24-A M.R.S. § 707 — ME Code / Title 24-A / Chapter 9 / Section 707
24-A §707. "Casualty insurance" defined
Status: in_force

1. Casualty insurance includes: A. Vehicle insurance. Insurance against loss of or damage to any land vehicle or aircraft or any draft or riding animal or to property while contained therein or thereon or being loaded or unloaded therein or therefrom, from any hazard or cause, and against any loss, liability or expense resulting from or incidental to ownership, maintenance or use of any such vehicle, aircraft or animal; together with insurance against accidental injury to individuals, irrespective of legal liability of the insured, including the named insured, while in, entering, alighting from, adjusting, repairing, cranking or caused by being struck by a vehicle, aircraft or draft or riding animal, if such insurance is issued as an incidental part of insurance on the vehicle, aircraft or draft or riding animal; [PL 1969, c. 132, §1 (NEW).] B. Liability insurance. Insurance against legal liability for the death, injury or disability of any human being, or for damage to property; and provision of medical, hospital, surgical, disability benefits to injured persons and funeral and death benefits to dependents, beneficiaries or personal representatives of persons killed, irrespective of legal liability of the insured, when issued as an incidental coverage with or supplemental to liability insurance; [PL 1969, c. 132, §1 (NEW).] C. Workers' compensation and employer's liability. Insurance, written on a primary basis, of the obligations accepted by, imposed upon or assumed by employers under law for death, disablement or injury of employees; [PL 1991, c. 872, §1 (AMD).] C-1. Employee benefit excess insurance. Insurance, protecting an employer against higher than expected obligations under an employee benefit plan, at retention levels that do not have the effect of making the plan an insured plan. Reinsurance provided to employers that self-insure their workers' compensation exposures pursuant to Title 39‑A, section 403 does not constitute employee benefit excess insurance. The transaction of employee benefit excess insurance does not constitute the conduct of the business of reinsurance; [PL 2007, c. 466, Pt. D, §4 (AMD).] D. Burglary and theft. Insurance against loss or damage by burglary, theft, larceny, robbery, forgery, fraud, vandalism, malicious mischief, confiscation or wrongful conversion, disposal or concealment, or from any attempt at any of the foregoing; including supplemental coverage for medical, hospital, surgical and funeral expense incurred by the named insured or any other person as a result of bodily injury during the commission of a burglary, robbery or theft by another; also insurance against loss of or damage to moneys, coins, bullion, securities, notes, drafts, acceptances or any other valuable papers and documents, resulting from any cause; [PL 1969, c. 132, §1 (NEW).] E. Personal property floater. Insurance upon personal effects against loss or damage from any cause; [PL 1969, c. 132, §1 (NEW).] F. Glass. Insurance against loss or damage to glass, including its lettering, ornamentation and fittings; [PL 1969, c. 132, §1 (NEW).] G. Boiler and machinery. Insurance against any liability and loss or damage to property or interest resulting from accidents to or explosions of boilers, pipes, pressure containers, machinery or apparatus, and to make inspection of and issue certificates of inspection upon boilers, machinery and apparatus of any kind, whether or not insured; [PL 1969, c. 132, §1 (NEW).] H. Leakage and fire extinguishing equipment. Insurance against loss or damage to any property or interest caused by the breakage or leakage of sprinklers, hoses, pumps and other fire extinguishing equipment or apparatus, water pipes or containers, or by water entering through leaks or openings in buildings, and insurance against loss or damage to such sprinklers, hoses, pumps and other fire extinguishing equipment or apparatus; [PL 1969, c. 132, §1 (NEW).] I. Credit. Insurance against loss or damage resulting from failure of debtors to pay their obligations to the insured; [PL 1969, c. 132, §1 (NEW).] J. Malpractice. Insurance against legal liability of the insured, and against loss, damage or expense incidental to a claim of such liability, and including medical hospital, surgical and funeral benefits to injured persons, irrespective of legal liability of the insured, arising out of the death, injury or disablement of any person, or arising out of damage to the economic interest of any person, as the result of negligence in rendering expert, fiduciary or professional service; [PL 1969, c. 132, §1 (NEW).] K. Elevator. Insurance against loss of or damage to any property of the insured, resulting from the ownership, maintenance or use of elevators, except loss or damage by fire, and to make inspection of and issue certificates of inspection upon elevators; [PL 1969, c. 132, §1 (NEW).] L. Congenital defects. Insurance against congenital defects in human beings; [PL 1969, c. 132, §1 (NEW).] M. Livestock. Insurance against loss or damage to livestock, and services of a veterinary for such animals; [PL 1969, c. 132, §1 (NEW).] N. Entertainments. Insurance indemnifying the producer of any motion picture, television, radio, theatrical, sport, spectacle, entertainment or similar production, event or exhibition against loss from interruption, postponement or cancellation thereof due to death, accidental injury or sickness of performers, participants, directors or other principals; [PL 1969, c. 132, §1 (NEW).] N-1. Involuntary unemployment. Insurance against the loss of income due to a permanent or temporary job loss or job change. Involuntary unemployment insurance may include labor dispute coverage. Governmental benefit programs are not considered involuntary unemployment insurance for purposes of this Title; and [PL 2001, c. 138, §2 (NEW).] O. Miscellaneous. Insurance against any other kind of loss, damage or liability properly a subject of insurance and not within any other kind of insurance as defined in this subchapter, if such insurance is not disapproved by the superintendent as being contrary to law or public policy. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).] [PL 2007, c. 466, Pt. D, §4 (AMD).]

2. Provision of medical, hospital, surgical and funeral benefits, and of coverage against accidental death or injury, as incidental to and part of other insurance as stated under subsection 1, paragraphs A (vehicle), B (liability), D (burglary), G (boiler and machinery), J (malpractice) and K (elevator) shall for all purposes be deemed to be the same kind of insurance to which it is so incidental, and shall not be subject to provisions of this Title applicable to life and health insurances. [PL 1969, c. 132, §1 (NEW).]

3. An insurer other than a casualty insurer may transact employee benefit excess insurance only if that insurer is authorized to insure the class of risk assumed by the underlying benefit plan. Employee benefit excess insurance, even if written by a life or health insurer, is not subject to chapters 29 and 31 to 37 , except to the extent that particular provisions are made expressly applicable by rule or law. No later than July 1, 1997, the superintendent shall by rule set standards distinguishing excess insurance from basic insurance. In developing these standards, the superintendent may consider the analysis supporting the recommendations of the National Association of Insurance Commissioners. [PL 1995, c. 673, Pt. B, §2 (AMD).]
24-A M.R.S. § 4618 — ME Code / Title 24-A / Chapter 62 / Section 4618
24-A §4618. Stay of proceedings; reopening default judgments
Status: in_force

All proceedings in which the impaired insurer is a party in any court in this State shall be stayed 60 days from the date an order of liquidation, rehabilitation or conservation is final to permit proper legal action by the association on any matters germane to its powers or duties. As to a judgment under any decision, order, verdict or finding based on default, the association may apply to have the judgment set aside by the same court that made the judgment and shall be permitted to defend against the suit on the merits. [PL 1983, c. 846 (NEW).]
24-A M.R.S. § 419 — ME Code / Title 24-A / Chapter 5 / Section 419
24-A §419. Duration of suspension; insurer's obligation during suspension period; reinstatement
Status: in_force

1. The suspension of an insurer's certificate of authority must be for such period as the superintendent specifies in the order of suspension. During the suspension period, the superintendent may rescind or shorten the suspension period by further order. The superintendent may reinstate the insurer's certificate of authority upon written request of the insurer if the superintendent finds that the causes of the suspension are no longer continuing and that the insurer is otherwise in compliance with the requirements of this Title. [PL 1995, c. 570, §2 (AMD).]

2. During the suspension period, the insurer shall not solicit or write any new business in this State, but shall file its annual statement, pay fees, licenses and taxes as required under this Title, and may service its business already in force in this State, as if the certificate of authority had continued in full force. [PL 1983, c. 419, §5 (AMD).]

3. Upon expiration of the suspension period, if within that period the certificate of authority has not terminated, the insurer's certificate of authority shall reinstate unless the superintendent finds that the causes of the suspension are continuing, or that the insurer is otherwise not in compliance with the requirements of this Title. [PL 1983, c. 419, §5 (AMD).]

4. Upon reinstatement of the insurer's certificate of authority, the authority of its agents in this State to represent the insurer shall likewise reinstate. The superintendent shall promptly notify the insurer and its agents in this State, of record in the bureau, of that reinstatement. [PL 1983, c. 419, §5 (AMD).]
24-A M.R.S. § 4309 — ME Code / Title 24-A / Chapter 56-A / Section 4309
24-A §4309. Adoption of rules
Status: in_force

The superintendent shall adopt rules and establish standards for health plans in order to carry out the purposes of this chapter. 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. C, §1 (NEW); PL 1995, c. 673, Pt. C, §2 (AFF).]
24-A M.R.S. § 1482 — ME Code / Title 24-A / Chapter 16 / Section 1482
24-A §1482. Educational requirements
Status: in_force

As a prerequisite to maintaining a license, licensees must complete a continuing education requirement every 2 years in programs or courses approved by the superintendent. The superintendent may establish by rule the amount of continuing education credit hours, not to exceed 30 hours, required under this section. Rules adopted pursuant to this section are routine technical rules pursuant to Title 5, chapter 375, subchapter 2‑A . The superintendent may, for good cause shown, grant an extension of time to any person to allow that person to comply with this subchapter. [PL 2005, c. 43, §3 (AMD).]
24-A M.R.S. § 2692 — ME Code / Title 24-A / Chapter 32-A / Section 2692
24-A §2692. Definitions
Status: in_force

As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 2001, c. 410, Pt. C, §1 (NEW).]

1. Certificate. "Certificate" means a statement of the coverage and provisions of a policy of group health insurance that has been delivered or issued for delivery in this State. "Certificate" includes riders, endorsements and enrollment forms, if attached. [PL 2001, c. 410, Pt. C, §1 (NEW).]

2. Dental plan. "Dental plan" means insurance written to provide coverage for dental treatment. [PL 2001, c. 410, Pt. C, §1 (NEW).]

3. Direct response advertising. "Direct response advertising" means a solicitation through a sponsoring or endorsing entity or individually through mail, telephone, the Internet or other mass communication media. [PL 2001, c. 410, Pt. C, §1 (NEW).]

4. Form. "Form" means a policy, contract, rider, endorsement or application as provided in section 2412 . [PL 2001, c. 410, Pt. C, §1 (NEW).]

5. Policy. "Policy" means an entire contract between the insurer and the insured, including riders, endorsements and the application, if attached. [PL 2001, c. 410, Pt. C, §1 (NEW).]

6. Vision care plan. "Vision care plan" means insurance written to provide coverage for eye care. [PL 2001, c. 410, Pt. C, §1 (NEW).]
24-A M.R.S. § 4320-S — ME Code / Title 24-A / Chapter 56-A / Section 4320-S
24-A §4320-S. Coverage for dental services for cancer patients
Status: in_force

1. Required coverage. Except as provided in subsection 2 , a carrier offering a health plan in this State shall provide coverage for medically necessary dental procedures in accordance with the following for an enrollee who has been diagnosed with cancer. A. Coverage must be provided for fluoride treatment and dental procedures that are medically necessary to reduce the risk of infection or eliminate infection or to treat tooth loss or decay in an enrollee prior to beginning cancer treatment, including chemotherapy, biological therapy or radiation therapy treatment. [PL 2021, c. 683, §1 (NEW).] B. Coverage must be provided for dental procedures that are medically necessary to reduce the risk of infection or eliminate infection or to treat tooth loss or decay that are the direct or indirect result of cancer treatment, including chemotherapy, biological therapy or radiation therapy treatment. [PL 2021, c. 683, §1 (NEW).] C. Coverage required under this subsection must include coverage for laboratory assessments, medications and treatments. [PL 2021, c. 683, §1 (NEW).] [PL 2021, c. 683, §1 (NEW).]

2. Routine preventive dental care not required. A carrier is not required to provide coverage for routine preventive dental care, including cleaning and sealants. [PL 2021, c. 683, §1 (NEW).]

Revisor's Note: §4320-S. Coverage for fertility services (As enacted by PL 2021, c. 692, §1 is REALLOCATED TO TITLE 24-A, SECTION 4320-U)
24-A M.R.S. § 2671 — ME Code / Title 24-A / Chapter 32 / Section 2671
24-A §2671. Definitions
Status: in_force

As used in this chapter, unless the context indicates otherwise, the following terms have the following meanings. [PL 1985, c. 704, §4 (NEW).]

1. "Administrator" means any person, other than a carrier, that administers a preferred provider arrangement. An administrator does not include a health maintenance organization licensed pursuant to chapter 56 or a nonprofit health care plan regulated by the superintendent pursuant to Title 24 . An employer exempt from the applicability of this chapter under the federal Employee Retirement Income Security Act of 1974, 29 United States Code, Sections 1001 to 1461 (1988) is not considered an administrator. [PL 1999, c. 609, §5 (AMD).]

1-A. "Capitation" has the same meaning as defined in section 4331, subsection 2 . [PL 1999, c. 609, §5 (NEW).]

2. [PL 1999, c. 609, §5 (RP).]

2-A. "Carrier" means an insurance company licensed in accordance with this Title, a fraternal benefit society authorized pursuant to chapter 55 or a nonprofit hospital or medical service organization licensed pursuant to Title 24 . An employer exempted from the applicability of this chapter under the federal Employee Retirement Income Security Act of 1974, 29 United States Code, Sections 1001 to 1461 (1988) is not considered a carrier. [PL 1999, c. 609, §5 (NEW).]

2-B. "Enrollee" means an individual entitled to reimbursement for expenses of health care services under a health plan. [PL 1999, c. 609, §5 (NEW).]

3. "Health care services" means health care services or products rendered or sold by a provider within the scope of the provider's legal authorization. [PL 1985, c. 704, §4 (NEW).]

3-A. "Health plan" means a plan offered or administered by a carrier that provides for the financing or delivery of health care services to persons enrolled in the plan. [PL 1999, c. 609, §5 (NEW).]

4. [PL 1999, c. 609, §5 (RP).]

5. [PL 1999, c. 609, §5 (RP).]

6. "Preferred provider" means a provider who enters into a preferred provider arrangement with an administrator or carrier. [PL 1999, c. 609, §5 (AMD).]

7. "Preferred provider arrangement" means a contract, agreement or arrangement between a carrier or administrator and a provider in which the provider agrees to provide services to a health plan enrollee whose plan benefits include incentives for the enrollee to use the services of that provider. [PL 1999, c. 609, §5 (AMD).]

8. "Provider" means an individual or entity duly licensed or otherwise legally authorized to provide health care services, including, but not limited to, the treatment of physical health and mental health and provision for medical supplies and pharmaceutical supplies. [PL 1999, c. 609, §5 (AMD).]

9. "Superintendent" means the Superintendent of Insurance. [PL 1999, c. 609, §5 (AMD).]
24-A M.R.S. § 766 — ME Code / Title 24-A / Chapter 9 / Section 766
24-A §766. Authority of the insurance regulatory official
Status: in_force

1. Transfer in the best interest of the policyholders. If an insurer domiciled in this State or in a jurisdiction having a substantially similar law is determined by the domiciliary insurance regulatory official to be in hazardous financial condition or an administrative proceeding has been instituted against it for the purpose of reorganizing or conserving the insurer, and the transfer of the contracts of insurance is in the best interest of the policyholders, as determined by the domiciliary insurance regulatory official, a transfer and novation may be effected notwithstanding the provisions of this subchapter. This may include a form of implied consent and adequate notification to the policyholder of the circumstances requiring the transfer as approved by the insurance regulatory official. [PL 1993, c. 603 (NEW).]

2. Protection. Notwithstanding any other provision of law, in the event that a transfer and novation is effected by a decision of a domiciliary insurance regulatory official under this section, the residents of this State whose policies are transferred to an unlicensed insurer are entitled to full protection under chapter 57, subchapter III and chapter 62 . [PL 1993, c. 603 (NEW).]
24-A M.R.S. § 1131 — ME Code / Title 24-A / Chapter 13 / Section 1131
24-A §1131. Miscellaneous investments
Status: in_force

1. An insurer may make loans or investments, not otherwise eligible, qualified or expressly permitted under this chapter, in an aggregate amount not over 10% of the insurer's assets and not over 1% of those assets as to any one such loan or investment. The investment limitations contained in this chapter, qualitative or quantitative or otherwise, shall not apply to loans or investments under this section, provided that all loans or investments made or acquired under this section shall meet the following requirements. A. The loan or investment must fulfill the requirements of section 1103 and otherwise qualify as a sound investment. [PL 2001, c. 72, §12 (AMD).] B. No such loan or investment may be represented by: (1) Any asset determined to be nonadmitted pursuant to section 901‑A or rules adopted under that section; (2) Any loan or investment expressly prohibited under section 1136 ; or (3) Agents' balances, or amounts advanced to or owing by agents, except as to mortgage loans and collateral loans to those agents otherwise authorized under this chapter. [PL 2001, c. 72, §12 (AMD).] C. No loan or investment may cause the insurer to exceed the specific diversification requirements enumerated in section 1106 . [PL 1987, c. 399, §12 (RPR).] [PL 2001, c. 72, §12 (AMD).]

2. The insurer shall keep a separate record of all loans and investments made under this section. Any such loan or investment that subsequent to the date of making or acquisition thereof has attained the standard of eligibility and qualifies under any other section of this chapter may thereupon be deemed to have been made or acquired under and in compliance with that section and shall no longer be considered to have been made or acquired under this section. [PL 1979, c. 458, §12 (RPR).]
24-A M.R.S. § 3487 — ME Code / Title 24-A / Chapter 47 / Section 3487
24-A §3487. Redomestication of insurers
Status: in_force

1. Redomestication of foreign insurers to Maine. Any stock or mutual insurer that is organized under the laws of any other state and has a valid certificate of authority to do business in this State may become a domestic insurer with approval of the superintendent by amending its articles of incorporation or equivalent corporate charter and by designating a location in this State as its principal place of business. The redomestication must be approved if the chief insurance regulatory official of the other state certifies to the superintendent that the redomestication is in compliance with all requirements established by the laws of that state, and the superintendent determines that the insurer's operations and corporate organization will comply with the requirements of this chapter and that the redomestication is not contrary to the interests of policyholders or the public. The amendments to the insurer's articles of incorporation may provide that the corporation is a continuation of the corporate identity of the original foreign corporation and that the original date of incorporation in its original domiciliary state is the date of incorporation of the domestic insurer. The insurer's certificate of authority must be amended as of the effective date of the superintendent's approval to reflect the insurer's status as a domestic insurer and its new home office, and the insurer is thereafter subject to all provisions of this Title applicable to domestic insurers. [PL 2013, c. 299, §19 (AMD).]

2. Redomestication of domestic insurers. Any domestic insurer may, upon the approval of the superintendent, transfer its domicile to any other state in which it is authorized to transact the business of insurance in accordance with the procedures established by the laws of that state. The proposed redomestication must be approved if the superintendent determines that the articles of incorporation have been amended in conformance with section 3310 and that the redomestication is not contrary to the interests of policyholders or the public. The insurer ceases to be a domestic insurer as of the date the redomestication is recognized by its new state of domicile. Unless the superintendent determines that the insurer no longer qualifies for a certificate of authority, the insurer's certificate of authority must be amended as of the effective date of the redomestication to reflect the insurer's status as a domestic insurer and its new home office in its new state of domicile, and the insurer is thereafter subject to all provisions of this Title applicable to foreign insurers. [PL 2013, c. 299, §19 (AMD).]

3. Effect of redomestication. The certificate of authority, producers' appointments and licenses, rate approvals and all other actions and permissions by the superintendent that are in effect at the time any insurer authorized to transact the business of insurance in this State transfers its corporate domicile to this State or any other state pursuant to this section or by merger, consolidation or any other lawful method continue in full force and effect upon the redomestication if the insurer remains duly qualified to transact the business of insurance in this State. All outstanding policies and other legal or contractual obligations of any redomesticating insurer remain in full force and need not be endorsed as to the new name of the company or its new location unless ordered by the superintendent. The insurer shall file new policy forms with the superintendent on or before the effective date of the redomestication but may use existing policy forms with appropriate endorsements if allowed by and under such conditions as approved by the superintendent. Each redomesticating insurer shall notify the superintendent of the details of the proposed redomestication and shall file promptly any resulting amendments to corporate documents filed or required to be filed with the superintendent. [PL 1999, c. 113, §23 (NEW).]

4. Filing with Secretary of State. Each insurer that transfers its domicile to this State shall file with the Secretary of State a long-form certificate of good standing or its equivalent, duly certified by the proper official of the previous state of domicile and an application for redomestication to become a Maine insurer in a form prescribed by the Secretary of State and approved by the superintendent. Each foreign insurer qualified to do business in this State that transfers its domicile to a state other than Maine shall file with the Secretary of State a notification by a foreign insurer of redomestication in a form prescribed by the Secretary of State and approved by the superintendent. Each domestic insurer that transfers its domicile to another state shall file with the Secretary of State a notification of redomestication in a form prescribed by the Secretary of State and approved by the superintendent. [RR 1999, c. 1, §36 (COR).]
24-A M.R.S. § 1108 — ME Code / Title 24-A / Chapter 13 / Section 1108
24-A §1108. Obligations, stock of certain federal and international agencies
Status: in_force

An insurer may invest in the obligations, or stock where stated, issued, assumed or guaranteed by the following agencies of the government of the United States of America, or in which such government is a participant, whether or not such obligations are guaranteed by such government: [PL 1969, c. 132, §1 (NEW).]

1. Farm Loan Bank. [PL 1969, c. 132, §1 (NEW).]

2. Commodity Credit Corporation. [PL 1969, c. 132, §1 (NEW).]

3. Federal Intermediate Credit Banks. [PL 1969, c. 132, §1 (NEW).]

4. Federal Land Banks. [PL 1969, c. 132, §1 (NEW).]

5. Central Bank for Cooperatives. [PL 1969, c. 132, §1 (NEW).]

6. Federal Home Loan Banks, and stock thereof. [PL 1969, c. 132, §1 (NEW).]

7. Federal National Mortgage Association, and stock thereof when acquired in connection with sale of mortgage loans to such association. [PL 1969, c. 132, §1 (NEW).]

8. International Bank for Reconstruction and Development. [PL 1969, c. 132, §1 (NEW).]

9. Inter-American Development Bank. [PL 1969, c. 132, §1 (NEW).]

10. Asian Development Bank. [PL 1969, c. 132, §1 (NEW).]

10-A. African Development Bank; and [PL 1987, c. 405, §36 (NEW).]

11. Any other similar agency of, or participated in by, the government of the United States of America and of similar financial quality. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 1493 — ME Code / Title 24-A / Chapter 16 / Section 1493
24-A §1493. License and registration requirement
Status: in_force

1. In-state risks. A person may not act in the capacity of an MGA with respect to risks located in this State for an insurer licensed in this State unless that person holds a valid Maine producer license and appointment authorizing the producer to sell the applicable kinds of insurance and unless registered with the superintendent as a managing general agent pursuant to subsection 5 . [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]

2. Out-of-state risks. A person may not act in the capacity of an MGA representing an insurer domiciled in this State with respect to risks located outside this State unless that person holds a valid Maine producer license and appointment in this State and unless registered with the superintendent as a managing general agent pursuant to subsection 5 . [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]

3. Bond. The superintendent may require a bond in an amount acceptable to the superintendent for the protection of the insurer. [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]

4. Errors and omissions policy. The superintendent may require the MGA to maintain an errors and omissions policy. [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]

5. Application. Each managing general agent shall file with the superintendent an application for registration as a managing general agent and shall pay the fee in section 601 . A. The superintendent shall prescribe, consistent with the applicable requirements of this subchapter, and furnish forms required under this subchapter in connection with application for an issuance of registration certificates and for notification of termination of contracts pursuant to section 1495 . [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] B. The application for registration must include the name and address of the insurer with whom the producer has an appointment pursuant to section 1420‑M and with whom the producer has a written contract pursuant to section 1494 , a statement of the duties that the producer is expected to perform on behalf of the insurer, the lines of insurance for which the producer is to be authorized to act and any other information the superintendent requests. [PL 2001, c. 259, §46 (AMD).] C. If the superintendent finds that the application is complete, the superintendent shall promptly issue a certificate of registration to the producer; otherwise, the superintendent shall refuse to issue the registration and promptly notify the producer and the insurer of the refusal, stating the grounds for refusal. The producer may request a hearing on the superintendent's denial pursuant to section 229 . [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] [PL 2001, c. 259, §46 (AMD).]

6. Duration. Unless notification of termination of contract is received pursuant to section 1495 , the certificate of registration remains in effect as long as the registrant continues to hold a valid Maine producer license and as long as the registrant complies with the provisions of this subchapter. A certificate of registration expires upon receipt by the superintendent of notification of termination of contract pursuant to section 1495 or upon notification of termination of the producer's license and the registrant shall promptly deliver the certificate of registration to the superintendent. [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]
24-A M.R.S. § 6718 — ME Code / Title 24-A / Chapter 83 / Section 6718
24-A §6718. Rules
Status: in_force

1. Authority. The superintendent may adopt rules to implement this chapter. Rules adopted pursuant to this subsection are major substantive rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2013, c. 238, Pt. E, §5 (NEW).]

2. Risk retention groups. Notwithstanding section 6719 , the superintendent shall adopt rules establishing financial standards and corporate governance standards for captive insurance companies that are risk retention groups as defined in section 6093, subsection 13 . Such rules may include, but are not limited to, rules making specified provisions of this Title applicable to captive insurance companies that are risk retention groups, subject to any modifications that the superintendent determines to be appropriate to the nature of a risk retention group's business. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2013, c. 238, Pt. E, §5 (NEW).]
24-A M.R.S. § 2725 — ME Code / Title 24-A / Chapter 33 / Section 2725
24-A §2725. Unpaid premiums
Status: in_force

There may be a provision as follows: Unpaid premium: Upon the payment of a claim under this policy, any premium then due and unpaid or covered by any note or written order may be deducted therefrom. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2773 — ME Code / Title 24-A / Chapter 34 / Section 2773
24-A §2773. Utilization review services
Status: in_force

As used in this chapter, unless the context indicates otherwise, "utilization review services" or "medical utilization review services" means a program or process by which a person, partnership or corporation, on behalf of an insurer, nonprofit service organization, 3rd-party administrator, health maintenance organization, preferred provider organization or employer that is a payor for or that arranges for payment of medical services, seeks to review the utilization, appropriateness or quality of medical services provided to a person whose medical services are paid for, partially or entirely, by that insurer, nonprofit service organization, 3rd-party administrator, health maintenance organization, preferred provider organization or employer. The terms include these programs or processes whether they apply prospectively or retrospectively to medical services. Utilization review services include, but are not limited to, the following: [PL 1993, c. 602, §7 (AMD).]

1. Second opinion programs. Second opinion programs; [PL 1989, c. 556, Pt. C, §2 (NEW).]

2. Prehospital admission certification. Prehospital admission certification; [PL 1989, c. 556, Pt. C, §2 (NEW).]

3. Preinpatient service eligibility certification. Preinpatient service eligibility certification; and [PL 1989, c. 556, Pt. C, §2 (NEW).]

4. Concurrent hospital review. Concurrent hospital review to determine appropriate length of stay. [PL 1989, c. 556, Pt. C, §2 (NEW).]
24-A M.R.S. § 2324 — ME Code / Title 24-A / Chapter 25 / Section 2324
24-A §2324. Interchange of rating plan data; consultation; cooperative action in rate-making
Status: in_force

1. Acting in accordance with the procedures set forth in the Maine Administrative Procedure Act, Title 5, chapter 375, subchapter II , the superintendent may promulgate reasonable rules and plans for the interchange of data necessary for the application of rating plans. [PL 1977, c. 694, §419 (RPR).]

2. In order to further uniform administration of rate regulatory laws, the superintendent and every insurer, advisory organization and rating organization may to the extent consistent with this chapter exchange information and experience data with insurance supervisory officials, insurers and rating organizations in other states and may consult with them with respect to rate making and the application of rating systems. [PL 1989, c. 797, §28 (AMD); PL 1989, c. 797, §§37, 38 (AFF).]

3. Cooperation among rating organizations, advisory organizations and insurers in activities related to rate making or in other matters within the scope of this chapter is authorized, but the filings resulting from such cooperation are subject to all provisions of this chapter which are applicable to filings generally. The superintendent may review such cooperative activities and practices and if, after a hearing, the superintendent finds that any such activity or practice is unfair or unreasonable or otherwise inconsistent with this chapter, the superintendent may issue a written order specifying in what respects such activity or practice is unfair or unreasonable or otherwise inconsistent with this chapter, and requiring the discontinuance of such activity or practice. [PL 1989, c. 797, §28 (AMD); PL 1989, c. 797, §§37, 38 (AFF).]
24-A M.R.S. § 3004 — ME Code / Title 24-A / Chapter 41 / Section 3004
24-A §3004. Lines numbered consecutively
Status: in_force

The lines of the conditions of the standard fire insurance policy shall be numbered consecutively at the option of the superintendent. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 2403 — ME Code / Title 24-A / Chapter 27 / Section 2403
24-A §2403. "Premium" defined
Status: in_force

"Premium" is the consideration for insurance, by whatever name called. Any "assessment", or any "membership", "policy", "survey", "inspection", "service" or similar fee or other charge in consideration for an insurance contract is deemed part of the premium. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2767 — ME Code / Title 24-A / Chapter 33 / Section 2767
24-A §2767. Coverage for children's early intervention services (REALLOCATED FROM TITLE 24-A, SECTION 2766)
Status: in_force

(REALLOCATED FROM TITLE 24-A, SECTION 2766)

1. Definition. For purposes of this section, "children's early intervention services" means services provided by licensed occupational therapists, physical therapists, speech-language pathologists or clinical social workers working with children from birth to 36 months of age with an identified developmental disability or delay as described in the federal Individuals with Disabilities Education Act, Part C, 20 United States Code, Section 1411, et seq. [PL 2011, c. 420, Pt. A, §23 (RAL).]

2. Required coverage. All individual health insurance policies, contracts and certificates must provide coverage for children's early intervention services in accordance with this subsection. A. A referral from the child's primary care provider is required. [PL 2011, c. 420, Pt. A, §23 (RAL).] B. The policy, contract or certificate may limit coverage to $3,200 per year for each child not to exceed $9,600 by the child's 3rd birthday. [PL 2011, c. 420, Pt. A, §23 (RAL).] C. The policy, contract or certificate 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 2011, c. 420, Pt. A, §23 (RAL).] [PL 2011, c. 420, Pt. A, §23 (RAL).]
24-A M.R.S. § 6217 — ME Code / Title 24-A / Chapter 73 / Section 6217
24-A §6217. Penalties and enforcement
Status: in_force

1. Cease and desist order. The superintendent may issue an order directing a provider to cease and desist from engaging in any act or practice in violation of this chapter. [PL 1987, c. 482, §1 (NEW).]

2. Superior Court. In the case of any violation under this chapter, if the superintendent elects not to issue a cease and desist order or in the event of noncompliance with a cease and desist order issued pursuant to this section, the superintendent may apply to the Superior Court to issue an injunction restraining the company in whole or in part from proceeding further with its business or may apply for an order of the court to command performance consistent with contractual obligations of the provider. [PL 1987, c. 482, §1 (NEW).]

3. Civil penalties. A person or organization in violation of this chapter shall be subject to a civil penalty of not more than $1,000 for each violation, payable to the State, to be recovered in a civil action. If a violation is willful, the person or organization shall be subject to a civil penalty of not more than $10,000 for each violation, payable to the State, to be recovered in a civil action. These penalties may be in addition to any other penalty provided by law. A separate violation may be held to exist for each day that the violation continues. [PL 1987, c. 482, §1 (NEW).]

4. Class E crime. Any person that violates any provision of this chapter commits a Class E crime. Each violation of this chapter shall constitute a separate offense. [PL 1987, c. 482, §1 (NEW).]
24-A M.R.S. § 2745-E — ME Code / Title 24-A / Chapter 33 / Section 2745-E
24-A §2745-E. Off-label use of prescription drugs for cancer
Status: in_force

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Medically accepted indication" includes any use of a drug that has been approved by the federal Food and Drug Administration and includes another use of the drug if that use is supported by one or more citations in the standard reference compendia or if the insurer involved, based upon guidance provided by the federal Department of Health and Human Services Medicare program pursuant to 42 United States Code, Section 1395x(t), determines that that use is medically accepted based on supportive clinical evidence in peer-reviewed medical literature. [PL 1997, c. 701, §2 (NEW).] B. "Off-label use" means the prescription and use of drugs for medically accepted indications other than those stated in the labeling approved by the federal Food and Drug Administration. [PL 1997, c. 701, §2 (NEW).] C. "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, §2 (NEW).] D. "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, §2 (NEW).] [PL 1997, c. 701, §2 (NEW).]

2. Required coverage for off-label use. All individual insurance policies and contracts that provide coverage for prescription drugs must provide coverage for off-label use in accordance with the following. A. Individual insurance policies and contracts that provide coverage for prescription drugs may not exclude coverage for any such drug used for the treatment of cancer for a medically accepted indication on the grounds that the drug has not been approved by the federal Food and Drug Administration for that indication, as long as use of that drug is a medically accepted indication for the treatment of cancer. [PL 1997, c. 701, §2 (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, §2 (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, §2 (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, §2 (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, §2 (NEW).] [PL 1997, c. 701, §2 (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, §2 (NEW).]

Revisor's Note: : §2745-E. Coverage for prostate cancer screening (As enacted by PL 1997, c. 754, §2 is REALLOCATED TO TITLE 24-A, SECTION 2745-G)
24-A M.R.S. § 3476 — ME Code / Title 24-A / Chapter 47 / Section 3476
24-A §3476. Acquisition of controlling stock
Status: in_force

1. Any person proposing to acquire the controlling capital stock or guaranty capital shares of any domestic stock insurer and thereby to change the control of the insurer, other than through merger or consolidation or affiliation as provided for in this chapter, shall first apply to the superintendent in writing for approval of such proposed change of control. The application shall state the names and addresses of the proposed new owners of the controlling stock or shares and contain such additional information as the superintendent may reasonably require. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

2. The superintendent may not approve the proposed change of control if the superintendent finds: A. That the proposed new owners are not qualified by character, experience and financial responsibility to control and operate the insurer, or cause the insurer to be operated, in a lawful and proper manner; [RR 2021, c. 2, Pt. A, §76 (COR).] B. That as a result of the proposed change of control the insurer may not be qualified for a certificate of authority under section 407 ; [RR 2021, c. 2, Pt. A, §77 (COR).] C. That the interests of the insurer or other stockholders of the insurer or policyholder would be impaired through the proposed change of control; or [PL 1969, c. 132, §1 (NEW).] D. That the proposed change of control would tend materially to lessen competition, or to create any monopoly, in a business of insurance in this State or elsewhere. [PL 1969, c. 132, §1 (NEW).] [RR 2021, c. 2, Pt. A, §§76, 77 (COR).]

3. If the superintendent does not by affirmative action approve or disapprove the proposed change of control within 30 days after the date such application was so filed with the superintendent, the proposed change may be made without such approval. Except that if the superintendent gives notice to the parties of a hearing to be held by the superintendent with respect to the proposed change of control, and the hearing is held within such 30 days or on a date mutually acceptable to the superintendent and the parties, the superintendent shall have 30 days after the conclusion of the hearing within which to so approve or disapprove the proposed change; and if not so approved or disapproved, the change may thereafter be made without the superintendent's approval. [PL 1989, c. 269, §15 (AMD).]

4. If the superintendent disapproves the proposed change, the superintendent shall give written notice thereof to the parties, setting forth in detail the reasons for disapproval. [RR 2021, c. 1, Pt. B, §285 (COR).]

5. The superintendent shall file a complaint with the District Court seeking to suspend or revoke the certificate of authority held by any insurer, the control of which has been changed in violation of this section. [PL 1977, c. 694, §428 (RPR); PL 1999, c. 547, Pt. B, §78 (AMD); PL 1999, c. 547, Pt. B, §80 (AFF).]
24-A M.R.S. § 2213 — ME Code / Title 24-A / Chapter 24 / Section 2213
24-A §2213. Information concerning previous adverse underwriting decisions
Status: in_force

Unless an inquiry of a regulated insurance entity or insurance support organization also requests the reasons for the underwriting decision or placement, a regulated insurance entity or insurance support organization may not seek information in connection with an insurance transaction concerning: [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]

1. Previous adverse decision. Any previous adverse underwriting decision experienced by an insurance consumer; or [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]

2. Residual market, surplus lines or substandard risk carrier. Any previous insurance coverage obtained by a consumer through a residual market, a surplus lines insurer or a carrier that specializes in substandard risks. [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]
24-A M.R.S. § 2826 — ME Code / Title 24-A / Chapter 35 / Section 2826
24-A §2826. Examination, autopsy
Status: in_force

There shall be a provision that the insurer shall have the right and opportunity to examine the person of the insured when and so often as it may reasonably require during the pendency of claim under the policy and also the right and opportunity to make an autopsy in case of death where it is not prohibited by law. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2163-A — ME Code / Title 24-A / Chapter 23 / Section 2163-A
24-A §2163-A. Permitted activities
Status: in_force

1. Permissible gifts and prizes. Notwithstanding any other provision in sections 2160 to 2163 , an insurer, an employee of an insurer or a producer may offer to give gifts in connection with marketing for the sale or retention of contracts of insurance, as long as the cost does not exceed $100 per year per person, and conduct raffles or drawings, as long as there is no participation cost to entrants and as long as the prizes are not valued in excess of $500. Nothing in sections 2160 to 2163 may be construed to prohibit an 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. Gifts and prizes given pursuant to this section may not be in the form of cash. [PL 2017, c. 84, §1 (NEW).]

2. Permissible value-added service or activity. An insurer, an employee of an insurer or a producer may offer to provide a value-added service or activity, offered or provided without fee or at a reduced fee, that is related to the coverage provided by an insurance contract if the provision of the value-added service or activity does not violate any other applicable statute or rule and is: A. Clearly identified and included within the insurance contract; or [PL 2017, c. 84, §1 (NEW).] B. Directly related to the servicing of the insurance contract or offered or undertaken to provide risk control for the benefit of a client. [PL 2017, c. 84, §1 (NEW).] [PL 2017, c. 84, §1 (NEW).]

3. Services for free or for less than fair market value. This section does not prohibit a person from offering or providing services, whether or not the services are directly related to an insurance contract, for free or for less than fair market value as long as the receipt of the services is not contingent upon the purchase of insurance and the services are offered on the same terms to all potential insurance customers. A person that offers or provides services under this subsection for free or for less than fair market value shall disclose conspicuously in writing to the recipient before the purchase of insurance, receipt of a quote for insurance or designation of an agent of record that receipt of the services is not contingent on the purchase of insurance. [PL 2017, c. 84, §1 (NEW).]

4. Rules. The superintendent may adopt rules as necessary to make reasonable modifications to the standards in this section. Rules adopted pursuant to this subsection are major substantive rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2017, c. 84, §1 (NEW).]
24-A M.R.S. § 1427-A — ME Code / Title 24-A / Chapter 16 / Section 1427-A
24-A §1427-A. Exemption from examination requirement
Status: in_force

1. Exemption. An individual who applies for an adjuster or consultant license in this State who was previously licensed as such in another state is not required to complete any prelicensing education or examination pursuant to section 1410 . This exemption is only available if the person is currently licensed in that state or if the application is received within 90 days of the cancellation of the applicant's previous license and if the prior state issues a certification that, at the time of cancellation, the applicant was in good standing in that state, or the state's producer database records, maintained by the National Association of Insurance Commissioners, its affiliates or subsidiaries or any successor organization, indicate that the adjuster or consultant is or was licensed in good standing for the type of license requested. [PL 2001, c. 259, §32 (NEW).]

2. Application. A person licensed as an adjuster or consultant in another state who moves to this State must apply within 90 days of establishing legal residence to become a resident licensee. Prelicensing education or examination is not required of that person to obtain the adjuster or consultant license type previously held in the prior state except when the superintendent determines otherwise by rule. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter II‑A . [PL 2001, c. 259, §32 (NEW).]

3. Other exemptions. An examination is not required of an applicant for the same type of license that the applicant previously held in this State within the past 2 years, other than a temporary license. This exemption applies only to persons who have met the applicable continuing education requirements during the 2-year period, who voluntarily terminated their previous license, and who continue to be fully qualified for the license. A person whose previous license was revoked or suspended may not become relicensed pursuant to this subsection. [PL 2001, c. 259, §32 (NEW).]
24-A M.R.S. § 6814 — ME Code / Title 24-A / Chapter 85 / Section 6814
24-A §6814. Unfair trade practices
Status: in_force

A violation of this chapter is an unfair trade practice under Title 5, chapter 10 and subject to the penalties contained in that chapter. [PL 1997, c. 430, §1 (NEW); PL 1997, c. 430, §2 (AFF).]
24-A M.R.S. § 2308 — ME Code / Title 24-A / Chapter 25 / Section 2308
24-A §2308. Excess rates
Status: in_force

1. A rate in excess of that provided by a filing otherwise applicable may be used on any specific risk, providing that the following requirements are satisfied. A. The insurer files a written application with the superintendent signed by the insured or applicant stating the reasons for the request. [PL 1989, c. 797, §11 (AMD); PL 1989, c. 797, §§37, 38 (AFF).] B. The superintendent assents to the use of an excess rate for the specific risk. [PL 1987, c. 337 (NEW).] [PL 1989, c. 797, §11 (AMD); PL 1989, c. 797, §§37, 38 (AFF).]

2. To promote the availability of coverage in lines of insurance when coverage is difficult to obtain or unavailable, a form more restrictive than that provided by filings otherwise applicable may be used on any specific risk, provided that the following requirements are satisfied. A. The restrictive form and applicable rates are filed with the bureau. [PL 1987, c. 337 (NEW).] B. A disclosure statement detailing the nature of the restriction or restrictions contained in the form and the manner in which the provisions of the restrictive form differ from an otherwise applicable filing is provided to and acknowledged by the applicant for insurance. [PL 1987, c. 337 (NEW).] C. A copy of the disclosure statement and the written application for insurance submitted by the applicant are submitted to the bureau. [PL 1987, c. 337 (NEW).] D. The superintendent does not disapprove the use of the restrictive form in the specific case. [PL 1987, c. 337 (NEW).] [PL 1995, c. 329, §32 (AMD).]

3. At any subsequent policy renewal in which additional or different restrictive policy forms or excess rates are employed, the provisions of this section must again be satisfied. [PL 1995, c. 329, §33 (NEW).]

4. Notification to the superintendent of cancellation or nonrenewal of a policy containing restrictive forms or employing excess rates is required within 30 days following cancellation or nonrenewal of the policy. [PL 1995, c. 329, §33 (NEW).]
24-A M.R.S. § 2916-C — ME Code / Title 24-A / Chapter 39 / Section 2916-C
24-A §2916-C. Discontinuance of a line of business
Status: in_force

If an insurer files a plan with the superintendent to discontinue business in a line of insurance subject to this subchapter, the superintendent may authorize the nonrenewal of policies in that line of business if the plan filed by the insurer demonstrates the availability of substantially similar coverage in the admitted market. The nonrenewal of a policyholder pursuant to this section may not be considered by an insurer in future coverage determinations. An insurer may resume transacting business in a line of insurance discontinued pursuant to this section upon written notification to the superintendent. [PL 2005, c. 49, §1 (AMD).]
24-A M.R.S. § 4352 — ME Code / Title 24-A / Chapter 57 / Section 4352
24-A §4352. Short title
Status: in_force

This chapter constitutes and may be cited as the "Insurance Rehabilitation and Liquidation Law." [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 4386 — ME Code / Title 24-A / Chapter 57 / Section 4386
24-A §4386. Application for approval
Status: in_force

1. Insolvency; assets disbursed. Within 120 days after a final determination of insolvency of a company by a court of competent jurisdiction of this State, the receiver shall make application to the court for approval of a proposal to disburse assets out of the company's marshaled assets, from time to time as those assets become available, to the Maine Insurance Guaranty Association, to the Maine Life and Health Insurance Guaranty Association and to any similar organization in another state. The Maine Insurance Guaranty Association, the Maine Life and Health Insurance Guaranty Association and any similar organizations in other states are referred to, collectively, as the associations. [PL 2017, c. 382, §1 (AMD).]

2. Proposals. The proposals shall at least include provisions for: A. Reserving amounts for the payment of the expenses of administration and the claims falling within the priorities established in section 4379, subsections 1 and 4‑B ; [PL 2017, c. 169, Pt. D, §6 (AMD).] B. Disbursement of the assets marshaled to date and subsequent disbursements of assets as they become available; [PL 1981, c. 347 (NEW).] C. Equitable allocation of disbursements to each of the associations entitled thereto; and [PL 1981, c. 347 (NEW).] D. The securing by the receiver from each of the associations entitled to disbursements pursuant to this section of an agreement to return to the receiver the assets, and interest earned thereon, previously disbursed as may be required to pay claims as secured creditors and claims falling within the priorities established in section 4379, subsections 1 to 6 , in accordance with those priorities. [PL 1981, c. 347 (NEW).] [PL 2017, c. 169, Pt. D, §6 (AMD).]

3. Disbursements to associations. The receiver's proposal shall provide for disbursements to the associations in amounts at least equal to the payments made or to be made thereby for which the association could assert claims against the receiver and shall further provide that if the assets available for disbursement, from time to time, do not equal or exceed the amounts of the payments made or to be made by the associations, then disbursements shall be in the amount of available assets. [PL 1981, c. 347 (NEW).]

4. Notice. Notice of the application shall be given to the associations in, and to the commissioners of insurance of, each of the states. Any such notice shall be deemed to have been given when deposited in the United States certified mails, first class postage prepaid, at least 30 days prior to submission of the application to the court. Action on the application may be taken by the court provided the notice has been given and provided further that the receiver's proposal complies with subsection 2, paragraphs A and D . [PL 1981, c. 347 (NEW).]
24-A M.R.S. § 953-A — ME Code / Title 24-A / Chapter 11 / Section 953-A
24-A §953-A. Applicable interest rates
Status: in_force

1. The interest rates used in determining the minimum standard for the valuation of the following shall be the calendar year statutory valuation interest rates, as defined in this section: A. All life insurance policies issued in a particular calendar year, on or after the operative date of the Standard Nonforfeiture Law for Life Insurance, section 2532‑A ; [PL 1983, c. 346, §3 (NEW).] B. All individual annuity and pure endowment contracts issued in a particular calendar year on or after January 1, 1984, or January 1, 1983, at the election of the insurer; [PL 1983, c. 346, §3 (NEW).] C. All annuities and pure endowments purchased in a particular calendar year on or after January 1, 1984, or January 1, 1983, at the election of the insurer, under group annuity and pure endowment contracts; and [PL 1983, c. 346, §3 (NEW).] D. The net increase, if any, in a particular calendar year after January 1, 1984, or January 1, 1983, at the election of the insurer, in amounts held under guaranteed interest contracts. [PL 1983, c. 346, §3 (NEW).] An insurer electing January 1, 1983, in lieu of January 1, 1984, in paragraph B , C or D , shall notify the superintendent of its election by written notice no later than December 31, 1983. [PL 1983, c. 346, §3 (NEW).]

2. The calendar year statutory valuation interest rates, I, shall be determined as follows and the results rounded to the nearest 1/4 of 1%: A. For life insurance: I = .03 + W (R 1 -.03) + W (R 2 -.09) 2 [PL 1983, c. 346, §3 (NEW).] B. For single premium immediate annuities and for annuity benefits involving life contingencies arising from other annuities with cash settlement options and from guaranteed interest contracts with cash settlement options: I=.03 + W (R -.03) where R 1 is the lesser of R and .09, R 2 is the greater of R and .09, R is the reference interest rate defined in this section, and W is the weighting factor defined in this section; [PL 1983, c. 346, §3 (NEW).] C. For other annuities with cash settlement options and guaranteed interest contracts with cash settlement options, valued on an issue year basis, except as stated in paragraph B , the formula for life insurance stated in paragraph A shall apply to annuities and guaranteed interest contracts with guarantee durations in excess of 10 years, and the formula for single premium immediate annuities stated in paragraph B shall apply to annuities and guaranteed interest contracts with guarantee duration of 10 years or less; [PL 1983, c. 346, §3 (NEW).] D. For other annuities with no cash settlement options and for guaranteed interest contracts with no cash settlement options, the formula for single premium annuities stated in paragraph B shall apply; and [PL 1983, c. 346, §3 (NEW).] E. For other annuities with cash settlement options and guaranteed interest contracts with cash settlement options, valued on a change in fund basis, the formula for single premium immediate annuities stated in paragraph B shall apply. [PL 1983, c. 346, §3 (NEW).] If the calendar year statutory valuation interest rate for any life insurance policies issued in any calendar year, determined without reference to this sentence, differs from the corresponding actual rate for similar policies issued in the immediately preceding calendar year by less than 1/2 of 1%, the calendar year statutory valuation interest rate for those life insurance policies shall be equal to the corresponding actual rate for the immediately preceding calendar year. For purposes of applying the immediately preceding sentence, the calendar year statutory valuation interest rate for life insurance policies issued in a calendar year shall be determined for 1980, by using the reference interest rate defined for 1979, and shall be determined for each subsequent calendar year, regardless of when the Standard Nonforfeiture Law for Life Insurance, section 2532‑A , becomes operative. [PL 1983, c. 346, §3 (NEW).]

3. The weighting factors in the formulas in subsection 2 are given in the following tables: A. Weighting Factors for Life Insurance: Guarantee Duration Weighting (Years) Factors 10 or less .50 More than 10, but not more than 20 .45 More than 20 .35 For life insurance, the guarantee duration is the maximum number of years the life insurance can remain in force on a basis guaranteed in policy or under options to convert to plans of life insurance with premium rates or nonforfeiture values or both which are guaranteed in the original policy; [PL 1983, c. 346, §3 (NEW).] B. Weighting factor for single premium immediate annuities and for annuity benefits involving life contingencies arising from other annuities with cash settlement options and guaranteed interest contracts with cash settlement options:.80; [PL 1983, c. 346, §3 (NEW).] C. Weighting factors for other annuities and for guaranteed interest contracts, except as stated in paragraph B , shall be as specified in subparagraphs (1), (2) and (3), according to the rules and definitions in subparagraphs (4), (5) and (6): (1) For annuities and guaranteed interest contracts valued on an issue year basis: Guarantee Weighting Factor for Plan Types Duration (Years) A B C 5 or less: .80 .60 .50 More than 5, but not more than 10: .75 .60 .50 More than 10, but not more than 20: .65 .50 .45 More than 20: .45 .35 .35 (2) For annuities and guaranteed interest contracts valued on a change in fund basis, the factors shown in subparagraph (1) increased by: Plan Type A B C .15 .25 .05; (3) For annuities and guaranteed interest contracts valued on an issue year basis, other than those with no cash settlement options, which do not guarantee interest on considerations received more than one year after issue or purchase and for annuities and guaranteed interest contracts valued on a change in fund basis which do not guarantee interest rates on considerations received more than 12 months beyond the valuation date, the factors shown in subparagraph (1) or derived in subparagraph (2) increased by: Plan Type A B C .05 .05 .05; (4) For other annuities with cash settlement options and guaranteed interest contracts with cash settlement options, the guarantee duration is the number of years for which the contract guarantees interest rates in excess of the calendar year statutory valuation interest rate for life insurance policies with guarantee duration in excess of 20 years. For other annuities with no cash settlement options and for guaranteed interest contracts with no cash settlement options, the guarantee duration is the number of years from the date of issue or date of purchase to the date annuity benefits are scheduled to commence; (5) Plan type as used in the subparagraphs (1), (2) and (3) tables is defined as follows. (a) Plan Type A. At any time policyholder may withdraw funds, only: With an adjustment to reflect changes in interest rates or asset values since receipt of the funds by the insurance company; without that adjustment, but in installments over 5 years or more; as an immediate life annuity; or no withdrawal permitted. (b) Plan Type B. Before expiration of the interest rate guarantee, policyholder may withdraw funds, only: With an adjustment to reflect changes in interest rates or asset values since receipt of the funds by the insurance company; without that adjustment, but in installments over 5 years or more; or no withdrawal permitted. At the end of interest rate guarantee, funds may be withdrawn without that adjustment in a single sum or installments over less than 5 years. (c) Plan Type C. Policyholder may withdraw funds before expiration of interest rate guarantee in a single sum or installments over less than 5 years, either: Without adjustment to reflect changes in interest rates or asset values since receipt of the funds by the insurance company; or subject only to a fixed surrender charge stipulated in the contract as a percentage of the fund; and (6) A company may elect to value guaranteed interest contracts with cash settlement options and annuities with cash settlement options on either an issue year basis or on a change in fund basis. Guaranteed interest contracts with no cash settlement options and other annuities with no cash settlement options must be valued on an issue year basis. As used in this section, an issue year basis of valuation refers to a valuation basis under which the interest rate used to determine the minimum valuation standard for the entire duration of the annuity or guaranteed interest contract is the calendar year valuation interest rate for the year of issue or year of purchase of the annuity or guaranteed interest contract, and the change in fund basis of valuation refers to a valuation basis under which the interest rate used to determine the minimum valuation standard applicable to each change in the fund held under the annuity or guaranteed interest contract is the calendar year valuation interest rate for the year of the change in the fund. [PL 1983, c. 346, §3 (NEW).] [PL 1983, c. 346, §3 (NEW).]

4. The reference interest rate referred to in subsection 2 is defined as follows: A. For all life insurance, the lesser of the average over a period of 36 months and the average over a period of 12 months, ending on June 30th of the calendar year next preceding the year of issue, of Moody's Corporate Bond Yield Average-Monthly Average Corporates, as published by Moody's Investors Service, Inc.; [PL 1983, c. 346, §3 (NEW).] B. For single premium immediate annuities and for annuity benefits involving life contingencies arising from other annuities with cash settlement options and guaranteed interest contracts with cash settlement options, the average over a period of 12 months, ending on June 30th of the calendar year of issue or year of purchase, of Moody's Corporate Bond Yield Average-Monthly Average Corporates, as published by Moody's Investors Service, Inc.; [PL 1983, c. 346, §3 (NEW).] C. For other annuities with cash settlement options and guaranteed interest contracts with cash settlement options, valued on a year of issue basis, except as stated in paragraph B , with guarantee duration in excess of 10 years, the lesser of the average over a period of 36 months and the average over a period of 12 months, ending on June 30th of the calendar year of issue or purchase, of Moody's Corporate Bond Yield Average-Monthly Average Corporates,as published by Moody's Investors Service, Inc.; [PL 1983, c. 346, §3 (NEW).] D. For other annuities with cash settlement options and guaranteed interest contracts with cash settlement options, valued on a year of issue basis, except as stated in paragraph B , with guarantee duration of 10 years or less, the average over a period of 12 months, ending on June 30th of the calendar year of issue or purchase, of Moody's Corporate Bond Yield Average-Monthly Average Corporates, as published by Moody's Investors Service, Inc.; [PL 1983, c. 346, §3 (NEW).] E. For other annuities with no cash settlement options and for guaranteed interest contracts with no cash settlement options, the average over a period of 12 months, ending on June 30th of the calendar year of issue or purchase, of Moody's Corporate Bond Yield Average-Monthly Average Corporates, as published by Moody's Investors Service, Inc.; and [PL 1983, c. 346, §3 (NEW).] F. For other annuities with cash settlement options and guaranteed interest contracts with cash settlement options, valued on a change in fund basis, except as stated in paragraph B , the average over a period of 12 months, ending on June 30th of the calendar year of the change in the fund, of Moody's Corporate Bond Yield Average-Monthly Average Corporates, as published by Moody's Investors Service, Inc. [PL 1983, c. 346, §3 (NEW).] [PL 1983, c. 346, §3 (NEW).]

5. In the event that Moody's Corporate Bond Yield Average-Monthly Average Corporates is no longer published by Moody's Investors Service, Inc., or in the event that the National Association of Insurance Commissioners determines that Moody's Corporate Bond Yield Average-Monthly Average Corporates, as published by Moody's Investors Service, Inc. is no longer appropriate for the determination of the reference interest rate, then an alternative method for determination of the reference interest rate, which is adopted by the National Association of Insurance Commissioners and approved by regulation promulgated by the superintendent, may be substituted. [PL 1983, c. 346, §3 (NEW).]
24 M.R.S. § 2305 — ME Code / Title 24 / Chapter 19 / Section 2305
24 §2305. -- Issuance of
Status: in_force

The superintendent shall issue a certificate of authority, which is continuous unless revoked or suspended by the superintendent, and collect payment of a fee, which is the same as for an insurer as provided in Title 24‑A, section 601 , if the applicant meets the following requirements: [PL 1997, c. 592, §1 (AMD).]

1. Plan. It is established to provide a bona fide nonprofit health care plan. [PL 1969, c. 419, §5 (AMD).]

2. Contracts. The contracts between the applicant and the participating providers of health care obligate each participating party to render service to which each subscriber may be entitled under the terms of the contract issued to the subscribers and such contracts are otherwise reasonable. [PL 1971, c. 444, §5 (AMD).]

3. Rates and benefits. The rates charged and benefits to be provided are as prescribed in sections 2316 , 2321 and 2322 . [PL 1977, c. 493, §1 (AMD).]

4. Contributions. Contributions to the working funds of the applicant are repayable only out of earned premiums in excess of operating expenses, payments to participating providers, and an adequate reserve required by the superintendent. [PL 1969, c. 419, §6 (AMD); PL 1973, c. 585, §12 (AMD).]

5. Money available. The money available for working capital must be sufficient to cover all acquisition costs and operating expenses for a reasonable time from the date of the issuance of the certificate of authority. [PL 1971, c. 444, §6 (RPR).]
24-A M.R.S. § 3 — ME Code / Title 24-A / Chapter 1 / Section 3
24-A §3. "Insurance" defined
Status: in_force

"Insurance" means a contract under which one undertakes to pay or indemnify another as to loss from certain specified contingencies or perils, to pay or grant a specified amount or determinable benefit or annuity in connection with ascertainable risk contingencies or to act as surety, except that the following types of contracts are not considered insurance: [PL 1997, c. 592, §9 (RPR).]

1. Charitable gift annuity. A charitable gift annuity agreement, as defined in section 703‑A ; [PL 1997, c. 592, §9 (NEW).]

2. Road or tourist service contract. A road or tourist service contract, other than a contract issued by a licensed insurer, related to the repair, operation and care of automobiles or to the protection and assistance of automobile owners or drivers; [PL 2011, c. 345, §1 (AMD); PL 2011, c. 345, §7 (AFF).]

3. Home service contract. A home service contract whereby, for a set fee and specified duration, a person agrees to defray the cost of repair or replacement or provide or arrange for the repair or replacement of all or any part of any structural component, appliance or system of a home necessitated by wear and tear, deterioration or inherent defect or by failure of an inspection to detect the likelihood of any such loss; and [PL 2011, c. 345, §1 (AMD); PL 2011, c. 345, §7 (AFF).]

4. Service contract. A service contract as defined in section 7102, subsection 11 . [PL 2011, c. 345, §2 (NEW); PL 2011, c. 345, §7 (AFF).]
24-A M.R.S. § 2156 — ME Code / Title 24-A / Chapter 23 / Section 2156
24-A §2156. False or misleading financial statements
Status: in_force

1. No person shall file with any supervisory or other public official, or make, publish, disseminate, circulate or deliver to any person, or place before the public, or cause directly or indirectly, to be made, published, disseminated, circulated, delivered to any person, or placed before the public, any false statement of financial condition of an insurer with intent to deceive. [PL 1969, c. 132, §1 (NEW).]

2. No person shall make any false entry in any book, report or statement of any insurer with intent to deceive any agent or examiner lawfully appointed to examine into its condition or into any of its affairs, or any public official to whom such insurer is required by law to report, or who has authority by law to examine into its condition or into any of its affairs, or, with like intent, willfully omit to make a true entry of any material fact pertaining to the business of such insurer in any book, report or statement of such insurer. [PL 1969, c. 132, §1 (NEW).]

3. No person shall advertise the capital or assets of an insurer without in the same advertisement setting forth the amount of the insurer's liabilities. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 6206 — ME Code / Title 24-A / Chapter 73 / Section 6206
24-A §6206. Required provisions of a continuing care agreement
Status: in_force

1. General provisions. In addition to such other provisions as may be prescribed by rules promulgated under this chapter, each continuing care agreement executed between a subscriber and a provider shall: A. State the name and business address of the provider; [PL 1987, c. 482, §1 (NEW).] B. State the name and address of the facility; [PL 1987, c. 482, §1 (NEW).] C. Show the total consideration paid by the subscriber for continuing care, including the value of all property transferred, donations, entrance fees, subscriptions, maintenance fees and any other fees paid or payable by or on behalf of a subscriber; [PL 1987, c. 482, §1 (NEW).] D. Specify all health care or supportive services which are to be provided by the provider or by a 3rd party to each subscriber, including in detail all items which each subscriber will receive and whether the items will be provided for a designated time period or for life; [PL 1987, c. 482, §1 (NEW).] E. State whether the provider requires the subscriber to purchase or maintain supplemental insurance; [PL 1987, c. 482, §1 (NEW).] F. Provide in clear and understandable language, in print no smaller than the largest type used in the body of the agreement, the terms governing the refund of any portion of the entrance fee in the event of rescission or termination of the agreement by the provider or by the subscriber; [PL 1987, c. 482, §1 (NEW).] G. State the terms under which an agreement is canceled by the death of the subscriber; [PL 1987, c. 482, §1 (NEW).] H. Provide in clear and understandable language in print no smaller than the largest type used in the agreement whether or not periodic fees, if charged, will be subject to periodic increases; [PL 1987, c. 482, §1 (NEW).] I. State the extent of funeral and burial services which will be provided by the provider; [PL 1987, c. 482, §1 (NEW).] J. Provide a description of the unit which the subscriber will occupy; [PL 1987, c. 482, §1 (NEW).] K. State the conditions, if any, under which a unit may be assigned to the use of another by the subscriber; [PL 1987, c. 482, §1 (NEW).] L. State the subscriber's and provider's respective rights and obligations as to the use of the facility and as to real and personal property of the subscriber placed in the custody of the provider; [PL 1987, c. 482, §1 (NEW).] M. State that the subscribers shall have the right to organize and operate a subscriber organization at the facility and to meet privately to conduct business; [PL 1987, c. 482, §1 (NEW).] N. State what, if any, fee adjustments will be made if the subscriber is voluntarily absent from the facility for an extended period of time; [PL 1987, c. 482, §1 (NEW).] O. Contain in capital letters in print no smaller than the largest type used in the agreement and underlined: "A preliminary or final certificate of authority is not an endorsement or guarantee of this facility by the State of Maine. The Superintendent of Insurance urges you to consult with an attorney and a suitable financial advisor before signing any documents."; [PL 1987, c. 482, §1 (NEW).] P. State that the subscriber will annually receive a financial and organizational disclosure statement; and [PL 1987, c. 482, §1 (NEW).] Q. Provide that the provider shall make available to the subscriber, upon request, any certified financial statement transmitted to the superintendent. [PL 1987, c. 482, §1 (NEW).] [PL 1987, c. 482, §1 (NEW).]

2. Additional specific provisions. Each continuing care agreement shall contain the following provisions: A. A description of the procedures to be followed by the provider when the provider temporarily or permanently changes the subscriber's accommodation within the facility, transfers the subscriber pursuant to section 6228 or transfers the subscriber to another health facility. A subscriber's accommodations may be changed only for the protection of the health or safety of the subscriber or the general welfare of the residents; [PL 1995, c. 452, §22 (AMD).] B. A description of the policies that will be implemented if the subscriber becomes unable to meet the fees; [PL 1987, c. 482, §1 (NEW).] C. A policy statement of the provider with regard to changes in accommodations and the procedure to be followed to implement that policy in the event of an increase or decrease in the number of persons occupying an individual unit, including a reasonable grievance procedure and a description of the circumstances whereby the provider may cancel the agreement prior to occupancy; [PL 1995, c. 452, §23 (AMD).] D. Specifications of the circumstances, if any, under which the subscriber will be required to apply for Medicare, Social Security or any other state or federal insurance or pension benefits; and [PL 1995, c. 452, §23 (AMD).] E. A statement of the rights of residents of continuing care retirement communities granted by section 6227 . [PL 1995, c. 452, §24 (NEW).] [PL 1995, c. 452, §§22-24 (AMD).]

3. Filing and approval. Continuing care agreements must be submitted in duplicate to the superintendent, who shall immediately forward one copy to the department. The department shall review the continuing care agreement for compliance with the requirements of subsection 2 . The superintendent shall review the continuing care agreement for compliance with the requirements of subsection 1 . [PL 1987, c. 482, §1 (NEW).]

No contract, or amendment to a contract, may be issued or delivered to any person in this State until a copy of the contract, or amendment to the contract, has been filed with and approved by the superintendent. A contract shall contain no provisions or statements which are untrue, unjust, unfair, inequitable, misleading, deceptive or which encourage misrepresentation. [PL 1987, c. 482, §1 (NEW).]

The contract, or amendment to the contract, shall be deemed approved by the superintendent 30 days following the date filed with the superintendent unless, prior to that date, it has been affirmatively approved or disapproved by the superintendent or unless the superintendent has not issued a final certificate of authority. The superintendent may not extend the period upon which he may affirmatively approve or disapprove any contract or amendment more than an additional 30 days. [PL 1987, c. 482, §1 (NEW).]
24-A M.R.S. § 2910-B — ME Code / Title 24-A / Chapter 39 / Section 2910-B
24-A §2910-B. Assessment of value of motor vehicle
Status: in_force

If an insurer uses the value of a comparable motor vehicle to assess the value of a damaged motor vehicle, the comparable motor vehicle used by the insurer must be in Maine, New Hampshire, Vermont, Massachusetts, Connecticut, Rhode Island or New York and the value of that comparable motor vehicle must be its value in Maine, New Hampshire, Vermont, Massachusetts, Connecticut, Rhode Island or New York to the extent comparable vehicles are available in these states. An insurer may use a comparable motor vehicle in a state not specified in this section only after determining that comparable motor vehicles are not available in the states specified in this section. [PL 2021, c. 283, §1 (NEW).]
24-A M.R.S. § 1906 — ME Code / Title 24-A / Chapter 18 / Section 1906
24-A §1906. Administrator requirements
Status: in_force

1. Each administrator shall identify to the superintendent any ownership interest or affiliation of any kind with any plan sponsor, health care service plan, health maintenance organization or insurer responsible directly or through reinsurance for providing benefits to any plan for which the administrator provides services as an administrator. [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]

2. An administrator shall provide services as an administrator only pursuant to a written agreement between the administrator and the plan sponsor, health care service plan, health maintenance organization or insurer. The administrator shall retain the written agreement as part of its records for the duration of the agreement and for 7 years after the agreement expires. [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]

3. An administrator shall maintain, in its principal office for the duration of the written agreement with any plan sponsor or insurer and for 7 years after the agreement expires, adequate books and records of all transactions involving a plan sponsor, health care service plan, health maintenance organization or insurer and covered individuals and beneficiaries. These books and records must be maintained in accordance with generally accepted standards of business recordkeeping. An administrator is not required to maintain copies of books and records if the originals are returned to the plan sponsor, health care service plan, health maintenance organization or insurer before the end of the 7-year period. The administrator shall maintain evidence of the return of the originals for the balance of the 7-year period. [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]

4. The administrator shall file with the superintendent the names and addresses of the insurers, health care service plans, health maintenance organizations and plan sponsors with whom the administrator has entered into written agreements. If an insurer, health care service plan, health maintenance organization or plan sponsor does not assume or bear the risk, the administrator must disclose the name and address of the ultimate risk bearer. In addition, at the time of a license renewal, the administrator shall also file with the superintendent for the most recent complete calendar year for all covered individuals in the State the total number of claims paid by the administrator by each plan sponsor and the total dollar amount of claims paid by each plan sponsor. This subsection applies to the initial application for an administrator's license and any renewal of a license. [PL 2001, c. 457, §20 (AMD).]

5. An administrator may use advertising pertaining to the plan only if that advertising has been approved in advance by the plan sponsor, health care service plan, health maintenance organization or insurer. [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]

6. Upon receiving instructions from the plan sponsor, health care service plan, health maintenance organization or insurer, an administrator shall deliver promptly to covered individuals or beneficiaries all policies, certificate booklets, termination notices or other written communications. [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]

7. An administrator may not receive compensation from a plan sponsor, health care service plan, health maintenance organization or insurer that is contingent upon the loss ratio of the plan. This subsection does not, however, prevent the administrator from engaging in cost containment activities with a plan sponsor, health care service plan, health maintenance organization or insurer. [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]

8. An administrator may not receive from any plan sponsor, health care service plan, health maintenance organization, insurer, covered individual or beneficiary under a plan any compensation or other payments except as expressly set forth in the written agreement between the administrator and the plan sponsor, health care service plan, health maintenance organization or insurer. [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]

9. Upon request of the superintendent, an administrator shall make available for examination, either at the Bureau of Insurance or at the licensee's principal place of business, all basic organizational documents, including, but not limited to, articles of incorporation, articles of association, partnership agreements, trade name certificates, trust agreements, shareholder agreements and other applicable documents and all amendments to those documents, bylaws, rules and regulations or similar documents regulating the conduct of the administrator's internal affairs. [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]

10. When acting as an administrator, the acts of an insurance administrator are deemed to be the acts of the plan sponsor, health care service plan, health maintenance organization, fraternal benefit society, nonprofit hospital or medical service organization or insurer. [PL 1997, c. 457, §30 (NEW).]

11. In addition to any other applicable provisions of law, the plan sponsor, health care service plan, health maintenance organization, fraternal benefit society, nonprofit hospital or medical service organization or insurer is accountable and may be penalized by the superintendent, as provided for in this Title, for the actions of its administrators. [PL 1997, c. 457, §30 (NEW).]
24-A M.R.S. § 2884 — ME Code / Title 24-A / Chapter 38 / Section 2884
24-A §2884. Legal services insurance authorized to be sold on a group basis
Status: in_force

An insurance company authorized to write legal services insurance in this State, which for the purposes of this chapter only is considered a form of health insurance, has the power to issue group legal services insurance policies or may, by providing for the mental and emotional welfare of individuals and members of an individual's family by defraying the costs of legal services, include legal services insurance in and as a part of a group health insurance policy. Group legal services insurance is that form of voluntary legal services insurance covering employees or members, with or without their eligible dependents, written under a master policy issued to any governmental corporation, unit, agency or department or to any employer, association of employers or employee leasing company registered pursuant to Title 32, chapter 125 , including the trustee or trustees of a fund established by that employer, association of employers or registered employee leasing company, a labor union or other employee organization, including the trustees of a fund established by that labor union or employee organization. The terms "employee" and "employees" have the same meaning as are given to those terms for the purposes of writing group life insurance in this State. Legal services insurance may only be issued in this State on a group policy basis. [PL 1995, c. 618, §4 (AMD).]
24-A M.R.S. § 2168-A — ME Code / Title 24-A / Chapter 23 / Section 2168-A
24-A §2168-A. Tie-in sales of insurance
Status: in_force

1. Definition. As used in this section, "tie-in sales" means the practice of tying the sale of one product to another. [PL 1991, c. 49 (NEW).]

2. Prohibited tie-in sales. In the purchase of insurance, tie-in sales are an unfair trade practice when: A. The consumer is required to place additional coverage with an insurer not of the consumer's choice in order to obtain a desired coverage; and [PL 1991, c. 49 (NEW).] B. The consumer's alternative opportunities to purchase the desired coverage are severely limited or nonexistent. [PL 1991, c. 49 (NEW).] [PL 1991, c. 49 (NEW).]

3. Penalties. An insurance contract sold in violation of the provisions of this section is voidable at the option of the consumer. Violations of this section are enforceable through section 12‑A . [PL 1991, c. 49 (NEW).]
24-A M.R.S. § 6214 — ME Code / Title 24-A / Chapter 73 / Section 6214
24-A §6214. Administrative rules
Status: in_force

The superintendent and the department, as provided in this section, shall administer this chapter and may: [PL 1987, c. 482, §1 (NEW).]

1. Forms. Prescribe, prepare and furnish all necessary forms; [PL 1987, c. 482, §1 (NEW).]

2. Fees. Establish and collect reasonable fees under this chapter; and [PL 1987, c. 482, §1 (NEW).]

3. Rules. Adopt, amend or repeal, as necessary, rules to implement and interpret this chapter. [PL 1987, c. 482, §1 (NEW).]
24-A M.R.S. § 2471 — ME Code / Title 24-A / Chapter 28 / Section 2471
24-A §2471. Short title -- Article 1
Status: in_force

This chapter may be known and cited as "the Interstate Insurance Product Regulation Compact." [PL 2003, c. 680, §1 (NEW).]
24-A M.R.S. § 731-A — ME Code / Title 24-A / Chapter 9 / Section 731-A
24-A §731-A. Acceptance of reinsurance
Status: in_force

An insurer may accept reinsurance only of such kinds of risks, and retain risk thereon within such limits, as the insurer is otherwise authorized to insure. [PL 1989, c. 846, Pt. E, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]
24-A M.R.S. § 6901 — ME Code / Title 24-A / Chapter 87 / Section 6901
24-A §6901. Short title
Status: in_force

This chapter may be known and cited as "the Dirigo Health Act." [PL 2003, c. 469, Pt. A, §8 (NEW).]
24-A M.R.S. § 6603-A — ME Code / Title 24-A / Chapter 81 / Section 6603-A
24-A §6603-A. Employee leasing companies
Status: in_force

An employee leasing company that provides health benefits on other than a fully insured basis for employees leased to client companies shall comply with the requirements of this section. [PL 1995, c. 618, §7 (NEW).]

1. Requirements for approval. The arrangement must meet the requirements of this subsection to obtain approval to establish a multiple-employer welfare arrangement or to maintain operations of a multiple-employer welfare arrangement. A. The employee leasing company must be registered in this State in accordance with Title 32, chapter 125 . [PL 1995, c. 618, §7 (NEW).] B. Within 4 months of the end of each fiscal year or within such extension of time as the superintendent for good cause may grant, the arrangement shall file with the superintendent an annual financial report certified by an independent certified public accountant. The report must include a letter of qualification from the accountant that meets the requirements of section 6611, subsection 1‑A . The report must provide the name and address of the insurer providing excess insurance and it must also include an analysis of the adequacy of reserves and contributions or premiums charged based on a review of past and projected claims and expenses. [PL 1995, c. 618, §7 (NEW).] C. Within 45 days of the end of each fiscal quarter, the arrangement shall file with the superintendent a letter from an independent certified public accountant attesting to the following: (1) That the employees have been paid in a timely fashion; (2) That all payroll taxes and income taxes withheld have been paid to the appropriate state or federal agency in a timely fashion; (3) With respect to any health care benefits provided on other than a fully insured basis, that specific excess insurance is maintained with a retention level adequate for the plan; and (4) With respect to any health care benefits provided on other than a fully insured basis, that appropriate loss and loss expense reserves are maintained that are adequate for the plan. [PL 1995, c. 618, §7 (NEW).] D. Any necessary excess insurance must be purchased from an insurer licensed to transact health or casualty insurance in the State. [PL 1995, c. 618, §7 (NEW).] E. The arrangement shall issue to each covered employee a contract, certificate, summary plan description or other evidence of the benefits and coverages provided. This evidence of the benefits and coverages provided must contain in boldface print in a conspicuous location the following statement: "The benefits and coverages described herein are provided by [name of employee leasing company] on a self-insured basis, not through a contract with a commercial insurance carrier." If the benefit plan or arrangement was in existence before April 30, 1996 and had previously issued benefit descriptions to the covered employees, the arrangement shall issue to each employee the additional written material necessary to meet the requirements of this paragraph. [PL 1995, c. 618, §7 (NEW).] F. The arrangement must pay the filing fee specified in section 601 at the time of the application for approval. [PL 1995, c. 618, §7 (NEW).] [PL 1995, c. 618, §7 (NEW).]

2. Application for approval. To obtain approval, an arrangement must submit a letter of application to the Superintendent that includes or has attached the material required by subsection 1 . If any information is not available at the time of application, the arrangement shall specify in the letter when that information will be provided. The superintendent, in the superintendent's discretion, may grant approval of an arrangement conditioned upon the timely receipt of the required information if the superintendent determines that the arrangement is funded at a level consistent with the purposes of this chapter. [PL 1995, c. 618, §7 (NEW).]

3. Other provisions. An arrangement approved pursuant to the requirements of this section is also subject to the requirements of sections 6606 , 6607 , 6610 , 6614 and 6616 . [PL 1995, c. 618, §7 (NEW).]

4. Grounds for denial, suspension or revocation of arrangement. The superintendent, in the superintendent's discretion, may deny, suspend or revoke the authorization granted pursuant to this section if the superintendent finds that the arrangement has failed to meet the requirements of this section, has refused to produce the required financial information or has refused to correct a deficiency determined pursuant to section 6606 . When failure to maintain compliance with the requirements of this section is the grounds for suspension or revocation of authority of an arrangement, the arrangement has 60 days after notification by the superintendent to take action necessary to correct the deficiency. [PL 1995, c. 618, §7 (NEW).]
24 M.R.S. § 2331 — ME Code / Title 24 / Chapter 19 / Section 2331
24 §2331. Optional coverage for optometric services
Status: in_force

1. Coverage required to be made available. Every nonprofit hospital or medical service organization which issues group health care contracts providing coverage for the services of a "physician" or "doctor" to residents of this State shall make available coverage for such services when performed by an optometrist to the extent the services are within the lawful scope of practice of an optometrist licensed to practice in this State, provided that the optometrist performing the services has contracted with the organization under terms and conditions which the organization deems satisfactory to its membership. [PL 1981, c. 698, §107 (RAL).]

2. Contract. The group contract 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. 698, §107 (RAL).]
24 M.R.S. § 2332-D — ME Code / Title 24 / Chapter 19 / Section 2332-D
24 §2332-D. Jury service
Status: in_force

1. Prohibition. A nonprofit hospital or medical service organization that issues group 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 1989, c. 801, §2 (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 1989, c. 801, §2 (NEW).]
24-A M.R.S. § 2159-E — ME Code / Title 24-A / Chapter 23 / Section 2159-E
24-A §2159-E. Discrimination against naloxone hydrochloride or another opioid overdose-reversing medication purchases prohibited in life insurance
Status: in_force

1. Discrimination prohibited. Notwithstanding any provision of law to the contrary and except as provided in subsection 2 , an insurer authorized to do business in this State may not: A. Limit coverage or refuse to issue or renew coverage of an individual under any life insurance policy due to the fact that the individual has been issued a prescription for naloxone hydrochloride or another opioid overdose-reversing medication or has purchased naloxone hydrochloride or another opioid overdose-reversing medication in accordance with Title 22, section 2353 ; [PL 2023, c. 161, §4 (AMD).] B. Consider the fact that an individual has been issued a prescription for naloxone hydrochloride or another opioid overdose-reversing medication or has purchased naloxone hydrochloride or another opioid overdose-reversing medication in determining the premium rate for coverage of that individual under a life insurance policy; or [PL 2023, c. 161, §4 (AMD).] C. Otherwise discriminate in the offering, issuance, cancellation, amount of coverage, price or any other condition of a life insurance policy based solely and without any additional actuarial justification upon the fact that an individual has been issued a prescription for naloxone hydrochloride or another opioid overdose-reversing medication or has purchased naloxone hydrochloride or another opioid overdose-reversing medication. [PL 2023, c. 161, §4 (AMD).] An opioid overdose-reversing medication referenced in this subsection must be approved by the federal Food and Drug Administration. [PL 2023, c. 161, §4 (AMD).]

2. Exception. An insurer may take an action described in subsection 1 with respect to an individual who has a demonstrated history of opioid use disorder. [PL 2019, c. 203, §1 (NEW).]
24-A M.R.S. § 6102 — ME Code / Title 24-A / Chapter 72-A / Section 6102
24-A §6102. Duty of agents or brokers to obtain license
Status: in_force

Any person acting, or offering to act, as an agent or broker for a risk retention group or purchasing group, which solicits members, sells insurance coverage, purchases coverage for its members located within the State or otherwise does business in this State shall, before commencing any such activity, obtain an appropriate license from the superintendent. [PL 1987, c. 481, §3 (NEW).]
24-A M.R.S. § 4203 — ME Code / Title 24-A / Chapter 56 / Section 4203
24-A §4203. Establishment of health maintenance organizations
Status: in_force

1. Subject to the Maine Certificate of Need Act of 2002, a person may apply to the superintendent for and obtain a certificate of authority to establish, maintain, own, merge with, organize or operate a health maintenance organization in compliance with this chapter. A person may not establish, maintain, own, merge with, organize or operate a health maintenance organization in this State either directly as a division or a line of business or indirectly through a subsidiary or affiliate, nor sell or offer to sell, or solicit offers to purchase or receive advance or periodic consideration in conjunction with, a health maintenance organization without obtaining a certificate of authority under this chapter. [PL 2003, c. 510, Pt. A, §19 (AMD).]

2. Every existing health maintenance organization as of the effective date of this chapter shall submit an application for a certificate of authority under subsection 3 within 30 days of the effective date of this chapter. Each such applicant may continue to operate until the superintendent acts upon the application. In the event that an application is denied under section 4204 , the applicant shall henceforth be treated as a health maintenance organization whose certificate of authority has been revoked. [PL 1975, c. 503 (NEW).]

3. Each application for a certificate of authority shall be verified by an officer or authorized representative of the applicant, shall be in a form prescribed by the superintendent and shall set forth or be accompanied by the following: A. A copy of the basic organizational document, if any, of the applicant such as the articles of incorporation, articles of association, partnership agreement, trust agreement or other applicable documents and all amendments thereto; [PL 1975, c. 503 (NEW).] B. A copy of the bylaws, rules and regulations, or similar document, if any, regulating the conduct of the internal affairs of the applicant; [PL 1975, c. 503 (NEW).] C. A list of the names, addresses and official positions of the persons who are to be responsible for the conduct of the affairs of the applicant, including all members of the board of directors, board of trustees, executive committee or other governing board or committee, the principal officers in the case of a corporation and the partners or members in the case of a partnership or association; [PL 1975, c. 503 (NEW).] D. A copy of any contract made or to be made between any providers or persons listed in paragraph C and the applicant; [PL 1975, c. 503 (NEW).] E. A statement generally describing the health maintenance organization, its health care services, facilities and personnel; [PL 1975, c. 503 (NEW).] F. A copy of the form of evidence of coverage to be issued to the enrollees; [PL 1975, c. 503 (NEW).] G. A copy of the form of the group contract, if any, which is to be issued to employers, unions, trustees or other organizations; [PL 1975, c. 503 (NEW).] H. Financial statements showing the applicant's assets, liabilities and sources of financial support. If the applicant's financial affairs are audited by independent certified public accountants, a copy of the applicant's most recent regular certified financial statement shall be deemed to satisfy this requirement, unless the superintendent directs that additional or more recent financial information is required for the proper administration of this chapter; [PL 1975, c. 503 (NEW).] I. A financial feasibility plan that includes detailed enrollment projections, the methodology for determining premium rates to be charged during the first 12 months of operations certified by an actuary or other qualified person, a projection of balance sheets, cash flow statements showing any capital expenditures, purchase and sale of investments and deposits with the State, income and expense statements anticipated from the start of operations until the organization has had net income for at least one year and a statement of the sources of working capital and any other sources of funding; [PL 1989, c. 842, §4 (RPR).] J. A power of attorney duly executed by such applicant, if not domiciled in this State, appointing the superintendent and the superintendent's successors in office, and duly authorized deputies, as the true and lawful attorney of such applicant in and for this State upon whom all lawful process in any legal action or proceeding against the health maintenance organization on a cause of action arising in this State may be served; [RR 2021, c. 1, Pt. B, §341 (COR).] K. A statement reasonably describing the geographic area or areas to be served; [PL 1975, c. 503 (NEW).] L. A description of the complaint and grievance procedures to be utilized as required under section 4303, subsection 4 and section 4211 ; [PL 1995, c. 673, Pt. D, §2 (AMD).] M. A description of the proposed quality assurance program, including the formal organization structure, methods for developing criteria, procedures for comprehensive evaluation of the quality of care rendered to enrollees, and processes to initiate corrective action and reevaluation when deficiencies in provider or organizational performance are identified; [PL 1989, c. 842, §5 (RPR).] N. A description of the mechanism by which enrollees will be afforded an opportunity to participate in matters of policy and operation under section 4206, subsection 2 ; [PL 1975, c. 503 (NEW).] O. A schedule of rates with supporting actuarial and other data; [PL 1975, c. 503 (NEW).] P. A description of a procedure to develop, compile, evaluate and report statistics relating to the cost of its operations, the pattern of utilization of its services, the availability and accessibility of its services and such other matters as may be reasonably required by the Commissioner of Human Services; [PL 1975, c. 503 (NEW).] Q. Such other information as the superintendent may reasonably require to make the determinations required in section 4204 ; [PL 1989, c. 842, §6 (AMD).] R. A description of procedures to be implemented to meet the protection against insolvency requirements in section 4204, subsection 2‑A, paragraph D and section 4204‑A ; and [PL 1989, c. 842, §7 (NEW).] S. A list of the names and addresses of all physicians and facilities with which the health maintenance organization has or will have agreements. If products are offered that pay full benefits only when providers within a subset of the contracted physicians or facilities are utilized, a list of the providers in that limited network must be included, as well as a list of the geographic areas where the products are offered. [PL 2011, c. 90, Pt. F, §5 (AMD).] [RR 2021, c. 1, Pt. B, §341 (COR).]

4. Each application for a certificate of authority shall be made in duplicate. Upon receipt of an application for a certificate of authority, the superintendent shall immediately transfer one copy to the Commissioner of Health and Human Services. [PL 1981, c. 501, §48 (NEW); PL 2003, c. 689, Pt. B, §7 (REV).]
24-A M.R.S. § 3155 — ME Code / Title 24-A / Chapter 44 / Section 3155
24-A §3155. Required disclosures
Status: in_force

1. Disclosures. An insurer transacting pet insurance shall disclose to consumers: A. Whether the policy excludes coverage due to any of the following: (1) A preexisting condition; (2) A hereditary disorder; (3) A congenital anomaly or disorder; or (4) A chronic condition; [PL 2021, c. 562, §1 (NEW).] B. Whether the policy includes any other exclusions and, if so, add the following statement: "Other exclusions may apply. Please refer to the exclusions section of the policy for more information."; [PL 2021, c. 562, §1 (NEW).] C. Any policy provision that limits coverage through a waiting period or affiliation period, a deductible, coinsurance or an annual or lifetime policy limit; [PL 2021, c. 562, §1 (NEW).] D. Whether the insurer reduces coverage or increases premiums based on the insured's claim history, the age of the covered pet or a change in the geographic location of the insured; and [PL 2021, c. 562, §1 (NEW).] E. Whether the underwriting company differs from the brand name used to market and sell the product. [PL 2021, c. 562, §1 (NEW).] [PL 2021, c. 562, §1 (NEW).]

2. Right to examine and return a policy. Unless the insured has filed a claim under a pet insurance policy, an applicant for pet insurance has the right to examine and return a policy, certificate or rider to the insurer or the insurer's producer within 15 days of its receipt and to have the premium refunded if, after examination of the policy, certificate or rider, the applicant is not satisfied for any reason. A pet insurance policy, certificate or rider must have a notice prominently printed on or attached to the first page including specific instructions for returning a policy. The following statement or language substantially similar to the following statement must be included: "You have 15 days from the day you receive this policy, certificate or rider to review it and return it to the company if you decide not to keep it. You do not have to tell the company why you are returning it. If you decide not to keep it, simply return it to the company at its administrative office or you may return it to the insurance producer that you bought it from as long as you have not filed a claim. You must return it within 15 days of the day you first received it. The company will refund the full amount of any premium paid within 30 days after it receives the returned policy, certificate or rider. The premium refund will be sent directly to the person who paid it. The policy, certificate or rider will be void as if it had never been issued." [PL 2021, c. 562, §1 (NEW).]

3. Basis for claims payments. An insurer shall clearly disclose a summary description of the basis on or formula by which the insurer determines claim payments under a pet insurance policy within the policy, prior to issuance of the policy and through a clear and conspicuous link on the main page of the insurer's or insurer's program administrator's publicly accessible website. [PL 2021, c. 562, §1 (NEW).]

4. Use of benefit schedule. An insurer that uses a benefit schedule to determine claim payments under a pet insurance policy shall: A. Clearly disclose the applicable benefit schedule in the policy; and [PL 2021, c. 562, §1 (NEW).] B. Disclose all benefit schedules used by the insurer under its pet insurance policies through a clear and conspicuous link on the main page of the insurer's or insurer's program administrator's publicly accessible website. [PL 2021, c. 562, §1 (NEW).] [PL 2021, c. 562, §1 (NEW).]

5. Fees. An insurer that determines claim payments under a pet insurance policy based on usual and customary fees, or any other reimbursement limitation based on prevailing veterinary expenses, shall: A. Include a usual and customary fee limitation provision in the policy that clearly describes the insurer's basis for determining usual and customary fees and how that basis is applied in calculating claim payments; and [PL 2021, c. 562, §1 (NEW).] B. Disclose the insurer's basis for determining usual and customary fees through a clear and conspicuous link on the main page of the insurer's or insurer's program administrator's publicly accessible website. [PL 2021, c. 562, §1 (NEW).] [PL 2021, c. 562, §1 (NEW).]

6. Medical examination. If a medical examination by a licensed veterinarian is required to effectuate coverage under a pet insurance policy, the insurer shall clearly and conspicuously disclose the required aspects of the examination prior to purchase and disclose that documentation of the examination may result in a preexisting condition exclusion. [PL 2021, c. 562, §1 (NEW).]

7. Waiting period. A waiting period and any applicable requirements for that waiting period must be clearly and prominently disclosed to consumers prior to the pet insurance policy purchase. [PL 2021, c. 562, §1 (NEW).]

8. Summary of policy provisions. An insurer shall include a summary of all policy provisions required in this section in a separate document titled "Insurer Disclosure of Important Policy Provisions." The insurer shall post the "Insurer Disclosure of Important Policy Provisions" document required in this subsection through a clear and conspicuous link on the main page of the insurer's or insurer's program administrator's publicly accessible website. In connection with the issuance of a new pet insurance policy, the insurer shall provide the consumer with a copy of the "Insurer Disclosure of Important Policy Provisions" document required in this subsection in at least 12-point type upon delivery of the policy. [PL 2021, c. 562, §1 (NEW).]

9. Written disclosure. At the time a pet insurance policy is issued or delivered to a policyholder, the insurer shall include a written disclosure with the following information, printed in 12-point boldface type: A. The bureau's mailing address and toll-free telephone number and a link to the bureau's publicly accessible website; [PL 2021, c. 562, §1 (NEW).] B. The address and customer service telephone number of the insurer or the producer of record; and [PL 2021, c. 562, §1 (NEW).] C. If the policy was issued or delivered by a producer, a statement advising the policyholder how to contact the producer for assistance. [PL 2021, c. 562, §1 (NEW).] [PL 2021, c. 562, §1 (NEW).]

10. Additional disclosures. The disclosures required in this section are in addition to any other disclosure requirements required by law, rule or regulation. [PL 2021, c. 562, §1 (NEW).]
24-A M.R.S. § 2937-A — ME Code / Title 24-A / Chapter 40 / Section 2937-A
24-A §2937-A. Disclosure of underwriting
Status: in_force

A person is deemed to be engaged in deceptive advertising if the person makes, publishes or circulates or causes to be made, published or circulated any written statement relating to an underwritten Maine mass marketing plan, if that written statement does not include a conspicuous notice that some members of the group to which the plan is marketed will not be eligible for insurance. A person making the statement is subject to a desist order issued under section 2165 and to any applicable penalty provided by law. [PL 1989, c. 192, §2 (NEW).]
24-A M.R.S. § 2808 — ME Code / Title 24-A / Chapter 35 / Section 2808
24-A §2808. Other groups
Status: in_force

Group health insurance offered to a resident of this State under a group health insurance policy issued to a group other than one described in sections 2804 to 2807‑A is subject to the following requirements. [PL 1981, c. 147, §8 (RPR).]

1. No group health insurance policy may be delivered in this State, pursuant to this section, unless the superintendent finds that: A. The policyholder is a bona fide group formed for purposes other than procurement of insurance; [PL 1987, c. 476, §4 (AMD).] B. The issuance of the group policy would be actuarially sound; [PL 1981, c. 147, §8 (NEW).] C. The issuance of the group policy would result in economies of acquisition or administration; and [PL 1987, c. 476, §4 (AMD).] D. The benefits are reasonable in relation to the premiums charged. [PL 1981, c. 147, §8 (NEW).] [PL 1987, c. 476, §4 (AMD).]

2. No group health insurance coverage may be offered in this State, pursuant to this section, by an insurer under a policy issued in another state, unless the superintendent has made a determination that the requirements of subsection 1, paragraphs A , B , C and D have been met. [PL 1987, c. 476, §5 (RPR).]

2-A. Notwithstanding subsections 1 and 2 , an employee leasing company registered pursuant to Title 32, chapter 125 qualifies as an eligible group for purposes of the purchase of group health insurance as provided in this section. [PL 1997, c. 393, Pt. A, §26 (AMD).]

3. The premium for the policy shall be paid either from the policyholder's funds or from funds contributed by the covered persons, or from both. [PL 1981, c. 147, §8 (NEW).]

4. Except as provided in section 2736‑C , section 2808‑B and chapter 36 , 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 1999, c. 256, Pt. G, §6 (AMD).]
24-A M.R.S. § 3415 — ME Code / Title 24-A / Chapter 47 / Section 3415
24-A §3415. Borrowed capital funds
Status: in_force

1. A domestic stock or mutual insurer may borrow money to defray the expenses of its organization, provide it with surplus funds or for any purpose of its business, upon a written agreement that such money is required to be repaid only out of the insurer's surplus in excess of that stipulated in the agreement. The agreement may provide for interest not exceeding, per annum, a rate of 5 percentage points in excess of the then current discount rate of the Federal Reserve Bank, Boston, which interest shall or shall not constitute a liability of the insurer as to its funds other than such excess of surplus as stipulated in the agreement. No commission or promotion expense may be paid in connection with any such loan, except that if sale is made of the loan securities through established securities brokers or by public offering, the insurer may pay the reasonable costs thereof approved by the superintendent. [PL 1983, c. 709, §4 (RPR).]

2. Money so borrowed, together with the interest thereon if so stipulated in the agreement, shall not form a part of the insurer's legal liabilities except as to its surplus in excess of the amount thereof stipulated in the agreement, or be the basis of any set-off or counterclaim; but until repaid, financial statements filed or published by the insurer shall show as a footnote thereto the amount thereof then unpaid together with any interest thereon accrued but unpaid. [PL 1969, c. 132, §1 (NEW).]

3. Any such loan is subject to the superintendent's approval. The insurer shall, in advance of the loan, file with the superintendent a statement of the purpose of the loan and a copy of the proposed loan agreement. The loan and agreement must be deemed approved unless within 15 days after date of such filing the insurer is notified of the superintendent's disapproval and the reasons therefor. The superintendent shall disapprove any proposed loan or agreement if the superintendent finds the loan is unnecessary or excessive for the purpose intended, or that the terms of the loan agreement are not fair and equitable to the parties and to other similar lenders, if any, to the insurer, or that the information so filed by the insurer is inadequate. [RR 2021, c. 1, Pt. B, §278 (COR).]

4. Any such loan to an insurer or substantial portion thereof may be repaid by the insurer when no longer reasonably necessary for the purpose originally intended. No repayment of such a loan, whether heretofore or hereafter outstanding shall be made, other than as provided in the loan agreement, unless approved in advance by the superintendent. [PL 1969, c. 177, §58 (AMD); PL 1973, c. 585, §12 (AMD).]

5. This section shall not apply to other kinds of loans obtained by the insurer in ordinary course of business, or to loans secured by pledge or mortgage of assets. [PL 1969, c. 132, §1 (NEW).]

6. Loans authorized under this section may be made by domestic insurers as well as by other persons; but such a loan shall not constitute an asset in any determination of the financial condition of the lending insurer. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2749-C — ME Code / Title 24-A / Chapter 33 / Section 2749-C
24-A §2749-C.  Mental health services coverage
Status: in_force

1. Coverage for treatment for certain mental illnesses. Coverage for medical treatment for mental illnesses listed in paragraph A‑1 by all individual policies is subject to this section. A. [PL 2019, c. 5, Pt. D, §1 (RP).] A-1. All individual contracts must provide, at a minimum, benefits according to paragraph B , subparagraph (1) for a person receiving medical treatment for any of the following categories of mental illness as defined in the Diagnostic and Statistical Manual as defined in section 2843, subsection 3, paragraph A‑1 , except for those that are designated as "V" codes by the Diagnostic and Statistical Manual: (1) Psychotic disorders, including schizophrenia; (2) Dissociative disorders; (3) Mood disorders; (4) Anxiety disorders; (5) Personality disorders; (6) Paraphilias; (7) Attention deficit and disruptive behavior disorders; (8) Pervasive developmental disorders; (9) Tic disorders; (10) Eating disorders, including bulimia and anorexia; and (11) Substance use disorders. For the purposes of this paragraph, the mental illness must be diagnosed by a licensed allopathic or osteopathic physician or a licensed psychologist who is trained and has received a doctorate in psychology specializing in the evaluation and treatment of mental illness. [PL 2019, c. 5, Pt. D, §1 (NEW).] B. All individual policies and contracts executed, delivered, issued for delivery, continued or renewed in this State must provide coverage providing benefits that meet the requirements of this paragraph. (1) The coverage must provide benefits for the treatment and diagnosis of mental illnesses under terms and conditions that are no less extensive than the benefits provided for medical treatment for physical illnesses. (2) At the request of a reimbursing insurer, a provider of medical treatment for mental illness shall furnish data substantiating that initial or continued treatment is medically necessary health care. When making the determination of whether treatment is medically necessary health care, the provider shall use the same criteria for medical treatment for mental illness as for medical treatment for physical illness under the individual policy. An insurer may not deny treatment for mental health services that use evidence-based practices and are determined to be medically necessary health care for an individual 21 years of age or younger. For the purposes of this subparagraph, "evidence-based practices" means clinically sound and scientifically based policies, practices and programs that reflect expert consensus on the prevention, treatment and recovery science, including, but not limited to, policies, practices and programs published and disseminated by the Substance Abuse and Mental Health Services Administration and the Title IV-E Prevention Services Clearinghouse within the United States Department of Health and Human Services, the What Works Clearinghouse within the United States Department of Education, Institute of Education Sciences and the California Evidence-Based Clearinghouse for Child Welfare within the California Department of Social Services, Office of Child Abuse Prevention. [PL 2021, c. 595, §2 (AMD).] [PL 2021, c. 595, §2 (AMD).]

2. Contracts; providers. An insurer incorporated under this chapter shall offer contracts to providers authorizing the provision of mental health services within the scope of the provider's licensure. [PL 2003, c. 20, Pt. VV, §9 (AMD); PL 2003, c. 20, Pt. VV, §25 (AFF).]

3. Limits; coinsurance; deductibles. A policy or contract that provides coverage for the services required by this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section. [PL 1995, c. 407, §5 (NEW).]

4. Reports to the superintendent. Every insurer subject to this section shall report its experience for each calendar year to the superintendent no later than April 30th of the following year. The report must be in a form prescribed by the superintendent and include the amount of claims paid in this State for the services required by this section and the total amount of claims paid in this State for individual health care policies, both separated according to those paid for inpatient, day treatment and outpatient services. The superintendent shall compile this data for all insurers in an annual report. [PL 1995, c. 407, §5 (NEW).]

5. Application. Except as otherwise provided, the requirements of this section apply to all policies and contracts executed, delivered, issued for delivery, continued or renewed in this State on or after July 1, 1996. For purposes of this section, all policies are deemed renewed no later than the next yearly anniversary of the contract date. Nothing in this section applies to accidental injury, specified disease, hospital indemnity, Medicare supplement, long-term care or other limited benefit health insurance policies. [PL 1995, c. 407, §5 (NEW).]
24-A M.R.S. § 2726 — ME Code / Title 24-A / Chapter 33 / Section 2726
24-A §2726. Conformity with state statutes
Status: in_force

There may be a provision as follows: Conformity with state statutes: Any provision of this policy which, on its effective date is in conflict with the statutes of the state in which the insured resides on such date is hereby amended to conform to the minimum requirements of such statutes. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 5051-A — ME Code / Title 24-A / Chapter 68 / Section 5051-A
24-A §5051-A. Required and prohibited provisions
Status: in_force

1. Prohibited provisions. A long-term care policy may not: A. Contain coverage for skilled nursing facilities only; [PL 1989, c. 556, Pt. B, §3 (NEW).] B. Exclude coverage for skilled, intermediate or custodial care received by a resident of a skilled nursing or intermediate care facility; [PL 1989, c. 556, Pt. B, §3 (NEW).] C. Require a prior hospital stay as a condition for any policy benefits; [PL 1989, c. 556, Pt. B, §3 (NEW).] D. Require a prior skilled nursing facility stay as a condition for intermediate care facility benefits; or [PL 1989, c. 556, Pt. B, §3 (NEW).] E. Require prior institutionalization as a condition of receipt of home health care benefits. [PL 1989, c. 556, Pt. B, §3 (NEW).] [PL 1989, c. 556, Pt. B, §3 (NEW).]

2. Required provisions. A long-term care policy must provide: A. Custodial care benefits that are at least 50% of those provided for skilled nursing care in a nursing facility provided that the benefits need not exceed usual, customary and reasonable charges; [PL 1989, c. 556, Pt. B, §3 (NEW).] B. Benefits for home health care services rendered by a home health care provider; [PL 1989, c. 556, Pt. B, §3 (NEW).] C. Home health care coverage for at least 90 visits in any continuous 12-month period during which coverage is in force; and [PL 1989, c. 556, Pt. B, §3 (NEW).] D. Per visit benefits for home health care services which are at least 50% of the daily benefit for skilled nursing facility confinement provided that the benefit need not exceed usual, customary and reasonable charges. [PL 1989, c. 556, Pt. B, §3 (NEW).] [PL 1989, c. 556, Pt. B, §3 (NEW).]
24-A M.R.S. § 4334 — ME Code / Title 24-A / Chapter 56-A / Section 4334
24-A §4334. Substantial insurance risk; substantial enrollment risk
Status: in_force

1. Substantial insurance risk. Substantial insurance risk is risk based on the use or costs of referral services only, when the downstream entity is at risk for more than 25% of potential payments by the carrier to the downstream entity. [PL 1999, c. 609, §20 (NEW).]

2. Substantial enrollment risk. Substantial enrollment risk exists when a carrier enters into a risk arrangement with a downstream entity involving more than 25% of the enrollees served by the carrier in the State unless the risk arrangement is a risk-sharing arrangement. [PL 1999, c. 609, §20 (NEW).]
24-A M.R.S. § 5006-A — ME Code / Title 24-A / Chapter 67 / Section 5006-A
24-A §5006-A. Filing requirements for advertising
Status: in_force

Every issuer of Medicare supplement insurance policies or certificates in this State shall provide a copy of any Medicare supplement advertisement intended for use in this State, whether through written, radio or television medium, to the superintendent for review or approval by the superintendent at least 30 days prior to the date the advertisement will be used in this State. [PL 1991, c. 740, §9 (NEW).]
24-A M.R.S. § 2885 — ME Code / Title 24-A / Chapter 38 / Section 2885
24-A §2885. Filing of group manual rates for informational purposes
Status: in_force

No policy of group legal services insurance may be delivered in this State until a copy of the group manual rates to be used in calculating the premium for these policies has been filed for informational purposes with the superintendent. [PL 1983, c. 801, §11 (NEW).]
24-A M.R.S. § 2264 — ME Code / Title 24-A / Chapter 24-B / Section 2264
24-A §2264. Information security program
Status: in_force

1. Implementation of information security program. Commensurate with the size and complexity of the licensee, the nature and scope of the licensee's activities, including its use of 3rd-party service providers, and the sensitivity of the nonpublic information used by the licensee or in the licensee's possession, custody or control, a licensee shall develop, implement and maintain a comprehensive, written information security program based on the licensee's risk assessment and containing administrative, technical and physical safeguards for the protection of nonpublic information and the licensee's information systems. [PL 2021, c. 24, §1 (NEW).]

2. Objectives of information security program. A licensee's information security program must be designed to: A. Protect the security and confidentiality of nonpublic information and the security of the licensee's information systems; [PL 2021, c. 24, §1 (NEW).] B. Protect against reasonably foreseeable threats or hazards to the security or integrity of nonpublic information and the licensee's information systems; [PL 2021, c. 24, §1 (NEW).] C. Protect against unauthorized access to or use of nonpublic information and minimize the likelihood of harm to any consumer; and [PL 2021, c. 24, §1 (NEW).] D. Define and periodically reevaluate a schedule for retention of nonpublic information and a mechanism for its destruction when it is no longer needed. [PL 2021, c. 24, §1 (NEW).] [PL 2021, c. 24, §1 (NEW).]

3. Risk assessment. A licensee shall: A. Designate one or more employees, an affiliate or another person to act on behalf of the licensee to be responsible for the licensee's information security program; [PL 2021, c. 24, §1 (NEW).] B. Identify reasonably foreseeable internal or external threats that could result in unauthorized access to or transmission, disclosure, misuse, alteration or destruction of nonpublic information, including threats to the security of the licensee's information systems and nonpublic information that are accessible to or held by 3rd-party service providers; [PL 2021, c. 24, §1 (NEW).] C. Assess the likelihood and potential damage of the threats described in paragraph B , taking into consideration the sensitivity of the nonpublic information; [PL 2021, c. 24, §1 (NEW).] D. Assess the sufficiency of policies, procedures and other safeguards in place to manage the threats described in paragraph B , including consideration of threats in each relevant area of the licensee's operations, including: (1) Employee training and management; (2) Information systems, including network and software design, as well as information classification, governance, processing, storage, transmission and disposal; and (3) Detecting, preventing and responding to attacks, intrusions or other system failures; and [PL 2021, c. 24, §1 (NEW).] E. At least annually, assess the effectiveness of the key controls, information systems and procedures and other safeguards in paragraph D implemented to manage the threats described in paragraph B that are identified in the licensee's ongoing assessment. [PL 2021, c. 24, §1 (NEW).] [PL 2021, c. 24, §1 (NEW).]

4. Risk management. Based on its risk assessment pursuant to subsection 3 , a licensee shall: A. Design its information security program to mitigate the identified risks, commensurate with the size and complexity of the licensee, the nature and scope of the licensee's activities, including its use of 3rd-party service providers, and the sensitivity of the nonpublic information used by the licensee or in the licensee's possession, custody or control; [PL 2021, c. 24, §1 (NEW).] B. Consider the following security measures and implement the measures considered appropriate: (1) Place access controls on information systems, including controls to authenticate and permit access only to authorized individuals to protect against the unauthorized acquisition of nonpublic information; (2) Identify and manage the data, personnel, devices, systems and facilities that enable the licensee to achieve its business purposes in accordance with their relative importance to business objectives and the licensee's risk management strategy; (3) Restrict access at physical locations containing nonpublic information to only authorized individuals; (4) Protect, by encryption or other appropriate means, all nonpublic information while it is being transmitted over an external network and all nonpublic information stored on a laptop computer or other portable computing or storage device or media; (5) Adopt secure development practices for applications developed and used by the licensee and procedures for evaluating, assessing or testing the security of externally developed applications used by the licensee; (6) Modify information systems in accordance with the licensee's information security program; (7) Use effective controls, which may include multifactor authentication procedures, for individuals accessing nonpublic information; (8) Regularly test and monitor systems and procedures to detect actual and attempted attacks on or intrusions into information systems; (9) Include audit trails within the information security program designed to detect and respond to cybersecurity events and to reconstruct material financial transactions sufficient to support normal operations and obligations of the licensee; (10) Implement measures to protect against destruction, loss or damage of nonpublic information due to environmental hazards, such as fire and water damage, or other catastrophes or technological failures; and (11) Develop, implement and maintain procedures for the secure disposal of nonpublic information in any format; [PL 2021, c. 24, §1 (NEW).] C. Include cybersecurity risks in the licensee's enterprise risk management process; [PL 2021, c. 24, §1 (NEW).] D. Stay informed regarding emerging threats to or vulnerabilities of information systems and use reasonable security measures when sharing information relative to the character of the sharing and the type of information shared; and [PL 2021, c. 24, §1 (NEW).] E. Provide its personnel with cybersecurity awareness training that is updated as necessary to reflect risks identified by the licensee in its risk assessment. [PL 2021, c. 24, §1 (NEW).] [PL 2021, c. 24, §1 (NEW).]

5. Oversight by board of directors. If a licensee has a board of directors, the board or an appropriate committee of the board, at a minimum, shall require the licensee's executive management or the executive management's delegates to: A. Develop, implement and maintain the licensee's information security program; and [PL 2021, c. 24, §1 (NEW).] B. Report to the board in writing at least annually the following information: (1) The overall status of the licensee's information security program and the licensee's compliance with this chapter; and (2) Material matters related to the information security program, addressing issues such as risk assessment, risk management and control decisions, 3rd-party service provider arrangements, results of testing, cybersecurity events or cybersecurity violations and the executive management's responses to cybersecurity events or cybersecurity violations, and recommendations for changes to the information security program. [PL 2021, c. 24, §1 (NEW).] If a licensee's executive management delegates any of its responsibilities under this section, the licensee's executive management shall oversee each delegate's efforts with respect to the development, implementation and maintenance of the licensee's information security program and shall require each delegate to submit a report to the board pursuant to paragraph B . [PL 2021, c. 24, §1 (NEW).]

6. Oversight of 3rd-party service provider arrangements. A licensee shall: A. Exercise due diligence in selecting its 3rd-party service providers; [PL 2025, c. 348, §30 (AMD).] B. Require each 3rd-party service provider to implement appropriate administrative, technical and physical safeguards to protect and secure the information systems and nonpublic information that are accessible to or held by the 3rd-party service provider; and [PL 2025, c. 348, §30 (AMD).] C. No later than January 1, 2027, require each 3rd-party service provider to notify the licensee when the 3rd-party service provider becomes aware of any cybersecurity event affecting nonpublic information obtained from the licensee that has occurred in an information system maintained by the 3rd-party service provider or by an ancillary service provider if the cybersecurity event has a reasonable likelihood of materially harming any consumer or any material part of the normal operations of the licensee. [PL 2025, c. 348, §30 (NEW).] [PL 2025, c. 348, §30 (AMD).]

7. Program adjustments. A licensee shall monitor, evaluate and adjust, as appropriate, its information security program consistent with any relevant changes in technology, the sensitivity of the licensee's nonpublic information, internal or external threats to nonpublic information and the licensee's own changing business arrangements, such as mergers and acquisitions, alliances and joint ventures, outsourcing arrangements and changes to information systems. [PL 2021, c. 24, §1 (NEW).]

8. Incident response plan. As part of its information security program, a licensee shall establish a written incident response plan designed to promptly respond to and recover from any cybersecurity event that compromises the confidentiality, integrity or availability of nonpublic information in its possession; the licensee's information systems; or the continuing functionality of any aspect of the licensee's business or operations. The incident response plan must address the following areas: A. The internal process for responding to a cybersecurity event; [PL 2021, c. 24, §1 (NEW).] B. The goals of the incident response plan; [PL 2021, c. 24, §1 (NEW).] C. The definition of clear roles, responsibilities and levels of decision-making authority; [PL 2021, c. 24, §1 (NEW).] D. External and internal communications and information sharing; [PL 2021, c. 24, §1 (NEW).] E. Requirements for the remediation of any identified weaknesses in the licensee's information systems and associated controls; [PL 2021, c. 24, §1 (NEW).] F. Documentation and reporting regarding cybersecurity events and related incident response activities; and [PL 2021, c. 24, §1 (NEW).] G. The evaluation and revision as necessary of the incident response plan following a cybersecurity event. [PL 2021, c. 24, §1 (NEW).] [PL 2021, c. 24, §1 (NEW).]

9. Annual certification to superintendent. By April 15th annually, an insurance carrier domiciled in this State shall submit to the superintendent a written statement certifying that the insurance carrier is in compliance with the requirements set forth in this section. An insurance carrier shall maintain for examination by the superintendent all records, schedules and data supporting this certification for a period of 5 years. To the extent that an insurance carrier has identified areas, systems or processes that require material improvement, updating or redesign, the insurance carrier shall document the identification and the remedial efforts planned and underway to address such areas, systems or processes. The documentation required pursuant to this subsection must be available for inspection by the superintendent. [PL 2021, c. 24, §1 (NEW).]
24-A M.R.S. § 3365 — ME Code / Title 24-A / Chapter 47 / Section 3365
24-A §3365. Levy of contingent liability
Status: in_force

1. If at any time the assets of a domestic mutual insurer are less than its liabilities, exclusive of guaranty capital shares, if any, at par value, and the minimum amount of surplus required to be maintained by it under this Title for authority to transact the kinds of insurance being transacted, and the deficiency is not cured from other sources, its directors may, if the same is approved by the superintendent as being reasonable and in the best interests of the insurer and its members, levy an assessment only on its members who held the policies providing for contingent liability at any time within the 12 months next preceding the date the levy was authorized by the board of directors, and such members shall be liable to the insurer for the amount so assessed. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

2. The levy of assessment shall be for such an amount as is required to cure such deficiency and to provide a reasonable amount of working funds above such minimum amount of surplus, but such working funds so provided shall not exceed 5% of the sum of the insurer's liabilities and such minimum required surplus as of the date of the levy. [PL 1969, c. 132, §1 (NEW).]

3. As to the respective policies subject to the levy, the assessment shall be computed upon the basis of premium earned during the period covered by the levy. [PL 1969, c. 132, §1 (NEW).]

4. A member may not have an offset or counterclaim against any assessment for which the member is liable, on account of any claim for unearned premium or loss payable. [RR 2021, c. 1, Pt. B, §269 (COR).]

5. As to life insurance, any part of such an assessment upon a member which remains unpaid following notice of assessment, demand for payment, and lapse of a reasonable waiting period as specified in such notice, may, if approved by the superintendent as being in the best interests of the insurer and its members, be secured by placing a lien upon the cash surrender values and accumulated dividends held or to be held by the insurer to the credit of the member's policy. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 2619 — ME Code / Title 24-A / Chapter 31 / Section 2619
24-A §2619. Payment of benefits
Status: reserved

The group life insurance policy shall contain a provision that any sum becoming due by reason of the death of the person insured shall be payable to the beneficiary designated by the person insured, except that where the policy contains conditions pertaining to family status the beneficiary may be the family member specified by the policy terms, subject to the provisions of the policy, in the event there is no designated beneficiary, as to all or any part of such sum, living at the death of the person insured, and subject to any right reserved by the insurer in the policy and set forth in the certificate to pay at its option a part of such sum not exceeding $2,000 to any person appearing to the insurer to be equitably entitled thereto by reason of having incurred funeral or other expenses incident to the last illness or death of the person insured. [PL 1981, c. 150, §21 (AMD).]
24-A M.R.S. § 6701 — ME Code / Title 24-A / Chapter 83 / Section 6701
24-A §6701. Definitions
Status: in_force

As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 1997, c. 435, §1 (NEW).]

1. Affiliated company. "Affiliated company" means any company in the same corporate system as a parent or a member organization by virtue of common ownership, control, operation or management. [PL 1997, c. 435, §1 (NEW).]

2. Association. "Association" means any legal association of individuals, corporations, limited liability companies, partnerships or associations that have been in continuous existence for at least one year, the member organizations of which: A. Own, control or hold with power to vote all of the outstanding voting securities of an association captive insurance company incorporated as a stock insurer; [PL 2009, c. 335, §1 (AMD).] B. Have complete voting control over an association captive insurance company incorporated as a mutual or reciprocal insurer; or [PL 2009, c. 335, §1 (AMD).] C. Constitute all of the subscribers of an association captive insurance company formed as a reciprocal insurer. [PL 2009, c. 335, §1 (NEW).] [PL 2009, c. 335, §1 (AMD).]

3. Association captive insurance company. "Association captive insurance company" means any company that insures risks of the member organizations of the association and their affiliated companies. [PL 1997, c. 435, §1 (NEW).]

4. Captive insurance company. "Captive insurance company" means any pure captive insurance company, sponsored captive insurance company, association captive insurance company or industrial insured captive insurance company formed or licensed under this chapter. [PL 2009, c. 335, §2 (AMD).]

5. Controlled unaffiliated business. "Controlled unaffiliated business" means a business entity that has a contractual relationship, such as a subcontractor or franchisee relationship, with the parent of a pure captive insurance company or with one or more of its affiliates, satisfying the following criteria: A. The business entity is not in the corporate system of the pure captive insurance company's parent; [PL 2017, c. 169, Pt. G, §1 (AMD).] B. The contractual relationship provides that all or a material part of the business entity's operations are dedicated to business activities undertaken or managed by the pure captive insurance company's parent or by one or more of its affiliates; and [PL 2017, c. 169, Pt. G, §1 (AMD).] C. [PL 2009, c. 335, §3 (RP).] D. Substantially all of the captive insurance company's coverage of the business entity is for risks arising out of the activities described in paragraph B , and those risks are managed by the captive insurance company in accordance with this chapter. [PL 2017, c. 169, Pt. G, §1 (AMD).] [PL 2017, c. 169, Pt. G, §1 (AMD).]

6. Industrial insured. "Industrial insured" means an insured: A. Who procures the insurance of any risk or risks by use of the services of a full-time employee acting as an insurance manager or buyer; [PL 1997, c. 435, §1 (NEW).] B. Whose aggregate annual premium for insurance on all risks totals at least $25,000; and [PL 1997, c. 435, §1 (NEW).] C. Who has at least 25 full-time employees. [PL 1997, c. 435, §1 (NEW).] [PL 1997, c. 435, §1 (NEW).]

7. Industrial insured captive insurance company. "Industrial insured captive insurance company" means any company that insures risks of the industrial insureds that comprise the industrial insured group and their affiliated companies. [PL 1997, c. 435, §1 (NEW).]

8. Industrial insured group. "Industrial insured group" means any group that meets either of the following criteria: A. A group of industrial insureds that collectively: (1) Owns, controls or holds with power to vote all of the outstanding voting securities of an industrial insured captive insurance company incorporated as a stock insurer; (2) Has complete voting control over an industrial insured captive insurance company incorporated as a mutual insurer; or (3) Constitutes all of the subscribers of an industrial insured captive insurance company formed as a reciprocal insurer; or [PL 2009, c. 335, §5 (AMD).] B. Any group created under the Product Liability Risk Retention Act of 1981, 15 United States Code, Section 3901 et seq., as amended, as a corporation or other limited liability association taxable as a stock insurance company or a mutual insurer under the laws of the State. [PL 1997, c. 435, §1 (NEW).] [PL 2009, c. 335, §5 (AMD).]

9. Member organization. "Member organization" means any individual, corporation, limited liability company, partnership or association that belongs to an association. [PL 2009, c. 335, §6 (AMD).]

10. Parent. "Parent" means a corporation, limited liability company, partnership or individual that directly or indirectly owns, controls or holds with power to vote more than 50% of the outstanding voting securities of a pure captive insurance company organized as a stock corporation or 50% of the membership interests of a pure captive insurance company organized as a nonprofit corporation. [PL 2009, c. 335, §7 (AMD).]

11. Pure captive insurance company. "Pure captive insurance company" means any company that insures risks of its parent and affiliated companies or controlled unaffiliated businesses but does not include those insurers that otherwise qualify for and elect to hold a certificate of authority as an insurer under section 414 . "Pure captive insurance company" includes, with respect to operations in this State unless otherwise restricted by the superintendent, a branch captive insurance company. [PL 2009, c. 335, §8 (AMD).]

12. Pure nonprofit captive insurance company. "Pure nonprofit captive insurance company" means a pure captive insurance company formed without capital stock as a nonprofit corporation, whose voting or membership interest is held by a parent organization formed under a nonprofit law. [PL 2017, c. 169, Pt. G, §2 (AMD).]
24-A M.R.S. § 2847-C — ME Code / Title 24-A / Chapter 35 / Section 2847-C
24-A §2847-C. Notification prior to cancellation; restrictions on cancellation, termination or lapse due to cognitive impairment or functional incapacity
Status: in_force

An insurer shall provide for notification of the insured person and another person, if designated by the insured, prior to cancellation of a health insurance certificate for nonpayment of premium. [PL 2011, c. 123, §3 (AMD); PL 2011, c. 123, §5 (AFF).]

Within 90 days after cancellation due to nonpayment of premium, a policyholder, a person authorized to act on behalf of the policyholder or a dependent of the policyholder covered under a health insurance policy or certificate may request reinstatement on the basis that the loss of coverage was a result of the policyholder's cognitive impairment or functional incapacity. An insurer may require a medical demonstration that the policyholder suffered from cognitive impairment or functional incapacity at the time of cancellation. If the medical demonstration is waived or substantiates the existence of a cognitive impairment or functional incapacity at the time of policy cancellation to the satisfaction of the insurer, the policy must be reinstated. The medical demonstration may be at the expense of the policyholder. [PL 2011, c. 123, §3 (NEW); PL 2011, c. 123, §5 (AFF).]

A policy reinstated pursuant to this section must cover any loss or claim occurring from the date of the cancellation. Within 15 days after request from an insurer, a policyholder of a policy reinstated pursuant to this section shall pay any unpaid premium from the date of the last premium payment at the rate that would have been in effect had the policy remained in force. If the premium is not paid as required, the policy may not be reinstated and the insurer is not responsible for claims incurred after the initial date of cancellation. If an insurer denies a request for reinstatement, the insurer shall notify the policyholder that the policyholder may request a hearing before the superintendent. [PL 2011, c. 123, §3 (NEW); PL 2011, c. 123, §5 (AFF).]

The superintendent may adopt rules to implement the requirements of this section. The rules may include, but are not limited to, definitions, minimum disclosure requirements, notice provisions and the right of reinstatement. Rules adopted pursuant to this section are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2011, c. 123, §3 (AMD); PL 2011, c. 123, §5 (AFF).]

The requirements of this section apply to all policies and certificates executed, delivered, issued for delivery, continued or renewed in this State. [PL 1991, c. 695, §5 (NEW); PL 1991, c. 824, Pt. A, §51 (NEW).]
24-A M.R.S. § 2837-D — ME Code / Title 24-A / Chapter 35 / Section 2837-D
24-A §2837-D. Medical food coverage for inborn error of metabolism
Status: in_force

1. Inborn error of metabolism; special modified low-protein food product. As used in this section, "inborn error of metabolism" means a genetically determined biochemical disorder in which a specific enzyme defect produces a metabolic block that may have pathogenic consequences at birth or later in life. As used in this section, "special modified low-protein food product" means food formulated to reduce the protein content to less than one gram of protein per serving and does not include foods naturally low in protein. [PL 1995, c. 369, §3 (NEW).]

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

3. Application. The requirements of this section apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 1996. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 1995, c. 369, §3 (NEW).]
24-A M.R.S. § 2174-B — ME Code / Title 24-A / Chapter 23 / Section 2174-B
24-A §2174-B. Law enforcement officers' and emergency responders' insurance rates
Status: in_force

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Law enforcement officer" means any person employed by a governmental entity who by virtue of that employment is vested by law with a duty to investigate and prosecute violators of the laws of this State and to arrest the offenders of the laws. [PL 1989, c. 737, §2 (NEW).] B. "Emergency responder" means: (1) A municipal firefighter, as defined in Title 30‑A, section 3151, subsection 2 ; or a volunteer firefighter, as defined in Title 30‑A, section 3151, subsection 4 , who is operating a municipal vehicle; or (2) An operator of a vehicle under Title 29‑A, section 2054 that is licensed or authorized pursuant to Title 32, chapter 2‑B as an ambulance or emergency medical services vehicle, when that operator is acting with the approval of an ambulance service or nontransporting service licensed pursuant to Title 32, chapter 2‑B . [PL 2011, c. 493, §1 (NEW).] [PL 2011, c. 493, §1 (AMD).]

2. Law enforcement officers; emergency responders. An insurer may not increase the premium for a personal insurance policy providing motor vehicle liability or collision insurance to a law enforcement officer or an emergency responder on the basis of one or more accidents involving a motor vehicle operated by the officer or emergency responder if: A. The accident occurred while the officer or emergency responder was operating a motor vehicle in the course and scope of employment; and [PL 2011, c. 493, §1 (AMD).] B. There is a policy of insurance other than the personal policy providing motor vehicle liability or collision coverage for the accident or accidents. [PL 1989, c. 737, §2 (NEW).] [PL 2011, c. 493, §1 (AMD).]

3. Governmental entity. This section in no way restricts the premium an insurer may charge a governmental entity for an insurance policy providing motor vehicle liability or collision insurance covering law enforcement officers or emergency responders. [PL 2011, c. 493, §1 (AMD).]

4. Penalty. An insurer who violates this section commits a civil violation pursuant to section 12‑A . [PL 1997, c. 114, §1 (NEW).]
24-A M.R.S. § 2718 — ME Code / Title 24-A / Chapter 33 / Section 2718
24-A §2718. Optional policy provisions
Status: in_force

Except as provided in section 2704, subsection 2 , no such policy delivered or issued for delivery to any person in this State shall contain provisions respecting the matters set forth in sections 2719 to 2728 , unless such provisions are in the words in which the same appear in the applicable section, except that the insurer may, at its option, use in lieu of any such provision a corresponding provision of different wording approved by the superintendent which is not less favorable in any respect to the insured or the beneficiary. Any such provision contained in the policy shall be preceded individually by the appropriate caption or, at the option of the insurer, by such appropriate individual or group captions or subcaptions as the superintendent may approve. [PL 1969, c. 177, §46 (AMD); PL 1973, c. 585, §12 (AMD).]
24 M.R.S. § 2304 — ME Code / Title 24 / Chapter 19 / Section 2304
24 §2304. Licenses
Status: in_force

Application for the authority provided for in section 2305 must be made in the form required by the superintendent and must contain the information the superintendent considers necessary. The application must be accompanied by a copy of each of the following documents: [RR 2019, c. 2, Pt. B, §73 (COR).]

1. Certificate of incorporation. Certificates of incorporation;

2. Bylaws. Bylaws;

3. Proposed contracts. Proposed contracts between the corporation and participating providers of health care showing the terms under which the health care service is to be furnished to subscribers; [PL 1969, c. 419, §3 (AMD).]

4. Rates and benefits. Contracts to be issued to subscribers showing a table of the rates to be charged and the benefits to which they are entitled;

5. Financial statement. Financial statement of the corporation, including the contributions paid or agreed to be paid to the corporation for working capital, the name of each contributor, and the terms of each contribution. The contributions must total at least $5,000.
24-A M.R.S. § 2387 — ME Code / Title 24-A / Chapter 25 / Section 2387
24-A §2387. Penalty for violations
Status: in_force

1. Civil penalties. A person or organization in violation of this chapter must be assessed by the superintendent a civil penalty not more than $1,000 for each violation, except that where a violation is willful, a civil penalty of not more than $10,000 must be assessed for each violation. These penalties may be in addition to any other penalty provided by law. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

2. Separate violation. For purposes of this section, an insurer using a rate for which that insurer has failed to file the rate, supplementary rate information or supporting information as required by this subchapter, has committed a separate violation for each day that failure continues. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

3. License. The license of an advisory organization, rating organization or insurer that fails to comply with an order of the superintendent may be suspended or revoked by the District Court. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF); PL 1999, c. 547, Pt. B, §78 (AMD); PL 1999, c. 547, Pt. B, §80 (AFF).]
24-A M.R.S. § 2381-A — ME Code / Title 24-A / Chapter 25 / Section 2381-A
24-A §2381-A. Purposes
Status: in_force

The purposes of this Act are: [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

1. Prohibition of certain behavior. To prohibit price-fixing agreements and other anticompetitive behavior by insurers; [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

2. Protection for policyholders and the public. To protect policyholders and the public from the adverse effects of excessive, inadequate or unfairly discriminatory rates; [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

3. Promotion of price competition. To promote price competition among insurers so as to provide rates that are responsive to competitive market conditions; [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

4. Provision of regulatory procedures. To provide regulatory procedures for the maintenance of appropriate data reporting systems; [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

5. Improvement of insurance. To improve availability, fairness and reliability of insurance; [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

6. Authorization of action. To authorize essential cooperative action among insurers in the rate-making process and to regulate such activity to prevent practices that tend to substantially lessen competition or create a monopoly; and [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

7. Encouragement of practices. To encourage the most efficient and economical marketing practices. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]
24 M.R.S. § 2319-A — ME Code / Title 24 / Chapter 19 / Section 2319-A
24 §2319-A. Mandated offer of domestic partner benefits
Status: in_force

1. Definition. [PL 2021, c. 567, §26 (RP).]

2. Mandated offer of domestic partner benefits. All individual or group contracts issued by any nonprofit hospital or medical service organization operating pursuant to this chapter must make available to an individual or group policyholder the option for additional benefits for the domestic partner of a subscriber or member, at appropriate rates and under the same terms and conditions as those benefits or options for benefits are provided to spouses of married subscribers or members covered under an individual or group policy. [PL 2001, c. 347, §1 (NEW); PL 2001, c. 347, §5 (AFF).]

3. Financial dependency. Financial dependency of a domestic partner on the subscriber or member may not be required as a condition for eligibility for coverage. [PL 2001, c. 347, §1 (NEW); PL 2001, c. 347, §5 (AFF).]

4. Evidence of domestic partnership. As a condition of eligibility for coverage, a nonprofit hospital and medical service organization or a group policyholder may require a subscriber or member and the subscriber's or member's domestic partner to sign an affidavit attesting that the subscriber or member and the subscriber's or member's domestic partner meet the definition of domestic partner under Title 1, section 72, subsection 2‑C and to show documentation of joint ownership or occupancy of real property, such as a joint deed, joint mortgage or joint lease, or the existence of a joint credit card, joint bank account or powers of attorney in which each domestic partner is authorized to act for the other. [PL 2021, c. 567, §27 (AMD).]

5. Preexisting conditions. A domestic partner is subject to the same provisions on coverage of preexisting conditions as any spouse or dependent of a subscriber or member. [PL 2001, c. 347, §1 (NEW); PL 2001, c. 347, §5 (AFF).]

6. Termination of domestic partner benefits. A nonprofit hospital and medical service organization may terminate coverage in accordance with other applicable provisions of this Title for the domestic partner of a subscriber or member upon notification by the subscriber or member that the domestic partner relationship has terminated. [PL 2021, c. 567, §28 (AMD).]

7. Construction. This section does not prohibit a nonprofit hospital and medical service organization from negotiating a policy providing domestic partner benefits to a policyholder that does not comply with the requirements of this section. [PL 2001, c. 347, §1 (NEW); PL 2001, c. 347, §5 (AFF).]
24-A M.R.S. § 2487 — ME Code / Title 24-A / Chapter 28 / Section 2487
24-A §2487. Binding effect of compact and other laws -- Article 16
Status: in_force

1. Laws of compacting state. Nothing in this chapter prevents the enforcement of any laws of a compacting state other than this compact, except as provided in subsection 2 . [PL 2003, c. 680, §1 (NEW).]

2. Exclusive provisions. For any product approved by or certified to the commission, the rules, uniform standards and any other requirements of the commission constitute the exclusive provisions applicable to the content, approval and certification of that product. For an advertisement that is subject to the commission's authority, any rule, uniform standard or other requirement of the commission that governs the content of the advertisement constitutes the exclusive provision that a commissioner may apply to the content of the advertisement. Notwithstanding this subsection, an action taken by the commission may not abrogate or restrict: A. The access of any person to state courts; [PL 2003, c. 680, §1 (NEW).] B. Remedies available under state law related to breach of contract, tort or other laws not specifically directed to the content of the product; [PL 2003, c. 680, §1 (NEW).] C. State law relating to the construction of insurance contracts; or [PL 2003, c. 680, §1 (NEW).] D. The authority of the attorney general of the state, including, but not limited to, maintaining any actions or proceedings, as authorized by law. [PL 2003, c. 680, §1 (NEW).] [PL 2003, c. 680, §1 (NEW).]

3. Insurance products subject to laws. All insurance products filed with individual states are subject to the laws of those states. [PL 2003, c. 680, §1 (NEW).]

4. Binding effect of compact. The compact is binding as follows. A. All lawful actions of the commission, including all rules and operating procedures promulgated by the commission, are binding upon the compacting states. [PL 2003, c. 680, §1 (NEW).] B. All agreements between the commission and the compacting states are binding in accordance with their terms. [PL 2003, c. 680, §1 (NEW).] C. Upon the request of a party to a conflict over the meaning or interpretation of commission actions, and upon a majority vote of the compacting states, the commission may issue advisory opinions regarding the meaning or interpretation in dispute. [PL 2003, c. 680, §1 (NEW).] D. In the event any provision of this compact exceeds the constitutional limits imposed on the legislature of a compacting state, the obligation, duty, power or jurisdiction sought to be conferred by that provision upon the commission is ineffective as to that compacting state, and that obligation, duty, power or jurisdiction remains in the compacting state and must be exercised by the agency thereof to which that obligation, duty, power or jurisdiction is delegated by law in effect at the time this compact becomes effective. [PL 2003, c. 680, §1 (NEW).] [PL 2003, c. 680, §1 (NEW).]
24-A M.R.S. § 6910 — ME Code / Title 24-A / Chapter 87 / Section 6910
24-A §6910. Dirigo Health Program
Status: in_force

1. Dirigo Health Program. Dirigo Health shall arrange for the provision of health benefits coverage through the Dirigo Health Program not later than October 1, 2004. The Dirigo Health Program must comply with all relevant requirements of this Title. Dirigo Health Program coverage may be offered by health insurance carriers that apply to the board and meet qualifications described in this section and any additional qualifications set by the board or may be provided through the Dirigo Health Self-administered Plan pursuant to section 6981 . [PL 2007, c. 447, §9 (AMD).]

2. Legislative approval of nonprofit health care plan or expansion of public plan. If health insurance carriers do not apply to offer and deliver Dirigo Health Program coverage, the board may have Dirigo Health provide access to health insurance by proposing the establishment of a nonprofit health care plan organized under Title 13‑B and authorized pursuant to Title 24, chapter 19 or by proposing the expansion of an existing public plan. If the board proposes the establishment of a nonprofit health care plan or the expansion of an existing public plan, the board shall submit its proposal, including, but not limited to, a funding mechanism to capitalize a nonprofit health care plan and any recommended legislation to the joint standing committee of the Legislature having jurisdiction over health insurance matters. Dirigo Health may not provide access to health insurance by establishing a nonprofit health care plan or through an existing public plan without specific legislative approval. [PL 2005, c. 400, Pt. C, §8 (AMD).]

3. Carrier participation requirements. To qualify as a carrier of Dirigo Health Program coverage, a health insurance carrier must: A. Provide the comprehensive health services and benefits as determined by the board, including a standard benefit package that meets the requirements for mandated coverage for specific health services, specific diseases and for certain providers of health services under Title 24 and this Title and any supplemental benefits the board wishes to make available; and [PL 2003, c. 469, Pt. A, §8 (NEW).] B. Ensure that: (1) Providers contracting with a carrier contracted to provide coverage to plan enrollees do not charge plan enrollees or 3rd parties for covered health care services in excess of the amount allowed by the carrier the provider has contracted with, except for applicable copayments, deductibles or coinsurance or as provided in section 4204, subsection 6 ; (2) Providers contracting with a carrier contracted to provide coverage to plan enrollees do not refuse to provide services to a plan enrollee on the basis of health status, medical condition, previous insurance status, race, age, religion, ancestry or national origin, citizenship status, sex, sexual orientation, gender identity, disability or marital status. This subparagraph may not be construed to require a provider to furnish medical services that are not within the scope of that provider's license; and (3) Providers contracting with a carrier contracted to provide coverage to plan enrollees are reimbursed at the negotiated reimbursement rates between the carrier and its provider network. [PL 2021, c. 553, §17 (AMD).] Health insurance carriers that seek to qualify to provide Dirigo Health Program coverage must also qualify as health plans in Medicaid. [PL 2021, c. 553, §17 (AMD).]

4. Contracting authority. Dirigo Health has contracting authority and powers to administer Dirigo Health Insurance as set out in this subsection. A. Dirigo Health may contract with health insurance carriers licensed to sell health insurance in this State or other private or public third-party administrators to provide Dirigo Health Program coverage. In addition: (1) Dirigo Health shall issue requests for proposals from health insurance carriers; (2) Dirigo Health may include quality improvement, disease prevention, disease management and cost-containment provisions in the contracts with participating health insurance carriers or may arrange for the provision of such services through contracts with other entities; (3) Dirigo Health shall require participating health insurance carriers to offer a benefit plan identical to the Dirigo Health Program, for which no Dirigo Health subsidies are available, in the general small group market; (4) Dirigo Health shall make payments to participating health insurance carriers under a Dirigo Health Program contract to provide Dirigo Health Program benefits to plan enrollees not enrolled in MaineCare; (5) Dirigo Health may set allowable rates for administration and underwriting gains for the Dirigo Health Program; (6) Dirigo Health may administer continuation benefits for eligible individuals from employers with 20 or more employees who have purchased health insurance coverage through Dirigo Health for the duration of their eligibility periods for continuation benefits pursuant to the federal Consolidated Omnibus Budget Reconciliation Act, Public Law 99-272, Title X, Private Health Insurance Coverage, Sections 10001 to 10003; and (7) Dirigo Health may administer or contract to administer the United States Internal Revenue Code of 1986, Section 125 plans for employers and employees participating in Dirigo Health, including medical expense reimbursement accounts and dependent care reimbursement accounts. [PL 2005, c. 400, Pt. C, §8 (AMD).] B. Dirigo Health shall contract with eligible businesses seeking assistance from Dirigo Health in arranging for health benefits coverage by the Dirigo Health Program for their employees and dependents as set out in this paragraph. (1) Dirigo Health may establish contract and other reporting forms and procedures necessary for the efficient administration of contracts. (2) Dirigo Health shall collect payments from participating employers and plan enrollees to cover the cost of: (a) The Dirigo Health Program for enrolled employees and dependents in contribution amounts determined by the board; (b) Dirigo Health's quality assurance, disease prevention, disease management and cost-containment programs; (c) Dirigo Health's administrative services; and (d) Other health promotion costs. (3) Dirigo Health shall establish the minimum required contribution levels, not to exceed 60%, to be paid by employers toward the aggregate payment in subparagraph (2) and establish an equivalent minimum amount to be paid by employers or plan enrollees and their dependents who are enrolled in MaineCare. The minimum required contribution level to be paid by employers must be prorated for employees that work less than the number of hours of a full-time equivalent employee as determined by the employer. Dirigo Health may establish a separate minimum contribution level to be paid by employers toward coverage for dependents of the employers' enrolled employees. (4) Dirigo Health shall require participating employers to certify that at least 75% of their employees that work 30 hours or more per week and who do not have other creditable coverage are enrolled in the Dirigo Health Program and that the employer group otherwise meets the minimum participation requirements specified by section 2808‑B, subsection 4, paragraph A . (5) Dirigo Health shall reduce the payment amounts for plan enrollees eligible for a subsidy under section 6912 accordingly. Dirigo Health shall return any payments made by plan enrollees also enrolled in MaineCare to those enrollees. (6) Dirigo Health shall require participating employers to pass on any subsidy in section 6912 to the plan enrollee qualifying for the subsidy, up to the amount of payments made by the plan enrollee. (7) Dirigo Health may establish other criteria for participation. (8) Dirigo Health may limit the number of participating employers. [PL 2005, c. 400, Pt. C, §8 (AMD).] C. Dirigo Health may permit eligible individuals to purchase Dirigo Health Program coverage for themselves and their dependents as set out in this paragraph. (1) Dirigo Health may establish contract and other reporting forms and procedures necessary for the efficient administration of contracts. (2) Dirigo Health may collect payments from eligible individuals participating in the Dirigo Health Program to cover the cost of: (a) Enrollment in the Dirigo Health Program for eligible individuals and dependents; (b) Dirigo Health's quality assurance, disease prevention, disease management and cost-containment programs; (c) Dirigo Health's administrative services; and (d) Other health promotion costs. (3) Dirigo Health shall reduce the payment amounts for individuals eligible for a subsidy under section 6912 accordingly. (4) Dirigo Health may require that eligible individuals certify that all their dependents are enrolled in the Dirigo Health Program or are covered by another creditable plan. (5) Dirigo Health may require an eligible individual who is currently employed by an eligible employer that does not offer health insurance to certify that the current employer did not provide access to an employer-sponsored benefits plan in the 12-month period immediately preceding the eligible individual's application. (6) Dirigo Health may limit the number of plan enrollees. (7) Dirigo Health may establish other criteria for participation. [PL 2005, c. 400, Pt. C, §8 (AMD).] [PL 2005, c. 400, Pt. C, §8 (AMD).]

5. Enrollment in Dirigo Health Program. Dirigo Health shall perform, at a minimum, the following functions to facilitate enrollment in the Dirigo Health Program. A. Dirigo Health shall publicize the availability of the Dirigo Health Program to businesses, self-employed individuals and others eligible to enroll in the Dirigo Health Program. [PL 2005, c. 400, Pt. C, §8 (AMD).] B. Dirigo Health shall screen all eligible individuals and employees for eligibility for subsidies under section 6912 and eligibility for MaineCare. To facilitate the screening and referral process, Dirigo Health shall provide a single application form for Dirigo Health and MaineCare. The application materials must inform applicants of subsidies available through Dirigo Health and of the additional coverage available through MaineCare. It must allow an applicant to choose on the application form to apply or not to apply for MaineCare or for a subsidy. It must allow an applicant to provide household financial information necessary to determine eligibility for MaineCare or a subsidy. Except when the applicant has declined to apply for MaineCare or a subsidy, an application must be treated as an application for Dirigo Health, for a subsidy and for MaineCare. MaineCare must make the final determination of eligibility for MaineCare. [PL 2003, c. 469, Pt. A, §8 (NEW).] C. Except as provided in this paragraph, the effective date of coverage for a new enrollee in the Dirigo Health Program is the first day of the month following receipt of the fully completed application for that enrollee by the carrier contracting with Dirigo Health or the first day of the next month if the fully completed application is received by the carrier within 10 calendar days of the end of the month. If a new enrollee in the Dirigo Health Program had prior coverage through an individual or small group policy, coverage under the Dirigo Health Program must take effect the day following termination of that enrollee's prior coverage. [PL 2005, c. 400, Pt. C, §8 (AMD).] [PL 2005, c. 400, Pt. C, §8 (AMD).]

6. Quality improvement, disease management and cost containment. Dirigo Health shall promote quality improvement, disease prevention, disease management and cost-containment programs as part of its administration of the Dirigo Health Program. [PL 2005, c. 400, Pt. C, §8 (AMD).]
24-A M.R.S. § 3612 — ME Code / Title 24-A / Chapter 51 / Section 3612
24-A §3612. Guaranty capital shares; deficiency and assessment
Status: in_force

When the cash and other available assets of an insurer with guaranty capital shares are exhausted, such part of the guaranty capital fund as may be required shall, with the approval of the superintendent, be drawn and used to pay losses then due. When such fund is so drawn upon, the directors of the insurer shall make good the amount so drawn by assessments upon the contingent funds or notes of the insurer or by borrowed funds as provided for under section 3415 ; and unless such fund is restored within 6 months from the date of withdrawal, the holders of guaranty fund shares shall be assessed in proportion to the amount of such shares owned by them for the purpose of restoring such capital. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 7754 — ME Code / Title 24-A / Chapter 103 / Section 7754
24-A §7754. Prohibition of certain discriminatory actions with respect to reimbursement of 340B entities
Status: in_force

With respect to reimbursement of a 340B entity for 340B drugs, a health insurance issuer, pharmacy benefits manager or other 3rd-party payor or agent may not: [PL 2025, c. 388, Pt. P, §5 (NEW).]

1. Reimbursement at lower rate prohibited. Reimburse a 340B entity for 340B drugs at a rate lower than that paid for the same drug to entities that are not 340B entities or lower the reimbursement amount for a claim on the basis that the claim is for a 340B drug; [PL 2025, c. 388, Pt. P, §5 (NEW).]

2. Imposition of different terms and conditions prohibited. Impose any terms or conditions on any 340B entity that differ from such terms or conditions applied to entities that are not 340B entities or pharmacies that are not 340B contract pharmacies because it is a 340B entity including, without limitation: A. Fees, charges, clawbacks or other adjustments or assessments. For purposes of this paragraph, "other adjustment or assessment" includes, without limitation, placing any additional requirements, restrictions or burdens upon the 340B entity that result in administrative costs or fees to the 340B entity that are not placed upon entities that are not 340B entities, including affiliate pharmacies of the health insurance issuer, pharmacy benefits manager or other 3rd-party payor; [PL 2025, c. 388, Pt. P, §5 (NEW).] B. Dispensing fees that are less than the dispensing fees for entities that are not 340B entities or pharmacies that are not 340B contract pharmacies; [PL 2025, c. 388, Pt. P, §5 (NEW).] C. Restrictions or requirements regarding participation in standard or preferred pharmacy networks; [PL 2025, c. 388, Pt. P, §5 (NEW).] D. Requirements relating to inventory management systems or to the frequency or scope of audits; [PL 2025, c. 388, Pt. P, §5 (NEW).] E. Requirements that a claim for a drug dispensed by a pharmacy include any identification, billing modifier, attestation or other indication that a drug is a 340B drug in order to be processed or submitted or reimbursed unless it is required by the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services or the Department of Health and Human Services for the administration of the MaineCare program; or [PL 2025, c. 388, Pt. P, §5 (NEW).] F. Any other restrictions, conditions, practices or policies that are not imposed on entities that are not 340B entities; [PL 2025, c. 388, Pt. P, §5 (NEW).] [PL 2025, c. 388, Pt. P, §5 (NEW).]

3. Reversal, resubmission or clarification of claims prohibited. Require a 340B entity to reverse, resubmit or clarify a claim after the initial adjudication unless these actions are in the normal course of pharmacy business and are not related to 340B drug pricing; [PL 2025, c. 388, Pt. P, §5 (NEW).]

4. Discrimination against 340B entity that interferes with patient choice. Discriminate against a 340B entity in a manner that prevents or interferes with a patient's choice to receive 340B drugs from the 340B entity, including the administration of the drugs. For purposes of this subsection, it is considered a discriminatory practice that prevents or interferes with a patient's choice to receive drugs at a 340B entity if a health insurance issuer, pharmacy benefits manager or other 3rd-party payor places any additional requirements, restrictions or burdens upon the 340B entity that differ from the terms and conditions applied to entities that are not 340B entities that result in administrative costs or fees to the 340B entity, including, but not limited to, requiring a claim for a drug dispensed by a pharmacy to include any identification, billing modifier, attestation or other indication that a drug is a 340B drug in order to be processed or resubmitted unless it is required by the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services or the Department of Health and Human Services for the administration of the MaineCare program; [PL 2025, c. 388, Pt. P, §5 (NEW).]

5. Discrimination against 340B entity that interferes with patient choice of delivery method. Include any other provision in a contract between a health insurance issuer, pharmacy benefits manager or other 3rd-party payor and a 340B entity that differs from the terms and conditions applied to entities that are not 340B entities that discriminates against the 340B entity that participates in the 340B program or prevents or interferes with a patient's choice to receive a 340B drug from a 340B entity, whether by direct administration, in-person dispensing, direct delivery, mail or other form of shipment; [PL 2025, c. 388, Pt. P, §5 (NEW).]

6. Restrictions or additional charges prohibited. Place a restriction or additional charge on a patient who chooses to receive 340B drugs from a 340B entity if the restriction or additional charge differs from the terms and conditions applied when patients choose to receive drugs that are not 340B drugs from an entity that is not a 340B entity or from a pharmacy that is not a 340B contract pharmacy; [PL 2025, c. 388, Pt. P, §5 (NEW).]

7. Submission of data pertaining to ingredient costs or pricing of 340B drugs prohibited. Require or compel the submission of ingredient costs or pricing data pertaining to 340B drugs from a 340B entity to any health insurance issuer, pharmacy benefits manager or other 3rd-party payor; or [PL 2025, c. 388, Pt. P, §5 (NEW).]

8. Exclusion from pharmacy network prohibited. Exclude any 340B entity from the health insurance issuer, pharmacy benefits manager or other 3rd-party payor network on the basis that the 340B entity dispenses 340B drugs or refuse to contract with a 340B entity for reasons other than those that apply equally to entities that are not 340B entities. [PL 2025, c. 388, Pt. P, §5 (NEW).]

This section may not be construed to limit a health insurance issuer's ability to use certain preferred pharmacies or develop networks of preferred pharmacies as long as a health insurance issuer's decision is not based on an entity's status as a 340B entity. [PL 2025, c. 388, Pt. P, §5 (NEW).]
24-A M.R.S. § 3413 — ME Code / Title 24-A / Chapter 47 / Section 3413
24-A §3413. Prohibited pecuniary interest of officials and others; use of confidential information prohibited
Status: in_force

1. Any officer or director, or any member of any committee or any employee of a domestic insurer, having the duty or power of investing or handling the insurer's funds, may not deposit or invest such funds except in the insurer's name; may not borrow the funds of the insurer; or be pecuniarily interested in any loan, pledge, deposit, security, investment, sale, purchase, exchange, reinsurance or other similar transaction or property of the insurer except as a stockholder, member, employee or director, unless the transaction is authorized or approved by the insurer's board of directors, with knowledge and recording of such pecuniary interest, by affirmative vote of not less than 2/3 of the directors; and may not take or receive to the officer's, director's or member's own use any fee, brokerage, commission, gift or other similar consideration for or on account of any such transaction made by or on behalf of the insurer. [RR 2021, c. 1, Pt. B, §272 (COR).]

2. A director, officer or employee of a domestic insurer may not directly or indirectly use for the director's, officer's or employee's own private pecuniary advantage confidential information concerning the insurer or its past, existing or proposed affairs or transactions acquired by the director, officer or employee in the course of the director's, officer's or employee's services as such director, officer or employee. The amount of any financial gain realized directly or indirectly by any such individual and accompanied by violation of this subsection belongs to the insurer, and is recoverable by the insurer by civil suit. This subsection does not apply as to transactions in shares of a stock insurer that are subject to section 16 of the Securities Exchange Act of 1934, as amended. [RR 2021, c. 1, Pt. B, §273 (COR).]

3. No insurer shall guarantee the financial obligation of any of its officers or directors. [PL 1969, c. 132, §1 (NEW).]

4. This section does not prohibit such a director, officer, member of a committee or employee from becoming a policyholder of the insurer and enjoying the usual rights of a policyholder or from participating as beneficiary in any pension trust, deferred compensation plan, profit sharing plan, stock option plan or similar plan authorized by the insurer and to which the director, officer, member of a committee or employee may be eligible; or prohibit any director or member of a committee from receiving a reasonable fee for lawful services actually rendered to the insurer. [RR 2021, c. 1, Pt. B, §274 (COR).]

5. The superintendent may, by regulation from time to time, define and permit additional exceptions to the prohibition contained in subsection 1 solely to enable payment of reasonable compensation to a director who is not otherwise an officer or employee of the insurer, or to a corporation or firm in which a director is interested, for necessary services performed or sales or purchases made to or for the insurer in the ordinary course of the insurer's business and in the usual private professional or business capacity of such director, corporation or firm. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 4118 — ME Code / Title 24-A / Chapter 55 / Section 4118
24-A §4118. Benefits not attachable
Status: in_force

No money or other benefit, charity, relief or aid to be paid, provided or rendered by any society, shall be liable to attachment, garnishment or other process, or to be seized, taken, appropriated or applied by any legal or equitable process or operation of law to pay any debt or liability of a member or beneficiary, or any other person who may have a right thereunder, either before or after payment by the society. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2387-B — ME Code / Title 24-A / Chapter 25 / Section 2387-B
24-A §2387-B. Savings provision
Status: in_force

Any experience rating, classification, statistical or other rating plan on file and approved or legally in effect and not required to be revised by this Act or by a decision of the superintendent remains approved for use in the State. These plans need not be refiled on the effective date of this Act. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

Any rates or forms approved for an insurer on file and approved or legally in effect and not required to be revised by this Act or by a decision of the superintendent remain approved for use in the State. These rates and forms need not be refiled on the effective date of this Act. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]
24-A M.R.S. § 3555 — ME Code / Title 24-A / Chapter 49 / Section 3555
24-A §3555. Powers of the superintendent
Status: in_force

1. Designate additional acting directors. If at any time during an acute emergency, the number of directors or acting directors of a domestic insurance organization who are capable of acting shall be less than 3, as determined by the superintendent after a reasonable investigation, the superintendent shall have the power to designate additional acting directors in such number as will bring to 3 the number of directors and acting directors who are capable of acting. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

2. Resolve controversies. To resolve controversy as to the power of any group of persons purporting to act as an emergency board of directors so to act, the superintendent shall, upon a determination that such action will tend to promote the safe and sound and orderly conduct of the business of any domestic insurance organization, have power to issue orders declaring that any such group shall or shall not have the powers of an emergency board of directors, or confirming, modifying or vacating in whole or in part any action taken or purportedly taken by any such group or by removing any acting director. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

3. Declare provisions of law operative or inoperative. At any time after an attack, upon the superintendent's determination that such action will tend to promote certainty as to the powers of insurance organizations or individuals pursuant to this chapter or that such action is desirable to enable insurance organizations to take preparatory precautions prior to the occurrence of an acute emergency, the superintendent has power to declare that any provision of this chapter that the superintendent specifies is operative with respect to any domestic insurance organization or to the Maine business of any other insurance organization that the superintendent may designate. Upon such declaration such organization and its directors, officers, acting directors and acting officers have all powers conferred by this chapter. The failure of the superintendent so to declare may not be construed to limit the powers of any organization or its directors, officers, acting directors or acting officers when an acute emergency exists in fact. At any time after the commencement of an acute emergency or after the superintendent declares any provision of this chapter operative under this subsection upon the superintendent's determination that an insurance organization is able, in whole or in part, to carry on its business in compliance with its charter and the laws, other than this chapter, the superintendent has power to declare that any provision of this chapter that the superintendent specifies is inoperative with respect to any domestic insurance organization or in the Maine business of any other insurance organization that the superintendent may designate. Upon such declaration, such organization is governed by its charter and the provisions of law other than this chapter, except insofar as they remain inoperative. [RR 2021, c. 1, Pt. B, §305 (COR).]

4. Possession of business and property. Upon the determination that, as a result of an acute emergency, the business and affairs of an insurance organization cannot otherwise be conducted in a safe and sound manner, the superintendent may forthwith take possession of the business and property of the insurance organization within this State or, if a domestic insurance organization, its business and property wherever situated. This chapter is applicable in any case in which the superintendent takes possession of an insurance organization under this subsection as though the insurance organization were an insurer of which the superintendent had taken possession under this chapter, except that any such provision is not applicable that the superintendent has declared inapplicable under this subsection. The superintendent has power to declare inapplicable any such provision upon the superintendent's determination that the same is inappropriate or unnecessary to protect the interest of the public or the stockholders or creditors of the insurance organization, in view of the acute emergency and the nature of the organization. [RR 2021, c. 1, Pt. B, §306 (COR).]

5. When powers exercised. The powers given the superintendent by subsections 2 and 4 may be exercised by the superintendent only in the event that there is not a court of competent jurisdiction available to which an application can be made for an order permitting the superintendent to exercise such powers with respect to a particular insurance organization. The powers conferred by subsection 4 may not be exercised in a case of an insurance organization that is not insolvent within the meaning of this chapter, unless the superintendent finds that such insurance organization lacks personnel able to manage its business in the interest of the public stockholders and policyholders. [RR 2021, c. 1, Pt. B, §307 (COR).]

6. Regulations. The superintendent shall have power to issue general and specific regulations, directives and orders consistent with and in furtherance of the purposes of this chapter. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 2839 — ME Code / Title 24-A / Chapter 35 / Section 2839
24-A §2839. Rates filed
Status: in_force

A policy of group or blanket health insurance may not be delivered in this State until a copy of the rates to be used in calculating the premium for these policies has been filed for informational purposes with the superintendent. The filing must include the base rates and a description of any procedures to be used to adjust the base rates to reflect factors including but not limited to age, gender, health status, claims experience, group size and coverage of dependents. Notwithstanding this section, rates for group Medicare supplement, nursing home care or long-term care insurance contracts and for certain association groups and other groups specified in section 2701, subsection 2, paragraph C must be filed in accordance with section 2736 . Rates for small group health insurance subject to section 2808‑B are subject to the additional filing requirements specified in that section. A filing required under this section must be made electronically in a format required by the superintendent unless exempted by rule adopted by the superintendent. Rules adopted pursuant to this section are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2011, c. 238, Pt. C, §1 (AMD).]