24-A M.R.S. § 4306-A — ME Code / Title 24-A / Chapter 56-A / Section 4306-A
24-A §4306-A. Patient access to obstetrical and gynecological care
Status: in_force

Notwithstanding any other requirements of this Title, a carrier offering a health plan in this State subject to the requirements of the federal Affordable Care Act: [PL 2011, c. 364, §29 (NEW).]

1. Authorization or referral not required. May not require authorization or referral by the carrier or any other person, including a primary care provider, in the case of a female enrollee who seeks coverage for obstetrical or gynecological care provided by a participating health care professional as described in the federal Affordable Care Act who specializes in obstetrics or gynecology. The health care professional shall agree to otherwise adhere to the health plan's or carrier's policies and procedures, including procedures regarding referrals and obtaining prior authorization and providing services pursuant to a treatment plan, if any, approved by the carrier; and [PL 2011, c. 364, §29 (NEW).]

2. Treated as primary care. Shall treat the provision of obstetrical and gynecological care by a participating health care professional as described in the federal Affordable Care Act who specializes in obstetrics or gynecology, pursuant to subsection 1 , as authorized by the primary care provider and the authorization of related obstetrical and gynecological items and services by that professional as the authorization of the primary care provider. [PL 2011, c. 364, §29 (NEW).]
24-A M.R.S. § 4133 — ME Code / Title 24-A / Chapter 55 / Section 4133
24-A §4133. Investments
Status: in_force

A society shall invest its funds only in such investments as are authorized by the laws of this State for the investment of assets of life insurers and subject to the limitations thereon. Any foreign or alien society permitted or seeking to do business in this State which invests its funds in accordance with the laws of the state, district, territory, country or province in which it is incorporated, shall be held to meet the requirements of this section for the investment of funds. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 3623 — ME Code / Title 24-A / Chapter 51 / Section 3623
24-A §3623. Limit of risk
Status: in_force

1. Except as provided in section 3607, subsection 1 , an insurer shall not retain liability as to any one risk in an amount exceeding 10% of its surplus and in addition 8% of the amount at any time due on its premium notes. [PL 1975, c. 124 (AMD).]

2. Valid reinsurance ceded by the insurer and then in force shall be deducted from the gross risk assumed in determining net risk retained. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 4303-G — ME Code / Title 24-A / Chapter 56-A / Section 4303-G
24-A §4303-G. Provider maintenance of certification requirements (WHOLE SECTION TEXT EFFECTIVE UNTIL 4/1/29) (WHOLE SECTION TEXT REPEALED 4/1/29)
Status: repealed

(CONTAINS TEXT WITH VARYING EFFECTIVE DATES)

(WHOLE SECTION TEXT EFFECTIVE UNTIL 4/1/29)

(WHOLE SECTION TEXT REPEALED 4/1/29)

The following provisions govern maintenance of certification requirements. [PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).]

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Hospital" means a hospital licensed and operating under Title 22, chapter 404 or 405 or the parent of such institution, or a hospital subsidiary or hospital affiliate in this State that provides medical services or medically related diagnostic and laboratory services or engages in ancillary activities supporting those services. [PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).] B. "Maintenance of certification program" means satisfactory participation in a program beyond the continuing medical education requirements currently in place by the Board of Licensure in Medicine or Board of Osteopathic Licensure, or initial board certification by a national or regional medical specialty board. [PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).] C. "Outpatient clinical practice" means any medical practice, home care or hospice organization or other nonhospital entity providing medical care through physicians. [PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).] D. "Physician" means an individual licensed under Title 32, chapter 36 or 48 . [PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).] [PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).]

2. Discrimination prohibited. A carrier offering a health plan in this State may not: A. Deny reimbursement to a physician, hospital or outpatient clinical practice for services rendered because a physician does not participate in a maintenance of certification program; [PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).] B. Provide lower reimbursement for services rendered by a physician, hospital or outpatient clinical practice because a physician does not participate in a maintenance of certification program; [PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).] C. Prohibit a physician, hospital or outpatient clinical practice from participating in any of the carrier's provider networks because a physician does not participate in a maintenance of certification program; or [PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).] D. Determine credentialing of a physician, hospital or outpatient clinical practice based on the status of a physician's, hospital's or outpatient clinical practice's participation in a maintenance of certification program. [PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).] [PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).]

3. Repeal. This section is repealed April 1, 2029. [PL 2023, c. 40, §1 (NEW); PL 2023, c. 40, §2 (AFF).]
24-A M.R.S. § 1420-L — ME Code / Title 24-A / Chapter 16 / Section 1420-L
24-A §1420-L. Commissions
Status: in_force

1. License required to pay. An insurance company or insurance producer may not pay a commission, service fee, brokerage or other valuable consideration to a person for selling, soliciting or negotiating insurance in this State if that person is required to be licensed under this subchapter and is not so licensed. [PL 2001, c. 259, §24 (NEW).]

2. License required to accept. A person may not accept a commission, service fee, brokerage or other valuable consideration for selling, soliciting or negotiating insurance in this State if that person is required to be licensed under this subchapter and is not so licensed. [PL 2001, c. 259, §24 (NEW).]

3. Deferral. Renewal or other deferred commissions may be paid to a person for selling, soliciting or negotiating insurance in this State if the person was required to be licensed under this subchapter at the time of the sale, solicitation or negotiation and was so licensed at that time. [PL 2001, c. 259, §24 (NEW).]

4. Assignments. An insurer or insurance producer may pay or assign commissions, service fees, brokerages or other valuable consideration to an insurance agency or to persons who do not sell, solicit or negotiate insurance in this State, unless the payment would violate chapter 23 or any other applicable provision of this Title. [PL 2001, c. 259, §24 (NEW).]
24-A M.R.S. § 2716 — ME Code / Title 24-A / Chapter 33 / Section 2716
24-A §2716. Change of beneficiary
Status: reserved

1. There shall be a provision as follows: Change of beneficiary: Unless the insured makes an irrevocable designation of beneficiary, the right to change the beneficiary is reserved to the insured and the consent of the beneficiary or beneficiaries shall not be requisite to surrender or assignment of this policy or to any change of beneficiary or beneficiaries, or to any other changes in this policy. [PL 1969, c. 132, §1 (NEW).]

2. The first clause of the above provision relating to the irrevocable designation of beneficiary may be omitted at the insurer's option. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 1101 — ME Code / Title 24-A / Chapter 13 / Section 1101
24-A §1101. Scope of chapter
Status: in_force

1. Subject to subsection 2 and section 1137 , this chapter applies to all insurers except life or health insurers that transact business of a type described in section 409, subsection 3 . [PL 1991, c. 385, §9 (NEW).]

2. Each domestic all lines insurer, as defined in section 409, subsection 2 , shall, for accounting and financing purposes, establish and maintain distinct accounts dedicated exclusively to the insurance it transacts under its life or health insurance authority and to the remainder of its business. Each account must include reserves and surplus funds adequate to financially support the underwriting activity. All assets allocated to life accounts and health accounts are subject to chapter 13‑A rather than this chapter. The books and records of any insurer writing more than one kind of business must reflect the assets and operations relating to each underwriting activity in detail sufficient to demonstrate compliance with this chapter and chapter 13‑A . [PL 1991, c. 385, §9 (NEW).]
24-A M.R.S. § 2424 — ME Code / Title 24-A / Chapter 27 / Section 2424
24-A §2424. Claims administration not waiver
Status: in_force

Without limitation of any right or defense of an insurer otherwise, none of the following acts by or on behalf of an insurer may be deemed to constitute a waiver of any provision of a policy or of any defense of the insurer thereunder: [RR 2009, c. 2, §67 (COR).]

1. Acknowledgement of the receipt of notice of loss or claim under the policy. [PL 1969, c. 132, §1 (NEW).]

2. Furnishing forms for reporting a loss or claim, for giving information relative thereto, or for making proof of loss, or receiving or acknowledging receipt of any such forms or proofs completed or uncompleted. [PL 1969, c. 132, §1 (NEW).]

3. Investigating any loss or claim under any policy or engaging in negotiations looking toward a possible settlement of any such loss or claim. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 6607 — ME Code / Title 24-A / Chapter 81 / Section 6607
24-A §6607. Trust deposit or surety bond
Status: in_force

If the superintendent determines that a multiple-employer welfare arrangement has failed to establish or maintain the actuarially indicated level of funding as required, the superintendent may require the arrangement to file a security deposit or a surety bond in accordance with this section. [PL 1995, c. 618, §11 (AMD).]

1. Deposit. If required, deposit funds, which may consist of cash, securities or any combination of cash and securities acceptable to the superintendent, must be filed with the superintendent for deposit with the Treasurer of State in an amount equal to the greater of either 25% of the immediately preceding 12 months' health care claims expenditures or 15% of the expected gross annual contributions for the current year. In no case may the amount of the deposit be less than $50,000 or more than $1,000,000 except that the superintendent, after due notice to all interested parties and opportunity for hearing, and after consideration of the records, may prescribe an amount in excess of $1,000,000. All income from deposits belongs to the depositing arrangement and must be paid to it when received. An arrangement that has made a security deposit, subject to approval of the superintendent, may withdraw that deposit or any part of that deposit after making a substitute deposit of cash, securities or any combination of cash and securities of equal amount and value. A judgment creditor or other claimant of a multiple-employer welfare arrangement may not levy upon any of the assets or securities held in this State as a deposit under this section. [PL 1993, c. 688, §1 (NEW).]

2. Surety bond in lieu of deposit. In lieu of the deposit required under subsection 1 , an arrangement may file with the superintendent a surety bond in like amount. The bond must be one issued by an authorized surety insurer, must be for the same purpose as the deposit in lieu of which it is filed and must be in a form prescribed by the superintendent. A bond may not be canceled or subject to cancellation unless at least 60 days' advance notice of cancellation in writing is filed with the superintendent and the chair of the trustees. [PL 1993, c. 688, §1 (NEW).]

3. Insolvency termination. In the event of a termination of an arrangement due to insolvency, a determination of impairment or the failure of the arrangement to pay any final judgment rendered against it in this State within 30 days after the judgment becomes final, the deposit held by the superintendent pursuant to subsection 1 or the bond held by the superintendent pursuant to subsection 2 must be applied to the extent of the insolvency or to the extent of any default in payment of benefit claims. Any deposit funds remaining in excess of the amount needed to make the arrangement solvent must be distributed in accordance with section 6610 . [PL 1993, c. 688, §1 (NEW).]
24-A M.R.S. § 2804-A — ME Code / Title 24-A / Chapter 35 / Section 2804-A
24-A §2804-A. Private purchasing alliances
Status: in_force

A group of individuals may be insured under a policy issued to a private purchasing alliance meeting the requirements of chapter 18‑A . [PL 1995, c. 673, Pt. A, §4 (NEW).]
24-A M.R.S. § 4343 — ME Code / Title 24-A / Chapter 56-A / Section 4343
24-A §4343. Rules
Status: in_force

The superintendent may adopt rules establishing application procedures and specific standards for meeting the requirements pursuant to this subchapter. Rules adopted pursuant to this subchapter are routine technical rules pursuant to Title 5, chapter 375, subchapter II‑A . [PL 1999, c. 609, §20 (NEW).]
24-A M.R.S. § 4606 — ME Code / Title 24-A / Chapter 62 / Section 4606
24-A §4606. Creation of the association
Status: in_force

1. Creation. There is created a nonprofit legal entity to be known as the Maine Life and Health Insurance Guaranty Association. All member insurers must be and remain members of the association as a condition of their authority to transact insurance or health maintenance organization business in this State. The association shall perform its functions under the plan of operation established and approved under section 4610 and shall exercise its powers through a board of directors established under section 4607 . For purposes of administration and assessment, the association shall maintain 3 accounts: A. The health insurance account; [PL 1983, c. 846 (NEW).] B. The life insurance account; and [PL 1983, c. 846 (NEW).] C. The annuity account, which must include annuity contracts owned by a governmental retirement plan or its trustee established under Section 401, Section 403(b) or Section 457 of the United States Internal Revenue Code. [PL 2005, c. 346, §6 (AMD); PL 2005, c. 346, §16 (AFF).] [PL 2017, c. 382, §14 (AMD).]

2. Supervision of association. The association is under the immediate supervision of the superintendent and is subject to the applicable provisions of the insurance laws of this State. Meetings or records of the association may be open to the public upon majority vote of the board of directors of the association. [PL 2005, c. 346, §6 (AMD); PL 2005, c. 346, §16 (AFF).]
24-A M.R.S. § 796-A — ME Code / Title 24-A / Chapter 9 / Section 796-A
24-A §796-A. Confidentiality of proprietary information
Status: in_force

Any requirement established by this subchapter to file proprietary business information with the superintendent does not in and of itself make that information a public record. Information filed with the superintendent pursuant to this subchapter is entitled to any privileges and confidentiality protections that would apply if the special purpose reinsurance vehicle were a captive insurance company licensed by the superintendent pursuant to section 6702 . [PL 2007, c. 386, §21 (NEW).]
24-A M.R.S. § 2325-A — ME Code / Title 24-A / Chapter 25 / Section 2325-A
24-A §2325-A. Market assistance plans
Status: in_force

1. Establishment. Whenever a particular type of insurance is unavailable or unaffordable, the superintendent may establish a market assistance plan. [PL 1987, c. 627 (NEW).]

2. Definition. For purposes of this section a "market assistance plan" is a voluntary agreement between the Bureau of Insurance and insurers that the insurers will write insurance at an agreed upon rate for those persons or groups that are unable to obtain coverage. [PL 1987, c. 627 (NEW).]

3. Notification. Whenever the superintendent determines that a market assistance plan is needed, the superintendent shall notify all insurers authorized to write the type of insurance covered by the plan that a market assistance plan is being established and their participation in the plan is requested. [PL 1987, c. 627 (NEW).]

4. Participation. Each insurer receiving a notice referred to in subsection 3 , shall respond within 30 days to the notice. Their response shall indicate the extent to which they are willing to participate and any reasons why they do not wish to participate or only wish to participate on a limited basis. [PL 1987, c. 627 (NEW).]

5. Report. The superintendent shall report to the joint standing committee of the Legislature having jurisdiction over insurance by January 30th of each year whether there is, or may be, within the year a lack of availability in any line of insurance. [PL 1987, c. 627 (NEW).]
24-A M.R.S. § 4212 — ME Code / Title 24-A / Chapter 56 / Section 4212
24-A §4212. Prohibited practices
Status: in_force

1. No health maintenance organization, or representative thereof, may cause or knowingly permit the use of advertising which is untrue or misleading, solicitation which is untrue or misleading, or any form of evidence of coverage which is deceptive. For purposes of this chapter: A. A statement or item of information shall be deemed to be untrue if it does not conform to fact in any respect which is or may be significant to an enrollee of, or person considering enrollment in, a health maintenance organization; [PL 1975, c. 503 (NEW).] B. A statement or item of information shall be deemed to be misleading, whether or not it may be literally untrue, if, in the total context in which such statement is made or such item of information is communicated, such statement or item of information may be reasonably understood by a reasonable person, not possessing special knowledge regarding health care coverage, as indicating any benefit or advantage or the absence of any exclusion, limitation or disadvantage of possible significance to an enrollee of, or person considering enrollment in, a health maintenance organization, if such benefit or advantage or absence of limitation, exclusion or disadvantage does not in fact exist; [PL 1975, c. 503 (NEW).] C. An evidence of coverage shall be deemed to be deceptive if the evidence of coverage taken as a whole, and with consideration given to typography and format, as well as language, shall be such as to cause a reasonable person, not possessing special knowledge regarding health maintenance organizations and evidences of coverage therefor, to expect benefits, services, charges or other advantages which the evidence of coverage does not provide or which the health maintenance organization issuing such evidence of coverage does not regularly make available for enrollees covered under such evidence of coverage. [PL 1975, c. 503 (NEW).] [PL 1975, c. 503 (NEW).]

2. An enrollee may not be cancelled nor denied renewal except for the following: A. Fraud or material misrepresentation; [PL 1995, c. 332, Pt. O, §6 (NEW).] B. Failure to pay the charge for coverage; [PL 1995, c. 332, Pt. O, §6 (NEW).] C. When the provisions of the State's community rating law are applicable, as provided by section 2736‑C, subsection 3, paragraph B and section 2808‑B, subsection 4, paragraph B ; or [PL 1995, c. 332, Pt. O, §6 (NEW).] D. Other reasons promulgated by the superintendent. [PL 1995, c. 332, Pt. O, §6 (NEW).] [PL 1995, c. 332, Pt. O, §6 (RPR).]

3. No health maintenance organization, unless licensed as an insurer, may use in its name, contracts or literature any of the words "insurance", "casualty", "surety", "mutual" or any other words descriptive of the insurance, casualty or surety business or deceptively similar to the name or description of any insurance or surety corporation doing business in this State. [PL 1975, c. 503 (NEW).]
24-A M.R.S. § 4234-E — ME Code / Title 24-A / Chapter 56 / Section 4234-E
24-A §4234-E. Off-label use of prescription drugs for HIV or AIDS
Status: in_force

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Off-label use" means the prescription and use of drugs for indications other than those stated in the labeling approved by the federal Food and Drug Administration. [PL 1997, c. 701, §4 (NEW).] B. "Peer-reviewed medical literature" means scientific studies published in at least 2 articles from major peer-reviewed medical journals that present data that supports the proposed off-label use as generally safe and effective. [PL 1997, c. 701, §4 (NEW).] C. "Standard reference compendia" means: (1) The United States Pharmacopeia Drug Information or information published by its successor organization; or (2) The American Hospital Formulary Service Drug Information or information published by its successor organization. [PL 1997, c. 701, §4 (NEW).] [PL 1997, c. 701, §4 (NEW).]

2. Required coverage for off-label use. All health maintenance organization individual and group contracts that provide coverage for prescription drugs must provide coverage for off-label use in accordance with the following. A. Health maintenance organization individual and group contracts that provide coverage for prescription drugs may not exclude coverage of any such drug used for the treatment of HIV or AIDS on the grounds that the drug has not been approved by the federal Food and Drug Administration for that indication, as long as that drug is recognized for the treatment of that indication in one of the standard reference compendia or in peer-reviewed medical literature. [PL 1997, c. 701, §4 (NEW).] B. Coverage of a drug required by this subsection also includes medically necessary services associated with the administration of the drug. [PL 1997, c. 701, §4 (NEW).] C. This subsection may not be construed to require coverage for a drug when the federal Food and Drug Administration has determined its use to be contraindicated for treatment of the current indication. [PL 1997, c. 701, §4 (NEW).] D. A drug use that is covered pursuant to paragraph A may not be denied coverage based on a "medical necessity" requirement except for a reason that is unrelated to the legal status of the drug use. [PL 1997, c. 701, §4 (NEW).] E. A contract that provides coverage of a drug as required by this subsection may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the same extent that these provisions are applicable to coverage of all prescription drugs and are not inconsistent with the requirements of this subsection. [PL 1997, c. 701, §4 (NEW).] [PL 1997, c. 701, §4 (NEW).]

3. Application. The requirements of this section apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 1999. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 1997, c. 701, §4 (NEW).]
24-A M.R.S. § 3159 — ME Code / Title 24-A / Chapter 44 / Section 3159
24-A §3159. Enforcement
Status: in_force

The superintendent may assess a civil penalty or take any other action permitted under section 12‑A against any person that violates any provision of this chapter. [PL 2021, c. 562, §1 (NEW).]
24-A M.R.S. § 2735-A — ME Code / Title 24-A / Chapter 33 / Section 2735-A
24-A §2735-A. Notice of rate filing and rate increase
Status: in_force

1. Notice of rate filing or rate increase on existing policies. An insurer offering individual health plans as defined in section 2736‑C must provide written notice by first class mail of a rate filing to all affected policyholders at least 60 days before the effective date of any proposed increase in premium rates or any proposed rating formula, classification of risks or modification of any formula or classification of risks. Except as otherwise provided in section 2736‑C, subsection 2‑B , the notice must also inform policyholders of their right to request a hearing pursuant to section 229 . The notice must show the proposed rate and, unless otherwise provided in section 2736‑C, subsection 2‑B , state that the rate is subject to regulatory approval. Except as otherwise provided in section 2736‑C, subsection 2‑B , the superintendent may not take final action on a rate filing until 40 days after the date notice is mailed by an insurer. An increase in premium rates may not be implemented until 60 days after the notice is provided or until the effective date under section 2736 , whichever is later. [PL 2011, c. 364, §1 (AMD).]

1-A. Notice of rate filings or rate increase on existing policies renewed in calendar year 2006. [PL 2005, c. 400, Pt. A, §1 (NEW); MRSA T. 24-A §2735-A, sub-§1-A (RP).]

2. Notice of rate increase on new business. When an insurer offering individual health plans as defined in section 2736 -C quotes a rate for new business, it must disclose any rate increase that the insurer anticipates implementing within the following 90 days. If the quote is in writing, the disclosure must also be in writing. If the increase is pending approval at the time of notice, the disclosure must include the proposed rate and state that it is subject to regulatory approval. If disclosure required by this subsection is not provided, an increase may not be implemented until at least 90 days after the date the quote is provided or the effective date under section 2736, whichever is later. [PL 2001, c. 432, §4 (NEW).]

3. Notice of rate increase on new business for calendar year 2006. [PL 2005, c. 400, Pt. A, §1 (NEW); MRSA T. 24-A §2735-A, sub-§3 (RP).]
24-A M.R.S. § 2721-A — ME Code / Title 24-A / Chapter 33 / Section 2721-A
24-A §2721-A. Overinsurance in accident policies; same insurer
Status: in_force

Whenever accident policies are effective immediately upon purchase, including but not limited to those policies purchased through coin-operated machines, there may be a provision included in the policy as follows: "If an accident policy or policies previously issued by the insurer to the insured be in force concurrently herewith making the aggregate indemnity for (insert type of coverage or coverages) in excess of $ (insert maximum limit of indemnity or indemnities) the excess is void and all premiums for such excess must be returned to the insured or to the insured's estate." [RR 2021, c. 1, Pt. B, §240 (COR).]
24-A M.R.S. § 1420-M — ME Code / Title 24-A / Chapter 16 / Section 1420-M
24-A §1420-M. Appointments
Status: in_force

1. Appointment. An insurance producer, including a nonresident producer acting pursuant to a national nonresident producer license issued through the National Association of Registered Agents and Brokers, may not act as an agent of an insurer unless the insurance producer becomes an appointed agent of that insurer. An insurance producer who is not acting as an agent of an insurer is not required to become appointed. [PL 2017, c. 115, §3 (AMD).]

2. Notice. To appoint a producer as its agent, the appointing insurer shall file, in a format approved by the superintendent, a notice of appointment within 15 days from the date the agency contract is executed or the first insurance application is submitted. An insurer may also elect to appoint a producer to all or some insurers within the insurer's holding company system or group by the filing of a single appointment request. [PL 2001, c. 259, §24 (NEW).]

3. Fee. An insurer shall pay an appointment fee, in the amount and method of payment set forth in section 601 , for each insurance producer appointed by the insurer. [PL 2001, c. 259, §24 (NEW).]

4. Renewal. An insurer shall remit, in a manner prescribed by the superintendent, a renewal appointment fee in the amount set forth in section 601 . [PL 2001, c. 259, §24 (NEW).]
24-A M.R.S. § 3301 — ME Code / Title 24-A / Chapter 47 / Section 3301
24-A §3301. Scope of chapter
Status: in_force

This chapter applies only as to domestic stock and mutual insurers transacting insurance on the cash premium or legal reserve plan. [PL 1973, c. 788, §107 (AMD).]

1. [PL 1973, c. 788, §107 (RP).]

2. [PL 1973, c. 788, §107 (RP).]
24-A M.R.S. § 4222-A — ME Code / Title 24-A / Chapter 56 / Section 4222-A
24-A §4222-A. Rules
Status: in_force

Subject to the applicable requirements and procedures of the Maine Administrative Procedure Act, Title 5, chapter 375, subchapter II , the superintendent may make, adopt, amend and rescind reasonable rules to aid the administration or effectuation of any provisions of this chapter. [PL 1993, c. 702, Pt. A, §17 (NEW).]
24-A M.R.S. § 4383 — ME Code / Title 24-A / Chapter 57 / Section 4383
24-A §4383. Order and levy of assessment
Status: in_force

1. Upon the filing and reading of the report and petition provided for in section 4382 , the court, ex parte, may order the superintendent to assess all members or subscribers of the insurer who may be subject to such an assessment, in such an aggregate amount as the court finds reasonably necessary to pay all valid claims as may be timely filed and proved in the delinquency proceedings, together with the costs and expenses of levying and collecting assessments and the costs and expenses of the delinquency proceedings in full. Any such order must require the superintendent to assess each such member or subscriber for the member's or subscriber's proportion of the aggregate assessment, according to such reasonable classification of such members or subscribers and formula as may be made by the superintendent and approved by the court. [RR 2021, c. 1, Pt. B, §377 (COR).]

2. The court may order additional assessments upon the filing and reading of any amendment or supplement to the report and petition referred to in subsection 1 , if such amendment or supplement is filed within 3 years after the date of the entry of the order of rehabilitation or liquidation. [PL 1969, c. 132, §1 (NEW).]

3. After the entry of the order to levy and assess members or subscribers of an insurer referred to in subsections 1 and 2 , the superintendent shall levy and assess members or subscribers in accordance with the order. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

4. The total of all assessments against any member or subscriber with respect to any policy, whether levied pursuant to any other provision of this Title, shall be for no greater amount than that specified in the policy or policies of the member or subscriber and as limited under this Title, except as to any policy which was issued at a rate of premium below the minimum rate lawfully permitted for the risk insured, in which event the assessment against any such policyholder shall be upon the basis of the minimum rate for such risk. [PL 1969, c. 132, §1 (NEW).]

5. No assessment shall be levied against any member or subscriber with respect to any nonassessable policy issued in accordance with this Title. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2416 — ME Code / Title 24-A / Chapter 27 / Section 2416
24-A §2416. Execution of policies
Status: in_force

1. Every insurance policy shall be executed in the name of and on behalf of the insurer by its officer, attorney in fact, employee, or representative duly authorized by the insurer. [PL 1969, c. 132, §1 (NEW).]

2. A facsimile signature of any such executing individual may be used in lieu of an original signature. [PL 1969, c. 132, §1 (NEW).]

3. No insurance contract heretofore or hereafter issued and which is otherwise valid shall be rendered invalid by reason of the apparent execution thereof on behalf of the insurer by the imprinted facsimile signature of an individual not authorized so to execute as of the date of the policy. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 3421 — ME Code / Title 24-A / Chapter 47 / Section 3421
24-A §3421. Solicitation, insuring in other states
Status: in_force

1. No domestic insurer shall knowingly solicit insurance business in any reciprocating state in which not then licensed as an authorized insurer. This subsection shall not prohibit advertising through publications and radio, television and other media originating outside such reciprocating state, if the insurer is licensed in the state in which the advertising originates and the advertising is not specifically directed to residents of such reciprocating state. This subsection shall not apply as to surplus lines insurance, or reinsurance, or prohibit insurance covering persons or risks located in a reciprocating state, under contracts solicited and issued in states in which the insurer is then licensed, or insurance otherwise effectuated in accordance with the laws of the reciprocating state. A "reciprocating" state, as used herein, is one under the laws of which a similar prohibition is imposed upon and enforced against insurers domiciled in that state. [PL 1969, c. 132, §1 (NEW).]

2. A domestic insurer duly authorized to transact insurance in another jurisdiction may frame and issue policies for delivery in such jurisdiction pursuant to applications for insurance solicited and obtained therein, in accordance with the laws thereof, subject only to such restrictions, if any, as may be contained in the insurer's articles of incorporation or bylaws; and subject, in the case of health insurers, to the provisions of section 2733 (policies issued for delivery in another state). [PL 2013, c. 299, §13 (AMD).]
24-A M.R.S. § 2483 — ME Code / Title 24-A / Chapter 28 / Section 2483
24-A §2483. Finance -- Article 12
Status: in_force

1. Commission shall fund its establishment and organization. The commission shall pay or provide for the payment of the reasonable expenses of its establishment and organization. To fund the cost of its initial operations, the commission may accept contributions and other forms of funding from the National Association of Insurance Commissioners, compacting states and other sources. Contributions and other forms of funding from other sources must be of such a nature that the independence of the commission concerning the performance of its duties is not compromised. [PL 2003, c. 680, §1 (NEW).]

2. Commission shall collect filing fee. The commission shall collect a filing fee from each insurer and 3rd-party filer filing a product with the commission to cover the cost of the operations and activities of the commission and its staff in a total amount sufficient to cover the commission's annual budget. [PL 2003, c. 680, §1 (NEW).]

3. Notice and comment for budget approval. The commission's budget for a fiscal year may not be approved until it has been subject to notice and comment as set forth in section 2478 . [PL 2003, c. 680, §1 (NEW).]

4. Commission exempt from taxation. The commission is exempt from all taxation in and by the compacting states. [PL 2003, c. 680, §1 (NEW).]

5. Commission authority to pledge credit of compacting state limited. The commission may not pledge the credit of any compacting state, except by and with the appropriate legal authority of that compacting state. [PL 2003, c. 680, §1 (NEW).]

6. Commission to keep complete and accurate accounts. The commission shall keep complete and accurate accounts of all its internal receipts, including grants and donations, and disbursements of all funds under its control. The internal financial accounts of the commission are subject to the accounting procedures established under its bylaws. The financial accounts and reports, including the system of internal controls and procedures of the commission, must be audited annually by an independent certified public accountant. Upon the determination of the commission, but no less frequently than every 3 years, the review of the independent auditor must include a management and performance audit of the commission. The commission shall make an annual report to the governor and legislature of each compacting state, which must include a report of the independent audit. The commission's internal accounts are not confidential and such materials may be shared with the commissioner of any compacting state upon request, except that any work papers related to any internal or independent audit and any information regarding the privacy of individuals and insurers' proprietary information, including trade secrets, must remain confidential. [PL 2003, c. 680, §1 (NEW).]

7. Compacting states do not have ownership of commission property. A compacting state does not have any claim to or ownership of any property held by or vested in the commission or to any commission funds held pursuant to the provisions of this compact. [PL 2003, c. 680, §1 (NEW).]
24-A M.R.S. § 3876 — ME Code / Title 24-A / Chapter 53 / Section 3876
24-A §3876. Impaired reciprocals
Status: in_force

1. If the assets of a domestic reciprocal insurer are at any time insufficient to discharge its liabilities, other than any liability on account of funds contributed by the attorney or others, and to maintain the required surplus, its attorney shall forthwith make up the deficiency or levy an assessment upon the subscribers for the amount needed to make up the deficiency; but subject to the limitation set forth in the power of attorney or policy. [PL 1969, c. 132, §1 (NEW).]

2. If the attorney fails to make up such deficiency or to make the assessment within 30 days after the superintendent orders the attorney to do so or if the deficiency is not fully made up within 60 days after the date the assessment was made, the insurer must be deemed insolvent and must be proceeded against as authorized by this Title. [RR 2021, c. 1, Pt. B, §322 (COR).]

3. If liquidation of such an insurer is ordered, an assessment shall be levied upon the subscribers for such an amount, subject to limits as provided by this chapter, as the superintendent determines to be necessary to discharge all liabilities of the insurer, exclusive of any funds contributed by the attorney or other persons, but including the reasonable cost of the liquidation. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 424 — ME Code / Title 24-A / Chapter 5 / Section 424
24-A §424. -- penalty for late or false statement
Status: in_force

1. An insurer failing, without just cause beyond the reasonable control of the insurer, to file its annual statement as required in section 423 shall forfeit to the State $25 for each day of delinquency, to be collected if necessary, by civil action against the insurer in the District Court, Southern Kennebec Division. [PL 1969, c. 132, §1 (NEW).]

2. Any director, officer, agent or employee of any insurer who subscribes to, makes or concurs in making or publishing, any annual or other statement required by law, knowing the same to contain any material statement that is false, commits a Class D crime. [PL 1991, c. 797, §9 (AMD).]
24 M.R.S. § 2332-I — ME Code / Title 24 / Chapter 19 / Section 2332-I
24 §2332-I. Effective date of cancellation
Status: in_force

Contracts that do not provide for any refund of premium when a subscriber requests cancellation prior to the end of the period for which premiums have been paid must state that no refund is payable and that the cancellation will take effect at the end of the period for which premiums have been paid unless the subscriber requests an earlier cancellation date. If a subscriber requests cancellation of a contract before the end of the period for which premiums have been paid, then the nonprofit hospital or medical service organization must inform the subscriber in writing that no refund is payable and give the subscriber an opportunity to amend the cancellation request to take effect at the end of the period for which premiums have been paid. [PL 1997, c. 604, Pt. F, §1 (NEW).]
24-A M.R.S. § 4350-B — ME Code / Title 24-A / Chapter 56-C / Section 4350-B
24-A §4350-B. Prescription drug formularies; pharmacy and therapeutics committee
Status: in_force

1. Pharmacy and therapeutics committee; use of formulary. A carrier, or a pharmacy benefits manager under contract with a carrier, shall establish a pharmacy and therapeutics committee. A carrier shall require its pharmacy and therapeutics committee or the pharmacy and therapeutics committee of the carrier's pharmacy benefits manager to use one or more formularies. [PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]

2. Pharmacy and therapeutics committee; no conflict of interest for members. A carrier, or a pharmacy benefits manager under contract with a carrier, may not allow a person with a conflict of interest, as described in paragraph A or B , to be a member of its pharmacy and therapeutics committee. A person may not serve as a member of a pharmacy and therapeutics committee if the person: A. Is employed, or was employed within the preceding year, by a pharmaceutical manufacturer, developer, labeler, wholesaler or distributor; or [PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).] B. Receives compensation, or received compensation within the preceding year, from a pharmaceutical manufacturer, developer, labeler, wholesaler or distributor. [PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).] [PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]

3. Compensation prohibited. A carrier, or a pharmacy benefits manager under contract with a carrier, shall prohibit its pharmacy and therapeutics committee or any member of the committee from receiving any compensation from a pharmaceutical manufacturer, developer, labeler, wholesaler or distributor. [PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]
24-A M.R.S. § 2881 — ME Code / Title 24-A / Chapter 38 / Section 2881
24-A §2881. Exemption from chapter
Status: in_force

Legal services insurance, as defined in this chapter, does not include the payment by a voluntary association, other than a voluntary association which is an insurer, on behalf of one of its members of fees, costs or expenses related to or arising out of legal services performed for the member by an attorney who either is an employee of the paying association or who provides the legal services to the association's member, pursuant to an agreement with that association. [PL 1983, c. 801, §11 (NEW).]
24-A M.R.S. § 2857 — ME Code / Title 24-A / Chapter 37 / Section 2857
24-A §2857. Policy provisions; delivery or disclosure to debtors
Status: in_force

1. Policy or certificate delivered. All consumer credit insurance must be evidenced by an individual policy, or in the case of group insurance by a certificate of insurance, which individual policy or group certificate of insurance must be delivered to the debtor. [PL 2001, c. 138, §10 (AMD).]

2. Content of policy or certificate. Each individual policy or group certificate of consumer credit insurance must, in addition to other requirements of law, set forth the name and home office address of the insurer, the name or names of the debtor, or, in the case of a certificate under a group policy, the identity by name or otherwise of the debtor; the premium or amount of payment, if a separate identifiable charge is paid by the debtor separately for consumer credit insurance; a description of the coverage, including the amount and term of the coverage, and any exceptions, limitations and restrictions, including conditions under which the policy may be terminated, which must be highlighted in bold print; and must state that the benefit is paid to the creditor to reduce or extinguish the unpaid indebtedness and, wherever the amount of insurance may exceed the unpaid indebtedness, that any excess is payable to a beneficiary, other than the creditor, named by the debtor or to the debtor's estate. During the 30 days immediately following the commencement date, the debtor may cancel the insurance and request in writing a full refund of premium for any reason. [PL 2001, c. 138, §10 (AMD).]

3. When delivered. The individual policy or group certificate of insurance must be delivered to the insured debtor at the time the indebtedness is incurred, except as otherwise provided. [PL 2001, c. 138, §10 (AMD).]

4. Notice of proposed insurance. If the individual policy or group certificate of insurance is not delivered to the debtor at the time indebtedness is incurred, a copy of the application for such policy or a notice of proposed insurance, signed by the debtor and setting forth the name and home office address of the insurer, the name or names of the debtor, the premium or amount of payment by the debtor, if a separate identifiable charge is made separately for consumer credit insurance, the amount, term and a brief description of the coverage provided, must be delivered to the debtor at the time such indebtedness is incurred. Failure to comply with the foregoing requirement precludes the use of such application as evidence in any action brought against the insured. The copy of the application for, or notice of proposed insurance, must refer exclusively to insurance coverage, and must be separate and apart from the loan, sale or other credit statement of account, instrument or agreement, unless the information required by this subsection is prominently set forth therein. Upon acceptance of the insurance by the insurer and within 30 days of the date upon which the indebtedness is incurred, the insurer shall cause the individual policy or group certificate of insurance to be delivered to the debtor. The application or notice of proposed insurance must state that upon acceptance by the insurer the insurance becomes effective as provided in section 2856 . [PL 2001, c. 138, §10 (AMD).]

5. Risk not accepted. If the named insurer does not accept the risk, the debtor must receive a policy or certificate of insurance setting forth the name and home office address of the substituted insurer and the amount of the premium to be charged, and if the amount of premium is less than that set forth in the notice of proposed insurance, an appropriate refund must be made. [PL 2001, c. 138, §10 (AMD).]
24-A M.R.S. § 3424 — ME Code / Title 24-A / Chapter 47 / Section 3424
24-A §3424. Restrictions during impairment; penalty
Status: in_force

1. During the existence of impairment of the capital stock or surplus of an insurer, as referred to in section 3423 , the superintendent shall require such restriction of, or arrangements as to, operations of the insurer while the impairment exists as the superintendent considers advisable for protection of policyholders, the insurer or the public. [RR 2021, c. 1, Pt. B, §282 (COR).]

2. Any officer, director, representative or employee of the insurer who knowingly violates or fails to comply with any such restriction or requirement shall upon conviction thereof be subject to fine of not less than $500 or more than $5,000, or imprisonment for less than one year or to both such fine and imprisonment. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 411 — ME Code / Title 24-A / Chapter 5 / Section 411
24-A §411. Insuring combinations without additional capital funds
Status: in_force

Without additional paid-in capital stock or additional surplus, an authorized insurer may also be authorized: [PL 1969, c. 132, §1 (NEW).]

1. If a life insurer, to grant annuities; [PL 1969, c. 132, §1 (NEW).]

2. If a health insurer, to insure against congenital defects, as defined in section 707 ; [PL 1969, c. 132, §1 (NEW).]

3. If a casualty insurer or multiple line insurer, to transact health insurance; except that this provision does not apply to a domestic insurer authorized to transact casualty insurance only, pursuant to section 410, subsection 1, paragraph A ; or [PL 1991, c. 385, §3 (AMD).]

4. To transact employee benefit excess insurance to the extent authorized pursuant to section 707, subsection 3 . [PL 1991, c. 385, §4 (NEW).]
24-A M.R.S. § 2436-B — ME Code / Title 24-A / Chapter 27 / Section 2436-B
24-A §2436-B. Declaratory judgment actions involving insurance policies
Status: in_force

1. Definition. For purposes of this section, "insured" means a natural person and does not include a corporation, trust, partnership, incorporated or unincorporated association or any other legal entity. [PL 2001, c. 126, §1 (NEW).]

2. Costs and attorney's fees. In an action pursuant to Title 14, chapter 707 to determine an insurer's contractual duty to defend an insured under an insurance policy, if the insured prevails in such action, the insurer shall pay court costs and reasonable attorney's fees. [PL 2001, c. 126, §1 (NEW).]

3. Application. This section does not apply to workers' compensation, disability, life, health, accidental injury, specified disease, hospital indemnity, Medicare supplement, long-term care or other limited benefit health insurance. [PL 2001, c. 126, §1 (NEW).]

4. Construction. This section may not be construed to permit any assignment of rights by an insured to any other person or to create or extend any right or cause of action for a 3rd-party claimant under an insurance policy. [PL 2001, c. 126, §1 (NEW).]
24-A M.R.S. § 4442 — ME Code / Title 24-A / Chapter 57 / Section 4442
24-A §4442. Effect of paid claims
Status: in_force

Any person recovering on a covered claim under this subchapter must be deemed to have assigned the person's rights under the policy to the association to the extent of the person's recovery from the association. Every insured or claimant seeking the protection of this subchapter shall cooperate with the association to the same extent as such person would have been required to cooperate with the insolvent insurer. The association has no cause of action against the insured of the insolvent insurer for any sums it has paid out except such causes of action as the insolvent insurer would have had if such sums had been paid by the insolvent insurer. In the case of an insolvent insurer operating on a plan with assessment liability, payment of claims by the association does not operate to reduce the liability of insureds to the receiver, liquidator or statutory successor for unpaid assessments. [RR 2021, c. 1, Pt. B, §388 (COR).]

The receiver, liquidator or statutory successor of an insolvent insurer shall be bound by settlements of covered claims by the association or a similar organization in another state. The court having jurisdiction shall grant such claims priority equal to that which the claimant would have been entitled in the absence of this subchapter against the assets of the insolvent insurer. The expenses of the association or similar organization in handling claims shall be accorded the same priority as the liquidator's expenses. [PL 1969, c. 561 (NEW).]

The association shall periodically file with the receiver or liquidator of the insolvent insurer statements of the covered claims paid by the association and estimates of anticipated claims on the association, which shall preserve the rights of the association against the assets of the insolvent insurer. [PL 1969, c. 561 (NEW).]
24-A M.R.S. § 4250 — ME Code / Title 24-A / Chapter 56 / Section 4250
24-A §4250. Coverage for hospice care services (REALLOCATED FROM TITLE 24-A, SECTION 4249)
Status: in_force

(REALLOCATED FROM TITLE 24-A, SECTION 4249)

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Hospice care services" means services provided on a 24-hours-a-day, 7-days-a-week basis to a person who is terminally ill and that person's family. "Hospice care services" includes, but is not limited to, physician services; nursing care; respite care; medical and social work services; counseling services; nutritional counseling; pain and symptom management; medical supplies and durable medical equipment; occupational, physical or speech therapies; volunteer services; home health care services; and bereavement services. [RR 2001, c. 1, §36 (RAL).] B. "Person who is terminally ill" means a person that has a medical prognosis that the person's life expectancy is 12 months or less if the illness runs its normal course. [RR 2001, c. 1, §36 (RAL).] [RR 2001, c. 1, §36 (RAL).]

2. Coverage for hospice care services. All health maintenance organization individual and group health contracts must provide coverage for hospice care services to a person who is terminally ill. Hospice care services must be provided according to a written care delivery plan developed by a hospice care provider and the recipient of hospice care services. Coverage for hospice care services must be provided whether the services are provided in a home setting or an inpatient setting. [RR 2001, c. 1, §36 (RAL).]

3. Application. The requirements of this section apply to all individual and group policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 2003, c. 517, Pt. B, §29 (NEW).]
24-A M.R.S. § 3601 — ME Code / Title 24-A / Chapter 51 / Section 3601
24-A §3601. Scope of chapter
Status: in_force

1. This chapter applies only as to domestic mutual insurers heretofore or hereafter authorized to transact and transacting property insurances in this State on the assessment plan, as defined in section 3603 , and to the assessment department of insurers also transacting insurance on the cash premium plan. [PL 1969, c. 177, §60 (AMD).]

2. Insurers to the extent to which subject to this chapter may in this chapter be referred to as "mutual assessment insurers." [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2159-A — ME Code / Title 24-A / Chapter 23 / Section 2159-A
24-A §2159-A. Insurance discrimination solely on account of physical or mental disability prohibited
Status: in_force

No insurer authorized to transact business in this State may refuse to insure or continue to insure, limit the amount, extent or kind of coverage available to an individual or charge an individual a rate different from that normally charged for the same coverage solely because the insured or the applicant for insurance is blind or partially blind. [PL 1985, c. 445 (RPR).]

An insurer authorized to transact business in this State may not refuse to insure or continue to insure, limit the amount, extent or kind of coverage available to an individual or charge an individual a rate different from that normally charged for the same coverage solely because the insured or the applicant for insurance has a physical or mental disability, as defined in Title 5, section 4553, subsection 7‑A , other than blindness or partial blindness, unless the basis for that action is clearly demonstrated through sound actuarial evidence. [PL 2021, c. 348, §36 (AMD).]

1. Deaf. [PL 1985, c. 445 (RP).]

2. Developmentally disabled. [PL 1985, c. 445 (RP).]
24 M.R.S. § 2310 — ME Code / Title 24 / Chapter 19 / Section 2310
24 §2310. Dissolution
Status: in_force

Any dissolution or liquidation of a corporation subject to this chapter must be conducted under the supervision of the superintendent, who has all power with respect thereto granted to the superintendent under Title 24-A with respect to the dissolution and liquidation of insurance companies. [RR 2019, c. 2, Pt. B, §75 (COR).]
24-A M.R.S. § 11 — ME Code / Title 24-A / Chapter 1 / Section 11
24-A §11. Particular provisions prevail
Status: in_force

Provisions of this Title as to a particular kind of insurance, type of insurer or matter shall prevail over provisions relating to insurance, insurers or matters in general. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2763 — ME Code / Title 24-A / Chapter 33 / Section 2763
24-A §2763. Coverage for colorectal cancer screening
Status: in_force

1. Colorectal cancer screening. For the purposes of this section, "colorectal cancer screening" means all colorectal cancer examinations and laboratory tests recommended by a health care provider in accordance with the most recently published colorectal cancer screening guidelines of a national cancer society. [PL 2019, c. 86, §1 (AMD); PL 2019, c. 86, §10 (AFF).]

2. Required coverage. All individual health insurance policies and contracts must provide coverage for colorectal cancer screening for asymptomatic individuals who are: A. At average risk for colorectal cancer according to the most recently published colorectal cancer screening guidelines of a national cancer society; or [PL 2019, c. 86, §2 (AMD); PL 2019, c. 86, §10 (AFF).] B. At high risk for colorectal cancer. [PL 2019, c. 86, §3 (AMD); PL 2019, c. 86, §10 (AFF).] [PL 2019, c. 86, §§2, 3 (AMD); PL 2019, c. 86, §10 (AFF).]

3. Billing. If a colonoscopy is recommended by a health care provider as the colorectal cancer screening test in accordance with this section and a lesion is discovered and removed during that colonoscopy, the health care provider must bill the insurance company for a screening colonoscopy as the primary procedure. [PL 2007, c. 516, §2 (NEW); PL 2007, c. 516, §5 (AFF).] Revisor's Note: §2763. Coverage for medically necessary infant formula (As enacted by PL 2007, c. 595, §2 is REALLOCATED TO TITLE 24-A, SECTION 2764)
24-A M.R.S. § 7107 — ME Code / Title 24-A / Chapter 91 / Section 7107
24-A §7107. Cancellation of reimbursement insurance policy
Status: in_force

An insurer that issued a reimbursement insurance policy may not cancel or nonrenew the policy for any reason, including at the request of the policyholder, until the insurer has delivered a notice of such action to the superintendent at least 45 days before such action. The cancellation or nonrenewal of a reimbursement insurance policy does not reduce the insurer's obligations as to service contracts issued by providers prior to the date of cancellation or nonrenewal. [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).]
24-A M.R.S. § 4440-A — ME Code / Title 24-A / Chapter 57 / Section 4440-A
24-A §4440-A. Special assessment
Status: in_force

1. Special assessment. If the maximum assessment, together with the other assets of the association in any account, does not provide in any one year in any account an amount sufficient to make all necessary payments from that account, the shortfall shall be assessed as an obligation of the other accounts of the association, with each member insurer's assessment to be in the proportion that its net direct written premiums for the calendar year preceding the assessment on the kinds of insurance in the accounts to be assessed bears to the total net direct written premiums of all member insurers for the same calendar year on the kinds of insurance in those accounts. The total of assessments against a member insurer under this section and section 4440 for any account in any one calendar year shall not exceed 2% of that member's net direct written premium on the kinds of insurance written in that account for the next preceding calendar year. [PL 1989, c. 67, §8 (NEW).]

2. Limit on assessment. Subject to the 2% limitation, an assessment made under this section may not exceed 5% of the average of a member insurer's net income of the 3 years prior to the year in which the assessment is made for any member insurer: A. That has surplus of less than $15,000,000 and either a ratio of total net direct written premium to total surplus greater than 2 or net income of less than $250,000 for the year preceding the assessment. For purposes of this subsection, "net income" means the sum of underwriting income and investment income, net of dividends to policyholders and federal and foreign income taxes incurred, as reported on the insurer's annual statement filed with the superintendent. "Total surplus" means surplus as regards policyholders, as reported on the insurer's annual statement filed with the superintendent; or [PL 1995, c. 289, §17 (AMD).] B. That has a surplus of less than $15,000,000 and has fewer than 3,000 policyholders. [PL 1995, c. 289, §17 (AMD).] [PL 1995, c. 289, §17 (AMD).]

3. Repealer. [PL 1989, c. 67, §8 (NEW); PL 1989, c. 751, §5 (RP).]

4. Notification to Legislature. Within 7 days after the board of directors votes to levy an assessment under this section, the chair of the board of directors shall notify the chairs of the legislative committee having jurisdiction over insurance matters that the association has voted to make such an assessment. The notification must: A. Be in writing; and [PL 1989, c. 751, §6 (NEW).] B. Include the total amount to be assessed against each account and the name of the account to which the assessed funds will be credited. [PL 1989, c. 751, §6 (NEW).] [PL 1989, c. 751, §6 (NEW).]
24 M.R.S. § 2315 — ME Code / Title 24 / Chapter 19 / Section 2315
24 §2315. Penalties
Status: in_force

Any person, firm, association or corporation, or any officer, agent, servant or employee thereof, who shall violate any of the provisions of this chapter shall be punished by the fines and penalties provided in Title 24-A applicable to health insurers. [PL 1971, c. 444, §10 (RPR).]
24-A M.R.S. § 5081 — ME Code / Title 24-A / Chapter 68-A / Section 5081
24-A §5081. Producer training requirements
Status: in_force

1. Training required. An individual may not sell, solicit or negotiate long-term care insurance unless: A. The individual is licensed as a life or health insurance producer; [PL 2007, c. 232, §3 (NEW).] B. The individual has completed a one-time training course that is no less than 8 hours in length; and [PL 2007, c. 232, §3 (NEW).] C. The individual completes ongoing training of no less than 4 hours every 24 months thereafter. [PL 2007, c. 232, §3 (NEW).] An individual licensed as a life or health insurance provider and who is actively selling, soliciting or negotiating long-term care insurance as of the effective date of this section must complete a one-time training course by July 1, 2008 and ongoing training every 24 months thereafter in order to continue selling, soliciting or negotiating long-term care insurance. The training required by this subsection must meet the requirements set forth in subsection 2 . The training requirements of subsection 2 may be approved as continuing education courses under chapter 16, subchapter 7 . [PL 2007, c. 232, §3 (NEW).]

2. Content of training. The one-time training required by this section must consist of topics related to long-term care insurance, long-term care services and, if applicable, qualified state long-term care insurance partnership programs, including, but not limited to: A. State and federal regulations and requirements and the relationship between the Long-term Care Partnership Program established in Title 22, section 3174‑GG and other public and private coverage of long-term care services, including Medicaid; [PL 2007, c. 232, §3 (NEW).] B. Available long-term care services and providers; [PL 2007, c. 232, §3 (NEW).] C. Changes or improvements in long-term care services or providers; [PL 2007, c. 232, §3 (NEW).] D. Alternatives to the purchase of private long-term care insurance; [PL 2007, c. 232, §3 (NEW).] E. The effect of inflation on benefits and the importance of inflation protection; and [PL 2007, c. 232, §3 (NEW).] F. Consumer suitability standards and guidelines. [PL 2007, c. 232, §3 (NEW).] The training required by this section may not include training that is specific to an insurer or company product or that includes any sales or marketing information, materials or training other than that required by state or federal law. [PL 2007, c. 232, §3 (NEW).]

3. Verification. An insurer shall: A. Obtain verification that a producer has received training required by this section before the producer may sell, solicit or negotiate the insurer's long-term care insurance products; [PL 2007, c. 232, §3 (NEW).] B. Maintain records of the verification under paragraph A for at least 3 years; and [PL 2007, c. 232, §3 (NEW).] C. Make verification records available to the superintendent upon request. [PL 2007, c. 232, §3 (NEW).] [PL 2007, c. 232, §3 (NEW).]

4. Records. An insurer shall maintain records with respect to the training of its producers concerning the distribution of its partnership policies that will allow the superintendent to provide assurance to the Department of Health and Human Services that producers have received the training required by this section and that its producers have demonstrated an understanding of the partnership policies and their relationship to public and private coverage of long-term care, including Medicaid, in this State. The records must be maintained for a period of at least 3 years after each producer has received the training required by this section and must be made available to the superintendent upon request. [PL 2007, c. 232, §3 (NEW).]

5. Reciprocity. The satisfaction of training requirements in this section in another state is considered to satisfy the training requirements in this section. [PL 2007, c. 232, §3 (NEW).]
24-A M.R.S. § 2160 — ME Code / Title 24-A / Chapter 23 / Section 2160
24-A §2160. Rebates -- life, health and annuity contracts
Status: in_force

1. Limitation. Except as otherwise provided by law, no person may: A. Knowingly permit or offer to make or make any contract of life insurance, life annuity or health insurance or agreement concerning that contract that is not plainly expressed in the contract issued; [PL 1997, c. 457, §38 (NEW).] B. Pay or allow or give or offer to pay, allow or give directly or indirectly as inducement to life or health insurance or life annuity: (1) Any rebate of premiums payable on the contract; (2) Any special favor or advantage in the dividends or other benefits; (3) Any paid employment or contract for services of any kind; or (4) Any valuable consideration or inducements not specified in the contract; or [PL 1997, c. 457, §38 (NEW).] C. Directly or indirectly give or sell or purchase or offer or agree to give, sell, purchase or allow as inducement to life or health insurance or life annuity or in connection with the insurance or annuity or any agreement, whether or not specified in the policy or contract, of any form or nature promising: (1) Returns or profits; (2) Any stocks, bonds or other securities; (3) Interest present in or contingent on or measured by the agreement of any insurer or other corporation, association or partnership; or (4) Any dividends or profits accrued or to accrue on an agreement. [PL 1997, c. 457, §38 (NEW).] [PL 1997, c. 457, §38 (NEW).]

2. Benefit not associated with indemnification or loss. Unless otherwise provided by law, a provision may not be included within an insurance policy if the sole intent of the provision is to give to the insured a benefit that is not associated with indemnification or loss. This subsection does not apply to annuities. [PL 1997, c. 592, §66 (AMD).]
24-A M.R.S. § 2827-A — ME Code / Title 24-A / Chapter 35 / Section 2827-A
24-A §2827-A. Assignment of benefits
Status: in_force

All policies and certificates providing benefits for medical or dental care on an expense-incurred basis must contain a provision permitting the insured to assign benefits for such care to the provider of the care. An assignment of benefits under this section does not affect or limit the payment of benefits otherwise payable under the policy or certificate. [PL 1999, c. 21, §3 (AMD).]
24-A M.R.S. § 3416 — ME Code / Title 24-A / Chapter 47 / Section 3416
24-A §3416. Dividends to stockholders
Status: in_force

1. A domestic stock insurer shall not pay any cash dividend to stockholders except out of that part of its available and accumulated surplus funds which is derived from realized net operating profits on its business and net realized capital gains. [PL 1969, c. 132, §1 (NEW).]

2. A cash dividend otherwise lawful may be payable out of the insurer's earned surplus even though its total surplus is then less than the aggregate of its past contributed or paid-in surplus. [PL 1969, c. 132, §1 (NEW).]

3. A stock dividend may be paid out of any available surplus funds, other than "surplus" resulting from borrowed capital funds such as provided for under section 3415 . [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 6095 — ME Code / Title 24-A / Chapter 72-A / Section 6095
24-A §6095. Risk retention groups not chartered in this State
Status: in_force

Risk retention groups chartered and licensed in states other than this State and seeking to do business as a risk retention group in this State must comply with the laws of this State in the following manner. [PL 1987, c. 481, §3 (NEW).]

1. Notice of operations and designation of agent for service of process. Before offering insurance in this State, a risk retention group shall submit to the superintendent: A. A statement identifying the state or states in which the risk retention group is chartered and licensed as a liability insurance company, the date of chartering and organization, its principal place of business and such other information, including information on its membership, as the superintendent may require to verify that the risk retention group is qualified under section 6093, subsection 13 ; [PL 1987, c. 481, §3 (NEW).] B. A copy of its plan of operation or a feasibility study and applicable revisions of the plan or study submitted to its state of domicile, provided that the provision relating to the submission of a plan of operation or a feasibility study does not apply with respect to any line or classification of liability insurance that was defined in the Product Liability Risk Retention Act of 1981 before October 27, 1986 and was offered before that date by any risk retention group that had been chartered and operating for not less than 3 years before that date; and [PL 1997, c. 592, §73 (AMD).] C. A designation of an agent for the purpose of receiving service of legal documents or process. That designation is subject to the provisions of section 421 , except that the appointment of a private agent is optional. A risk retention group that does not elect to designate an agent in accordance with section 421, subsection 1 shall appoint the superintendent as its agent. [PL 2013, c. 238, Pt. E, §3 (AMD).] [PL 2013, c. 238, Pt. E, §3 (AMD).]

2. Financial condition. Any risk retention group transacting business in this State shall submit to the superintendent: A. Annually, on or before March 1st, a copy of the group's financial statement submitted to the state in which the risk retention group is chartered and licensed, which shall be certified by an independent public accountant and contain a statement of opinion on loss and loss adjustment expense reserves made by a member of the American Academy of Actuaries who is qualified to certify casualty loss reserves; [PL 1987, c. 481, §3 (NEW).] B. A copy of each report of examination of the risk retention group as certified by the superintendent or public official conducting the examination; [PL 1987, c. 481, §3 (NEW).] C. Upon request by the superintendent, a copy of any audit performed with respect to the risk retention group; and [PL 1987, c. 481, §3 (NEW).] D. Such information as may be required to verify its continuing qualification as a risk retention group under section 6093, subsection 13 . [PL 1987, c. 481, §3 (NEW).] [PL 1987, c. 481, §3 (NEW).]

3. Taxation. Each risk retention group shall be responsible for the payment of premium tax in accordance with Title 36, section 2513‑A . [PL 1987, c. 481, §3 (NEW).]

4. Deceptive, false or fraudulent practices. To the extent not preempted by the Risk Retention Amendments of 1986, any risk retention group shall be subject to the provisions of chapter 23 , and Title 5, chapter 10 . [PL 1987, c. 481, §3 (NEW).]

5. Examination regarding financial condition. Any risk retention group must submit to an examination by the superintendent to determine its financial condition if the superintendent of the jurisdiction in which the group is chartered and licensed has not performed a timely examination or does not initiate an examination within 90 days after a request by the superintendent. Any such examination shall be coordinated to avoid unjustified repetition and conducted in an expeditious manner and in accordance with the National Association of Insurance Commissioner's Examiner Handbook, as applicable. [PL 1987, c. 481, §3 (NEW).]

6. Notice to purchasers. Any policy issued by a risk retention group shall contain in 10 point type on the front page and the declaration page, the following notice: "NOTICE This policy is issued by your risk retention group. Your risk retention group may not be subject to all of the insurance laws and regulations of your state. State insurance insolvency guaranty funds are not available for your risk retention group." [PL 1987, c. 481, §3 (NEW).]

7. Prohibited acts regarding solicitation or sale. The following acts by a risk retention group are prohibited: A. The solicitation or sale of insurance by a risk retention group to any person who is not eligible for membership in those groups; and [PL 1987, c. 481, §3 (NEW).] B. The solicitation or sale of insurance by, or operation of, a risk retention group that is in a hazardous financial condition or is financially impaired. [PL 1987, c. 481, §3 (NEW).] [PL 1987, c. 481, §3 (NEW).]

8. Prohibition on ownership by an insurance company. No risk retention group shall be allowed to do business in this State if an insurance company is directly or indirectly a member or owner of that risk retention group, other than in the case of a risk retention group, all of whose members are insurance companies. [PL 1987, c. 481, §3 (NEW).]

9. Prohibited coverage. No risk retention group may offer insurance policy coverage prohibited by the laws of this State or by the Risk Retention Amendments of 1986. [PL 1987, c. 481, §3 (NEW).]

10. Delinquency proceedings. A risk retention group not chartered in this State and doing business in this State must comply with a lawful order issued in a voluntary dissolution proceeding or in a delinquency proceeding commenced by a state insurance superintendent if there has been a finding of financial impairment after an examination under subsection 5 . [PL 1987, c. 481, §3 (NEW).]
24-A M.R.S. § 4320-F — ME Code / Title 24-A / Chapter 56-A / Section 4320-F
24-A §4320-F. Oversight of plans offered on the American Health Benefit Exchange and the SHOP Exchange
Status: in_force

1. Superintendent's authority preserved. Except as otherwise expressly provided by applicable law, the requirements established by this Title, Title 24 and rules adopted by the superintendent continue to apply to carriers and health plans and are not extinguished or modified in any way by: A. Certification of a health plan as a qualified health plan or any other determination made by the American Health Benefit Exchange or the SHOP Exchange pursuant to the federal Affordable Care Act; or [PL 2011, c. 364, §34 (NEW).] B. Recognition by the applicable federal agency of a carrier as a qualified nonprofit health insurance issuer or as an issuer of multistate qualified health plans, or of a health plan as a multistate qualified health plan, pursuant to the federal Affordable Care Act. [PL 2011, c. 364, §34 (NEW).] [PL 2011, c. 364, §34 (NEW).]

2. Coordination with exchanges. The superintendent has all additional powers and duties conferred upon a state insurance regulator with respect to the American Health Benefit Exchange and the SHOP Exchange by the federal Affordable Care Act. The superintendent may enter into agreements with the American Health Benefit Exchange and the SHOP Exchange relating to coordination of responsibilities, and such agreements may provide for the superintendent to assume additional authority relating to the certification of qualified health plans or the authorization of a carrier to participate in the American Health Benefit Exchange or the SHOP Exchange. [PL 2011, c. 364, §34 (NEW).]
24-A M.R.S. § 2168-B — ME Code / Title 24-A / Chapter 23 / Section 2168-B
24-A §2168-B. Solicitation or negotiation involving purchasers or borrowers
Status: in_force

A licensed agent or broker affiliated with a lender or creditor may not solicit an application for an insurance contract in connection with the extension of credit or negotiate such a contract from a purchaser or borrower whom the agent or broker knows, or should have known, has applied to receive an extension of credit from that lender or creditor until such time as the creditor or lender has provided by hand or sent written notice to the purchaser or borrower of its action on the application or has documented in writing in the lender's or creditor's records its action on the application. This section does not limit the ability of a lender or creditor to do any of the following: [PL 1997, c. 315, §25 (NEW).]

1. Marketing activities. To engage at any time in marketing activities and solicitations for the sale of insurance, including through the mail or by telephone, that are not specifically directed toward purchasers or borrowers who have applied to receive an extension of credit. [PL 1997, c. 315, §25 (NEW).]

This section does not apply to group health and group life insurance to the extent authorized by chapters 31 and 35 when the insured is enrolled in the insurance policy, credit life and credit health insurance to the extent authorized by chapter 37 , credit property insurance, credit involuntary unemployment insurance, forced placed property insurance, a vendor's single interest policy or any other insurance product as determined by the superintendent. [PL 1997, c. 315, §25 (NEW).]

"Affiliate" has the same meaning as set forth in section 1443‑A, subsection 1, paragraph A with respect to financial institutions and credit unions and in Title 9‑A, section 4‑403 with respect to supervised lenders. [PL 1999, c. 127, Pt. A, §40 (AMD).]
24-A M.R.S. § 2624 — ME Code / Title 24-A / Chapter 31 / Section 2624
24-A §2624. Information to debtor
Status: in_force

In the case of a policy insuring the lives of debtors, a provision that the insurer will furnish to the policyholder for delivery to each debtor insured under the policy a certificate of insurance describing the coverage and specifying that the death benefit shall first be applied to reduce or extinguish the indebtedness. [PL 1981, c. 150, §28 (RPR).]
24-A M.R.S. § 7701 — ME Code / Title 24-A / Chapter 101 / Section 7701
24-A §7701. Definitions
Status: in_force

As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 2025, c. 33, Pt. A, §1 (NEW).]

1. Administrator. "Administrator" means the bureau or an entity with which the bureau contracts for the administration of the program. [PL 2025, c. 33, Pt. A, §1 (NEW).]

2. Fund. "Fund" means the Home Resiliency Fund established in section 7702 . [PL 2025, c. 33, Pt. A, §1 (NEW).]

3. Grant. "Grant" means the award of funds for an approved project. [PL 2025, c. 33, Pt. A, §1 (NEW).]

4. Home resiliency project; project. "Home resiliency project" or "project" means a project designed to make a home more resistant to damage from extreme weather events. [PL 2025, c. 33, Pt. A, §1 (NEW).]

5. Program. "Program" means the Home Resiliency Program established in section 7702 . [PL 2025, c. 33, Pt. A, §1 (NEW).]
24-A M.R.S. § 2837-C — ME Code / Title 24-A / Chapter 35 / Section 2837-C
24-A §2837-C. Coverage for breast cancer treatment
Status: in_force

1. Inpatient care. All group health policies providing coverage for medical and surgical benefits, except accidental injury, specified disease, hospital indemnity, Medicare supplement, long-term care and other limited benefit health insurance policies and contracts, must ensure that inpatient coverage with respect to the treatment of breast cancer is provided for a period of time determined by the attending physician, after providing notice to the patient regarding the coverage required by this subsection and in consultation with the patient, to be medically appropriate following a mastectomy, a lumpectomy or a lymph node dissection for the treatment of breast cancer. Nothing in this subsection may be construed to require the provision of inpatient coverage if the attending physician and patient determine that a shorter period of hospital stay is appropriate. In implementing the requirements of this subsection, a group health policy may not modify the terms and conditions of coverage based on the determination by any enrollee to request less than the minimum coverage required under this subsection. All group health policies must provide written notice to each enrollee under the contract regarding the coverage required by this subsection. The notice must be prominently positioned in any literature or correspondence made available or distributed by the plan and must be transmitted in the next mailing made by the plan to the enrollee or as part of any yearly information packet sent to the enrollee, whichever is earlier. The notice must also be made available to any physician participating in the insurer's provider network. [PL 2015, c. 227, §3 (AMD); PL 2015, c. 227, §5 (AFF).]

2. Reconstruction. All group health policies providing coverage for mastectomy surgery must provide coverage for reconstruction of the breast on which surgery has been performed and surgery and reconstruction of the other breast to produce a symmetrical appearance if the patient elects reconstruction and in the manner chosen by the patient and the physician. [PL 1997, c. 408, §6 (NEW); PL 1997, c. 408, §8 (AFF).]

3. Application. The requirements of this section apply to all group policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 2003, c. 517, Pt. B, §15 (NEW).]
24-A M.R.S. § 2841 — ME Code / Title 24-A / Chapter 35 / Section 2841
24-A §2841. Optional coverage for optometric services
Status: in_force

1. Coverage required to be made available. Every insurer which issues for delivery in this State group health policies which provide coverage on an expense-incurred basis for the services of a "physician" or "doctor" to residents of this State shall make available to all groups coverage for such services when performed by an optometrist, to the extent the services are within the scope of the practice of an optometrist licensed to practice in this State. [PL 1981, c. 254, §2 (NEW).]

2. Policy. The group or blanket policy making available coverage for the services referred to in this section shall contain provisions for maximum benefits and coinsurance, and reasonable limitations, deductibles and exclusions. [PL 1981, c. 254, §2 (NEW).]
24-A M.R.S. § 5051-B — ME Code / Title 24-A / Chapter 68 / Section 5051-B
24-A §5051-B. Alternative policies
Status: in_force

1. Innovative long-term care products permitted. Notwithstanding section 5051‑A , an insurer, organization or plan may offer a long-term care policy, within the meaning of section 5051, subsection 1 , which does not meet one or more of the requirements of section 5051‑A if the Superintendent of Insurance finds that: A. For each requirement of section 5051‑A which is not satisfied, there is a valid reason why that requirement is inappropriate for the policy design in question; [PL 1989, c. 556, Pt. B, §3 (NEW).] B. The total package of benefits provided is at least as comprehensive as that required by section 5051‑A ; and [PL 1989, c. 556, Pt. B, §3 (NEW).] C. Availability of the policy would be in the best interest of the public taking into consideration the following factors: (1) Whether the policy accomplishes the goal of providing dependable benefits for long-term care; and (2) Whether the plans for marketing the policy contain adequate safeguards to minimize any confusion that may be caused to consumers by the failure of the policy to fall within the established guidelines of this section. [PL 1989, c. 556, Pt. B, §3 (NEW).] [PL 1989, c. 556, Pt. B, §3 (NEW).]

2. Qualifications for tax incentives. If the superintendent finds that a policy meets the criteria of subsection 1 , the superintendent, in determining whether to certify the policy for tax incentives under section 5054 , shall consider the policy to comply with each of the requirements of section 5051‑A . [PL 1989, c. 556, Pt. B, §3 (NEW).]
24-A M.R.S. § 201 — ME Code / Title 24-A / Chapter 3 / Section 201
24-A §201. Superintendent of Insurance; appointment; term
Status: in_force

1. The Superintendent of Insurance is the head of the Bureau of Insurance. [PL 1973, c. 585, §7 (RPR).]

2. The superintendent shall be appointed by the Governor and subject to review by the joint standing committee of the Legislature having jurisdiction over banking and insurance and to confirmation by the Legislature. [PL 1987, c. 105, §3 (AMD).]

3. The superintendent shall hold the superintendent's office for 5 years or until the superintendent's successor has been appointed and has qualified. Any vacancy occurring must be filled by appointment for the unexpired portion of the term. [RR 2021, c. 1, Pt. B, §148 (COR).]

4. The superintendent shall be removable for cause by impeachment or by address of the Governor to both branches of the Legislature, and Title 5, section 931, subsection 2 , shall not apply. [PL 1987, c. 402, Pt. A, §151 (AMD).]
24-A M.R.S. § 7401 — ME Code / Title 24-A / Chapter 95 / Section 7401
24-A §7401. Short title
Status: in_force

This chapter may be known and cited as "the Peer-to-peer Car Sharing Insurance Act." [PL 2019, c. 367, §1 (NEW).]
24-A M.R.S. § 2902-F — ME Code / Title 24-A / Chapter 39 / Section 2902-F
24-A §2902-F. Volunteer drivers
Status: in_force

An insurer may not refuse to issue motor vehicle liability insurance to an applicant solely because the applicant is a volunteer driver. An insurer may not impose a surcharge or otherwise increase the rate for a motor vehicle policy solely on the basis that the named insured, a member of the insured's household or a person who customarily operates the insured's vehicle is a volunteer driver. For purposes of this section, "volunteer driver" means a person who provides services, including transporting individuals or goods, without compensation above expenses to a nonprofit agency or charitable organization as defined in Title 14, section 158‑A . This section does not prohibit an insurer from refusing to renew, imposing a surcharge or otherwise raising the rate for a motor vehicle liability insurance policy based upon factors other than the volunteer status of the insured driver. [PL 1995, c. 132, §1 (NEW).]
24-A M.R.S. § 2604-A — ME Code / Title 24-A / Chapter 31 / Section 2604-A
24-A §2604-A. Debtor groups
Status: in_force

The lives of a group of individuals may be insured under a policy issued to a creditor or its parent holding company or to a trustee or trustees or agent designated by 2 or more creditors, which creditor, holding company, affiliate, trustee, trustees or agent is considered the policyholder, to insure debtors of the creditor or creditors, subject to the following requirements. [PL 2015, c. 329, Pt. A, §13 (NEW).]

1. The debtors eligible for insurance under the policy are all of the debtors of the creditor or creditors, or all of any class or classes thereof. The policy may provide that the term "debtors" includes: A. Borrowers of money or purchasers or lessees of goods, services or property for which payment is arranged through a credit transaction; [PL 1981, c. 150, §5 (NEW); PL 1981, c. 175, §2 (NEW).] B. The debtors of one or more subsidiary corporations; and [PL 1981, c. 150, §5 (NEW); PL 1981, c. 175, §2 (NEW).] C. The debtors of one or more affiliated corporations, proprietorships or partnerships if the business of the policyholder and of the affiliated corporations, proprietorships or partnerships is under common control. [PL 1981, c. 150, §5 (NEW); PL 1981, c. 175, §2 (NEW).] [PL 1981, c. 150, §5 (NEW); PL 1981, c. 175, §2 (NEW).]

2. The premium for the policy shall be paid either from the creditor's funds, or from charges collected from the insured debtors, or from both. Except as provided in subsection 3 , a policy on which no part of the premium is to be derived from funds contributed by insured debtors specifically for their insurance must insure all eligible debtors. [PL 1981, c. 150, §5 (NEW); PL 1981, c. 175, §2 (NEW).]

3. An insurer may exclude any debtors as to whom evidence of individual insurability is not satisfactory to the insurer. [PL 2015, c. 329, Pt. B, §2 (RPR).]

4. The amount of credit life insurance shall at no time exceed the unpaid amount financed plus earned interest and an allowance for delinquencies as determined by the superintendent or, in the case of open-end credit, the balance upon which a finance charge may be imposed plus earned interest and an allowance for delinquencies as determined by the superintendent. Where the indebtedness is repayable in one sum to the creditor, the insurance on the life of any debtor shall in no instance be in effect for a period in excess of 18 months, except that such insurance may be continued for an additional period not exceeding 6 months in the case of default, extension or recasting of the loan. [PL 1981, c. 150, §5 (NEW); PL 1981, c. 175, §2 (NEW).]

5. The insurance may be payable to the creditor or any successor to the right, title and interest of the creditor. The payment shall reduce or extinguish the unpaid indebtedness of the debtor to the extent of the payment. [PL 1981, c. 150, §5 (NEW); PL 1981, c. 175, §2 (NEW).]

6. Notwithstanding the provisions of this section, insurance on agricultural credit transaction commitments may be written up to the amount of the loan commitment on a nondecreasing or level term plan. Insurance on educational credit transaction commitments may be written up to the amount of the loan commitment less the amount of any repayments made on the loan. [PL 1981, c. 150, §5 (NEW); PL 1981, c. 175, §2 (NEW).]

7. Notwithstanding subsection 1 , in the case of a group policy issued pursuant to this section which provides life insurance on the term plan upon the lives of persons indebted to a creditor, where the indebtedness is secured to the creditor by a mortgage on real estate, where the insurance is afforded on an optional basis and where a separate charge is made to the debtor by the creditor for the insurance, both the debtor and not more than one comaker of the indebtedness are eligible to apply for insurance jointly under the group policy, provided that both of them are individually and jointly liable to repay the indebtedness. This subsection may not be held to restrict the right of an insurer to require satisfactory evidence of insurability of any person requesting the insurance, nor to preclude those exclusions from eligibility for insurance under such a group policy as may be contained therein. Nothing in this subsection may prohibit insurance on the life of one debtor only, if desired by the debtor. [PL 1981, c. 150, §5 (NEW); PL 1981, c. 175, §2 (NEW).]
24-A M.R.S. § 7751 — ME Code / Title 24-A / Chapter 103 / Section 7751
24-A §7751. Short title
Status: in_force

This chapter may be known and cited as "the Protect Health Care for Rural and Underserved Communities Act." [PL 2025, c. 388, Pt. P, §5 (NEW).]
24-A M.R.S. § 2749 — ME Code / Title 24-A / Chapter 33 / Section 2749
24-A §2749. Utilization review data
Status: in_force

1. Report required. On or before April 1st of each year, any insurer which issues a program or contract in this State providing coverage for hospital care that contains a provision whereby in nonemergency cases the insured is required to be prospectively evaluated through a prehospital admission certification, preinpatient service eligibility program or any similar preutilization review or screening procedure prior to the delivery of contemplated hospitalization, inpatient or outpatient health care or medical services which are prescribed or ordered by a duly licensed physician shall file a report on the results of that evaluation for the preceding year with the superintendent which shall contain the following: A. The number and type of evaluations performed. (1) For the purposes of this section, the term "type of evaluations" means the following preutilization review categories: Presurgical inpatient days; setting of medical service, such as inpatient or outpatient services; and the number of days of service; [PL 1987, c. 168, §4 (NEW).] B. The result of the evaluation, such as whether the medical necessity of the level of service contemplated by the patient's physician was agreed to or whether benefits paid for the service were reduced by the insurer; [PL 1987, c. 168, §4 (NEW).] C. The number and result of any appeals by patients or their physicians as a result of initial review decisions to reduce benefits for services as determined through prospective evaluations; and [PL 1987, c. 168, §4 (NEW).] D. Any complaints filed in a court of competent jurisdiction and served upon an insurer filing under this section stating a cause of action against that insurer on the basis of damages to patients alleged to have been proximately caused by a delay, reduction or denial of medical benefits by the insurer, as determined through prospective evaluations, and the determination of liability or other disposition of the complaint. [PL 1987, c. 168, §4 (NEW).] [PL 1987, c. 168, §4 (NEW).]

2. Maine residents. This section is applicable to evaluations, appeals and complaints relating to Maine residents only. [PL 1987, c. 168, §4 (NEW).]

3. Confidentiality. Any information provided pursuant to this section shall not identify the names of patients. [PL 1987, c. 168, §4 (NEW).]
24-A M.R.S. § 4234-B — ME Code / Title 24-A / Chapter 56 / Section 4234-B
24-A §4234-B. Maternity and routine newborn care
Status: in_force

Individual and group contracts and certificates issued by a health maintenance organization that provide maternity benefits, including benefits for childbirth, shall provide coverage for services related to maternity and routine newborn care, including coverage for hospital stay, in accordance with the attending physician's or attending certified nurse midwife's determination in conjunction with the mother that the mother and newborn meet the criteria outlined in the "Guidelines for Perinatal Care," published by the American Academy of Pediatrics and the American College of Obstetrics and Gynecology. For the purposes of this section, "routine newborn care" does not include any services provided after the mother has been discharged from the hospital. For the purposes of this section, "attending physician" includes the obstetrician, pediatrician or other physician attending the mother and newborn. Benefits for routine newborn care required by this section are part of the mother's benefit. The mother and the newborn are treated as one person in calculating the deductible, coinsurance and copayments for coverage required by this section. [PL 2003, c. 517, Pt. B, §23 (AMD).]
24-A M.R.S. § 4350-F — ME Code / Title 24-A / Chapter 56-C / Section 4350-F
24-A §4350-F. Spread pricing prohibition (WHOLE SECTION TEXT EFFECTIVE UNTIL 1/01/31) (WHOLE SECTION TEXT REPEALED 1/01/31)
Status: repealed

(CONTAINS TEXT WITH VARYING EFFECTIVE DATES)

(WHOLE SECTION TEXT EFFECTIVE UNTIL 1/01/31)

(WHOLE SECTION TEXT REPEALED 1/01/31)

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Pharmacy benefits management fee" means a fee that covers the cost of providing one or more pharmacy benefits manager services, as described in section 4347, subsection 17 , and that does not exceed the value of the service or services actually performed by the pharmacy benefits manager. [PL 2025, c. 291, §1 (NEW); PL 2025, c. 291, §2 (AFF).] B. "Spread pricing" means any amount charged or claimed by a pharmacy benefits manager in excess of the ingredient cost for a dispensed prescription drug plus the dispensing fee paid directly or indirectly to any pharmacy or pharmacist on behalf of the health plan, less any pharmacy benefits management fee. [PL 2025, c. 291, §1 (NEW); PL 2025, c. 291, §2 (AFF).] [PL 2025, c. 291, §1 (NEW); PL 2025, c. 291, §2 (AFF).]

2. Spread pricing prohibited. A carrier or pharmacy benefits manager may not, either directly or through an intermediary, agent or affiliate, engage in, facilitate or enter into a contract with another person involving spread pricing in this State. [PL 2025, c. 291, §1 (NEW); PL 2025, c. 291, §2 (AFF).]

3. Annual certification of compliance. Beginning December 31, 2026 and annually by December 31st thereafter, a carrier, or a pharmacy benefits manager under contract with a carrier, operating in the State shall certify to the superintendent that it has fully complied with the requirements of this section throughout the prior calendar year. The certification must be signed by the chief executive officer or chief financial officer of the carrier or pharmacy benefits manager. [PL 2025, c. 291, §1 (NEW); PL 2025, c. 291, §2 (AFF).]

4. Penalty. A violation of this section is subject to enforcement by the superintendent pursuant to section 12‑A . [PL 2025, c. 291, §1 (NEW); PL 2025, c. 291, §2 (AFF).]

5. Exemption. This section does not apply to the MaineCare program. [PL 2025, c. 291, §1 (NEW); PL 2025, c. 291, §2 (AFF).]

6. Repeal. This section is repealed January 1, 2031. [PL 2025, c. 291, §1 (NEW); PL 2025, c. 291, §2 (AFF).]
24-A M.R.S. § 2834 — ME Code / Title 24-A / Chapter 35 / Section 2834
24-A §2834. Newborn children coverage
Status: in_force

All group and blanket health insurance policies and certificates providing coverage on an expense-incurred basis must provide that health insurance benefits are payable for a newly born child of the insured or subscriber from the moment of birth. An adopted child is deemed to be newly born to the adoptive parents from the date of the signed placement agreement. Preexisting conditions of an adopted child may not be excluded from coverage. [PL 2003, c. 517, Pt. A, §5 (AMD); PL 2003, c. 517, Pt. A, §13 (AFF).]

The coverage for newly born children must consist of coverage of injury or sickness or other benefits provided by the policy, including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities. [PL 1997, c. 604, Pt. C, §3 (AMD).]

If payment of a specific premium or subscription fee is required to provide coverage for a child, the policy or contract may require that notification of birth of a newly born child and payment of the required premium or fees must be furnished to the insurer or nonprofit service or indemnity corporation within 31 days after the date of birth in order to have the coverage continue beyond that 31-day period. The payment may be required to be retroactive to the date of birth. Benefits required by section 2834‑A must be paid regardless of whether coverage under this section is elected. [PL 1997, c. 604, Pt. C, §3 (AMD).]

The requirements of this section apply to all policies and certificates delivered or issued for delivery in this State. [PL 2003, c. 517, Pt. A, §6 (AMD); PL 2003, c. 517, Pt. A, §13 (AFF).]
24-A M.R.S. § 2303-A — ME Code / Title 24-A / Chapter 25 / Section 2303-A
24-A §2303-A. Surcharge
Status: in_force

An insurer may not surcharge a motor vehicle insurance policy based on a motor vehicle operator's license suspension when that suspension is pursuant to Title 29‑A, section 2472, subsection 3, paragraph B , except in accordance with this section. If the person had an alcohol level of at least 0.05 grams or more of alcohol but less than 0.08 grams of alcohol per 100 milliliters of blood or 210 liters of breath, the surcharge is limited to 20%. If the person had an alcohol level of at least 0.02 grams of alcohol but less than 0.05 grams of alcohol per 100 milliliters of blood or 210 liters of breath, the surcharge is limited to 10%. If the policy covers multiple vehicles, the surcharge may be applied only to that portion of the rate attributable to a single vehicle. [PL 2009, c. 447, §22 (AMD).]
24-A M.R.S. § 6911 — ME Code / Title 24-A / Chapter 87 / Section 6911
24-A §6911. Coordination with MaineCare
Status: in_force

The Department of Health and Human Services is the state agency responsible for the financing and administration of MaineCare. It shall pay for MaineCare benefits for MaineCare-eligible individuals, including those enrolled in health plans in MaineCare that are providing coverage under the Dirigo Health Program. An individual participating in the Dirigo Health Program who applies for and is determined eligible for MaineCare is enrolled directly in MaineCare. [PL 2005, c. 400, Pt. A, §6 (AMD).]
24-A M.R.S. § 4367 — ME Code / Title 24-A / Chapter 57 / Section 4367
24-A §4367. Claims against foreign insurers
Status: in_force

1. In a delinquency proceeding in a reciprocal state against an insurer domiciled in that state, claimants against such insurer who reside within this State may file claims either with the ancillary receiver, if any, appointed in this State, or with the domiciliary receiver. All such claims must be filed on or before the last date fixed for the filing of claims in the domiciliary delinquency proceedings. [PL 1969, c. 132, §1 (NEW).]

2. Controverted claims belonging to claimants residing in this State may either: A. Be proved in the domiciliary state as provided by the law of that state, or [PL 1969, c. 132, §1 (NEW).] B. If ancillary proceedings have been commenced in this State, be proved in those proceedings. In the event that any such claimant elects to prove a claim in this State, the claimant shall file the claim with the ancillary receiver and shall give notice in writing to the receiver in the domiciliary state, either by registered or certified mail or by personal service at least 40 days prior to the date set for hearing. The notice must contain a concise statement of the amount of the claim, the facts on which the claim is based and the priorities asserted, if any. If the domiciliary receiver within 30 days after the giving of such notice gives notice in writing to the ancillary receiver and to the claimant, either by registered or certified mail or by personal service, of the domiciliary receiver's intention to contest such claim, the domiciliary receiver is entitled to appear or to be represented in any proceeding in this State involving adjudication of the claim. The final allowance of the claim by the courts of this State must be accepted as conclusive as to its amount and must also be accepted as conclusive as to its priority, if any, against special deposits or other security located within this State. [RR 2021, c. 1, Pt. B, §364 (COR).] [RR 2021, c. 1, Pt. B, §364 (COR).]

3. The courts of this State shall give full faith and credit to any stay of or injunction barring new actions against an insurer or its receiver, or the continuation of existing actions against an insurer or its receiver, when the stay or injunction is pursuant to an order to liquidate or rehabilitate an insurer issued in accordance with the delinquency laws of a reciprocal state. [PL 2021, c. 16, §15 (NEW).]
24-A M.R.S. § 2835 — ME Code / Title 24-A / Chapter 35 / Section 2835
24-A §2835. Mental health services
Status: in_force

1. Notwithstanding any provision of a health insurance policy or certificate issued under a group policy subject to this chapter, whenever the policy provides for payment or reimbursement for services that are within the lawful scope of practice of a professional listed in subsection 2‑A , any person covered by the policy is entitled to reimbursement for these services if the services are performed by a physician or a professional listed in subsection 2‑A . Payment or reimbursement for services rendered by a professional listed in subsection 2‑A, paragraph B , C , D , E or F may not be conditioned upon prior diagnosis or referral by a physician or other health care professional, except when diagnosis of the condition for which the services are rendered is beyond the scope of their licensure. [PL 2005, c. 683, Pt. A, §40 (RPR).]

2. Nothing in subsection 1 may be construed to require a health insurance policy subject to this chapter to provide for reimbursement of services that are within the lawful scope of practice of a professional listed in subsection 2‑A . [PL 2005, c. 683, Pt. A, §40 (RPR).]

2-A. Subsections 1 and 2 apply with respect to the following types of professionals: A. A psychologist licensed to practice in this State; [PL 2005, c. 683, Pt. A, §40 (RPR).] B. A certified social worker licensed for the independent practice of social work in this State; [PL 2005, c. 683, Pt. A, §40 (RPR).] C. A licensed clinical professional counselor licensed for the independent practice of counseling in this State; [PL 2005, c. 683, Pt. A, §40 (RPR).] D. A licensed nurse who is certified by the American Nurses' Association as a clinical specialist in adult psychiatric and mental health nursing or as a clinical specialist in child and adolescent psychiatric and mental health nursing; [PL 2005, c. 683, Pt. A, §40 (RPR).] E. A marriage and family therapist licensed as a marriage and family therapist in this State; and [PL 2005, c. 683, Pt. A, §40 (NEW).] F. A licensed pastoral counselor licensed as a pastoral counselor in this State. [PL 2005, c. 683, Pt. A, §40 (NEW).] [PL 2005, c. 683, Pt. A, §40 (RPR).]

3. Mental health services provided by counseling professionals. Except as provided in subsection 1 with regard to reimbursement of clinical professional counselors, pastoral counselors and marriage and family therapists licensed in this State, an insurer that issues group health care contracts providing coverage for mental health services shall make available coverage for those services when performed by a counseling professional who is licensed by the State pursuant to Title 32, chapter 119 to assess and treat interpersonal and intrapersonal problems, has at least a master's degree in counseling or a related field from an accredited educational institution and has been employed as a counselor for at least 2 years. Any contract providing coverage for the services of counseling professionals pursuant to this section may be subject to any reasonable limitations, maximum benefits, coinsurance, deductibles or exclusion provisions applicable to overall benefits under the contract. This subsection applies to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this subsection, all contracts are deemed renewed no later than the next yearly anniversary of the contract date. [PL 2005, c. 683, Pt. A, §40 (RPR).]
24-A M.R.S. § 3101 — ME Code / Title 24-A / Chapter 43 / Section 3101
24-A §3101. Contracts subject to general provisions
Status: in_force

All contracts of surety insurance delivered or issued for delivery in this State and covering subjects resident, located, or to be performed in this State are also subject to the applicable provisions of chapter 27 (the insurance contract) and to other applicable provisions of this Title. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 3367 — ME Code / Title 24-A / Chapter 47 / Section 3367
24-A §3367. Nonassessable policies; limits of assessability; use of funds; combination operation
Status: in_force

1. A domestic mutual insurer may extinguish the contingent liability to assessment of its members as to cash premium plan policies in force and may omit provisions imposing contingent liability in such policies currently issued while it has and maintains surplus, as determined by its financial statement filed with the superintendent as of the year end next preceding, of not less than $100,000 as to an insurer formed prior to January 1, 1968, and of not less than $200,000 as to an insurer formed after January 1, 1968. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

2. If the insurer after qualifying to issue such a nonassessable policy fails to maintain the applicable above requirement, it shall cease to issue nonassessable policies until it has again met and maintained the requirement for a period of one year. [PL 1969, c. 132, §1 (NEW).]

3. Any assessment levied under the contingent liability provisions of the policy shall be for the exclusive benefit of the holders of policies subject to contingent liability, and such policyholders shall not be liable to assessment in an amount greater in proportion to the total deficiency than the ratio that the deficiency attributable to the contingently liable business bears to the total deficiency. An assessment shall apply only to the holders of the type of policy or plan under which the deficiency occurred, and funds received from the assessment shall be for the exclusive benefit of such holders. [PL 1969, c. 132, §1 (NEW).]

4. Nothing in this chapter shall be deemed to prohibit a domestic mutual insurer formed prior to January 1, 1968 from at any one time transacting, in respective departments or divisions of its operations, insurance business on any two or all of the following bases: A. Cash premium plan, without contingent liability to assessment, and issuance of nonassessable policies if qualified therefor as above provided in this section; [PL 1969, c. 132, §1 (NEW).] B. Cash premium plan, with contingent liability to assessment; and [PL 1969, c. 132, §1 (NEW).] C. Assessment plan. [PL 1969, c. 132, §1 (NEW).] [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2531 — ME Code / Title 24-A / Chapter 29 / Section 2531
24-A §2531. Paid-up nonforfeiture benefits
Status: in_force

Any paid-up nonforfeiture benefit available under the policy in the event of default in a premium payment due on any policy anniversary shall be such that its present value as of such anniversary shall be at least equal to the cash surrender value then provided for by the policy or, if none is provided for, that cash surrender value which would have been required by sections 2529 to 2534 in the absence of the condition that premiums shall have been paid for at least a specified period. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 6096 — ME Code / Title 24-A / Chapter 72-A / Section 6096
24-A §6096. Compulsory associations
Status: in_force

1. Financial contribution. No risk retention group may be required or permitted to join or contribute financially to any insurance insolvency guaranty fund or similar mechanism in this State, nor may any risk retention group or its insureds or claimants against its insureds, receive any benefit from any such fund for claims arising under the insurance policies issued by the risk retention group. [PL 1987, c. 481, §3 (NEW).]

2. Insurer not authorized. When a purchasing group obtains insurance covering its members' risks from an insurer not authorized in this State or a risk retention group, these risks, wherever resident or located, shall not be covered by any insurance guaranty fund or similar mechanism in this State. [PL 1987, c. 481, §3 (NEW).]

3. Authorized insurer. When a purchasing group obtains insurance covering its members' risks from an insurer authorized in this State, only risks resident or located in this State shall be covered by the Maine Insurance Guaranty Association subject to chapter 57, subchapter III . [PL 1987, c. 481, §3 (NEW).]
24-A M.R.S. § 2927 — ME Code / Title 24-A / Chapter 39 / Section 2927
24-A §2927. Personal automobile insurance; rental vehicle coverage
Status: in_force

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Authorized driver" means: (1) The renter; (2) The renter's spouse, if that person is a licensed driver meeting the rental company's minimum age requirement; (3) The renter's employer or coworker, if that person is engaged in business activity with the renter and is a licensed driver meeting the rental company's minimum age requirement; (4) A person who operates the vehicle during an emergency or while parking the vehicle in the course of that person's employment at a commercial establishment; or (5) A person listed by the rental company on the rental agreement as an authorized driver. [PL 1991, c. 335 (NEW).] B. "Covered rental agreement" means a written agreement with a term of 45 continuous days or fewer setting forth the terms and conditions governing the use of a covered rental vehicle provided by a rental company. [PL 1991, c. 335 (NEW).] C. "Covered rental vehicle" means a private passenger motor vehicle rented pursuant to a covered rental agreement, regardless of where that rental vehicle is registered, rented or operated. [PL 1991, c. 335 (NEW).] D. "Private passenger motor vehicle" includes a private passenger automobile, a sport utility vehicle, a pickup truck and a van, as defined in rule. [PL 2019, c. 376, §1 (AMD).] E. "Rental company" means any person or organization, including franchisees, in the business of providing private passenger motor vehicles to the public. [PL 1991, c. 335 (NEW).] [PL 2019, c. 376, §1 (AMD).]

2. Rental vehicle coverage required. A personal automobile insurance policy that provides liability and collision, liability and comprehensive or liability, comprehensive and collision coverage must provide coverage for the obligation of the insured for actual damage to a covered rental vehicle, including charges for verifiable and actual loss of use not to exceed 30 days, rented by an insured in the United States, its territories or possessions, or Canada under a covered rental agreement. The deductible applicable to the covered rental vehicle may not exceed the highest of the deductibles for the collision coverage in the event of a collision loss or for the comprehensive coverage in the event of a comprehensive loss, applicable to the insured vehicle. [PL 1991, c. 335 (NEW).]

3. Notice to insureds. Every policy to which this section applies, either upon policy issuance or upon the first renewal after January 1, 1992, must be accompanied or supplemented by a notice, in a form prescribed or approved by the superintendent, advising the insured of the rental vehicle coverage provided pursuant to this section. [PL 1991, c. 335 (NEW).]

4. Application. This subchapter applies to all personal automobile policies issued for delivery in this State or renewed on or after January 1, 1992. [PL 1991, c. 335 (NEW).]

5. Rulemaking. The superintendent shall adopt rules as necessary to implement this section. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2019, c. 376, §2 (NEW).]
24-A M.R.S. § 749 — ME Code / Title 24-A / Chapter 9 / Section 749
24-A §749. Prohibited acts
Status: in_force

The reinsurance intermediary-manager may not: [PL 1991, c. 828, §20 (NEW).]

1. Retrocession. Retrocede business on behalf of the reinsurer; except that, the reinsurance intermediary-manager may facultatively retrocede business pursuant to obligatory facultative agreements if the contract with the reinsurer contains reinsurance underwriting guidelines for any such retrocession. The guidelines must include a list of reinsurers with which automatic agreements are in effect, commission schedules and for each reinsurer, the coverages and amounts or percentages that may be reinsured; [PL 1991, c. 828, §20 (NEW).]

2. Use of syndicates. Commit the reinsurer to participate in reinsurance syndicates; [PL 1991, c. 828, §20 (NEW).]

3. Use of other licensees. Make use of any agent or broker without ensuring that the agent or broker is lawfully licensed to transact the kind of reinsurance for which the agent or broker is being used; [PL 1991, c. 828, §20 (NEW).]

4. Claim payment. Without prior approval of the reinsurer, pay or commit the reinsurer to pay a claim, net of retrocessions, that exceeds the lesser of an amount specified by the reinsurer or one percent of the reinsurer's policyholder surplus as of December 31st of the next preceding calendar year; [PL 1991, c. 828, §20 (NEW).]

5. Claim recovery. Collect any payment from a retrocessionaire or commit the reinsurer to any claim settlement with a retrocessionaire, without prior approval of the reinsurer. If prior approval is given, a report must be promptly forwarded to the reinsurer; [PL 1991, c. 828, §20 (NEW).]

6. Joint employment. Jointly employ an individual who is employed by the reinsurer unless the reinsurance intermediary-manager is under common control with the reinsurer subject to section 222 ; or [PL 1991, c. 828, §20 (NEW).]

7. Subcontract. Assign duties under a contract to a subcontracting manager. [PL 1991, c. 828, §20 (NEW).]
24-A M.R.S. § 3360 — ME Code / Title 24-A / Chapter 47 / Section 3360
24-A §3360. Members are policyholders
Status: in_force

1. Each policyholder of a domestic mutual insurer, other than of a reinsurance contract, is a member of the insurer with all rights and obligations of such membership, as the charter and as the policy shall so specify. [PL 1969, c. 132, §1 (NEW).]

2. Any person, government or governmental agency, state or political subdivision thereof, public or private corporation, board, association, firm, estate, trustee or fiduciary may be a member of a domestic, foreign or alien mutual insurer. Any officer, stockholder, trustee or legal representative of any such corporation, board, association or estate may be recognized as acting for or on its behalf for the purpose of such membership, and shall not be personally liable upon any contract of insurance for acting in such representative capacity. [PL 1969, c. 132, §1 (NEW).]

3. Any domestic corporation may participate as a member of a mutual insurer as an incidental purpose for which such corporation is organized, and as much granted as the rights and powers expressly conferred. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 3551 — ME Code / Title 24-A / Chapter 49 / Section 3551
24-A §3551. Purpose
Status: in_force

Enemy attack could seriously disrupt the management functions of an insurance organization. Prompt resumption of insurance operations following attack is in the public interest and requires provisions for the continuity of management. It is essential that advance corporate action be taken to provide for the reconstitution of the board of directors or substitute governing body, for the succession of key personnel and for the designation of alternate headquarters. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2847-D — ME Code / Title 24-A / Chapter 35 / Section 2847-D
24-A §2847-D. Penalty for noncompliance with utilization review programs
Status: in_force

A policy or certificate issued or renewed after April 8, 1994 may not contain a provision that permits, upon retroactive review and confirmation of medical necessity, the imposition of a penalty of more than $500 for failure to provide notification under a utilization review program. This section does not limit the right of insurers to deny a claim when appropriate prospective or retroactive review concludes that services or treatment rendered were not medically necessary. [PL 1995, c. 332, Pt. M, §9 (AMD).]
24-A M.R.S. § 3852 — ME Code / Title 24-A / Chapter 53 / Section 3852
24-A §3852. Scope of chapter -- existing insurers
Status: in_force

1. All authorized reciprocal insurers shall be governed by those sections of this chapter not expressly made applicable to domestic reciprocals. [PL 1969, c. 132, §1 (NEW).]

2. Existing authorized reciprocal insurers shall after January 1, 1970 comply with this chapter, and shall make such amendments to their subscribers' agreement, power of attorney, policies and other documents and accounts and perform such other acts as may be required for such compliance. [PL 1973, c. 625, §152 (AMD).]
24-A M.R.S. § 2847-R — ME Code / Title 24-A / Chapter 35 / Section 2847-R
24-A §2847-R. Enrollment of dependent children in dental coverage
Status: in_force

1. Offer of dependent coverage; enrollment period. All group dental insurance policies, contracts and certificates that offer dependent coverage must offer the opportunity to enroll a dependent child in the dental insurance coverage at appropriate rates during the following periods: A. From birth to 30 days of age; and [PL 2009, c. 578, §3 (NEW); PL 2009, c. 578, §4 (AFF).] B. Any open or annual enrollment period. [PL 2009, c. 578, §3 (NEW); PL 2009, c. 578, §4 (AFF).] [PL 2009, c. 578, §3 (NEW); PL 2009, c. 578, §4 (AFF).]

Revisor's Note: §2847-R. Coverage for children's early intervention services (As enacted by PL 2009, c. 634, §3; §5 is REALLOCATED TO TITLE 24-A, SECTION 2847-S)

Revisor's Note: §2847-R. Coverage for the diagnosis and treatment of autism spectrum disorders (As enacted by PL 2009, c. 635, §3; §6 is REALLOCATED TO TITLE 24-A, §2847-T)
24-A M.R.S. § 1117 — ME Code / Title 24-A / Chapter 13 / Section 1117
24-A §1117. Equipment trust certificates
Status: in_force

An insurer may invest in equipment trust obligations or certificates which are adequately secured, or in other adequately secured instruments evidencing an interest in transportation equipment wholly or in part within the United States of America and a right to receive determined portions of rental, purchase or other fixed obligatory payments for the use or purchase of such transportation equipment. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 409 — ME Code / Title 24-A / Chapter 5 / Section 409
24-A §409. Insurance lines combinations
Status: in_force

An insurer may be authorized to transact such kinds of insurance as it is qualified for under this Title, except that a reciprocal insurer may not transact life insurance. Qualified insurers may transact combinations of business as follows. [PL 1991, c. 385, §1 (AMD).]

1. Multiple lines insurer. A multiple lines insurer is authorized to transact more than one kind of coverage if all kinds of coverage fall within the categories listed in sections 704 to 708 . [PL 1991, c. 385, §1 (NEW).]

2. All lines insurer. An all lines insurer is authorized to transact life insurance and one or more of the kinds of coverage, other than health insurance, that may be transacted by a multiple lines insurer. [PL 1991, c. 385, §1 (NEW).]

3. Life or health insurer. A life or health insurer is authorized to transact life insurance, life and annuity insurance or health insurance as defined in sections 702 to 704‑A . A life insurer, health insurer or a life and health insurer does not become an all lines insurer merely by transacting specific lines of casualty insurance that life or health insurers are expressly authorized by law to transact. [PL 2007, c. 199, Pt. E, §1 (AMD).]
24-A M.R.S. § 4339 — ME Code / Title 24-A / Chapter 56-A / Section 4339
24-A §4339. Contractual provisions to demonstrate financial viability
Status: in_force

If a carrier applies for a waiver under section 4332, subsection 2 , the carrier may demonstrate the financial viability and condition of the downstream entity through the terms of the contract, including one or more of the following: [PL 1999, c. 609, §20 (NEW).]

1. Books, accounts and records. A contractual provision authorizing the carrier to access the downstream entity's books, accounts and records according to terms and conditions on which the carrier and the downstream entity agree; [PL 1999, c. 609, §20 (NEW).]

2. Financial statements. A contractual provision requiring the downstream entity to provide to the carrier interim unaudited financial statements on a regular and ongoing basis as well as an annual financial statement, accompanied by a certified public accountant's opinion, appropriate to the magnitude of risk involved; [PL 1999, c. 609, §20 (NEW).]

3. Reserves. A contractual provision authorizing the carrier to receive information regarding the downstream entity's reserves; [PL 1999, c. 609, §20 (NEW).]

4. Letter of credit. A contractual provision requiring the downstream entity to post a letter of credit or other acceptable financial security; [PL 1999, c. 609, §20 (NEW).]

5. Fees. A contractual provision under which the carrier withholds fees payable to the downstream entity or to the providers for which it acts; [PL 1999, c. 609, §20 (NEW).]

6. General liability insurance. A contractual provision requiring the downstream entity to carry general liability insurance and requiring participating providers to carry professional liability insurance in an amount and from an insurer mutually acceptable to the carrier and the downstream entity; [PL 1999, c. 609, §20 (NEW).]

7. Surety bond. A contractual provision requiring the downstream entity to secure a surety bond to cover the downstream entity's performance under the contract; or [PL 1999, c. 609, §20 (NEW).]

8. Excess of loss insurance. A contractual provision requiring the downstream entity to secure excess of loss insurance or reinsurance in an amount and from an insurer mutually acceptable to the carrier and the downstream entity. [PL 1999, c. 609, §20 (NEW).]
24-A M.R.S. § 753 — ME Code / Title 24-A / Chapter 9 / Section 753
24-A §753. Rules
Status: in_force

The superintendent may adopt reasonable rules for the implementation and administration of the provisions of this subchapter. [PL 1991, c. 828, §20 (NEW).]
24-A M.R.S. § 2847-B — ME Code / Title 24-A / Chapter 35 / Section 2847-B
24-A §2847-B. Jury service
Status: in_force

1. Prohibition. An insurer that issues group or blanket health care contracts providing coverage for medical care to residents of this State may not terminate coverage for any person covered under those contracts because the person has been summonsed for or is engaged in jury service under Title 14, chapter 305, subchapter I‑A . [PL 1991, c. 695, §5 (NEW); PL 1991, c. 824, Pt. A, §51 (NEW).]

2. Application. This section applies to all policies and any certificate executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 1991. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 1991, c. 695, §5 (NEW); PL 1991, c. 824, Pt. A, §51 (NEW).]
24-A M.R.S. § 3608 — ME Code / Title 24-A / Chapter 51 / Section 3608
24-A §3608. Capital funds required; new mutual assessment insurers
Status: in_force

A mutual insurer hereafter organized to transact property insurance on the assessment plan shall not be authorized to transact insurance unless it: [PL 1969, c. 132, §1 (NEW).]

1. Establishes and maintains guaranty capital funds of at least $50,000, all of which shall have been paid in, in cash, and [PL 1969, c. 132, §1 (NEW).]

2. Receives not less than 25 bona fide written applications from not less than 25 persons for insurance of the kind proposed to be transacted, of not less than $100,000 in amount at risk as to principal hazards to be insured, and [PL 1969, c. 132, §1 (NEW).]

3. Receives or collects the initial payment on the premium for the insurance applied for, together with such premium notes as it is contemplated to use in connection with applications for insurance in general, and [PL 1969, c. 132, §1 (NEW).]

4. Is otherwise qualified for such authority under this chapter. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 1119 — ME Code / Title 24-A / Chapter 13 / Section 1119
24-A §1119. Savings and loan institutions
Status: in_force

An insurer may invest in the shares of savings and loan or buildings and loan associations or in the savings accounts of federal savings and loan associations, to the extent that the investment or account is insured by the Federal Savings and Loan Insurance Corporation pursuant to the National Housing Act of 1934, as amended. [PL 1969, c. 177, §24 (AMD).]
24-A M.R.S. § 4326 — ME Code / Title 24-A / Chapter 56-A / Section 4326
24-A §4326. Health Insurance Consumer Assistance Program
Status: in_force

1. Establishment. The Health Insurance Consumer Assistance Program, referred to in this section as "the consumer assistance program," is established to provide support for consumers, including prospective consumers, of health insurance, referred to in this section as "consumers," and to customer assistance programs and public and private health insurance assistance programs. [PL 2019, c. 522, §1 (NEW).]

2. Consumer assistance program services. The services provided by the consumer assistance program may include: A. Assisting consumers with filing complaints and appeals with a group health plan, health insurance carrier or independent review organization and providing information about the internal and external appeal and grievance processes of a group health plan, health insurance carrier or independent review organization; [PL 2019, c. 522, §1 (NEW).] B. Collecting, tracking and quantifying inquiries regarding health insurance and problems encountered by consumers; [PL 2019, c. 522, §1 (NEW).] C. Educating consumers on their rights and responsibilities with respect to health insurance coverage; [PL 2019, c. 522, §1 (NEW).] D. Assisting consumers with obtaining health insurance coverage by providing information, referrals or other assistance; [PL 2019, c. 522, §1 (NEW).] E. Assisting with obtaining federal health insurance premium tax credits under Section 36B of the United States Internal Revenue Code of 1986, as amended; and [PL 2019, c. 522, §1 (NEW).] F. Providing information to the public about the services of the consumer assistance program through a comprehensive outreach program and a toll-free telephone number. [PL 2019, c. 522, §1 (NEW).] [PL 2019, c. 522, §1 (NEW).]

3. Contract for operation. The Attorney General shall contract with a nonprofit, independent health insurance consumer assistance entity, which may not be an insurer, to operate the consumer assistance program. [PL 2019, c. 522, §1 (NEW).]

4. Report. The operator of the consumer assistance program shall report to the Attorney General, according to the requirements of the contract under subsection 3 , on aggregate data relevant to the services provided by and activities of the consumer assistance program, and annually, by January 31st, the Attorney General shall report to the joint standing committee of the Legislature having jurisdiction over health insurance matters on the aggregate data. [PL 2025, c. 369, §1 (AMD).]

5. Funding. The State shall provide necessary funding for the consumer assistance program. [PL 2021, c. 206, §1 (NEW).]
24-A M.R.S. § 3480 — ME Code / Title 24-A / Chapter 47 / Section 3480
24-A §3480. -- approval by superintendent
Status: in_force

1. The plan and agreement referred to in section 3479 shall not be effectuated until filed with and approved by the superintendent in writing. The insurers shall furnish the superintendent such additional information in relation to the proposed merger or consolidation as the superintendent may reasonably require. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

2. The superintendent shall approve the plan and agreement unless the superintendent finds that it: A. Is contrary to law; or [PL 1969, c. 132, §1 (NEW).] B. Is inequitable to the policyholders of any domestic insurer involved; [RR 2021, c. 1, Pt. B, §288 (COR).] C. Would substantially reduce the security of and service to be rendered to policyholders of the domestic insurer; [RR 2021, c. 1, Pt. B, §288 (COR).] 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).] [RR 2021, c. 1, Pt. B, §288 (COR).]

3. If the superintendent does not approve the plan and agreement the superintendent shall so notify the insurers parties thereto in writing, specifying the superintendent's reasons therefor. [RR 2021, c. 1, Pt. B, §289 (COR).]
24-A M.R.S. § 2174 — ME Code / Title 24-A / Chapter 23 / Section 2174
24-A §2174. Illegal dealing in premiums; excess charges for insurance
Status: in_force

1. No person shall knowingly collect any sum as premium or charge for insurance, which insurance is not then provided or is not in due course to be provided, subject to acceptance of the risk by the insurer, by an insurance policy issued by an insurer as authorized by this Title. [PL 1969, c. 132, §1 (NEW).]

2. No person shall willfully collect as premium or charge for insurance any sum in excess of the premium or charge applicable to such insurance, and as specified in the policy, in accordance with the applicable classifications and rates as filed with and approved by the superintendent; or, in cases where classifications, premiums, or rates are not required by this Title to be so filed and approved, such premiums and charges shall not be in excess of those specified in the policy and as fixed by the insurer. This provision shall not be deemed to prohibit the charging and collection, by surplus lines brokers licensed under chapter 19 , of the amount of applicable state and federal taxes and nominal service charge to cover communication expenses, in addition to the premium required by the insurer. This provision shall not be deemed to prohibit the charging and collection, by a life insurer, of amounts actually to be expended for medical examination of an applicant for life insurance or for reinstatement of a life insurance policy. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24 M.R.S. § 2307-A — ME Code / Title 24 / Chapter 19 / Section 2307-A
24 §2307-A. Rules
Status: in_force

Subject to the Maine Administrative Procedure Act, the superintendent may make, adopt, amend and rescind reasonable rules to aid the administration or effectuation of the provisions of this Title. [PL 1993, c. 702, Pt. A, §5 (NEW).]
24-A M.R.S. § 2167 — ME Code / Title 24-A / Chapter 23 / Section 2167
24-A §2167. Service upon unauthorized insurers
Status: in_force

Provisions of this chapter applicable to insurers apply fully to unauthorized insurers. If an action under this chapter is brought against an unauthorized insurer, section 2105 applies to all process, notices and statements of charges. [PL 1991, c. 298, §14 (NEW).]

1. [PL 1991, c. 298, §14 (RP).]

2. [PL 1991, c. 298, §14 (RP).]

3. [PL 1991, c. 298, §14 (RP).]

4. [PL 1991, c. 298, §14 (RP).]
24-A M.R.S. § 2931 — ME Code / Title 24-A / Chapter 40 / Section 2931
24-A §2931. Purpose
Status: in_force

The purpose of this chapter is to prevent abuses in connection with sale of casualty and property insurance in this State pursuant to mass marketing plans, while preserving for consumers the potential benefits of this form of marketing. [PL 1973, c. 625, §146 (NEW).]
24-A M.R.S. § 2603 — ME Code / Title 24-A / Chapter 31 / Section 2603
24-A §2603. Employee groups
Status: in_force

The lives of a group of individuals may be insured under a policy issued to an employer or to the trustees of a fund established by an employer, which employer or trustees are considered the policyholder, to insure employees of the employer for the benefit of persons other than the employer, subject to the following requirements. [PL 1981, c. 150, §3 (RPR).]

1. The employees eligible for insurance under the policy shall be all of the employees of the employer, or all of any class or classes thereof. The policy may provide that the term "employees" includes the employees of one or more subsidiary corporations, and the employees, individual proprietors and partners of one or more affiliated corporations, proprietorships or partnerships if the business of the employer and of the affiliated corporations, proprietorships or partnerships is under common control. The policy may provide that the term "employees" includes the individual proprietor or partners if the employer is an individual proprietorship or partnership. The policy may provide that the term "employees" includes retired employees and directors of a corporate employer. A policy issued to insure the employees of a public body may provide that the term "employees" includes elected or appointed officials. [PL 1981, c. 150, §3 (RPR).]

2. The premium for the policy shall be paid either from the employer's funds or from funds contributed by the insured employees, or from both. Except as provided in subsection 3 , a policy on which no part of the premium is to be derived from funds contributed by the insured employees must insure all eligible employees, except those who reject that coverage in writing. [PL 1981, c. 150, §3 (RPR).]

3. An insurer may exclude or limit the coverage on any person as to whom evidence of individual insurability is not satisfactory to the insurer. [PL 1981, c. 150, §3 (RPR).]

4. [PL 1981, c. 150, §3 (RP).]
24-A M.R.S. § 2848-A — ME Code / Title 24-A / Chapter 36 / Section 2848-A
24-A §2848-A. Applicability to certain self-insured employers
Status: in_force

For purposes of this chapter, an uninsured employee health plan that covers employees working in this State, including the uninsured portion of a partially insured employee health plan, is considered a group medical insurance policy and the employer maintaining the plan is considered an insurer, if the plan is subject to state regulation by virtue of the governmental plan or nonelecting church plan exception to the federal definition of "employee benefit plan" in the federal Employee Retirement Income Security Act, 29 United States Code, Section 1003(b). [PL 1997, c. 445, §23 (NEW); PL 1997, c. 445, §32 (AFF).]
24 M.R.S. § 2317 — ME Code / Title 24 / Chapter 19 / Section 2317
24 §2317. Other provisions applicable
Status: in_force

The following chapters and provisions of Title 24‑A , where and to the extent not inconsistent with this chapter and the reasonable implications thereof, shall apply to such corporations only to the extent provided for by rules and regulations issued by the superintendent to such corporations: [PL 1973, c. 585, §12 (AMD).]

1. Chapter 1. General definitions and provisions. [PL 1971, c. 444, §11 (NEW).]

2. Chapter 3. The Insurance Superintendent. [PL 1971, c. 444, §11 (NEW); PL 1973, c. 585, §12 (AMD).]

3. Chapter 23. Trade practices and frauds. [PL 1971, c. 444, §11 (NEW).]

4. Chapter 49. Continuity of management. [PL 1971, c. 444, §11 (NEW).]

5. Chapter 57. Delinquent insurers; rehabilitation and liquidation. [PL 1971, c. 444, §11 (NEW).]
24-A M.R.S. § 2014 — ME Code / Title 24-A / Chapter 19 / Section 2014
24-A §2014. Producer with surplus lines authority may compensate another producer
Status: in_force

A licensed producer with surplus lines authority may accept and place surplus line business for any insurance producer licensed in this State for the kind of insurance involved, and may compensate the producer for the business. [PL 1997, c. 592, §60 (AMD).]
24-A M.R.S. § 2847-L — ME Code / Title 24-A / Chapter 35 / Section 2847-L
24-A §2847-L. Offer of coverage for breast reduction surgery and symptomatic varicose vein surgery
Status: in_force

All group health insurance policies, contracts and certificates must make available coverage for breast reduction surgery and symptomatic varicose vein surgery determined to be medically necessary health care as defined in section 4301‑A, subsection 10‑A . [PL 2005, c. 128, §3 (NEW); PL 2005, c. 128, §5 (AFF).]
24-A M.R.S. § 1466 — ME Code / Title 24-A / Chapter 16 / Section 1466
24-A §1466. Commissions and fees
Status: in_force

1. Property and casualty consultant. A property and casualty consultant and any person in which the consultant has an interest may not, directly or indirectly, charge a consultant fee and receive or share in any commission for the sale of insurance as a producer on any policy or certificate of insurance unless the advice given by the producer for the insurance occurs at least 12 months before or after the period of employment as a consultant as specified in the contract required by section 1465 . This subsection does not prevent a licensed property and casualty insurance producer from receiving a fee rather than commission on the sale of property and casualty insurance in accordance with section 1450 and rules adopted by the superintendent. [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).]

2. Life and health consultant. A life and health consultant may charge a consulting fee and receive commissions for the sale of insurance as an insurance producer if both the consulting fee and the insurance commissions are provided for in a written agreement, in a form approved by the superintendent, signed by the client and the consultant. [PL 1999, c. 225, §5 (AMD).]
24-A M.R.S. § 6203-B — ME Code / Title 24-A / Chapter 73 / Section 6203-B
24-A §6203-B. Escrow account
Status: in_force

1. Deposit of funds. When funds are required to be deposited in an escrow account pursuant to section 6203 , the following apply. A. The escrow account must be established in a bank or trust company authorized to do business in this State within the meaning of Title 9‑B, section 131, subsection 2 and acceptable to the superintendent. The funds deposited in the escrow account must be kept and maintained in an account separate from the provider's business accounts. [PL 1995, c. 452, §21 (NEW).] B. An escrow agreement must be entered into between the bank or trust company and the provider of the facility. The agreement must state that its purpose is to protect the subscriber or the prospective subscriber. Upon presentation of evidence to the superintendent of compliance with applicable portions of this chapter, or upon order of a court of competent jurisdiction, the escrow agent shall release and pay over the funds or portions of the funds together with any interest accrued on the funds or earned from investment of the funds to the provider or subscriber as directed. [PL 1995, c. 452, §21 (NEW).] C. When funds are received from a prospective subscriber, the provider shall deliver to the subscriber a copy of the executed deposit agreement. The deposit agreement must state the payor's name and address, the date, the price of the care agreement and the amount of money paid. A copy of each agreement together with the funds must be deposited with the escrow agent. [PL 1995, c. 452, §21 (NEW).] D. Checks, drafts and money orders for deposit from prospective subscribers may be made payable only to the escrow agent. At the request of a prospective subscriber of a facility, the escrow agent shall issue a statement indicating the status of the subscriber's portion of the escrow account. [PL 1995, c. 452, §21 (NEW).] E. All funds deposited in the escrow account remain the property of the subscriber until released to the provider in accordance with this chapter. The funds are not subject to any liens or charges by the escrow agent or judgments, garnishments or creditor's claims against the provider or facility. [PL 1995, c. 452, §21 (NEW).] F. At the request of either the provider or the superintendent, the escrow agent shall issue a statement indicating the status of an escrow account. [PL 1995, c. 452, §21 (NEW).] G. Upon determining that the requirements of section 6203, subsection 3, paragraph E have been met, the superintendent shall authorize the escrow agent to release, and the escrow agent shall release, to the provider the amount of escrowed funds received from prospective subscribers and deposited in the account while the provider was operating under a preliminary certificate of authority. [PL 1995, c. 452, §21 (NEW).] [PL 1995, c. 452, §21 (NEW).]

2. Agreement. Any agreement establishing an escrow account required under the provisions of this chapter is subject to approval by the superintendent. The agreement must be in writing and contain, in addition to any other provisions required by law, a provision by which the escrow agent agrees to abide by the duties imposed under this section. [PL 1995, c. 452, §21 (NEW).]

3. Monthly statement; withdrawal of funds. The agreement must require the escrow agent to furnish the provider with a monthly statement indicating the amount of any disbursements from or deposits to the escrow account and the condition of the account during the monthly period covered by the statement. On or before the 20th day of the month following the month for which the monthly statement is due, the provider shall file with the superintendent a copy of the escrow agent's monthly statement. The escrow agent or the escrow agent's designee and the provider shall notify the superintendent in writing 10 days before the payment to the provider of any portion of any funds required to be escrowed under the provisions of this chapter. [PL 1995, c. 452, §21 (NEW).]
24-A M.R.S. § 2847-M — ME Code / Title 24-A / Chapter 35 / Section 2847-M
24-A §2847-M. Enrollment for individuals or families establishing eligibility for MaineCare
Status: in_force

When an individual or family is eligible for MaineCare and is also eligible for health insurance coverage provided by an employer, the insurer must permit the individual or family to enroll in the health insurance coverage without regard to any enrollment season restrictions. [PL 2007, c. 448, §11 (NEW).] Revisor's Note: §2847-M. Coverage for hearing aids (As enacted by PL 2007, c. 452, §3 is REALLOCATED TO TITLE 24-A, SECTION 2847-O)
24-A M.R.S. § 3872 — ME Code / Title 24-A / Chapter 53 / Section 3872
24-A §3872. Aggregate liability
Status: in_force

No one policy or subscriber as to such policy shall be assessed or charged with an aggregate of contingent liability as to obligations incurred by a domestic reciprocal insurer in any one calendar year, in excess of the amount provided for in the power of attorney or in the subscribers' agreement, computed solely upon premium earned on such policy during that year. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 6612 — ME Code / Title 24-A / Chapter 81 / Section 6612
24-A §6612. Place of business; records maintenance
Status: in_force

Each arrangement must have and maintain its principal place of business in the State and must make available to the superintendent complete records of its assets, transactions and affairs in accordance with such methods and systems as are customary for or suitable to the kind or kinds of business transacted. [PL 1993, c. 688, §1 (NEW).]
24-A M.R.S. § 2328 — ME Code / Title 24-A / Chapter 25 / Section 2328
24-A §2328. Examinations
Status: in_force

The superintendent shall examine the affairs, transactions, accounts and records of each advisory organization licensed in this State as provided in section 2321‑A , and of joint underwriters and joint reinsurers as defined in section 2322‑A , as often as the superintendent considers advisable, but not less frequently than once every 5 years. The examination must be conducted in the same manner and is subject to the same applicable provisions as apply to examination of insurers in chapter 3 . The reasonable costs of any such examination must be paid by the organization or association so examined. In lieu of any such examination, the superintendent may accept the report of an examination made by the insurance supervisory official of another state, pursuant to the laws of such state. [PL 2023, c. 405, Pt. A, §85 (AMD).]

If the examination of a rating organization is satisfied by acceptance of another state's report on that rating organization, the superintendent shall submit a report to the joint standing committee of the Legislature having jurisdiction over banking and insurance concerning the superintendent's analysis of that report, any deficiencies noted by the superintendent or in the other state's report and what action has been taken to correct those deficiencies. [PL 1989, c. 356, §2 (NEW).]
24-A M.R.S. § 2532-B — ME Code / Title 24-A / Chapter 29 / Section 2532-B
24-A §2532-B. Superintendent's authority to approve certain new plans
Status: in_force

1. In the case of any plan of life insurance which provides for future premium determination, the amounts of which are to be determined by the insurer based on then estimates of future experience, or in the case of any plan of life insurance which is of such a nature that minimum values cannot be determined by the methods described in sections 2529 to 2532‑A herein, then: A. The superintendent must be satisfied that the benefits provided under the plan are substantially as favorable to policyholders and insureds as the minimum benefits otherwise required by sections 2529 to 2532‑A herein; [PL 1983, c. 346, §14 (NEW).] B. The superintendent must be satisfied that the benefits and the pattern of premiums of that plan are not such as to mislead prospective policyholders or insureds; and [PL 1983, c. 346, §14 (NEW).] C. The cash surrender values and paid-up nonforfeiture benefits provided by that plan must not be less than the minimum values and benefits required for the plan computed by a method consistent with the principles of this Standard Nonforfeiture Law for Life Insurance, as determined by regulations promulgated by the superintendent. [PL 1983, c. 346, §14 (NEW).] [PL 1983, c. 346, §14 (NEW).]
24-A M.R.S. § 7602 — ME Code / Title 24-A / Chapter 99 / Section 7602
24-A §7602. Licensure of self-storage providers
Status: in_force

1. License required. A self-storage provider must obtain a limited lines license under this chapter prior to selling or offering coverage under a policy of self-storage insurance. [PL 2021, c. 676, Pt. A, §42 (NEW).]

2. Authority provided by license. A limited lines license issued under this chapter authorizes any employee or authorized representative of a self-storage provider to sell or offer coverage under a policy of self-storage insurance to a customer at each location at which the self-storage provider engages with a customer or prospective customer. [PL 2021, c. 676, Pt. A, §42 (NEW).]

3. List of locations. In connection with a self-storage provider's application for a license under section 7606 and upon request by the superintendent, the self-storage provider shall provide a list to the superintendent of all locations in this State at which the self-storage provider offers coverage. [PL 2021, c. 676, Pt. A, §42 (NEW).]

4. Activities authorized by license. Notwithstanding any provision of law to the contrary, a license issued pursuant to this chapter authorizes the licensee and its employees or authorized representatives to engage only in those activities that are expressly permitted in this chapter. [PL 2021, c. 676, Pt. A, §42 (NEW).]
24-A M.R.S. § 2921 — ME Code / Title 24-A / Chapter 39 / Section 2921
24-A §2921. Insured told of alternate coverage
Status: in_force

When automobile bodily injury and property damage liability coverage is cancelled or not renewed, other than for nonpayment of premium, the insurer shall notify the named insured of the named insured's possible eligibility for automobile liability insurance through the Maine Automobile Insurance Plan. Such notice must accompany the notice of cancellation or intent not to renew. [RR 2021, c. 1, Pt. B, §257 (COR).]
24-A M.R.S. § 4208 — ME Code / Title 24-A / Chapter 56 / Section 4208
24-A §4208. Annual and interim reports
Status: in_force

1. Every health maintenance organization shall file annual and quarterly financial statements substantially similar to those required of health insurers under sections 423 , 423‑A and 423‑D , verified by at least 3 principal officers, and shall provide a copy of each statement to the Commissioner of Health and Human Services. The superintendent may by rule or order require the filing of more frequent reports. [PL 2017, c. 169, Pt. A, §11 (AMD).]

1-A. The annual and quarterly statements must be prepared in accordance with the National Association of Insurance Commissioners annual and quarterly statement instructions and must follow practices and procedures prescribed by the National Association of Insurance Commissioners accounting practices and procedures manual for health maintenance organizations. If the health maintenance organization is operated as a division or line of business by an insurer or by a nonprofit hospital or medical service corporation, the superintendent shall designate the applicable portions of the financial statement form that must be filed, so as to eliminate information that is inapplicable to health maintenance organizations that are not separately incorporated and to minimize duplication between the statement filed under this section and the overall financial statement of the insurer or nonprofit hospital or medical service corporation. [PL 2017, c. 169, Pt. A, §11 (NEW).]

1-B. Every health maintenance organization shall file an annual audit opinion substantially similar to those required of insurers under section 221‑A . [PL 2017, c. 169, Pt. A, §11 (NEW).]

2. [PL 1993, c. 313, §34 (RP).]

3. The annual and quarterly statements must include, if required by the Commissioner of Health and Human Services or by the superintendent: A. A summary of information compiled pursuant to section 4204 in the form required by the Commissioner of Health and Human Services; and [PL 2017, c. 169, Pt. A, §11 (AMD).] B. Other information related to the performance of the health maintenance organization that is necessary to enable the superintendent to carry out the superintendent's duties under this chapter. [PL 1993, c. 313, §35 (NEW).] [PL 2017, c. 169, Pt. A, §11 (AMD).]

4. The superintendent may refuse to continue or may suspend or revoke the certificate of authority of a health maintenance organization failing to file an annual or quarterly statement when due. [PL 2017, c. 169, Pt. A, §11 (AMD).]
24-A M.R.S. § 2829 — ME Code / Title 24-A / Chapter 35 / Section 2829
24-A §2829. Exceptions
Status: in_force

1. Any portion of any such policy, delivered or issued for delivery in this State, which purports, by reason of the circumstances under which a loss is incurred, to reduce any benefits promised thereunder to an amount less than that provided for the same loss occurring under ordinary circumstances, shall be printed in such policy and in each certificate issued thereunder, in bold face type and with greater prominence than any other portion of the rest of such policy or certificate, respectively; and all other exceptions of the policy shall be printed in the policy and certificate with the same prominence as the benefits to which they apply. [PL 1969, c. 132, §1 (NEW).]

2. If any such policy contains any provision which affects the liability of the insurer because of any violation of law by the insured during the term of the policy, it shall be in the following form: The insurer shall not be liable for death, injury incurred or disease contracted, to which a contributing cause was the insured's commission of or attempt to commit a felony, or which occurs while the insured is engaged in an illegal occupation. [PL 1969, c. 132, §1 (NEW).]

3. If any such policy contains any provision which affects the liability of the insurer because of the insured's use of intoxicating liquor or narcotics or hallucinogenic drugs during the term of the policy, it shall be in the following form: The insurer shall not be liable for death, injury incurred or disease contracted while the insured is intoxicated or under the influence of narcotics or hallucinogenic drugs unless administered on the advice of a physician. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 1465 — ME Code / Title 24-A / Chapter 16 / Section 1465
24-A §1465. Consulting contract required
Status: in_force

A licensee may not act in any further capacity for which a license is required without having first entered into a written contract with a client. The contract must include, without limitation, the amount and basis of any consulting fee and the duration of employment and must be in a form approved by the superintendent. [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).]
24-A M.R.S. § 2382-F — ME Code / Title 24-A / Chapter 25 / Section 2382-F
24-A §2382-F. Report required
Status: in_force

In order to comply with Title 26, section 61, subsection 1‑A , on or before March 1st of each year, every workers' compensation insurer shall file a report with the superintendent showing the amount of total actual paid workers' compensation losses and the total actual paid workers' compensation medical payments for the previous calendar year. [PL 1997, c. 126, §3 (NEW).]
24 M.R.S. § 2303 — ME Code / Title 24 / Chapter 19 / Section 2303
24 §2303. Mental health services
Status: in_force

1. Such corporation mentioned in section 2301 may enter into contracts for the rendering of health care to the subscribers only with institutions or persons licensed or accredited by the appropriate departments, commissions or boards of the several states. All contracts for the provision of health care issued by the corporation shall constitute direct obligations of the provider of health care with which the corporation has contracted for that care. Contracts issued under a health care plan shall provide that the private provider-patient relationship shall exist between the patient and provider of health care, that the patient shall have a free choice of any provider of health care able and willing to provide those services, all of which shall be based upon definite agreements covering health care provided through duly licensed providers, and any such provider of health care shall be free to refuse service for appropriate professional reasons. Nothing in this section may be construed to prohibit reciprocal arrangements for the exchange of health care between similar nonprofit hospital and medical service plans. [PL 1983, c. 515, §1 (AMD).]

2. Mental health services provided by psychologists or certified social workers. [PL 1999, c. 256, Pt. M, §2 (RP).]

3. [PL 1983, c. 515, §2 (RP).]

4. [PL 1999, c. 256, Pt. M, §3 (RP).]

5. [PL 1999, c. 256, Pt. M, §4 (RP).]
24-A M.R.S. § 1495 — ME Code / Title 24-A / Chapter 16 / Section 1495
24-A §1495. Duties of insurers
Status: in_force

1. Records for each MGA. The insurer shall require and maintain on file an independent financial examination of current origin prepared on the basis of statutory accounting prescribed or permitted by the superintendent respecting each MGA with which the insurer has done business. [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]

2. Actuarial review. If an MGA establishes loss reserves, the insurer shall annually obtain the opinion of an actuary or actuaries who specialize in the type of insurance under consideration, attesting to the adequacy of loss reserves established for losses incurred and outstanding on business produced by the MGA. This requirement is in addition to any other required loss reserve certification. [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]

3. On-site review. The insurer shall periodically and at least semiannually conduct an on-site review of the underwriting and claims processing operations of the MGA. [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]

4. Binding authority. Binding authority for all reinsurance contracts or participation in insurance or reinsurance syndicates rests with an officer of the insurer, who may not be affiliated with the MGA. [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]

5. Notice of termination. Within 30 days of termination of a contract with an MGA, the insurer shall provide written notification of that termination to the superintendent. [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]

6. Quarterly review. An insurer shall review its books and records each quarter to determine if any producer has become, by operation of section 1492, subsection 3 , an MGA as defined in that section. If the insurer determines that its producer has become an MGA, the insurer shall promptly notify the producer and the superintendent of that determination and the insurer and producer must fully comply with the provisions of this subchapter within 30 days. [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]

7. Board member qualifications. An insurer may not appoint to its board of directors an officer, director, employee, producer or controlling shareholder of its managing general agents. This subsection does not apply to relationships governed by section 222 or chapter 77 to the extent that control of an insurer is permissible under section 222 or chapter 77 . [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]
24-A M.R.S. § 3161 — ME Code / Title 24-A / Chapter 44 / Section 3161
24-A §3161. Effective date
Status: in_force

This chapter takes effect January 1, 2023. [PL 2021, c. 562, §1 (NEW).]
24-A M.R.S. § 4319 — ME Code / Title 24-A / Chapter 56-A / Section 4319
24-A §4319. Rebates
Status: in_force

1. Rebates required. Carriers must provide rebates in the large group, small group and individual markets if the medical loss ratio under subsection 2 is less than the minimum medical loss ratio under subsection 3 . [PL 2019, c. 5, Pt. A, §23 (AMD).]

2. Medical loss ratio. For purposes of this section, the medical loss ratio is the ratio of the numerator to the denominator as described in paragraphs A and B , respectively, plus any credibility adjustment. For the purposes of this subsection: A. The numerator is the amount expended on reimbursement for clinical services provided to enrollees and activities that improve health care quality; and [PL 2011, c. 90, Pt. D, §5 (NEW).] B. The denominator is the total amount of premium revenue excluding federal and state taxes and licensing and regulatory fees paid and after accounting for payments or receipts for risk adjustment, risk corridors and reinsurance pursuant to federal law. [PL 2011, c. 90, Pt. D, §5 (NEW).] [PL 2019, c. 5, Pt. A, §23 (AMD).]

3. Minimum medical loss ratio. The minimum medical loss ratio is: A. In the large group market, 85%; [PL 2011, c. 90, Pt. D, §5 (NEW).] B. In the small group market, 80%; and [PL 2011, c. 90, Pt. D, §5 (NEW).] C. In the individual market, 80%. [PL 2019, c. 5, Pt. A, §23 (AMD).] [PL 2019, c. 5, Pt. A, §23 (AMD).]

4. Rules. The superintendent may adopt rules to implement this section in a substantially similar manner as required under the federal Affordable Care Act in effect as of January 1, 2019, including, but not limited to, rules establishing the period for which the medical loss ratio is calculated. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2019, c. 5, Pt. A, §23 (NEW).]
24-A M.R.S. § 4142 — ME Code / Title 24-A / Chapter 55 / Section 4142
24-A §4142. Exemption of certain societies
Status: in_force

Nothing contained in this chapter shall be so construed as to affect or apply to: [PL 1969, c. 132, §1 (NEW).]

1. Grand or subordinate lodges of societies, orders or associations now doing business in this State which provide benefits exclusively through local or subordinate lodges; [PL 1969, c. 132, §1 (NEW).]

2. Orders, societies or associations which admit to membership only persons engaged in one or more crafts or hazardous occupations, in the same or similar lines of business, insuring only their own members and their families, and the ladies' societies or ladies' auxiliaries to such orders, societies or associations; [PL 1969, c. 132, §1 (NEW).]

3. Domestic societies which limit their membership to employees of a particular city or town, designated firm, business house or corporation which provide for a death benefit of not more than $400 or disability benefits of not more than $350 to any person in any one year, or both; or [PL 1969, c. 132, §1 (NEW).]

4. Domestic societies or associations of a purely religious, charitable or benevolent description, which provide for a death benefit of not more than $400 or for disability benefits of not more than $350 to any one person in any one year, or both. [PL 1969, c. 132, §1 (NEW).]

Any such society or association described in subsections 3 or 4 supra which provides for death or disability benefits for which benefit certificates are issued, and any such society or association included in subsection 4 which has more than 1,000 members, shall not be exempted from the provisions of this chapter but shall comply with all requirements thereof. [PL 1969, c. 132, §1 (NEW).]

No society which, by the provisions of this section, is exempt from the requirements of this chapter, except any society described in subsection 2 , shall give or allow, or promise to give or allow to any person any compensation for procuring new members. [PL 1969, c. 132, §1 (NEW).]

Every society which provides for benefits in case of death or disability resulting solely from accident, and which does not obligate itself to pay natural death or sick benefits shall have all of the privileges and be subject to all the applicable provisions and regulations of this chapter except that the provisions thereof relating to medical examination, valuations of benefit certificates, and incontestability shall not apply to such society. [PL 1969, c. 132, §1 (NEW).]

The superintendent may require from any society or association, by examination or otherwise, such information as will enable the superintendent to determine whether such society or association is exempt from this chapter. [RR 2021, c. 1, Pt. B, §340 (COR).]

Societies, exempted under this section, shall also be exempt from all other provisions of the insurance laws of this State. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2701 — ME Code / Title 24-A / Chapter 33 / Section 2701
24-A §2701. Scope of chapter
Status: in_force

Nothing in this chapter shall apply to or affect: [PL 1969, c. 132, §1 (NEW).]

1. Any policy of liability or workers' compensation insurance with or without supplementary expense coverage therein; [PL 1989, c. 502, Pt. A, §94 (AMD).]

2. Any group or blanket policy, except that: A. Sections 2736 , 2736‑A and 2736‑B apply to group Medicare supplement policies as defined in chapter 67 , group nursing home care and long-term care insurance policies as defined in chapter 68 or 68‑A ; [PL 2003, c. 428, Pt. G, §3 (AMD).] B. Section 2752 applies with respect to mandated benefits for group or blanket health policies; and [PL 1995, c. 332, Pt. J, §1 (AMD).] C. Sections 2736 , 2736‑A , 2736‑B and 2736‑C apply to: (1) Association groups as defined by section 2805‑A , except as to any employer subgroups of the association group when the employer is a member of the group and provides coverage through the group as a bona fide employee benefit; (1-A) Credit union groups as defined by section 2807‑A ; and (2) Other groups as defined by section 2808 , except: (a) Employee leasing companies registered pursuant to Title 32, chapter 125 ; and (b) As to any employer subgroups of the other group when the employer provides coverage to its employees through the group as a bona fide employee benefit. [PL 2009, c. 244, Pt. F, §1 (AMD).] [PL 2009, c. 244, Pt. F, §1 (AMD).]

3. Life insurance, endowment or annuity contracts, or contracts supplemental thereto which contain only such provisions relating to health insurance as: A. Provide additional benefits in case of death or dismemberment or loss of sight by accident or accidental means, or as [PL 1969, c. 132, §1 (NEW).] B. Operate to safeguard such contracts against lapse, or to give a special surrender value or special benefit or an annuity in the event that the insured or annuitant becomes totally and permanently disabled, as defined by the contract or supplemental contract; [PL 1983, c. 801, §8 (AMD).] [PL 1983, c. 801, §8 (AMD).]

4. Reinsurance; and [PL 1983, c. 801, §8 (AMD).]

5. Legal services insurance. [PL 1983, c. 801, §9 (NEW).]
24-A M.R.S. § 2551 — ME Code / Title 24-A / Chapter 29 / Section 2551
24-A §2551. Proration of values; additional benefits
Status: in_force

For any contract which provides, within the same contract by rider or supplemental contract provision, both annuity benefits and life insurance benefits that are in excess of the greater of cash surrender benefits or a return of the gross considerations with interest, the minimum nonforfeiture benefits shall be equal to the sum of the minimum nonforfeiture benefits for the annuity portion and the minimum nonforfeiture benefits, if any, for the life insurance portion computed as if each portion were a separate contract. Notwithstanding the provisions of sections 2545 to 2548 and section 2550 , additional benefits payable, in the event of total and permanent disability, as reversionary annuity or deferred reversionary annuity benefits, or as other policy benefits additional to life insurance, endowment and annuity benefits, and considerations for all these additional benefits, shall be disregarded in ascertaining the minimum nonforfeiture amounts, paid-up annuity, cash surrender and death benefits that may be required by sections 2541 to 2551. The inclusion of the additional benefits shall not be required in any paid-up benefits, unless the additional benefits separately would require minimum nonforfeiture amounts, paid-up annuity, cash surrender and death benefits. [PL 1979, c. 442, §4 (NEW).]
24-A M.R.S. § 6222 — ME Code / Title 24-A / Chapter 73 / Section 6222
24-A §6222. Examinations
Status: in_force

1. Examination by superintendent. The superintendent may make an examination of the affairs of any provider as often as he deems it necessary for the protection of the interests of the people of this State, but not less frequently than once every 3 years. [PL 1987, c. 482, §1 (NEW).]

2. Examination by department. The department may make an examination concerning the quality of health and supportive services of any provider as often as the department deems it necessary for the protection of the interests of the people of this State, but not less frequently than once every year. [PL 1987, c. 482, §1 (NEW).]

3. Records. Every provider shall submit its books and records relating to health and supportive services to such examinations and in every way facilitate the examination. For the purpose of examinations, the superintendent and the department may administer oaths to and examine the officers and agents of the provider. [PL 1987, c. 482, §1 (NEW).]

4. Expenses. The reasonable expenses of examinations performed by the superintendent under this section shall be assessed against the organization being examined and remitted to the superintendent. [PL 1987, c. 482, §1 (NEW).]
24-A M.R.S. § 1114 — ME Code / Title 24-A / Chapter 13 / Section 1114
24-A §1114. Insurance stocks
Status: in_force

1. An insurer may invest in the stocks of other solvent insurers formed under the laws of this or another state, which stocks meet the applicable requirements of section 1112 (preferred or guaranteed stocks) or 1113 (common stocks). [PL 1969, c. 132, §1 (NEW).]

2. With the superintendent's advance written consent an insurer may acquire and hold the controlling interest in the outstanding voting stock of a stock insurer formed under the laws of this or another state. The superintendent may not give consent if the superintendent finds that such acquisition would not be in the best interests of the insurers involved, or of their respective policyholders or stockholders, or that it would materially tend to lessen competition or to result in any monopoly in the insurance business. [RR 2021, c. 1, Pt. B, §188 (COR).]
24-A M.R.S. § 2006 — ME Code / Title 24-A / Chapter 19 / Section 2006
24-A §2006. Open lines for export
Status: in_force

1. The superintendent may by order declare eligible for export generally and without compliance with section 2004, subsections 2 , 3 and 4 , any class or classes of insurance coverage or risk for which the superintendent finds, after a hearing of which notice was given to each insurer authorized to transact such class or classes in this State, that there is not a reasonable or adequate market among authorized insurers either as to acceptance of the risk, contract terms, or premium or premium rate. Any such order shall continue in effect during the existence of the conditions upon which predicated, but subject to earlier termination by the superintendent. [PL 1997, c. 592, §52 (AMD).]

2. The producer shall file with or as directed by the superintendent a memorandum as to each such coverage placed by the producer with a nonadmitted insurer, in such form and context as the superintendent may reasonably require for the identification of the coverage and determination of the tax payable to the State relative thereto. [PL 2025, c. 348, §16 (AMD).]

3. A producer may also place with authorized insurers any insurance coverage made eligible for export generally under subsection 1 , and without regard to rate or form filings that may otherwise be applicable as to the authorized insurer. As to coverages so placed in an authorized insurer the premium tax thereon must be reported and paid by the insurer as required generally under the law of this State. [PL 1997, c. 592, §53 (AMD).]
24-A M.R.S. § 1957 — ME Code / Title 24-A / Chapter 18-A / Section 1957
24-A §1957. Rulemaking
Status: in_force

The superintendent shall adopt rules necessary to carry out the requirements of this chapter before January 1, 1997. All rules adopted pursuant to this chapter are major substantive rules as defined in Title 5, chapter 375, subchapter II‑A . [PL 1995, c. 673, Pt. A, §3 (NEW).]
24-A M.R.S. § 2832 — ME Code / Title 24-A / Chapter 35 / Section 2832
24-A §2832. Maternity benefits for unmarried women certificate holders and the minor dependents of certificate holders with dependent or family coverage required
Status: in_force

All group or blanket health insurance policies, contracts and certificates shall provide the same maternity benefits for unmarried women certificate holders, and the minor dependents of certificate holders with dependent or family coverage, as is provided married certificate holders with maternity coverage and the wives of certificate holders with maternity coverage. This requirement applies to all group or blanket insurance written or renewed after the effective date of this Act, and includes, but is not limited to, all types and forms of group insurance issued by individual companies or corporations. [PL 2003, c. 517, Pt. B, §11 (AMD).]
24 M.R.S. § 2332-F — ME Code / Title 24 / Chapter 19 / Section 2332-F
24 §2332-F. Coverage for diabetes supplies
Status: in_force

All individual and group nonprofit hospital and medical services plan policies, contracts and certificates and all nonprofit health care plan policies, contracts and certificates must provide coverage for the medically appropriate and necessary equipment, limited to insulin, oral hypoglycemic agents, monitors, test strips, syringes and lancets, and the out-patient self-management training and educational services used to treat diabetes, if: [PL 2003, c. 517, Pt. A, §3 (AMD); PL 2003, c. 517, Pt. A, §13 (AFF).]

1. Certification of medical necessity. The subscriber's treating physician or a physician who specializes in the treatment of diabetes certifies that the equipment and services are necessary; and [PL 1995, c. 592, §1 (NEW).]

2. Provision of medical services. The diabetes out-patient self-management training and educational services are provided through ambulatory diabetes education facilities authorized by the State's Diabetes Control Project within the Bureau of Health. [PL 1995, c. 592, §1 (NEW).] Revisor's Note: §2332-F. Gynecological and obstetrical services (As enacted by PL 1995, c. 617, §2 and affected by §6 is REALLOCATED TO TITLE 24, SECTION 2332-G)
24-A M.R.S. § 2440 — ME Code / Title 24-A / Chapter 27 / Section 2440
24-A §2440. Applicability
Status: in_force

1. Application. This Act shall apply to all policies delivered or issued for delivery in this State by an insurer on or after the date the forms must be approved under this Act, but nothing in this Act shall apply to: A. Any policy which is a security subject to federal jurisdiction; [PL 1979, c. 267, §2 (NEW).] B. Any group policy covering a group of 1,000 or more lives at date of issue, other than a group credit life or health insurance policy; this shall not exempt any certificate issued pursuant to a group policy delivered or issued for delivery in this State; [PL 1979, c. 267, §2 (NEW).] C. Any group annuity contract which serves as a funding vehicle for pension, profit-sharing or deferred compensation plans; [PL 1979, c. 267, §2 (NEW).] D. Any form used in connection with, as a conversion from, as an addition to, or in exchange pursuant to a contractual provision for, a policy delivered or issued for delivery on a form approved or permitted to be issued prior to the dates the forms must be approved under this section; [PL 1979, c. 267, §2 (NEW).] E. The renewal of a policy delivered or issued for delivery prior to the dates the forms must be approved under this Act. [PL 1979, c. 267, §2 (NEW).] [PL 1979, c. 267, §2 (NEW).]

2. Exception. No other statute of this State setting language simplification standards shall apply to any policy forms. [PL 1979, c. 267, §2 (NEW).]
24-A M.R.S. § 7756 — ME Code / Title 24-A / Chapter 103 / Section 7756
24-A §7756. Contracting under 340B program
Status: in_force

As permitted under federal law and regulation, a 340B entity shall, to the extent possible, contract with a 340B contract pharmacy that is located in this State. [PL 2025, c. 388, Pt. P, §5 (NEW).]
24-A M.R.S. § 2330 — ME Code / Title 24-A / Chapter 25 / Section 2330
24-A §2330. Appeals from superintendent
Status: in_force

Any insurer, advisory organization or rating organization aggrieved by any order or decision of the superintendent may appeal therefrom as provided in section 236 . [PL 1989, c. 797, §34 (AMD); PL 1989, c. 797, §§37, 38 (AFF).]
24-A M.R.S. § 2018 — ME Code / Title 24-A / Chapter 19 / Section 2018
24-A §2018. Failure to pay tax
Status: in_force

If any producer fails to remit the tax provided by section 2016 within 30 days after the tax is due, the superintendent may, following an adjudicatory hearing, assess a penalty of not less than $25 for each day of delinquency. Any fine collected by the superintendent must be paid to the Treasurer of State and credited to the Insurance Regulatory Fund. [PL 1997, c. 592, §63 (AMD).]
24-A M.R.S. § 3041 — ME Code / Title 24-A / Chapter 41 / Section 3041
24-A §3041. Time limit for adjusting, paying fire loss; penalty
Status: in_force

1. In case of physical loss by fire to property insured by any insurer, the insurer or its representative shall begin adjustment of such loss within 20 days after the receipt of the notice of loss provided for by the policy. [PL 1969, c. 132, §1 (NEW).]

2. In any statute relating to fire insurance or in any policy of fire insurance, reference to the date of loss or the time when a loss occurs shall mean the day of the fire against which the policy insures. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 3861 — ME Code / Title 24-A / Chapter 53 / Section 3861
24-A §3861. Deposit in lieu of bond
Status: in_force

In lieu of the bond required under section 3860 , the attorney may maintain on deposit with the Treasurer of State through the office of the superintendent, a like amount in cash or in value of securities qualified under this Title as insurers' investments, and subject to the same conditions as the bond. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 2002-A — ME Code / Title 24-A / Chapter 19 / Section 2002-A
24-A §2002-A. Exemptions from provisions
Status: in_force

1. The following kinds of insurance must be procured from authorized insurers and are not eligible for export in the surplus lines market: A. Life insurance; [PL 1993, c. 153, §16 (NEW).] B. Health insurance, except disability insurance; [PL 2025, c. 348, §12 (AMD).] C. Employee benefit excess insurance; or [PL 2025, c. 348, §12 (AMD).] D. Workers' compensation insurance. [PL 2025, c. 348, §12 (NEW).] [PL 2025, c. 348, §12 (AMD).]

2. This surplus lines law may not be used to place reinsurance. This subsection does not prohibit the cession or assumption of reinsurance, including reinsurance of workers' compensation self-insurers, as otherwise permitted by this Title. [PL 2025, c. 348, §13 (AMD).]

3. Producers with surplus lines authority may procure the following kinds of insurance from eligible surplus lines insurers without adherence to the procedures set forth in section 2004 or any other requirement to determine whether the full amount or type of insurance sought can be obtained from admitted insurers: A. Wet marine and transportation insurance; [PL 1993, c. 153, §16 (NEW).] B. Insurance on subjects located, resident or to be performed wholly outside of this State, or on vehicles or aircraft owned and principally garaged outside this State; [PL 1993, c. 153, §16 (NEW).] C. Insurance on operations of railroads engaged in transportation in interstate commerce and their property used in such operations; [PL 2011, c. 331, §2 (AMD); PL 2011, c. 331, §§16, 17 (AFF).] D. Insurance on aircraft owned or operated by manufacturers of aircraft or of aircraft operated in commercial interstate flight, or cargo of such aircraft, or against liability other than workers' compensation and employer's liability arising out of the ownership, maintenance or use of such aircraft; or [PL 2011, c. 331, §2 (AMD); PL 2011, c. 331, §§16, 17 (AFF).] E. Insurance placed by a producer with surplus lines authority for an exempt commercial purchaser if: (1) The producer has disclosed to the exempt commercial purchaser that such insurance may or may not be available from the admitted market that provides greater protection with more regulatory oversight; and (2) The exempt commercial purchaser has subsequently requested in writing for the producer to procure or place such insurance from a nonadmitted insurer. [PL 2011, c. 331, §2 (NEW); PL 2011, c. 331, §§16, 17 (AFF).] [PL 2011, c. 331, §2 (AMD); PL 2011, c. 331, §§16, 17 (AFF).]
24-A M.R.S. § 6914 — ME Code / Title 24-A / Chapter 87 / Section 6914
24-A §6914. Intragovernmental transfer
Status: in_force

Starting July 1, 2004, and ending September 30, 2012, Dirigo Health shall transfer funds, as necessary, to a special dedicated, nonlapsing revenue account administered by the agency of State Government that administers MaineCare for the purpose of providing a state match for federal Medicaid services provided to individuals eligible pursuant to Title 22, section 3174‑G, subsection 1, paragraph E whose nonfarm income is greater than 150% of the nonfarm income official poverty line and is below or equal to 200% of the nonfarm income official poverty line. Dirigo Health shall annually set the amount of contribution. [PL 2011, c. 477, Pt. Y, §1 (AMD).]

Beginning January 1, 2012, and ending September 30, 2012, Dirigo Health shall transfer funds as necessary to a special dedicated, nonlapsing revenue account administered by the agency of State Government that administers MaineCare for the purpose of providing a state match for federal Medicaid services provided to individuals eligible pursuant to Title 22, section 3174‑G, subsection 1, paragraph E whose nonfarm income is greater than 133% of the nonfarm income official poverty line and is below or equal to 150% of the nonfarm income official poverty line. Dirigo Health shall annually set the amount of contribution. [PL 2011, c. 477, Pt. Y, §1 (AMD).]

Beginning September 1, 2012, but not later than June 30, 2013, Dirigo Health shall transfer $7,210,000 from the Dirigo Health Enterprise Fund to the Medical Care - Payments to Providers, Other Special Revenue Funds account in the Department of Health and Human Services for the purpose of providing a state match for federal Medicaid services. [PL 2013, c. 1, Pt. X, §1 (AMD).]
24-A M.R.S. § 6094 — ME Code / Title 24-A / Chapter 72-A / Section 6094
24-A §6094. Risk retention groups chartered in this State
Status: in_force

A risk retention group shall be chartered and authorized, pursuant to the provisions of this title, as a liability insurer to write only liability insurance pursuant to this Act and, except as provided elsewhere in this Act, must comply with all the laws, rules and requirements applicable to insurers chartered and licensed in this State and with section 6095 to the extent these requirements are not a limitation on laws, rules or requirements of this State. Before it may offer insurance in any state, each risk retention group shall also submit for approval to the superintendent a plan of operation or a feasibility study and revisions of that plan or study if the group intends to offer any additional lines of liability insurance. The group shall not offer any additional kinds of liability insurance in this State or in any other state, until a revision of such plan or study is approved by the superintendent. [PL 1987, c. 481, §3 (NEW).]

In addition to other requirements for licensure, the risk retention group shall, at the time of filing its application for license, provide to the superintendent in summary form the following information: The identity of the initial members of the group, the identity of those individuals who organized the group or who will provide administrative services or otherwise influence or control the activities of the group, the amount, source and nature of initial capitalization, the coverages to be afforded, and the states in which the group intends to operate. Upon receipt of the information the superintendent shall forward it to the National Association of Insurance Commissioners. This notification shall not be deemed to satisfy other requirements of this chapter. [PL 1987, c. 481, §3 (NEW).]
24-A M.R.S. § 6302 — ME Code / Title 24-A / Chapter 75 / Section 6302
24-A §6302. Purpose
Status: in_force

The purpose of this chapter is to promote perinatal services in underserved areas of the State. [PL 1991, c. 734, §2 (AMD).]
24-A M.R.S. § 6902 — ME Code / Title 24-A / Chapter 87 / Section 6902
24-A §6902. Dirigo Health established; declaration of necessity
Status: in_force

Dirigo Health is established as an independent executive agency to arrange for the provision of comprehensive, affordable health care coverage to eligible small employers, including the self-employed, their employees and dependents, and individuals on a voluntary basis. Dirigo Health is also responsible for monitoring and improving the quality of health care in this State. The exercise by Dirigo Health of the powers conferred by this chapter must be deemed and held to be the performance of essential governmental functions. [PL 2003, c. 469, Pt. A, §8 (NEW).]
24-A M.R.S. § 786 — ME Code / Title 24-A / Chapter 9 / Section 786
24-A §786. Affiliation
Status: in_force

Notwithstanding the provisions of section 222 , the special purpose reinsurance vehicle, the special purpose reinsurance vehicle organizer or subsequent debt or equity investors in special purpose reinsurance vehicle securities are not deemed affiliates of the ceding insurer by virtue of the special purpose reinsurance vehicle contract between the ceding insurer and the reinsurance vehicle, the securities of the reinsurance vehicle or related agreements necessary to implement the special purpose reinsurance vehicle insurance securitization. [PL 2007, c. 386, §15 (AMD).]
24-A M.R.S. § 3304 — ME Code / Title 24-A / Chapter 47 / Section 3304
24-A §3304. Applicability of general corporation statutes
Status: in_force

Domestic stock and mutual insurers shall be governed by the applicable provisions of the general statutes of this State relating to private corporations organized for profit, as such statutes are now or hereafter may be constituted, except where such general statutes are in conflict with the express provisions of this Title and the reasonable implications thereof, and in which case the provisions of this Title shall govern. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2837-H — ME Code / Title 24-A / Chapter 35 / Section 2837-H
24-A §2837-H. Coverage for prostate cancer screening (REALLOCATED FROM TITLE 24-A, SECTION 2837-F)
Status: in_force

(REALLOCATED FROM TITLE 24-A, SECTION 2837-F)

1. Definition. As used in this section, "services for the early detection of prostate cancer" means the following procedures provided to a man for the purpose of early detection of prostate cancer: A. A digital rectal examination; and [RR 1997, c. 2, §52 (RAL).] B. A prostate-specific antigen test. [RR 1997, c. 2, §52 (RAL).] [RR 1997, c. 2, §52 (RAL).]

2. Required coverage for prostate cancer screening. All group insurance policies and contracts except accidental injury, specified disease, hospital indemnity, Medicare supplement, long-term care and other limited benefit health insurance policies and contracts must provide coverage for services for the early detection of prostate cancer. The contracts must reimburse for services for the early detection of prostate cancer, if recommended by a physician, at least once a year for men 50 years of age or older until a man reaches the age of 72. [RR 1997, c. 2, §52 (RAL).]

3. Application. The requirements of this section apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State on or after September 1, 1998. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [RR 1997, c. 2, §52 (RAL).]
24-A M.R.S. § 5078 — ME Code / Title 24-A / Chapter 68-A / Section 5078
24-A §5078. Rulemaking
Status: in_force

The superintendent shall adopt rules to promote premium adequacy, to protect a policyholder and a certificate holder in the event of substantial rate increases and to establish minimum standards for marketing practices, insurance producer compensation, insurance producer education, insurance producer testing, penalties and reporting practices for long-term care insurance. Rules adopted pursuant to this section are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2007, c. 232, §2 (AMD).]
24-A M.R.S. § 2764 — ME Code / Title 24-A / Chapter 33 / Section 2764
24-A §2764. Coverage for medically necessary infant formula (REALLOCATED FROM TITLE 24-A, SECTION 2763)
Status: in_force

(REALLOCATED FROM TITLE 24-A, SECTION 2763)

All individual health insurance policies, contracts and certificates must provide coverage for amino acid-based elemental infant formula for children 2 years of age and under in accordance with this section. [RR 2007, c. 2, §11 (RAL).]

1. Determination of medical necessity. Coverage for amino acid-based elemental infant formula must be provided when a licensed physician has submitted documentation that the amino acid-based elemental infant formula is medically necessary health care as defined in section 4301‑A, subsection 10‑A , that the amino acid-based elemental infant formula is the predominant source of nutritional intake at a rate of 50% or greater and that other commercial infant formulas, including cow milk-based and soy milk-based formulas have been tried and have failed or are contraindicated. A licensed physician may be required to confirm and document ongoing medical necessity at least annually. [RR 2007, c. 2, §11 (RAL).]

2. Method of delivery. Coverage for amino acid-based elemental infant formula must be provided without regard to the method of delivery of the formula. [RR 2007, c. 2, §11 (RAL).]

3. Required diagnosis. Coverage for amino acid-based elemental infant formula must be provided when a licensed physician has diagnosed and through medical evaluation has documented one of the following conditions: A. Symptomatic allergic colitis or proctitis; [RR 2007, c. 2, §11 (RAL).] B. Laboratory- or biopsy-proven allergic or eosinophilic gastroenteritis; [RR 2007, c. 2, §11 (RAL).] C. A history of anaphylaxis; [RR 2007, c. 2, §11 (RAL).] D. Gastroesophageal reflux disease that is nonresponsive to standard medical therapies; [RR 2007, c. 2, §11 (RAL).] E. Severe vomiting or diarrhea resulting in clinically significant dehydration requiring treatment by a medical provider; [RR 2007, c. 2, §11 (RAL).] F. Cystic fibrosis; or [RR 2007, c. 2, §11 (RAL).] G. Malabsorption of cow milk-based or soy milk-based infant formula. [RR 2007, c. 2, §11 (RAL).] [RR 2007, c. 2, §11 (RAL).]

4. Health savings accounts. Coverage for amino acid-based elemental infant formula under a health insurance policy, contract or certificate issued in connection with a health savings account as authorized under Title XII of the federal Medicare Prescription Drug, Improvement, and Modernization Act of 2003 may be subject to the same deductible and out-of-pocket limits that apply to overall benefits under the policy, contract or certificate. [RR 2007, c. 2, §11 (RAL).]
24-A M.R.S. § 2840-A — ME Code / Title 24-A / Chapter 35 / Section 2840-A
24-A §2840-A. Coverage for chiropractic services
Status: in_force

1. Therapeutic, adjustive and manipulative services. Notwithstanding any other provisions of this chapter, every insurer which issues group or blanket health care contracts providing coverage for the services of a "physician" or "doctor" to residents of this State shall provide coverage to any subscriber or other person covered under those contracts for those services when performed by a chiropractor, to the extent that the services are within the lawful scope of practice of a chiropractor licensed to practice in this State. Therapeutic, adjustive and manipulative services shall be covered whether performed by an allopathic, osteopathic or chiropractic doctor. [PL 1985, c. 516, §5 (NEW).]

2. Limits; coinsurance; deductibles. Any contract which provides coverage for the services required by this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section. [PL 1985, c. 516, §5 (NEW).]

3. Reports to the Superintendent of Insurance. Every insurer subject to this section shall report its experience for each calendar year to the Superintendent of Insurance not later than April 30th of the following year. The report must be in a form prescribed by the superintendent and include the amount of claims paid in this State for the services required by this section and the total amount of claims paid in this State for health care contracts. The report must include complaints concerning access to services under this section and the results of those complaints. The superintendent shall compile this data for all insurers in an annual report. [PL 1993, c. 669, §3 (AMD).]

4. Application; expiration. [PL 1989, c. 141, §6 (RP).]

5. Reimbursement; discrimination. An insurer subject to this section may not refuse to reimburse a chiropractic provider who participates in the insurer's provider network for providing a health care service or procedure covered by the insurer as long as the chiropractic provider is acting within the lawful scope of that provider's license in the delivery of the covered service or procedure. Consistent with reasonable medical management techniques specified under the insurer's contract with respect to the method, treatment or setting for a covered service or procedure, the insurer may not discriminate based on the chiropractic provider's license. This subsection does not require an insurer to accept all chiropractic providers into a network or govern the amount of the reimbursement paid to a chiropractic provider. [PL 2015, c. 111, §2 (NEW); PL 2015, c. 111, §4 (AFF).]
24-A M.R.S. § 7755 — ME Code / Title 24-A / Chapter 103 / Section 7755
24-A §7755. MaineCare program not affected
Status: in_force

This chapter does not apply to the MaineCare program as a payor when the MaineCare program provides reimbursement for covered outpatient drugs as defined in 42 United States Code, Section 1396r-8(k)(2). [PL 2025, c. 388, Pt. P, §5 (NEW).]
24-A M.R.S. § 6207 — ME Code / Title 24-A / Chapter 73 / Section 6207
24-A §6207. Continuing care agreement; condominium
Status: in_force

Pursuant to a continuing care agreement, a subscriber may purchase or may be the beneficiary of a purchase of a condominium as defined in Title 33, section 1601‑103, subsection 7 . With respect to a continuing care agreement pursuant to which a condominium will be purchased the following provisions are applicable: [PL 1987, c. 482, §1 (NEW).]

1. Copy of declaration; filing. A copy of the declaration prepared pursuant to the Maine Condominium Act, Title 33, chapter 31 , along with a copy of any registration statement filed with the United States Securities and Exchange Commission or the Office of Securities, must be filed with the superintendent prior to the sale of any of the condominium units; and [PL 2001, c. 182, §7 (AMD).]

2. Bylaws and rules; filing. The bylaws and rules of the unit owners' association shall be filed with the superintendent for informational purposes. [PL 1987, c. 482, §1 (NEW).]

Any materials required to be filed with the superintendent pursuant to this chapter and contained in the declaration, public offering statements, bylaws or rules of the unit owners' association may be submitted in that format to the superintendent. Any disclosure requirements contained in this chapter may be satisfied by the timely delivery of the documents described in this section to the subscriber, supplemented where necessary by any additional information required pursuant to this chapter. [PL 1987, c. 482, §1 (NEW).]