 (AFF).]

11-B. Workers' compensation insurance adjuster. "Workers' compensation insurance adjuster" means a person who adjusts workers' compensation claims governed by Title 39 or 39‑A . Notwithstanding any provision of law to the contrary, a person who on January 1, 2018 is licensed as a property and casualty insurance adjuster is automatically granted workers' compensation authority on that date. [PL 2017, c. 152, §3 (NEW); PL 2017, c. 152, §5 (AFF).]

12. Resident. "Resident" means any of the following: A. An individual who is domiciled in this State and who is not licensed elsewhere as a resident producer, consultant or adjuster; [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] B. An individual whose principal place of business is located in this State and who is not licensed elsewhere as a resident producer, consultant or adjuster; or [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] C. A business entity either incorporated in this State or having its principal place of business in this State that is not licensed as a resident business entity elsewhere. [PL 2001, c. 259, §8 (AMD).] [PL 2001, c. 259, §8 (AMD).]

13. Service representative. [PL 2001, c. 259, §9 (RP).]
24-A M.R.S. § 4222-B — ME Code / Title 24-A / Chapter 56 / Section 4222-B
24-A §4222-B. Applicability
Status: in_force

1. Every health maintenance organization licensed under this chapter is considered an insurer for purposes of those provisions of the insurance laws that do not expressly reference health maintenance organizations, but are applicable to health maintenance organizations under this chapter. [PL 1995, c. 332, Pt. O, §8 (NEW).]

2. The requirements of chapter 36 , continuity of health insurance coverage law, apply to health maintenance organizations. [PL 1995, c. 332, Pt. O, §8 (NEW).]

3. The requirements of sections 2736‑C and 2808‑B , community rating law, apply to health maintenance organizations, except that a health maintenance organization is not required to offer coverage or accept applications from an eligible group or individual located outside the health maintenance organization's approved service area. [PL 1995, c. 332, Pt. O, §8 (NEW).]

4. The requirements of chapter 23 and any rules adopted pursuant to it, to the extent not inconsistent with this chapter and the reasonable implications of this chapter, apply to health maintenance organizations. [PL 1995, c. 332, Pt. O, §8 (NEW).]

5. The requirements of sections 221 to 228 , to the extent not inconsistent with this chapter and the reasonable implications of this chapter, apply to domestic health maintenance organizations. [PL 2017, c. 169, Pt. A, §12 (AMD).]

6. The requirements of chapter 57, subchapters I and II apply to health maintenance organizations. [PL 2001, c. 88, §6 (AMD).]

7. The requirements of section 421 apply to health maintenance organizations. [PL 1997, c. 457, §50 (AMD).]

8. The requirements of chapter 32 , the Preferred Provider Arrangement Act of 1986, apply to health maintenance organizations only with respect to activities that are not otherwise authorized by chapter 56 . [PL 1995, c. 332, Pt. O, §8 (NEW).]

9. The requirements of chapter 56‑A and any rules adopted pursuant to that chapter apply to health maintenance organizations. [PL 1995, c. 673, Pt. D, §7 (NEW).]

10. The requirements of section 237 apply to health maintenance organizations, including those operated and organized as a division or line of business of a nonprofit hospital, medical or health care service organization. [PL 1997, c. 79, §3 (NEW).]

11. The requirements of sections 2834 and 2834‑B apply to health maintenance organizations. [PL 1997, c. 445, §31 (NEW); PL 1997, c. 445, §32 (AFF).]

12. The requirements of chapter 24 and any rules adopted pursuant to that chapter apply to health maintenance organizations. [PL 1997, c. 677, §4 (NEW).]

13. The requirements of sections 2436 and 2436‑A apply to health maintenance organizations. [PL 1999, c. 256, Pt. F, §1 (NEW).]

14. The requirement of filing a report of experience of claims payment for substance use disorder treatment in the format prescribed by section 2842, subsection 9 ; for chiropractic services in the format prescribed by section 2748, subsection 3 and section 2840‑A, subsection 3 ; and for breast cancer screening services in the format prescribed by section 2745‑A, subsection 4 and section 2837‑A, subsection 4 applies to health maintenance organizations. [PL 2017, c. 407, Pt. A, §97 (AMD).]

15. The requirements of section 415‑A apply to health maintenance organizations. [PL 2001, c. 88, §7 (NEW).]

15. (REALLOCATED TO T. 24-A, §4222-B, sub-§20) [RR 2001, c. 1, §35 (RAL).]

16. The requirements of sections 3483 and 3484 apply to health maintenance organizations. [PL 2001, c. 88, §7 (NEW).]

17. Section 2803‑A , relating to disclosure of loss information, applies to health maintenance organizations. [PL 2001, c. 410, Pt. B, §3 (NEW).]

18. The requirement of section 2809‑A, subsection 11 to continue group coverage under certain circumstances applies to health maintenance organizations. [PL 2001, c. 410, Pt. B, §3 (NEW).]

19. Section 12‑A , relating to penalties, applies to health maintenance organizations. [PL 2001, c. 410, Pt. B, §3 (NEW).]

20. (REALLOCATED FROM T. 24-A, §4222-B, sub-§15) Sections 2735‑A and 2839‑A , relating to notice of rate filings and rate increases, apply to health maintenance organizations. [RR 2001, c. 1, §35 (RAL).]

21. Section 2723‑A, subsection 3 and section 2844, subsection 3 apply to health maintenance organizations. [PL 2005, c. 121, Pt. D, §4 (NEW).]

22. Sections 2713‑A and 2823‑A , relating to explanation and notice to parents, apply to health maintenance organizations. [PL 2009, c. 244, Pt. B, §3 (NEW).]

23. Section 423‑C , relating to reporting of material investment and reinsurance transactions, applies to health maintenance organizations. [PL 2017, c. 169, Pt. A, §13 (NEW).]

24. Section 423‑G , relating to corporate governance annual disclosure filings, applies to health maintenance organizations. [PL 2017, c. 169, Pt. A, §13 (NEW).]
24-A M.R.S. § 2547 — ME Code / Title 24-A / Chapter 29 / Section 2547
24-A §2547. Calculation of paid-up annuity benefits
Status: in_force

For contracts which do not provide cash surrender benefits, the present value of any paid-up annuity benefit available as a nonforfeiture option at any time prior to maturity shall not be less than the present value of that portion of the maturity value of the paid-up annuity benefit provided under the contract arising from considerations paid prior to the time the contract is surrendered in exchange for, or changed to, a deferred paid-up annuity, the present value being calculated for the period prior to the maturity date on the basis of the interest rate specified in the contract for accumulating the net considerations to determine the maturity value, and increased by existing additional amounts credited by the insurer to the contract. For contracts which do not provide any death benefits prior to the commencement of any annuity payments, the present values shall be calculated on the basis of the interest rate and the mortality table specified in the contract for determining the maturity value of the paid-up annuity benefit. In no event shall the present value of a paid-up annuity benefit be less than the minimum nonforfeiture amount at that time. [PL 1979, c. 442, §4 (NEW).]
24-A M.R.S. § 3474 — ME Code / Title 24-A / Chapter 47 / Section 3474
24-A §3474. Merger, consolidation of stock insurers
Status: in_force

1. Subject to the provisions of this section, a domestic stock insurer, whether or not authorized to transact insurance in this State, may merge or consolidate with one or more domestic or foreign stock corporations by complying with the applicable provisions of the laws of this State governing the merger or consolidation of stock corporations formed for profit. A. A corporation merging or consolidating with a domestic stock insurer must be incorporated as an insurer in the manner provided by its state of incorporation, but the corporation need not be authorized or licensed to transact insurance by any state prior to the merger or consolidation. [PL 1989, c. 611, §2 (NEW); PL 1989, c. 611, §4 (AFF).] B. A foreign or alien insurer may merge or consolidate pursuant to this section with a domestic insurer only if, at the time of the merger or consolidation: (1) The domestic insurer is authorized to transact insurance in this State; or (2) The foreign or alien insurer meets all requirements applicable to a domestic insurer set forth in this Title for initial authorization to transact in this State the kinds of insurance, as defined in chapter 9 , then transacted by that insurer in any jurisdiction. [PL 1989, c. 611, §2 (NEW); PL 1989, c. 611, §4 (AFF).] C. A domestic insurer may not participate in a merger or consolidation that will result in the surviving or new corporation being domiciled in a jurisdiction other than this State unless the surviving or new insurer in the merger or consolidation obtains a certificate of authority in the jurisdiction in which it will be domiciled and in this State to transact the kinds of insurance for which any participating insurers were authorized at the time of the merger or consolidation and agrees to maintain that certificate of authority in this State until and unless the superintendent approves a plan of withdrawal filed pursuant to section 415‑A . [RR 1991, c. 2, §92 (COR).] D. The following provisions apply to the authority of the surviving or new corporation to transact insurance in this State following the merger or consolidation. (1) If the surviving or new corporation is a domestic insurer and no participating corporation in the merger or consolidation was authorized or licensed to transact insurance in this State, the surviving or new domestic insurer shall meet all applicable requirements of this Title for initial authorization to transact all kinds of insurance, as defined in chapter 9 , formerly transacted by any participating insurer or insurers in any jurisdiction. (2) If the surviving or new corporation is a domestic insurer and seeks authority to transact kinds of insurance other than those for which the domestic insurer or insurers participating in the merger or consolidation were authorized at the time of the merger or consolidation, that corporation must meet the requirements set forth in this Title for initial authorization to transact those kinds of insurance. (3) If the surviving or new corporation is a foreign or alien insurer that seeks to transact insurance in this State, that corporation shall meet all applicable requirements of this Title for initial authorization to transact all kinds of insurance, as defined in chapter 9 , formerly transacted by any participating insurer or insurers as well as for any additional kinds of insurance for which authority is sought. [PL 1989, c. 611, §2 (NEW); PL 1989, c. 611, §4 (AFF).] [RR 1991, c. 2, §92 (COR).]

2. No such merger or consolidation shall be effectuated unless in advance thereof the plan and agreement therefor have been filed with the superintendent and approved in writing by the superintendent after a hearing thereon after notice to the stockholders of each insurer involved. The superintendent shall give such approval within a reasonable time after such filing unless the superintendent finds that the plan or agreement: A. Is contrary to law; [PL 1989, c. 611, §3 (AMD); PL 1989, c. 611, §4 (AFF).] B. Is unfair or inequitable to the policyholders of any insurer involved; [PL 1989, c. 611, §3 (AMD); PL 1989, c. 611, §4 (AFF).] C. Would substantially reduce the security of and service to be rendered to policyholders of the domestic insurer in this State or elsewhere; [PL 1989, c. 611, §3 (AMD); PL 1989, c. 611, §4 (AFF).] D. Would materially tend to lessen competition in the insurance business in this State or elsewhere as to the kinds of insurance involved, or would materially tend to create a monopoly as to such business; or [PL 1969, c. 132, §1 (NEW).] E. Is subject to other material and reasonable objections. [PL 1969, c. 132, §1 (NEW).] In making any determination required by paragraph C , the superintendent may consider, among other factors, whether the surplus of the surviving or new corporation satisfies the requirements of section 410 . [PL 1989, c. 611, §3 (AMD); PL 1989, c. 611, §4 (AFF).]

3. No director, officer, agent or employee of any insurer party to the merger or consolidation shall receive any fee, commission, compensation or other valuable consideration whatsoever for in any manner aiding, promoting or assisting therein except as set forth in the plan or agreement. [PL 1969, c. 132, §1 (NEW).]

4. If the superintendent does not approve the plan or agreement, the superintendent shall so notify the insurer in writing specifying the superintendent's reasons therefor. [RR 2021, c. 1, Pt. B, §283 (COR).]
24-A M.R.S. § 7005 — ME Code / Title 24-A / Chapter 89 / Section 7005
24-A §7005. Violations
Status: in_force

1. Penalties. If a vendor or its employee or authorized representative violates any provision of this chapter, the superintendent may enforce this chapter in accordance with section 12‑A except the superintendent may not impose a fine exceeding $15,000 for aggregate conduct in violation of this chapter. [PL 2011, c. 297, §5 (NEW).]

2. Suspension or revocation. In addition to any other penalties authorized by law, the superintendent may: A. Suspend the authority of a vendor to transact portable electronic device insurance; [PL 2011, c. 297, §5 (NEW).] B. Suspend the authority of a vendor to transact portable electronic device insurance pursuant to this chapter at specific business locations where violations have occurred; and [PL 2011, c. 297, §5 (NEW).] C. Suspend or revoke the authority of an individual employee or authorized representative of a vendor to act under a limited lines license under section 7002, subsection 2 . [PL 2011, c. 297, §5 (NEW).] [PL 2011, c. 297, §5 (NEW).]
24-A M.R.S. § 2537 — ME Code / Title 24-A / Chapter 29 / Section 2537
24-A §2537. Separate accounts
Status: in_force

1. Any domestic insurer may establish one or more separate accounts, including that type known as a unit investment trust, as defined by the Investment Company Act of 1940, Stat. 789, 15 U.S.C. § 80a, et seq., as amended, and may allocate to such separate accounts, in accordance with the terms of a written contract or agreement or annuity or pension, profitsharing or retirement plan, whether or not qualified under the applicable provisions of the Internal Revenue Code, 68A Stat. 1, 26 U.S.C. § 1, et seq., as amended, with any individual or any group, any amounts, including without limitation proceeds applied under optional modes of settlement or under dividend options, paid or remitted to or held by the insurer which are to be applied to provide for life insurance or annuities and benefits incidental thereto, payable in fixed and guaranteed or variable dollar amounts, or both. [PL 1973, c. 560, §3 (AMD).]

2. The amounts allocated to each account of that type and accumulations thereon may be invested and reinvested as provided in section 1159 (special investments: separate accounts). Amounts allocated to a separate account in the exercise of the power granted by this section shall be owned by the insurer, and the insurer shall not be, nor hold itself out to be, a trustee with respect to those amounts. [PL 1987, c. 399, §15 (AMD).]

3. The income, gains and losses, realized or unrealized, from assets allocated to a separate account shall be credited to or charged against the separate account, without regard to other income, gains or losses of the insurer. If and to the extent so provided under the applicable contracts, that portion of the assets of any such separate account equal to the reserves and other contract liabilities with respect to such account shall not be chargeable with liabilities arising out of any other business the insurer may conduct. [PL 1973, c. 560, §5 (AMD).]

4. Unless otherwise approved by the superintendent, assets allocated to a separate account shall be valued at their market value on the date of that valuation, or if there is no readily available market, then in accordance with the terms of the contract or the rules or other written agreement applicable to that separate account; except that, unless otherwise approved by the superintendent, the portion of the assets of that separate account at least equal to the insurer's reserve liability with regard to the guaranteed benefits and funds referred to in section 1159 , if any, shall be valued in accordance with rules otherwise applicable to the insurer's assets. [PL 1987, c. 399, §16 (AMD).]

5. If the contract or agreement provides for payment of benefits in variable amounts, it shall contain a statement of the essential features of the procedure to be followed by the insurer in determining the dollar amount of such variable benefits. Any such contract or agreement, under which the benefits vary to reflect investment experience, including a group agreement and any certificate in evidence of variable benefits issued thereunder, shall state that such dollar amount will so vary and shall contain on its first page a statement that the benefits thereunder are on a variable basis. [PL 1973, c. 560, §7 (AMD).]

6. No insurer shall deliver or issue for delivery within this State any contract or agreement providing benefits in variable amounts under this section unless it is duly authorized to conduct a life insurance or annuity business within this State and has satisfied the superintendent that its condition or methods of operation in connection with the issuance of such contracts or agreements will not render its operation hazardous to the public or its policyholders in this State. In determining the qualification of an insurer requesting such authority, the superintendent shall consider, among other things: A. The history and financial condition of the insurer; [PL 1969, c. 132, §1 (NEW).] B. The character, responsibility and general fitness of the officers and directors of the insurer; and [PL 1969, c. 132, §1 (NEW).] C. The law and regulation under which the insurer is authorized in the state of domicile to issue variable contracts. [PL 1973, c. 560, §8 (RPR).] An insurer which issues variable contracts and which is a subsidiary of, or affiliated through common management or ownership with, another life insurer authorized to transact business in this State may be deemed by the superintendent to have met the provisions of this subsection, if either it or the parent or affiliated insurer meets the requirements hereof. [PL 1973, c. 560, §§8, 9 (AMD); PL 1973, c. 585, §12 (AMD).]

7. Any insurer which establishes one or more separate accounts pursuant to subsection 1 , to the extent it deems necessary to comply with the Investment Company Act of 1940, 54 Stat. 789, 15 U.S.C. § 80a, et seq., as amended, may amend its charter to provide, with respect to any separate account or any portion thereof, for the benefit of persons having beneficial interests therein, special voting and other rights and special procedures for the conduct of the business and affairs of such separate account or portion thereof, including without limitation special rights and procedures relating to investment policy, investment advisory services, selection of independent public accountants, and selection of a committee, the members of which need not be otherwise affiliated with the insurer, to manage the business and affairs of such separate account or portion thereof. In addition, the insurer may make such other provisions in respect to the separate account, as the insurer may deem appropriate to facilitate compliance with any requirements of, or pursuant to, any federal or state law, now or hereafter in effect. However, this subsection shall not in any manner affect existing laws pertaining to the voting rights of the policyholders of the insurer. [PL 1969, c. 132, §1 (NEW).]

8. No sale, exchange or other transfer of assets may be made by an insurer between any of its separate accounts or between any other investment account and one or more of its separate accounts unless, in case of a transfer into a separate account, such transfer is made solely to establish the account or to support the operation of the contracts with respect to the separate account to which the transfer is made, and unless such transfer, whether into or from a separate account is made, A. By a transfer of cash, or [PL 1969, c. 132, §1 (NEW).] B. By a transfer of securities having a readily determinable market value, as long as such transfer of securities is approved by the superintendent. The superintendent may approve other transfers among such accounts if, in the superintendent's opinion, such transfers would not be inequitable. [RR 2021, c. 1, Pt. B, §226 (COR).] [RR 2021, c. 1, Pt. B, §226 (COR).]

9. The insurer shall not, in connection with the allocation of investments or expenses, or in any other respect, discriminate unfairly between separate accounts or between separate and other accounts, but this subsection shall not require the insurer to follow uniform investment policies for its accounts. [PL 1969, c. 132, §1 (NEW).]

10. A variable annuity contract delivered or issued for delivery in this State may include as an incidental benefit a provision for payment on death during the deferred period of an amount equal to either the value of the contract at the time of death or the sum of the premiums less adjusted withdrawals from the policy, whichever is greater. The beneficiary under the contract may not be paid any other amount. A variable annuity contract that includes such incidental benefit may not be deemed to be life insurance and therefore is not subject to the provisions of this Title governing life insurance contracts. A variable annuity contract with a provision for any other benefit on death during the deferred period is subject to the provisions of this Title governing life insurance contracts. A payment on death pursuant to a variable annuity contract under this subsection must be made in accordance with section 2436 . This subsection applies to variable annuity contracts delivered or issued for delivery in this State on or after January 1, 2009. [PL 2011, c. 163, §1 (AMD).]

11. Notwithstanding any other provision of law, the superintendent shall have sole authority to regulate the issuance and sale of variable contracts and to promulgate such rules and regulations as may be necessary for the effectuation of this section. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

12. Except for sections 2505 , 2510 , 2511 , 2512 , 2528 to 2534 and 2614 , in the case of a variable life insurance policy and except as otherwise provided in this section, all pertinent provisions of this Title shall apply to separate accounts and contracts relating thereto. Any individual variable life insurance contract, delivered or issued for delivery in this State, shall contain grace, reinstatement and nonforfeiture provisions appropriate to such a contract. Any individual variable annuity contract, delivered or issued for delivery in this State, shall contain grace and reinstatement provisions appropriate to such a contract. Any group variable life insurance contract, delivered or issued for delivery in this State, shall contain grace provisions appropriate to such a contract. The reserve liability for variable contracts shall be established in accordance with actuarial procedures that recognize the variable nature of the benefits provided and any mortality guarantees. [PL 1973, c. 560, §11 (RPR).]
24-A M.R.S. § 6221 — ME Code / Title 24-A / Chapter 73 / Section 6221
24-A §6221. Fees
Status: in_force

Every provider subject to this chapter shall pay to the superintendent the following fees: [PL 1987, c. 482, §1 (NEW).]

1. Initial application. For filing an initial application for a certificate of authority, $1,500; and [PL 1987, c. 482, §1 (NEW).]

2. Annual report. For filing each annual report, $100. [PL 1987, c. 482, §1 (NEW).]
24-A M.R.S. § 2907 — ME Code / Title 24-A / Chapter 39 / Section 2907
24-A §2907. Coverage for sales tax credit
Status: in_force

All contracts of motor vehicle casualty insurance delivered or issued for delivery in this State covering motor vehicles registered in this State shall provide coverage for the value of the sales tax credit that would have been available upon trade thereof at the highest book value at the time of loss or destruction of the insured vehicle. [PL 1973, c. 219 (NEW).]
24-A M.R.S. § 6952 — ME Code / Title 24-A / Chapter 87 / Section 6952
24-A §6952. Maine Quality Forum Advisory Council
Status: in_force

The Maine Quality Forum Advisory Council, referred to in this subchapter as "the advisory council," is a 17-member body established by Title 5, section 12004‑I, subsection 30‑A , to advise the forum. Except as provided in section 6907, subsection 2 , information obtained by the advisory council is a public record as provided by Title 1, chapter 13, subchapter 1 . [PL 2003, c. 469, Pt. A, §8 (NEW).]

1. Appointment; composition. The Governor shall appoint the following members with the approval of the joint standing committee of the Legislature having jurisdiction over health and human services matters: A. Seven members representing providers, including 3 physicians, one registered nurse, one representative of hospitals, one mental health provider and one health care practitioner who is not a physician. The 3 physician members must represent allopathic physicians, osteopathic physicians, primary care physicians and specialist physicians; [PL 2003, c. 469, Pt. A, §8 (NEW).] B. Four members representing consumers, including one employee who receives health care through a commercially insured product, one representative of organized labor, one representative of a consumer health advocacy group and one representative of the uninsured or MaineCare recipients; [PL 2003, c. 469, Pt. A, §8 (NEW).] C. Four members representing employers, including one member of the State Employee Health Commission, one representative of a private employer with more than 1,000 full-time equivalent employees, one representative of a private employer with 50 to 1,000 full-time employees and one representative of a private employer with fewer than 50 employees; [PL 2003, c. 469, Pt. A, §8 (NEW).] D. One representative of a private health plan; and [PL 2003, c. 469, Pt. A, §8 (NEW).] E. One representative of the MaineCare program. [PL 2003, c. 469, Pt. A, §8 (NEW).] Prior to making appointments to the advisory council, the Governor shall seek nominations from the public and from a statewide allopathic association, a statewide osteopathic association, a statewide hospital association, a statewide nurses association, a statewide health purchasing collaborative, a statewide health management coalition, organized labor, a statewide organization representing consumers advocating for affordable health care, a statewide association representing consumers of mental health services, a national association of retired persons, a statewide citizen action organization, a statewide organization advocating equal justice, a statewide organization representing local chambers of commerce, a statewide organization representing businesses for social responsibility, a statewide small business alliance, a national federation of independent businesses, a statewide association of health plans and other entities as appropriate. [PL 2003, c. 469, Pt. A, §8 (NEW).]

2. Terms. Members of the advisory council serve 5-year terms except for initial appointments. Initial appointments must include 5 members appointed to 3-year terms, 6 members appointed to 4-year terms and 6 members appointed to 5-year terms. A member may not serve more than 2 consecutive terms. [PL 2003, c. 469, Pt. A, §8 (NEW).]

3. Compensation. Members of the advisory council are eligible for compensation according to the provisions of Title 5, chapter 379 . [PL 2003, c. 469, Pt. A, §8 (NEW).]

4. Quorum. A quorum is a majority of the members of the advisory council. [PL 2003, c. 469, Pt. A, §8 (NEW).]

5. Chair and officers. The advisory council shall annually choose one of its members to serve as chair for a one-year term. The advisory council may select other officers and designate their duties. [PL 2003, c. 469, Pt. A, §8 (NEW).]

6. Meetings. The advisory council shall meet at least 4 times a year at regular intervals and may meet at other times at the call of the chair or the executive director of Dirigo Health. Meetings of the council are public proceedings as provided by Title 1, chapter 13, subchapter 1 . [PL 2003, c. 469, Pt. A, §8 (NEW).]

7. Duties. The advisory council shall: A. Convene a group of health care providers to provide input and advice to the council. The council shall invite members broadly representing health care practitioners as defined in Title 24, section 2502, subsection 1‑A , health care providers as defined in Title 24, section 2502, subsection 2 , federally qualified health centers and pharmacists. Members serve as volunteers and without compensation or reimbursement for expenses; [PL 2003, c. 469, Pt. A, §8 (NEW).] B. Provide expertise in health care quality to assist the board; [PL 2003, c. 469, Pt. A, §8 (NEW).] C. Advise and support the forum by: (1) Establishing and monitoring, with Dirigo Health, an annual work plan for the forum; (2) Providing guidance in the adoption of quality and performance measures; (3) Serving as a liaison between the provider group established in paragraph A and the forum; (4) Conducting public hearings and meetings; and (5) Reviewing consumer education materials developed by the forum; [PL 2003, c. 469, Pt. A, §8 (NEW).] D. Make recommendations regarding quality assurance and quality improvement priorities; and [PL 2011, c. 90, Pt. J, §24 (AMD).] E. Serve as a liaison between the forum and other organizations working in the field of health care quality. [PL 2003, c. 469, Pt. A, §8 (NEW).] [PL 2011, c. 90, Pt. J, §24 (AMD).]
24-A M.R.S. § 2409 — ME Code / Title 24-A / Chapter 27 / Section 2409
24-A §2409. Alteration of application, life and health insurance
Status: in_force

An alteration of any written application for any life or health insurance policy or annuity contract may not be made by any person other than the applicant without the applicant's written consent, except that insertions may be made by the insurer, for administrative purposes only, in such manner as to indicate clearly that such insertions are not to be ascribed to the applicant. [RR 2021, c. 1, Pt. B, §211 (COR).]
24-A M.R.S. § 4207-A — ME Code / Title 24-A / Chapter 56 / Section 4207-A
24-A §4207-A. Point-of-service products
Status: in_force

1. Product design; mandatory requirements. A point-of-service product, filed and approved for use subject to the requirements of section 4207, subsection 4 , at a minimum must: A. Provide all services required by law to be provided by health maintenance organizations as in-plan covered services, including emergency services; [PL 1991, c. 709, §5 (NEW).] B. Provide incentives for enrollees to use in-plan covered services; and [PL 1991, c. 709, §5 (NEW).] C. Offer out-of-plan covered services only if those services are provided by the point-of-service product on an in-plan basis. [PL 1991, c. 709, §5 (NEW).] [PL 1991, c. 709, §5 (NEW).]

2. Product design; optional provisions. A point-of-service product may: A. Limit or exclude specific types of services from coverage when obtained out of plan; [PL 1991, c. 709, §5 (NEW).] B. Include annual out-of-pocket limits and annual and lifetime maximum benefit allowances for out-of-plan covered services that are separate from any limits and allowances applied to in-plan covered services; [PL 1991, c. 709, §5 (NEW).] C. Limit the groups to which the point-of-service product is offered. If the point-of-service product is offered to a group, it must be offered to all eligible members of that group; and [PL 1991, c. 709, §5 (NEW).] D. Include those services that an enrollee obtains from a participating physician for which proper authorization was not given. [PL 1991, c. 709, §5 (NEW).] [PL 1991, c. 709, §5 (NEW).]

3. Product limitations and exclusions. A health maintenance organization is subject to the following requirements as to its point-of-service product. A. A health maintenance organization may not expend more than 20% of its total annual health care expenditures for out-of-plan covered services. [PL 1991, c. 709, §5 (NEW).] B. If compliance with the amount specified in paragraph A is not demonstrated on a quarterly basis in a health maintenance organization's quarterly financial report, the superintendent may prohibit the health maintenance organization from offering a point-of-service product for new issues or for the renewal of existing contracts until compliance has been demonstrated. [PL 1991, c. 709, §5 (NEW).] [PL 1991, c. 709, §5 (NEW).]

4. Plan requirements. A health maintenance organization may not issue a point-of-service product until it has filed and has had approved by the superintendent a plan to comply with this section, including, in addition to any other requirements of this section, group contracts, subscriber contracts and other materials used by enrollees. A. Marketing materials must be filed upon request of the superintendent. Member handbooks must be filed for approval only when the initial point-of-service plan is filed and when substantial modifications are made in the point-of-service plan that change policy terms respecting benefits or change the manner in which enrollees may access provider services. [PL 1991, c. 709, §5 (NEW).] B. The plan must include, but is not limited to, provisions demonstrating that the health maintenance organization will: (1) Design the benefit levels for in-plan covered services and out-of-plan covered services to achieve the desired level of in-plan utilization; and (2) Provide or arrange for the provision of adequate systems to: (a) Process and pay claims for out-of-plan covered services; (b) Meet the requirements of a point-of-service product as set by this section or by rule of the superintendent; and (c) Generate accurate financial and regulatory reports on a timely basis in order for the superintendent to evaluate experience with the point-of-service product and monitor compliance with point-of-service product provisions. [PL 1991, c. 709, §5 (NEW).] [PL 1991, c. 709, §5 (NEW).]

5. Claims processing. Explanation of benefits given to an enrollee of a point-of-service plan must contain an explanation of coverage for self-referral health care services that is adequate to permit an enrollee to determine claims liability under the plan. [PL 1991, c. 709, §5 (NEW).]

5-A. Assignment of benefits. All point-of-service contracts and certificates must contain a provision permitting the insured to assign any benefits provided for medical or dental care on an expense-incurred basis to the provider of the care. An assignment of benefits under this subsection does not affect or limit the payment of benefits otherwise payable under the contract or certificate. [PL 1999, c. 21, §4 (AMD).]

6. Disclosure. All marketing materials, subscriber contracts, member handbooks or other material used by enrollees must contain a clear and concise explanation of point-of-service health care services. The explanation must include: A. The method of reimbursement; [PL 1991, c. 709, §5 (NEW).] B. Applicable copayments and deductibles; [PL 1991, c. 709, §5 (NEW).] C. Other uncovered costs or charges; [PL 1991, c. 709, §5 (NEW).] D. The services that an enrollee is permitted to obtain on a self-referral basis; and [PL 1991, c. 709, §5 (NEW).] E. Instructions regarding submission of claims for self-referred health care services. [PL 1991, c. 709, §5 (NEW).] [PL 1991, c. 709, §5 (NEW).]
24-A M.R.S. § 784-A — ME Code / Title 24-A / Chapter 9 / Section 784-A
24-A §784-A. Protected cells
Status: in_force

1. Establishment of protected cells. A special purpose reinsurance vehicle may establish and maintain one or more protected cells with the prior written approval of the superintendent, subject to compliance with the provisions of this section. A. A protected cell may be established only for the purpose of insuring or reinsuring risks of one or more special purpose reinsurance vehicle contracts with the intent of facilitating an insurance securitization. The establishment of a protected cell in compliance with this section in connection with a lawful insurance securitization does not constitute a fraudulent conveyance, a scheme to defraud creditors or a transaction of business for a fraudulent purpose. [PL 2007, c. 386, §14 (NEW).] B. Each protected cell must be accounted for separately on the books and records of the special purpose reinsurance vehicle to reflect the financial condition and results of operations of the protected cell, net income or loss, dividends or other distributions for the special purpose reinsurance vehicle contract with each cell and other factors as may be provided in the special purpose reinsurance vehicle contract, insurance securitization transaction documents, plan of operation or business plan, or as required by the superintendent. The special purpose reinsurance vehicle must establish administrative and accounting procedures necessary for the proper attribution of protected cell assets and protected cell liabilities to each protected cell. The directors of a special purpose reinsurance vehicle shall keep the protected cell assets and liabilities attributable to each protected cell separate and separately identifiable from the assets and liabilities of the special purpose reinsurance vehicle's general account and from the protected cell assets and liabilities attributable to any other protected cell. [PL 2007, c. 386, §14 (NEW).] C. Amounts attributed to a protected cell under this section, including assets transferred to a protected cell account, are owned by the special purpose reinsurance vehicle, and the special purpose reinsurance vehicle is not and may not hold itself out to be a trustee with respect to those protected cell assets of that protected cell account. [PL 2007, c. 386, §14 (NEW).] D. All attributions of assets and liabilities between a protected cell and the general account must be in accordance with the plan of operation approved by the superintendent. No other attribution of assets or liabilities may be made by a special purpose reinsurance vehicle between the special purpose reinsurance vehicle's general account and its protected cell or cells. The special purpose reinsurance vehicle must attribute all insurance obligations, assets and liabilities relating to a special purpose reinsurance vehicle contract and the related insurance securitization transaction, including any securities issued by the special purpose reinsurance vehicle as part of the insurance securitization and any taxes or other obligations arising by operation of law, to the associated protected cell. [PL 2007, c. 386, §14 (NEW).] E. The assets of a protected cell are not chargeable with liabilities arising out of a special purpose reinsurance vehicle contract related to or associated with another protected cell. More than one special purpose reinsurance vehicle contract may not be attributed to the same protected cell unless those special purpose reinsurance vehicle contracts are intended to be, and ultimately are, part of a single securitization transaction. [PL 2007, c. 386, §14 (NEW).] F. A sale, exchange or other transfer of assets may not be made by the special purpose reinsurance vehicle between or among any of its protected cells without the consent of the superintendent, the ceding insurer or insurers and the holders of the securities issued by each protected cell. [PL 2007, c. 386, §14 (NEW).] G. A sale, exchange, transfer of assets, dividend or distribution may not be made from a protected cell without the superintendent's approval except as authorized in advance under the special purpose reinsurance vehicle contract or related insurance securitization transaction documents and may not be approved if the sale, exchange, transfer, dividend or distribution would result in insolvency or impairment with respect to a protected cell. [PL 2007, c. 386, §14 (NEW).] H. A special purpose reinsurance vehicle may pay interest or repay principal, or both, and make distributions or repayments in respect of any securities attributed to a particular protected cell from assets or cash flows relating to or emerging from the special purpose reinsurance vehicle contract and the insurance securitization transactions that are attributable to that particular protected cell in accordance with the provisions of this subchapter or as otherwise approved by the superintendent. [PL 2007, c. 386, §14 (NEW).] [PL 2007, c. 386, §14 (NEW).]

2. Approval of protected cells. A special purpose reinsurance vehicle contract with or attributable to a protected cell does not take effect without the superintendent's prior written approval, and the addition of each new protected cell constitutes a change in the business plan requiring the superintendent's prior written approval and the amendment of the special purpose reinsurance vehicle's limited certificate of authority. The superintendent may retain legal, financial and examination services from outside the bureau to examine and investigate the application for a protected cell, the reasonable cost of which may be charged against the applicant, or the superintendent may use internal resources to examine and investigate the application, the reasonable cost of which may be charged against the applicant up to a maximum of $12,000, or both. The application for approval of a protected cell must include a plan of operation for the protected cell consistent with the requirements of section 782, subsection 2, paragraph H . [PL 2007, c. 386, §14 (NEW).]

3. Minimum capital requirements. A special purpose reinsurance vehicle with protected cells shall possess and maintain capitalization in each protected cell in the amount and manner required for a special purpose reinsurance vehicle in section 787 and, in addition, shall possess and maintain minimum capitalization separate and apart from the capitalization of its protected cell or cells in an amount determined by the superintendent after giving due consideration of the special purpose reinsurance vehicle's business plan, feasibility study and proforma financial statements, including the nature of the risks to be insured or reinsured. [PL 2007, c. 386, §14 (NEW).]

4. Status of protected cells. A protected cell is not a legal person separate from the special purpose reinsurance vehicle. However, a protected cell must have its own distinct name or designation that includes the words "protected cell" and all protected cells must be identified by name in the special purpose reinsurance vehicle's limited certificate of authority. The special purpose reinsurance vehicle shall hold all assets attributable to the protected cell in one or more separately established and identified protected cell accounts bearing the name or designation of that protected cell. A. The assets of a protected cell are available only to the ceding insurer and other creditors of that protected cell and may not be used to pay expenses or claims other than those attributable to the protected cell. Creditors with respect to a protected cell are not entitled to any recourse against the protected cell assets of other protected cells or the assets of the special purpose reinsurance vehicle's general account. If an obligation of a special purpose reinsurance vehicle relates only to the general account, the creditor is entitled to have recourse with respect to that obligation only to the assets of the general account. [PL 2007, c. 386, §14 (NEW).] B. Protected cell assets may not be pledged or otherwise encumbered except for the benefit of creditors of that protected cell in furtherance of the securitization in accordance with the approved plan of operation. [PL 2007, c. 386, §14 (NEW).] C. All contracts or other documentation reflecting protected cell liabilities must clearly indicate that only the protected cell assets are available for the satisfaction of those protected cell liabilities. In all special purpose reinsurance vehicle insurance securitizations involving a protected cell, the contracts or other documentation effecting the transaction must contain provisions identifying the protected cell to which the transaction is attributed. In addition, the contracts or other documentation must clearly disclose that the assets of that protected cell, and only those assets, are available to pay the obligations of that protected cell. However, failure to include express language attributing obligations under a contract to a protected cell does not give a party the right to void or reform the contract if the party had notice that the contract related to a protected cell. [PL 2007, c. 386, §14 (NEW).] D. If the special purpose reinsurance vehicle enters into a contract involving more than one protected cell, the rights and obligations relating to each protected cell must be several rather than joint and the contract must make clear provisions for their apportionment between protected cells. [PL 2007, c. 386, §14 (NEW).] E. In any action or proceeding involving the potential for monetary recovery by or against a special purpose reinsurance vehicle with protected cells, or for nonmonetary relief relating to a particular protected cell or cells, any process, pleading or order must name the specific cell or cells affected, including if applicable the general account. [PL 2007, c. 386, §14 (NEW).] [PL 2007, c. 386, §14 (NEW).]

5. Separate administrative services. A special purpose reinsurance vehicle may contract with or arrange for an investment advisor, commodity trading advisor or other 3rd party to manage the assets or administer the obligations of a protected cell, if all remuneration, expenses and other compensation arising out of services performed with respect to that protected cell are payable only from the assets of that protected cell or, with the approval of the superintendent, from the assets of the special purpose reinsurance vehicle's general account. [PL 2007, c. 386, §14 (NEW).]

6. Notice of impairment or insolvency. A special purpose reinsurance vehicle with protected cells shall notify the superintendent in writing within 10 business days after the special purpose reinsurance vehicle or any protected cell becomes impaired or insolvent. [PL 2007, c. 386, §14 (NEW).]

7. Conversion to protected cell framework. A special purpose reinsurance vehicle without protected cells may apply to the superintendent in accordance with subsection 2 to revise its plan of operation to establish one or more protected cells. If there is an existing insurance securitization in force at the time of the application, the revised plan of operation must provide for the establishment of a protected cell for that securitization and the transfer to the protected cell of all assets and liabilities relating to the securitization. [PL 2007, c. 386, §14 (NEW).]

8. Termination of protected cell. At the cessation of business of a protected cell in accordance with the plan approved by the superintendent, the special purpose reinsurance vehicle shall close out the protected cell account and the superintendent shall modify the limited certificate of authority to reflect the termination. [PL 2007, c. 386, §14 (NEW).]
24 M.R.S. § 2308-A — ME Code / Title 24 / Chapter 19 / Section 2308-A
24 §2308-A. Health insurance affiliates
Status: in_force

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Foreign health service plan" means a nonprofit hospital and medical service organization or similar nonprofit entity organized under the laws of another state. [PL 1997, c. 344, §5 (NEW).] B. "Health insurance affiliate" means any domestic for-profit stock insurer required to be authorized under Title 24‑A, section 404 to provide health insurance or any domestic for-profit stock health maintenance organization required to be licensed under Title 24‑A, chapter 56 that is formed, acquired, invested in or otherwise established, whether directly or indirectly, by a nonprofit hospital and medical service organization. [PL 1997, c. 344, §5 (NEW).] C. "Nonprofit hospital and medical service organization" or "organization" means a corporation or other entity authorized by the superintendent and organized pursuant to this chapter for the purpose of providing nonprofit hospital service plans within the meaning of section 2301, subsection 1 , nonprofit medical service plans within the meaning of section 2301, subsection 2 and any organization that provides only nonprofit health care plans within the meaning of section 2301, subsection 3 . [PL 2003, c. 171, §17 (AMD).] D. "Ownership interest" means any equity interest in a health insurance affiliate, including, without limitation, capital stock, voting securities, securities convertible into voting securities, general partnership shares, limited partnership shares, surplus notes or other interests possessing voting rights. [PL 1997, c. 344, §5 (NEW).] E. "Person" has the meaning set forth in Title 24‑A, section 222, subsection 2, paragraph E . [PL 1997, c. 344, §5 (NEW).] [PL 2003, c. 171, §17 (AMD).]

2. Authorization. A nonprofit hospital and medical service organization may not, directly or indirectly, form, acquire, invest in or otherwise establish a health insurance affiliate unless: A. The organization has substantial control over the health insurance affiliate, which control for purposes of this section must be satisfied by: (1) Ownership of 50% or more of the outstanding ownership interests of the health insurance affiliate; (2) Ownership of or the power to vote, directly or indirectly, 50% or more of the voting securities of the health insurance affiliate; (3) The legal authority to prevent any change in the articles of incorporation, bylaws or other establishing or governing documents of the health insurance affiliate without its consent; (4) The legal authority to prevent any change in the health insurance affiliate's legal status or trade names, the geographic area in which the health insurance affiliate operates or the fundamental type of business in which the health insurance affiliate engages without its consent; and (5) Fifty percent or more control of the management policies or operations of the health insurance affiliate. An organization that does not meet the requirements of subparagraphs (1), (2) and (5) is deemed to meet those requirements if the organization and one or more nonprofit hospital and medical service organizations or foreign health service plans, in the aggregate, meet the requirements of subparagraphs (1), (2) and (5). At all times the organization's ownership interest in the health insurance affiliate must exceed the aggregate ownership interests in the health insurance affiliate owned or controlled by any persons permitted to hold ownership interests pursuant to paragraph B ; [PL 1997, c. 344, §5 (NEW).] B. Individuals or nonprofit and noncharitable entities owning or controlling ownership interests in the health insurance affiliate are subject to the following limitations so that only: (1) Up to a maximum of 25% of the ownership interests in the health insurance affiliate may be owned or controlled by individual physicians licensed to practice in this State, as long as the remaining ownership interests are owned or controlled by the organization under paragraph A , subparagraph (1), the organization and one or more organizations or foreign health service plans under paragraph A , subparagraph (2) or nonprofit charitable health care entities under paragraph C ; or (2) Up to a maximum of 20% of the ownership interests in the health insurance affiliate, in the aggregate, may be owned or controlled by nonprofit and noncharitable entities formed by physicians licensed to practice in this State and hospitals licensed in this State for the purpose of arranging for or delivering health care, or a combination of such an entity and individual physicians licensed to practice in this State as long as the remaining ownership interests are owned or controlled by the organization under paragraph A , subparagraph (1), the organization and one or more organizations or foreign health service plans under paragraph A , subparagraph (2) or nonprofit charitable health care entities under paragraph C ; [PL 1997, c. 344, §5 (NEW).] C. Any ownership interests not owned or controlled by the organization under paragraph A , subparagraph (1), the organization and one or more organizations or foreign health service plans under paragraph A or persons described under paragraph B are owned or controlled by nonprofit charitable entities that qualify for federal income tax exemption under the United States Internal Revenue Code of 1986, Section 501(c)(3) or (c)(4), as amended; [PL 1997, c. 344, §5 (NEW).] D. The health insurance affiliate meets the following requirements with respect to its officers, directors and employees: (1) No ownership interests of the health insurance affiliate are owned or controlled by officers, directors or employees of: (a) The health insurance affiliate; (b) Any person owning or controlling ownership interests in the health insurance affiliate; or (c) Any affiliate of a person described in this subparagraph or subparagraph (2); (2) Notwithstanding subparagraph (1), an individual that owns or controls an ownership interest in a health insurance affiliate, including an individual serving as an officer, director or employee of a person described in paragraph B that owns or controls an ownership interest in a health insurance affiliate, serves as a director of the health insurance affiliate, subject to the limitations set forth in subparagraph (4); (3) Notwithstanding subparagraph (1), at any time, no more than one officer of the health insurance affiliate is an individual that owns or controls an ownership interest in a health insurance affiliate, or an individual serving as an officer, director or employee of a person described in paragraph B that owns or controls an ownership interest in a health insurance affiliate; (4) The total percentage of directors of a health insurance affiliate who represent or are appointed by each person described in paragraph B that owns or controls an ownership interest in the health insurance affiliate does not exceed the total percentage ownership interests in the health insurance affiliate owned or controlled by persons described in paragraph B ; and (5) The health insurance affiliate has in place procedures and policies to prohibit conflicts of interest that may benefit the persons described in subparagraph (1), divisions (a), (b) and (c), including, but not limited to, conflicts to the detriment of the health insurance affiliate's ability to fulfill its charitable purposes. Nothing contained in this paragraph prohibits interlocking boards of directors between or among the person described in subparagraph (1), divisions (a), (b) and (c), provided no officer, director or employee of any person described in subparagraph (1), divisions (a), (b) and (c) owns or controls an ownership interest prohibited by this paragraph; [PL 1997, c. 344, §5 (NEW).] E. The organization provides written notice to the superintendent at least 60 days prior to forming, acquiring, investing in or otherwise establishing a health insurance affiliate; and [PL 1997, c. 344, §5 (NEW).] F. At all times when the organization owns or controls an ownership interest in the health insurance affiliate, the organization or the health insurance affiliate, together or separately, does not inappropriately stratify risks. For the purpose of this paragraph, the superintendent may treat the organization and the health insurance affiliate as a single person. If the superintendent determines that this paragraph has been violated, the superintendent shall provide the organization and the health insurance affiliate with notice of the violation and a reasonable opportunity to cure the violation. [PL 1997, c. 344, §5 (NEW).] [PL 1997, c. 344, §5 (NEW).]

3. Application of Title 24-A. The provisions of Title 24‑A apply to a health insurance affiliate in accordance with the following: A. A health insurance affiliate that is a health insurer is subject to all the following provisions: (1) Title 24‑A, section 222 ; (2) Title 24‑A, section 423‑C ; (3) Title 24‑A, section 425 ; (4) Title 24‑A, chapter 47, subchapter IV ; (5) Title 24‑A, section 4614, subsections 4 and 6 ; and (6) All other applicable provisions of Title 24‑A ; [PL 1997, c. 344, §5 (NEW).] B. A health insurance affiliate that is a health maintenance organization is subject to all the following provisions: (1) Title 24‑A, section 222, subsections 2 to 10 and Title 24‑A, section 222, subsections 13‑A to 18 ; (2) Title 24‑A, section 423‑C ; (3) Title 24‑A, section 425 ; (4) Title 24‑A, sections 3474 to 3476 ; (5) Title 24‑A, section 3483 ; and (6) All other applicable provisions of Title 24‑A ; and [PL 2023, c. 405, Pt. A, §82 (AMD).] C. The provisions of Title 24‑A, section 4214 do not apply to a health insurance affiliate. [PL 1997, c. 344, §5 (NEW).] [PL 2023, c. 405, Pt. A, §82 (AMD).]

4. Control. For the purposes of this section and Title 24‑A, section 222 , a health insurance affiliate is presumed to be controlled by the nonprofit hospital and medical service organization, notwithstanding that the organization may not have actual control. Notwithstanding that the organization is presumed to control the health insurance affiliate under this subsection, the superintendent may determine that one or more other persons also control the health insurance affiliate. The superintendent, in the superintendent's sole discretion, may determine that a health insurance affiliate is not controlled by an organization that owns or controls less than 50% of the ownership interests of a health insurance affiliate pursuant to subsection 2, paragraph A . [PL 1997, c. 344, §5 (NEW).]

5. Continuing obligations; penalties. In addition to all requirements for obtaining or maintaining a certificate of authority from the superintendent under Title 24‑A , a health insurance affiliate must continuously meet all requirements of this section and Title 5, section 194‑A, subsection 7 . The superintendent's determination that a health insurance affiliate has failed to meet the requirements of this section or Title 5, section 194‑A, subsection 7 constitutes grounds for suspension or revocation of the health insurance affiliate's certificate of authority under Title 24‑A, section 417 and grounds for commencement of delinquency proceedings under Title 24‑A, chapter 57 . Upon any such failure, the superintendent may require any person who owns or controls any ownership interest in the health insurance affiliate to dispose of that ownership interest within the later of 18 months after the date of the failure as determined by the superintendent, 18 months after the superintendent's determination that a failure has occurred or such other time as the superintendent may prescribe. The superintendent may permit one owner to dispose of its ownership interest to another owner. [PL 1997, c. 344, §5 (NEW).]

6. Capital contributions. Any person who acquires any ownership interests in the health insurance affiliate shall make capital contributions in cash or the cash equivalent in proportion to that person's ownership interests in the health insurance affiliate. The superintendent, in the superintendent's sole discretion, may permit other forms of capital contributions that do not have the effect of diluting the ownership or control of the health insurance affiliate by the nonprofit hospital and medical service organization. [PL 1997, c. 344, §5 (NEW).]

7. Transactions with related persons. In addition to the requirements contained under Title 24‑A and other applicable law, all transactions between a health insurance affiliate and any related person must be consistent with fair market value in an arm's length transaction. For purposes of this subsection, a "related person" means: A. Any person who owns or controls an ownership interest in a health insurance affiliate; [PL 1997, c. 344, §5 (NEW).] B. Any person who is a beneficial owner, as defined in Title 24‑A, section 222, subsection 2, paragraph A‑1 , of any ownership interest in the health insurance affiliate; [PL 1997, c. 344, §5 (NEW).] C. Any person who, directly or indirectly, has the power to control the management, policies or operations of the health insurance affiliate; or [PL 1997, c. 344, §5 (NEW).] D. Any affiliate of the health insurance affiliate or of any person described in paragraphs A to C . [PL 1997, c. 344, §5 (NEW).] [PL 1997, c. 344, §5 (NEW).]

8. Distribution of working capital and surplus. No less frequently than annually, a health insurance affiliate shall distribute to those persons who own or control any ownership interest providing for the right to receive dividends or distributions any excess working capital and surplus, subject to rules adopted and decisions issued by the superintendent. Nothing in this subsection limits the authority of the Superior Court under Title 5, section 194‑A, subsection 7 . [PL 1997, c. 344, §5 (NEW).]

9. Investment restrictions. Any investment by a nonprofit hospital and medical service organization in a health insurance affiliate under this section is subject to all applicable investment restrictions, including, without limitation, Title 24‑A, section 222 and Title 24‑A, chapter 13‑A . A health insurance affiliate in which an organization owns or controls 50% or more ownership interest is deemed to be a subsidiary of the organization for purposes of Title 24‑A, section 1157, subsection 5, paragraph B . [PL 1997, c. 344, §5 (NEW).]

10. Aggregate transactions. The superintendent may aggregate any transactions that are part of a plan or series of like transactions to determine whether those transactions comply with this section and other applicable laws. [PL 1997, c. 344, §5 (NEW).]

11. Oversight. In addition to other applicable provisions of this Title and Title 24‑A , any person whose domicile is outside the State that owns or controls an ownership interest in a health insurance affiliate and any affiliate of that organization: A. Is subject to the jurisdiction of the superintendent and the courts of this State; and [PL 1997, c. 344, §5 (NEW).] B. Must appoint the superintendent as lawful agent for receipt of service of process. [PL 1997, c. 344, §5 (NEW).] [PL 1997, c. 344, §5 (NEW).]

12. Attorney General to intervene. In any proceeding before the superintendent involving the health insurance affiliate in which the Attorney General intervenes, the Attorney General has the right to review all documents or other information received by the superintendent or in connection with the proceeding. The Attorney General is subject to all confidentiality provisions for those documents or information that apply to the superintendent. [PL 1997, c. 344, §5 (NEW).]

13. Rules. The superintendent may adopt rules to carry out the purposes of this section. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter II‑A . [PL 1997, c. 344, §5 (NEW).]
24-A M.R.S. § 1110 — ME Code / Title 24-A / Chapter 13 / Section 1110
24-A §1110. -- certain terms defined; net earnings
Status: in_force

1. [PL 1999, c. 715, §3 (RP).]

1-A. Definitions. As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. A. "Admitted assets" means assets recognized by the superintendent pursuant to section 901‑A . [PL 2001, c. 72, §11 (AMD).] B. "Aggregate amount of investments" means the aggregate value of those investments as determined in accordance with statutory accounting principles pursuant to section 901‑A and any rules adopted under that section. [PL 2001, c. 72, §11 (AMD).] C. "Asset value" is that value that may be contained in the annual statement of the corporation filed pursuant to section 423 . [PL 1999, c. 715, §4 (NEW).] D. "Bona fide hedging transaction" means a purchase or sale of foreign currency or of a contract, option, call, put or right entered into for the purpose of offsetting changes in foreign currency exchange rates, in the market value of investments held or proposed to be acquired by the insurer or in the market value of liabilities that the insurer has or expects to incur, pursuant to a duly adopted resolution of the insurer's board of directors and written operations procedure submitted to the superintendent before making any such purchases and sales, as long as: (1) There is a high correlation between changes in the market value of those hedging purchases and sales and the market value of the assets and liabilities to be hedged; and (2) Books and records regarding all such purchases and sales are maintained by the insurer in accordance with generally accepted accounting principles. The superintendent may adopt further rules regarding the form and content of resolutions, operation procedures, books and accounts and further accounting treatment and valuation methods necessary to ensure compliance with this definition. [PL 1999, c. 715, §4 (NEW).] E. "Domestic institution" means an institution created or existing under the laws of the United States or any state, district or territory. [PL 1999, c. 715, §4 (NEW).] F. "Fixed charges" includes interest on funded and unfunded debt and amortization of debt discount, but in the case of a bank or trust company, interest paid by that institution upon any deposit or any certificate or other evidence of a deposit may not be deemed a fixed charge of such an institution. [PL 1999, c. 715, §4 (NEW).] G. "High-yield obligations" means obligations that are neither investment grade nor medium grade obligations. [PL 1999, c. 715, §4 (NEW).] H. "Institution" means a corporation, a joint-stock association, a business trust, a business partnership, a business joint venture or any other similar entity. [PL 1999, c. 715, §4 (NEW).] I. "Investment grade obligation" means an obligation that at the time of acquisition by the insurer is rated "1" or "2" by the Securities Valuation Office of the National Association of Insurance Commissioners. If not valued by the Securities Valuation Office of the National Association of Insurance Commissioners, "investment grade obligation" means an obligation that at the time of acquisition by the insurer is rated the equivalent of "1" or "2" by one of the following nationally recognized independent rating agencies: Moody's Investors Service, Inc., Standard and Poor's Division of The McGraw-Hill Companies, Inc., Fitch Investors Service, Inc., or Duff and Phelps Credit Rating Company. [PL 1999, c. 715, §4 (NEW).] J. "Medium grade obligation" means an obligation that at the time of acquisition by the insurer is rated by the Securities Valuation Office of the National Association of Insurance Commissioners as "Class 3" quality. If not valued by the Securities Valuation Office of the National Association of Insurance Commissioners, "medium grade obligation" means an obligation that at the time of acquisition by the insurer is rated the equivalent of "3" by Moody's Investors Service, Inc., Standard and Poor's Division of The McGraw-Hill Companies, Inc., Fitch Investors Service, Inc., or Duff and Phelps Credit Rating Company. [PL 1999, c. 715, §4 (NEW).] K. "Net earnings available for fixed charges" means net income after deducting operating and maintenance expenses, taxes other than federal, state and other income taxes, depreciation and depletion, but excluding extraordinary nonrecurring items of income or expense appearing in the regular financial statements of the issuing, assuming or guaranteeing institutions. [PL 1999, c. 715, §4 (NEW).] L. "Not acquired by the insurer from an issuer, underwriter or dealer" means acquired by the insurer in an exempt transaction described in the United States Securities Act of 1933, Section 4(1) or Section 4(3), 15 United States Code, Section 77d(1) or Section 77d(3), as from time to time amended. [PL 1999, c. 715, §4 (NEW).] M. "Obligations" includes bonds, debentures, notes or other evidences of indebtedness. [PL 1999, c. 715, §4 (NEW).] N. "Qualified broker or dealer" means a broker or dealer that is organized under the laws of a state, is registered under the United States Securities Exchange Act of 1934, 15 United States Code, Sections 78a to 78kk and has net capital in excess of $250,000,000. [PL 1999, c. 715, §4 (NEW).] O. "Qualified financial institution" means a bank or a trust company that is organized under the laws of a state or the United States, has assets in excess of $5,000,000,000, has, or its parent corporation has, senior obligations outstanding rated "AA" or better and has a ratio of primary capital to total assets of at least 5 1/2% and a ratio of total capital to total assets of at least 6%. [PL 1999, c. 715, §4 (NEW).] P. "Qualified for public sale" means registered under the United States Securities Act of 1933, 15 United States Code, Sections 77a to 77aa. [PL 1999, c. 715, §4 (NEW).] Q. "Subsidiary" has the same meaning as defined in section 222, subsection 2, paragraph F . The term "subsidiary" does not include a separate account established under section 2537 . [PL 1999, c. 715, §4 (NEW).] R. "United States" when used to signify place includes those geographical areas and the lands and waters adjacent to those geographical areas under the jurisdiction of the United States. [PL 1999, c. 715, §4 (NEW).] [PL 2001, c. 72, §11 (AMD).]

2. If net earnings are determined in reliance upon consolidated earnings statements of parent and subsidiary institutions, such net earnings shall be determined after provisions for income taxes of only those subsidiaries in which the parent institution owns directly or indirectly less than 90% of all classes of voting stock, and after proper allowance for minority stock interest, if any; and the required coverage of fixed charges shall be computed on a basis including fixed charges and preferred dividends of subsidiaries other than those payable by such subsidiaries to the parent corporation or to any other of such subsidiaries, except that if the minority common stock interest in the subsidiary corporation is substantial, the fixed charges and preferred dividends may be apportioned in accordance with regulations prescribed by the superintendent. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

3. [PL 1999, c. 715, §5 (RP).]
24-A M.R.S. § 3049 — ME Code / Title 24-A / Chapter 41 / Section 3049
24-A §3049. Notice of cancellation; reasons
Status: in_force

No policy may be cancelled except by notice to the insured as provided in this subchapter. No notice of cancellation of a policy shall be effective unless it is based on one or more of the following reasons: [PL 1973, c. 239 (NEW).]

1. Nonpayment of premium, including nonpayment of any additional premiums, calculated in accordance with the current rating manual of the insurer, justified by a physical change in the insured property or a change in its occupancy or use. A notice of cancellation for nonpayment of premium is not effective unless deemed received under section 3050 after the premium due date; [PL 2007, c. 188, Pt. C, §9 (AMD).]

2. Conviction of the named insured of a crime having as one of its necessary elements an act increasing any hazard insured against; [PL 1973, c. 239 (NEW).]

3. Discovery of fraud or material misrepresentation by any one of the following: A. The insured or the insured's representative in obtaining the insurance; or [PL 2003, c. 671, Pt. A, §3 (AMD).] B. The named insured in pursuing a claim under the policy; [PL 1973, c. 239 (NEW).] [PL 2003, c. 671, Pt. A, §3 (AMD).]

4. Discovery of either: A. Negligent acts or omissions by the insured substantially increasing any of the hazards insured against; or [PL 2003, c. 671, Pt. A, §4 (NEW).] B. A failure to disclose a material fact in relation to the application for insurance that would, if coverage is effectuated without knowledge by the insurer, substantially alter the terms of the policy; [PL 2003, c. 671, Pt. A, §4 (NEW).] [PL 2003, c. 671, Pt. A, §4 (RPR).]

4-A. Violation of terms or conditions of the policy; [PL 2015, c. 69, §1 (NEW).]

5. Physical changes in the insured property that result in the property becoming uninsurable; [PL 2003, c. 671, Pt. A, §5 (AMD).]

6. The insured property is vacant and custodial care is not maintained on the property; [PL 2003, c. 671, Pt. A, §6 (NEW).]

7. The presence of a trampoline on the premises if the insured is notified that the policy will be cancelled if the trampoline is not removed and the trampoline, after notice, remains on the property 30 or more days after the date of notice; [PL 2003, c. 671, Pt. A, §6 (NEW).]

8. The presence of a swimming pool upon the insured property that is not fenced in, in accordance with the standards established in Title 22, section 1631 , if the pool remains in noncompliance with those standards for 30 days after notice by the insurer of the defective condition and intent to cancel the policy; [PL 2003, c. 671, Pt. A, §6 (NEW).]

9. A loss occasioned by a dog bite, unless, after notice of cancellation or nonrenewal is received, the insured removes the dog; or [PL 2003, c. 671, Pt. A, §6 (NEW).]

10. Failure to comply with reasonable loss control recommendations within 90 days after notice from the insurer. [PL 2003, c. 671, Pt. A, §6 (NEW).]

This section does not apply to any policy or coverage that has been in effect less than 90 days at the time notice of cancellation is received by the named insured, or 120 days in the case of residential property that is expected to be continuously unoccupied for 3 months in any 12-month period and that is other than the insured's primary residence, unless it is a renewal policy. An insured does not have the right to a hearing before the Superintendent of Insurance for the purpose of contesting cancellation of a new policy that has been in force less than 90 days or 120 days in the case of residential property other than the insured's primary residence that is expected to be continuously unoccupied for 3 months in any 12-month period. [PL 2003, c. 671, Pt. A, §7 (AMD).]

This section shall not apply to the nonrenewal of a policy. [PL 1977, c. 414, §1 (NEW).]

"Nonpayment of premium" means failure of the named insured to discharge when due any of the named insured's obligations in connection with the payment of premium on the policy, or any installment of a premium, whether the premium is payable directly to the insurer or its agent or indirectly under any premium finance plan or extension of credit. [RR 2021, c. 1, Pt. B, §266 (COR).]
24-A M.R.S. § 6812-A — ME Code / Title 24-A / Chapter 85 / Section 6812-A
24-A §6812-A. Inquiries and optional disclosures by life insurers
Status: in_force

1. Permitted inquiries regarding premium financing. In addition to any other information a life insurer may lawfully request in an application for insurance, the insurer may ask whether the proposed owner intends to pay premiums with the assistance of financing from a lender that will use the policy as collateral to support the financing, and if so, whether: A. The applicant has entered into any agreement or arrangement providing for the future sale of this life insurance policy; [PL 2009, c. 376, §15 (NEW).] B. The loan arrangement for the policy provides funds sufficient to pay for some or all of the premiums, costs and expenses associated with obtaining and maintaining the applicant's life insurance policy; [PL 2009, c. 376, §15 (NEW).] C. The applicant has entered into any agreement by which the applicant is to receive consideration in exchange for procuring the policy; and [PL 2009, c. 376, §15 (NEW).] D. The borrower has an insurable interest in the insured. [PL 2009, c. 376, §15 (NEW).] [PL 2009, c. 376, §15 (NEW).]

2. Prohibited transactions. If the information obtained by the life insurer demonstrates that the loan provides funds that can be used for a purpose other than paying for the premiums, costs and expenses associated with obtaining and maintaining the life insurance policy and loan or that the transaction otherwise violates this chapter, the insurer shall reject the application. [PL 2009, c. 376, §15 (NEW).]

3. Optional disclosures by the life insurer. The insurer may make disclosures to the applicant, the insured and other affected persons, either on the application, an amendment to the application or a separate document, in the following form: "If you have entered into a loan arrangement in which the policy is used as collateral and the policy does change ownership at some point in the future in satisfaction of the loan, the following may be true: A. A change of ownership could lead to a stranger owning an interest in the insured's life; [PL 2009, c. 376, §15 (NEW).] B. Your ability to purchase future insurance on the insured’s life could be limited because there is a limit to how much coverage insurers will issue on one life; [PL 2009, c. 376, §15 (NEW).] C. Should there be a change of ownership and should you wish to obtain more insurance coverage on the insured’s life in the future, the insured’s higher issue age, a change in health status or other factors may reduce the ability to obtain coverage or may result in significantly higher premiums; and [PL 2009, c. 376, §15 (NEW).] D. You should consult a professional advisor because a change in ownership in satisfaction of the loan may result in tax consequences to the owner, depending on the structure of the loan." [PL 2009, c. 376, §15 (NEW).] [PL 2009, c. 376, §15 (NEW).]
24-A M.R.S. § 4320-H — ME Code / Title 24-A / Chapter 56-A / Section 4320-H
24-A §4320-H. Payment reform pilot projects (REALLOCATED FROM TITLE 24-A, SECTION 4320)
Status: in_force

(REALLOCATED FROM TITLE 24-A, SECTION 4320)

1. Pilot projects. Beginning March 1, 2012, the superintendent may authorize pilot projects in accordance with this subsection that allow a health insurance carrier that offers health plans in this State to implement payment reform strategies with providers through an accountable care organization to reduce costs and improve the quality of patient care. For purposes of this section, "accountable care organization" means a group of health care providers operating under a payment agreement to provide health care services to a defined set of individuals with established benchmarks for the quality and cost of those health care services consistent with federal law and regulation. A. The superintendent may approve a pilot project between a carrier and an accountable care organization that utilizes payment methodologies and purchasing strategies, including, but not limited to: alternatives to fee-for-service models, such as blended capitation rates, episodes-of-care payments, medical home models and global budgets; pay-for-performance programs; tiering of providers; and evidence-based purchasing strategies. [RR 2011, c. 1, §43 (RAL).] B. Prior to approving a pilot project, the superintendent shall consider whether the proposed pilot project is consistent with the principles for payment reform developed by the Advisory Council on Health Systems Development established under former Title 2, section 104 . [RR 2011, c. 1, §43 (RAL).] [RR 2011, c. 1, §43 (RAL).]

2. Rulemaking. The superintendent shall establish by rule procedures and policies that facilitate the implementation of a pilot project pursuant to this section, including, but not limited to, a process for a health insurance carrier's submitting a pilot project proposal and minimum requirements for approval of a pilot project. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A and must be adopted no later than December 1, 2011. [RR 2011, c. 1, §43 (RAL).]

3. Report. Beginning in 2013, the superintendent shall report by March 1st annually to the joint standing committee of the Legislature having jurisdiction over insurance and financial services matters on the status of any pilot project approved by the superintendent pursuant to this section. The report must include an analysis of the cost and benefits of any approved pilot project in reducing health care costs, including any impact on premiums, and in improving the quality of care. [RR 2011, c. 1, §43 (RAL).]

4. Evaluation. During the First Regular Session of the 129th Legislature, the joint standing committee of the Legislature having jurisdiction over insurance and financial services matters shall conduct an evaluation of the effectiveness of any pilot project approved by the superintendent pursuant to this section and make a determination whether to continue, amend or repeal the authorization for the pilot project. The joint standing committee of the Legislature having jurisdiction over insurance and financial services matters may report out a bill based on the evaluation to the First Regular Session of the 129th Legislature. [RR 2011, c. 1, §43 (RAL).]

5. Construction. This section may not be construed to restrict or limit the right of a carrier to engage in activities expressly permitted by this Title or to require a carrier to obtain prior approval as a pilot project to engage in those activities. [RR 2011, c. 1, §43 (RAL).]
24 M.R.S. § 2322 — ME Code / Title 24 / Chapter 19 / Section 2322
24 §2322. Hearing
Status: in_force

If at any time the superintendent has reason to believe that a filing does not meet the requirements that rates not be excessive, inadequate or unfairly discriminatory or that the filing violates any of Title 24‑A, chapter 23 , to the extent it is applicable pursuant to section 2317 , the superintendent shall cause a hearing to be held. [RR 2019, c. 2, Pt. B, §77 (COR).]

Hearings held under this section shall conform to the procedural requirement set forth in the Maine Administrative Procedure Act, Title 5, chapter 375, subchapter IV . [PL 1979, c. 558, §3 (RPR).]
24-A M.R.S. § 4364 — ME Code / Title 24-A / Chapter 57 / Section 4364
24-A §4364. Conduct of delinquency proceedings against domestic insurers and certain alien insurers
Status: in_force

1. Whenever under this chapter a receiver is to be appointed in delinquency proceedings for an insurer, the court shall appoint the superintendent as such receiver. The court shall order the superintendent forthwith to take possession of the assets of the insurer and to administer the same under the orders of the court. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

2. As a domiciliary receiver, the superintendent is vested by operation of law with the title to all of the property, contracts and rights of action and all of the books and records of the insurer, wherever located, as of the date of entry of the order directing the superintendent to rehabilitate or liquidate a domestic insurer or to liquidate the United States branch of an alien insurer domiciled in this State, and the superintendent has the right to recover the same and reduce the same to possession; except that ancillary receivers in reciprocal states have, as to assets located in their respective states, the rights and powers that are herein prescribed for ancillary receivers appointed in this State as to assets located in this State. [RR 2021, c. 1, Pt. B, §356 (COR).]

3. The filing or recording of the order directing possession to be taken, or a certified copy thereof, in any office where instruments affecting title to property are required to be filed or recorded shall impart the same notice as would be imparted by a deed, bill of sale or other evidence of title duly filed or recorded. [PL 1969, c. 132, §1 (NEW).]

4. The superintendent as domiciliary receiver is responsible for the proper administration of all assets coming into the superintendent's possession or control. The court may at any time require a bond from the superintendent or the superintendent's deputies, if considered desirable for the protection of such assets. [RR 2021, c. 1, Pt. B, §357 (COR).]

5. Upon taking possession of the assets of an insurer, the domiciliary receiver shall immediately proceed to conduct the business of the insurer or to take such steps as are authorized by this chapter for the purpose of rehabilitating, liquidating or conserving the affairs or assets of the insurer. [PL 1969, c. 132, §1 (NEW).]

6. In connection with delinquency proceedings, the superintendent may appoint one or more special deputy superintendents to act for the superintendent and the superintendent may employ such counsel, clerks and assistants as the superintendent considers necessary. The compensation of the special deputies, counsel, clerks or assistants and all expenses of taking possession of the insurer and of conducting the proceedings are fixed by the receiver and must be paid out of the funds or assets of the insurer. Within the limits of duties imposed upon them, special deputies possess all the powers given to and, in the exercise of those powers, are subject to all of the duties imposed upon the receiver with respect to such proceedings. [RR 2021, c. 1, Pt. B, §358 (COR).]

7. During such receivership the superintendent shall file in the court, at regular intervals not less frequently than quarterly, the superintendent's true reports in summary form of the insurer's affairs under the receivership, and of progress being made in accomplishing the objectives of the receivership. All such reports, together with such additional or special reports as the court may reasonably require, are subject to review by the court; and all actions of the receiver therein reported are subject to the court's approval, but the court may not withhold approval or disapprove any such action unless found by the court after a hearing thereon in open court to be unlawful, arbitrary or capricious. [RR 2021, c. 1, Pt. B, §359 (COR).]
24-A M.R.S. § 2705 — ME Code / Title 24-A / Chapter 33 / Section 2705
24-A §2705. Entire contract -- changes
Status: in_force

There shall be a provision as follows: [PL 1969, c. 132, §1 (NEW).]

Entire contract; changes: This policy, including the endorsements and the attached papers, if any, constitutes the entire contract of insurance. No change in this policy shall be valid until approved by an executive officer of the insurer and unless such approval be endorsed hereon or attached hereto. No agent has authority to change this policy or to waive any of its provisions. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 1421 — ME Code / Title 24-A / Chapter 16 / Section 1421
24-A §1421. Licensing forms
Status: in_force

The superintendent or an independent licensing service designated by the superintendent shall prescribe, consistent with the applicable requirements of this chapter, and furnish all forms required under this chapter in connection with applications for and issuance of licenses. The superintendent or an independent testing service designated by the superintendent shall prescribe and furnish all forms required in connection with examinations for licenses. [PL 1997, c. 592, §24 (AMD).]
24-A M.R.S. § 2814 — ME Code / Title 24-A / Chapter 35 / Section 2814
24-A §2814. Blanket health insurance; payments; beneficiaries
Status: in_force

All benefits under any blanket health insurance policy are payable to the person insured, or to the person's designated beneficiary or beneficiaries, or to the person's estate, as are specified in the policy, except that if the person insured be a minor, such benefits may be made payable to the person's parent, guardian or other person actually supporting the person, or to a person or persons chiefly dependent upon the person for support and maintenance. [RR 2021, c. 1, Pt. B, §245 (COR).]
24-A M.R.S. § 953 — ME Code / Title 24-A / Chapter 11 / Section 953
24-A §953. Minimum standards
Status: in_force

1. This subsection applies only to policies and contracts issued prior to January 1, 1948, or such earlier date after July 21, 1945, as shall have been elected by an insurer as the date on and after which it would comply with the standard nonforfeiture law. Except as otherwise provided in subsection 3 , the legal minimum standard of value for such life insurance policies issued on or after the first day of September, 1931, by any life insurer chartered by this State, shall be the American Experience Table of Mortality with interest at 3 1/2% per year. Any such life insurer may, at its option, value its insurance policies issued on and after such day, in accordance with their terms on the basis of the American Men Ultimate Table of Mortality with interest not higher than 3 1/2% per year by the net level premium method. Reserves for all such policies and contracts may be calculated, at the option of the insurer, according to any standards which produce greater aggregate reserves for all such policies and contracts than the minimum reserves required by this subsection. [PL 1975, c. 342, §1 (AMD).]

2. This subsection applies only to policies and contracts issued on and after January 1, 1948, or the earlier date after July 21, 1945, as shall have been elected by an insurer as the date on and after which it would comply with the standard nonforfeiture law. Except as otherwise provided in subsection 3 and section 953‑A , the minimum standard for the valuation of all those policies and contracts shall be the commissioners reserve valuation method defined in section 954 , 3 1/2% interest, or in the case of policies and contracts, other than annuity and pure endowment contracts, issued on or after December 31, 1975, 4% interest, and the following tables, or in the case of these policies and contracts, other than annuity and pure endowment contracts, issued on or after January 1, 1980, 4 1/2% interest, and the following tables. A. Standard Ordinary Mortality Table. For all ordinary policies of life insurance issued on the standard basis, excluding any disability and accidental death benefits in these policies, -- the Commissioners 1941 Standard Ordinary Mortality Table; provided that the Commissioners 1958 Standard Ordinary Mortality Table shall be the table for the minimum standard for those policies issued on and after January 1, 1966, or such earlier date after September 12, 1959, as shall have been elected by an insurer as the date on and after which it would use such table as the basis for minimum cash surrender values and nonforfeiture benefits under the standard nonforfeiture law and prior to the operative date of the Standard Nonforfeiture Law for Life Insurance, section 2532‑A ; provided that for any category of those policies issued on female risks all modified net premiums and present values referred to in sections 951 to 957 may be calculated according to an age not more than 3 years younger than the actual age of the insured, or in the case of those policies issued on or after January 1, 1980, according to an age not more than 6 years younger than the actual age of the insured. For those policies issued on or after the operative date of the Standard Nonforfeiture Law for Life Insurance, section 2532‑A , the Commissioners 1980 Standard Ordinary Mortality Table, or at the election of the company for any one or more specified plans of life insurance, the Commissioners 1980 Standard Ordinary Mortality Table with Ten-Year Select Mortality Factors or any ordinary mortality table, adopted after 1980 by the National Association of Insurance Commissioners, that is approved by regulation promulgated by the superintendent for use in determining the minimum standard of valuation for the policies. [PL 1983, c. 346, §2 (AMD).] B. Standard Industrial Mortality Table. For all industrial life insurance policies issued on the standard basis, excluding any disability and accidental death benefits in the policies, -- the 1941 Standard Industrial Mortality Table; provided that the Commissioners 1961 Standard Industrial Mortality Table, or any industrial mortality table, adopted after 1980 by the National Association of Insurance Commissioners, that is approved by regulation promulgated by the superintendent for use in determining the minimum standard of valuation for those policies, shall be the table for the minimum standard for those policies issued on and after January 1, 1968, or such earlier date after September 1, 1963, as shall have been elected by the insurer as the date on and after which it would use such table as the basis for minimum cash surrender values and nonforfeiture benefits under the standard nonforfeiture law. [PL 1983, c. 346, §2 (AMD).] C. Standard Annuity Mortality Table or Annuity Mortality Table. For individual annuity and pure endowment contracts, excluding any disability and accidental death benefits in those policies -- the 1937 Standard Annuity Mortality Table or, at the option of the insurer, the Annuity Mortality Table for 1949, Ultimate, or any modification of either of these tables approved by the superintendent. [PL 1983, c. 346, §2 (AMD).] D. Group Annuity Mortality Table. For group annuity and pure endowment contracts, excluding any disability and accidental death benefits in those policies -- the Group Annuity Mortality Table for 1951, any modification of the table approved by the superintendent, or, at the option of the insurer, any of the tables or modifications of tables specified for individual annuity and pure endowment contracts. [PL 1983, c. 346, §2 (AMD).] E. Class (3) Disability Table. For total and permanent disability benefits in or supplementary to ordinary policies or contracts -- for policies or contracts issued on or after January 1, 1966, the tables of Period 2 disablement rates and the 1930 to 1950 termination rates of the 1952 Disability Study of the Society of Actuaries, with due regard to the type of benefit or any tables of disablement rates and termination rates, adopted after 1980 by the National Association of Insurance Commissioners, that are approved by regulation promulgated by the superintendent for use in determining the minimum standard of valuation for those policies; for policies or contracts issued on or after January 1, 1961 and prior to January 1, 1966, either those tables or, at the option of the insurer, the Class (3) Disability Table (1926); and for policies issued prior to January 1, 1961, the Class (3) Disability Table (1926). Any such table shall, for active lives, be combined with a mortality table permitted for calculating the reserves for life insurance policies. [PL 1983, c. 346, §2 (AMD).] F. Inter-Company Double Indemnity Mortality Table. For accidental death benefits in or supplementary to policies -- for policies issued on or after January 1, 1966, the 1959 Accidental Death Benefits Table or any accidental death benefits table, adopted after 1980 by the National Association of Insurance Commissioners, that is approved by regulation promulgated by the superintendent for use in determining the minimum standard of valuation for those policies; for policies issued on or after January 1, 1961 and prior to January 1, 1966, either that table or, at the option of the insurer, the Inter-Company Double Indemnity Mortality Table; and for policies issued prior to January 1, 1961, the Inter-Company Double Indemnity Mortality Table. Either table shall be combined with a mortality table permitted for calculating the reserves for life insurance policies. [PL 1983, c. 346, §2 (AMD).] G. Group Life Insurance Tables. For group life insurance, life insurance issued on the substandard basis and other special benefits -- such table as may be approved by the superintendent. [PL 1983, c. 346, §2 (AMD).] [PL 1983, c. 346, §2 (AMD).]

3. Except as provided in section 953‑A , the minimum standard for the valuation of all individual annuity and pure endowment contracts issued on or after the effective date of this subsection, as defined herein, and for all annuities and pure endowments purchased on or after the effective date under group annuity and pure endowment contracts, shall be the commissioners reserve valuation method defined in section 954 and the following tables and interest rates. A. 1971 Individual Annuity Mortality Table. For individual annuity and pure endowment contracts, excluding any disability and accidental death benefits in those contracts -- the 1971 Individual Annuity Mortality Table, or any individual annuity mortality table, adopted after 1980 by the National Association of Insurance Commissioners, that is approved by regulation promulgated by the superintendent for use in determining the minimum standard of valuation for those contracts, or any modification of these tables approved by the superintendent, and 6% interest for single premium immediate annuity contracts, and 4% interest for all other individual annuity and pure endowment contracts, or in the case of these contracts issued on or after January 1, 1980, 7 1/2% interest for individual single premium immediate annuity contracts, 5 1/2% interest for single premium deferred annuity and pure endowment contracts and 4 1/2% interest for all other individual annuity and pure endowment contracts. [PL 1983, c. 346, §2 (AMD).] B. 1971 Group Annuity Mortality Table. For all annuities and pure endowments purchased under group annuity and pure endowment contracts, excluding any disability and accidental death benefits purchased under those contracts -- the 1971 Group Annuity Mortality Table, or any group annuity mortality table, adopted after 1980 by the National Association of Insurance Commissioners, that is approved by regulation promulgated by the superintendent for use in determining the minimum standard of valuation for those annuities and pure endowments, or any modification of these tables approved by the superintendent, and 6% interest, or in the case of annuities and pure endowments purchased under those contracts on or after January 1, 1980, 7 1/2% interest. [PL 1983, c. 346, §2 (AMD).] This subsection shall not apply to any insurer before January 1, 1979, unless the insurer shall have filed with the superintendent an election to comply with the provisions of this subsection after a specified date before January 1, 1979, provided that an insurer may elect different dates on which this subsection shall apply to individual and pure endowment contracts and to group annuity and pure endowment contracts. If an insurer makes no such election, this subsection shall apply to that insurer on January 1, 1979. [PL 1983, c. 346, §2 (AMD).]
24-A M.R.S. § 6459 — ME Code / Title 24-A / Chapter 79 / Section 6459
24-A §6459. Supplemental provisions
Status: in_force

1. Existing authority supplemented. The provisions of this chapter are supplemental to any other provisions of the laws of this State and do not preclude or limit any other powers or duties of the superintendent under those laws, including, but not limited to, sections 417 , 3423 and 3424 and chapter 57 . [PL 1997, c. 81, §9 (NEW).]

2. Rules. The superintendent may adopt rules to carry out the purposes of this chapter. Rules adopted pursuant to this chapter are routine technical rules as defined in Title 5, chapter 375, subchapter II‑A . [PL 1997, c. 81, §9 (NEW).]

3. Exemptions. The superintendent may exempt from the application of this chapter any domestic property and casualty insurer that: A. Writes business only in the State; [PL 1997, c. 81, §9 (NEW).] B. Writes direct annual premium of $2,000,000 or less; and [PL 1997, c. 81, §9 (NEW).] C. Assumes no reinsurance in excess of 5% of direct premium written. [PL 1997, c. 81, §9 (NEW).] [PL 1997, c. 81, §9 (NEW).]
24-A M.R.S. § 3422 — ME Code / Title 24-A / Chapter 47 / Section 3422
24-A §3422. Purchase of own shares by stock insurer
Status: in_force

A domestic stock insurer shall have the right to purchase or acquire shares of its own stock only as follows: [PL 1969, c. 132, §1 (NEW).]

1. For elimination of fractional shares. [PL 1969, c. 132, §1 (NEW).]

2. Incidental to the enforcement of rights of the insurer with respect to lawful transactions previously entered into in good faith for purposes other than the acquisition of such shares. [PL 1969, c. 132, §1 (NEW).]

3. For the purposes of a general savings and investment plan for employees or agents of the insurer. [PL 1969, c. 132, §1 (NEW).]

4. For mutualization of the insurer, as provided in section 3472 . [PL 1969, c. 132, §1 (NEW).]

5. For retirement or otherwise of the shares under a plan submitted to and approved in writing by the superintendent. The superintendent may not approve a plan unless found by the superintendent to be reasonable, fair and equitable as to remaining stockholders of the insurer, and not materially adverse to the protection of the insurer's policyholders. [RR 2021, c. 1, Pt. B, §280 (COR).]