24-A M.R.S. § 5082 — ME Code / Title 24-A / Chapter 68-A / Section 5082
24-A §5082. Long-term Care Partnership Program; availability of qualified policies
Status: in_force

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Eligible policyholder" means: (1) An individual who holds a qualified individual policy issued before or during the notice period by an insurer that actively markets individual partnership policies in this State on or after the effective date of this section and is not receiving benefits or in a waiting period to receive benefits; or (2) An employer or other group policyholder that holds a qualified group policy issued before or during the notice period by an insurer that actively markets group partnership policies in this State on or after the effective date of this section. [PL 2011, c. 198, §1 (NEW).] B. "Long-term Care Partnership Program" means the Long-term Care Partnership Program established in Title 22, section 3174‑GG . [PL 2011, c. 198, §1 (NEW).] C. "Notice period" means the period between July 1, 2004 and the date an insurer begins actively marketing partnership policies in this State. [PL 2011, c. 198, §1 (NEW).] D. "Partnership policy" means a long-term care insurance policy with an effective date of July 1, 2009 or later that is offered with the intent to meet the requirements of the Long-term Care Partnership Program. [PL 2011, c. 198, §1 (NEW).] E. "Qualified policy" means a long-term care insurance policy that is offered with the intent to meet the requirements of 26 United States Code, Section 7702B(b). [PL 2011, c. 198, §1 (NEW).] [PL 2011, c. 198, §1 (NEW).]

2. Notice. The following provisions apply to an insurer that actively markets a partnership policy in this State on or after the effective date of this section. With respect to an employer group, an insurer shall provide any notice required under this section to the employer that is the policyholder of a qualified policy. A. An insurer that actively markets partnership policies in this State as of the effective date of this section shall provide notice to an eligible policyholder that purchased a qualified policy during the notice period that the policyholder may be able to participate in the Long-term Care Partnership Program. The insurer shall initiate the exchange process in accordance with subsection 4 within 12 months of the effective date of this section. [PL 2011, c. 198, §1 (NEW).] B. An insurer that begins to actively market partnership policies in this State after the effective date of this section shall provide notice to an eligible policyholder that purchased a qualified policy during the notice period that the policyholder may be able to participate in the Long-term Care Partnership Program. The insurer shall initiate the exchange process in accordance with subsection 4 within 12 months of the date the insurer begins to market partnership policies in this State. [PL 2011, c. 198, §1 (NEW).] [PL 2011, c. 198, §1 (NEW).]

3. Request for review. In addition to the requirements of subsection 2 , at the request of an eligible policyholder of a qualified policy issued prior to the notice period, an insurer that actively markets partnership policies in this State shall review the qualified policy to identify whether the qualified policy meets the requirements of the Long-term Care Partnership Program and take an action described in subsection 4, paragraph A or B . If a request for review under this subsection is made more than 12 months after the effective date of this section, the insurer has no obligation to review the policy. [PL 2011, c. 198, §1 (NEW).]

4. Exchange process. An insurer that actively markets partnership policies in this State shall identify those qualified policies issued during the notice period that currently meet all the requirements of the Long-term Care Partnership Program as specified in Bureau of Insurance Bulletin 368 dated January 22, 2010 for use with the Long-term Care Partnership Program and those that do not meet all of the requirements and: A. For those qualified policies that currently meet all of the requirements, issue to each policyholder the Important Notice Regarding Your Policy's Long-term Care Insurance Partnership Status, as prescribed in the Appendix of Bureau of Insurance Bulletin 368 dated January 22, 2010, along with a policy amendment reflecting the effective date of the partnership status; and [PL 2011, c. 198, §1 (NEW).] B. For those qualified policies that do not meet all of the requirements, notify each policyholder that the policy may be eligible for an exchange to a partnership policy. The insurer shall also notify the policyholder that the exchange is subject to underwriting and that the premium for the new policy is based on the policyholder's attained age on the date of the exchange. The policyholder has 60 days from the date of the notice to consider this offer. If the policyholder accepts the offer after 60 days, the insurer is not obligated to process an exchange. If the policyholder requests additional coverage, the additional coverage is also subject to underwriting and the premium for the additional coverage must be based on the policyholder's attained age on the date the changes take effect. [PL 2011, c. 198, §1 (NEW).] [PL 2011, c. 198, §1 (NEW).]

5. Individual policyholder no longer receiving benefits. If an individual policyholder is not an eligible policyholder because the policyholder is receiving benefits or is in a waiting period to receive benefits, that individual policyholder has 12 months from the expiration of any waiting period after which the policyholder does not begin to receive benefits or from the expiration of any period when benefits have ended to request a review by an insurer as otherwise provided under subsection 3 . [PL 2011, c. 198, §1 (NEW).]

6. Applicability. If an insurer does not actively market both individual and group partnership policies in this State, this section applies to that insurer only with respect to the particular market in which the insurer actively markets partnership policies. [PL 2011, c. 198, §1 (NEW).]
24-A M.R.S. § 3102 — ME Code / Title 24-A / Chapter 43 / Section 3102
24-A §3102. Acceptance as surety on bonds
Status: in_force

Any insurer duly authorized to transact surety insurance in this State may be accepted as surety upon the bond of any person required by the laws of the State to execute a bond. If such insurer shall furnish satisfactory evidence of its ability to provide all the security required by law, no additional surety may be exacted, but other surety or sureties may, in the discretion of the official authorized to approve such bond, be required. Such insurer may be released from its liability on the same terms and conditions as are by law prescribed for the release of individuals. It is the true intent and meaning of this section to enable corporations created for that purpose to become surety on bonds required by law, subject to all the rights and liabilities of private individuals. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 1115 — ME Code / Title 24-A / Chapter 13 / Section 1115
24-A §1115. Stocks of subsidiaries
Status: in_force

1. An insurer may invest in the stock of its subsidiary insurance corporation formed or acquired by it; or in the stock of its subsidiary business corporation or corporations formed and engaged solely in any one or more of the following businesses: A. In any business necessary and incidental to the convenient operation of the insurer's insurance business, or to the administration of any of its lawful affairs, or to the service or benefit of its policyholders; [PL 1969, c. 132, §1 (NEW).] B. Providing any of actuarial, computer, data processing, accounting, claims, appraisal, collection, loss prevention or safety engineering and similar services; [PL 1969, c. 132, §1 (NEW).] C. Real estate management and development; [PL 1969, c. 132, §1 (NEW).] D. Premium financing; [PL 1969, c. 132, §1 (NEW).] E. Financing of agents of the insurer; [PL 1969, c. 132, §1 (NEW).] F. Acting as investment adviser or principal underwriter of an investment company or companies, registered as such under the Investment Companies Act of 1940; [PL 1969, c. 132, §1 (NEW).] G. Financial and investment counseling services; [PL 1969, c. 132, §1 (NEW).] H. Administration of self-insurance plans; [PL 1969, c. 132, §1 (NEW).] I. Administration of self-insured pension and similar plans, or the self-insured portions of such plans; [PL 1969, c. 132, §1 (NEW).] J. Acting as administrative agent for a government instrumentality which is performing an insurance function; [PL 1969, c. 132, §1 (NEW).] K. Securities broker-dealer; [PL 1969, c. 132, §1 (NEW).] L. Escrow services; [PL 1969, c. 132, §1 (NEW).] M. Trust services with respect to funds payable or paid by it under its insurance contracts; or [PL 1999, c. 715, §6 (AMD).] N. A depository institution, or any company that controls such an institution, that is subject to the federal Gramm-Leach-Bliley Act, Sections 104(c) and 306(2), 113 Stat. 1338 as long as the insurer's total investment in all such subsidiaries does not exceed 5% of the insurer's admitted assets. [PL 1999, c. 715, §7 (NEW).] [PL 1999, c. 715, §§6, 7 (AMD).]

2. For the purposes of this section a "subsidiary" is a corporation of which the insurer owns sufficient stock to give it effective control. [PL 1969, c. 132, §1 (NEW).]

3. [PL 1987, c. 399, §7 (RP).]
24-A M.R.S. § 4114 — ME Code / Title 24-A / Chapter 55 / Section 4114
24-A §4114. Benefits
Status: in_force

1. A society authorized to do business in this State may provide for the payment of: A. Death benefits in any form; [PL 1969, c. 132, §1 (NEW).] B. Endowment benefits; [PL 1969, c. 132, §1 (NEW).] C. Annuity benefits; [PL 1969, c. 132, §1 (NEW).] D. Temporary or permanent disability benefits as a result of disease or accident; [PL 1969, c. 132, §1 (NEW).] E. Hospital, medical or nursing benefits due to sickness or bodily infirmity or accident; and [PL 1969, c. 132, §1 (NEW).] F. Monument or tombstone benefits to the memory of deceased members not exceeding in any case the sum of $300. [PL 1969, c. 132, §1 (NEW).] [PL 1969, c. 132, §1 (NEW).]

2. Such benefits may be provided on the lives of members or, upon application of a member, on the lives of the member's family, including the member, the member's spouse and minor children, in the same or separate certificates. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2453 — ME Code / Title 24-A / Chapter 27 / Section 2453
24-A §2453. Effective date of cancellation
Status: in_force

Life and health insurance policies that do not provide for any refund of premium when a policyholder requests cancellation prior to the end of the period for which premiums have been paid must state that no refund is payable and that the cancellation will take effect at the end of the period for which premiums have been paid unless the policyholder requests an earlier cancellation date. If a policyholder requests cancellation of a contract before the end of the period for which premiums have been paid, then the insurer must inform the policyholder in writing that no refund is payable and give the policyholder an opportunity to amend the cancellation request to take effect at the end of the period for which premiums have been paid. [PL 1997, c. 604, Pt. F, §2 (NEW).]
24-A M.R.S. § 6605 — ME Code / Title 24-A / Chapter 81 / Section 6605
24-A §6605. Fund balance
Status: in_force

Each multiple-employer welfare arrangement shall maintain a positive fund balance. [PL 1993, c. 688, §1 (NEW).]
24-A M.R.S. § 7053 — ME Code / Title 24-A / Chapter 90 / Section 7053
24-A §7053. Licensure; nonlicensed activities; compensation
Status: in_force

1. Issuance of license. The issuance of a license is governed by this subsection. A. Upon receipt of an application in the form and manner prescribed by the superintendent, the superintendent may issue a supervising travel insurance producer license, which is a limited license, to a business entity authorizing the business entity to sell, solicit or negotiate travel insurance as a supervising travel insurance producer on behalf of a licensed insurer. A person may not act as a supervising travel insurance producer unless licensed under this subsection or as provided in section 7052‑A, subsection 11 . A travel retailer may not sell, solicit or negotiate travel insurance unless licensed as a producer or registered in accordance with section 7054, subsection 2 . [PL 2021, c. 354, §7 (NEW).] B. A person licensed in a major line of authority as an insurance producer may sell, solicit and negotiate travel insurance. [PL 2021, c. 354, §7 (NEW).] [PL 2021, c. 354, §7 (RPR).]

2. Nonlicensed activities. A travel retailer or its employees or authorized representatives do not need a license under this chapter if the retailer is on the registry, as provided in section 7054, subsection 2 , and the insurance-related activities of the travel retailer, its employees and authorized representatives are limited to offering and disseminating travel insurance in compliance with this chapter. [PL 2015, c. 133, §4 (NEW).]

3. Compensation. Notwithstanding any provision of law to the contrary, if the insurance-related activities of a travel retailer and its employees and authorized representatives are limited to offering and disseminating travel insurance on behalf of and under the direction of a supervising travel insurance producer, and the travel retailer is registered pursuant to section 7054, subsection 2 , the travel retailer and its employees and authorized representatives are permitted to receive related compensation on sales made in accordance with this chapter. [PL 2021, c. 354, §8 (AMD).]
24-A M.R.S. § 1414 — ME Code / Title 24-A / Chapter 16 / Section 1414
24-A §1414. Trade names
Status: in_force

A licensee doing business under any name other than the licensee's legal name is required to notify the superintendent prior to using the trade name. [PL 2001, c. 259, §15 (RPR).]
24-A M.R.S. § 7007 — ME Code / Title 24-A / Chapter 89 / Section 7007
24-A §7007. Application for license and fees
Status: in_force

1. Application for license to be filed with superintendent. A sworn application for a license under this chapter must be made to and filed with the superintendent on forms prescribed and furnished by the superintendent. [PL 2011, c. 297, §5 (NEW).]

2. Contents of application. In addition to other information required by the superintendent, the application must: A. Provide the name, residence address and other information required by the superintendent for an employee or officer of the vendor that is designated by the applicant as the person responsible for the vendor's compliance with the requirements of this chapter. If the vendor derives more than 50% of its revenue from the sale of portable electronic device insurance, the information specified in this paragraph must be provided for all officers, directors and shareholders of record having beneficial ownership of 10% or more of any class of securities registered under the federal securities laws; [PL 2011, c. 297, §5 (NEW).] B. Appoint the superintendent as the applicant's attorney to receive service of all legal process issued against it in any civil action or proceeding in this State and agree that process so served is valid and binding against the applicant. The appointment is irrevocable, binds the company and any successor in interest as well as the assets or liabilities of the applicant and must remain in effect as long as the applicant's license remains in force in this State; and [PL 2011, c. 297, §5 (NEW).] C. Provide the location of the applicant's home office. [PL 2011, c. 297, §5 (NEW).] [PL 2011, c. 297, §5 (NEW).]

3. Time of application. An application for licensure under this chapter must be made within 90 days of the application being made available by the superintendent. [PL 2011, c. 297, §5 (NEW).]

4. Initial license valid for 24 months. An initial license issued pursuant to this chapter is valid for 24 months and expires on the last day of the 24th month. [PL 2011, c. 297, §5 (NEW).]

5. Fee. Each vendor licensed under this chapter shall pay to the superintendent a fee as prescribed by section 601, subsection 29 . [PL 2011, c. 297, §5 (NEW).]
24-A M.R.S. § 743 — ME Code / Title 24-A / Chapter 9 / Section 743
24-A §743. General provisions
Status: in_force

The superintendent may issue a reinsurance intermediary license to any person or organization that complies with the requirements of this subchapter. [PL 1995, c. 544, §8 (AMD).]

1. Licensing; persons that are not individuals. Licensing of a firm, association, partnership or corporation is subject to this subsection. A. A license issued to a firm, association, partnership or corporation authorizes all the members of the firm, association, partnership or corporation and employees of those entities to act as reinsurance intermediaries if each individual is named in the application and registered with the superintendent. Those individuals exercise the license power only for and in the name of the organization. This paragraph does not prevent an individual from being separately licensed and acting in that individual's own behalf and name. [PL 1995, c. 544, §8 (AMD).] B. The superintendent may not license a firm, association, partnership or corporation unless the license is within purposes stated in the partnership agreement or articles of incorporation. All licensees are subject to the applicable standards of section 407, subsection 2 . [PL 2013, c. 299, §1 (AMD).] C. All licensees under this subsection are subject to the same restrictions with regard to business names as applied to insurers under section 408 . [PL 1995, c. 544, §8 (AMD).] [PL 2013, c. 299, §1 (AMD).]

2. Advertising. Licensees may advertise only in the name under which they are licensed. [PL 1991, c. 828, §20 (NEW).]

3. Notice of change. Licensees shall promptly notify the superintendent of every change in address and notify the superintendent of every change among its members, directors and officers and of other individuals designated in or registered to the license. [PL 1995, c. 544, §8 (AMD).]

4. Refusal. The superintendent may refuse to issue a license to a reinsurance intermediary if, in the superintendent's judgment, the applicant, any person named on the application, or a member, principal, officer or director of the applicant, is not trustworthy, has given cause for revocation or suspension of such license or has failed to comply with any prerequisite for the issuance of such license, or that any controlling person of an applicant is not trustworthy to act as a reinsurance intermediary. [PL 1995, c. 544, §8 (AMD).]

5. Superintendent review. If the superintendent finds that the application is complete and that the applicant is otherwise qualified for the license applied for, the superintendent shall promptly issue the license. Otherwise, the superintendent shall refuse to issue the license, promptly notify the applicant of the refusal and state the grounds for refusal. [PL 1991, c. 828, §20 (NEW).]

6. Refund. If the license is refused, the superintendent shall promptly refund to the applicant all fees received for application for a reinsurance intermediary license. [PL 1991, c. 828, §20 (NEW).]

7. Duration. Unless revoked or suspended, a reinsurance intermediary license remains in effect as long as the licensee pays the annual fee required by section 601 before the anniversary date of the license. [PL 1995, c. 544, §8 (AMD).]
24-A M.R.S. § 2523 — ME Code / Title 24-A / Chapter 29 / Section 2523
24-A §2523. Reinstatement -- annuities
Status: in_force

In an annuity or pure endowment contract, other than a reversionary or group annuity, there shall be a provision that the contract may be reinstated at any time within one year from the default in making stipulated payments to the insurer, unless the cash surrender value has been paid, but all overdue stipulated payments shall be paid with interest thereon at a rate to be specified in the contract but not exceeding 6% per annum payable annually and the payment or reinstatement of any other indebtedness to the insurer upon the contract with interest at the policy loan interest rate, and in cases where applicable the insurer may also include a requirement of evidence of insurability satisfactory to the insurer. [PL 1981, c. 188, §3 (AMD).]
24-A M.R.S. § 2208 — ME Code / Title 24-A / Chapter 24 / Section 2208
24-A §2208. Content of disclosure authorization forms
Status: in_force

Notwithstanding any other provision of law, a regulated insurance entity or insurance support organization may not use a disclosure authorization form unless the form or statement: [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]

1. Signed. Is signed by the insurance consumer except that: A. A consumer's spouse, family member or other authorized individual may sign the disclosure authorization form if: (1) The individual is acting under a valid written power of attorney or acting pursuant to the Uniform Health Care Decisions Act; or (2) The individual is the consumer's parent or legal guardian, in which case the authorization is valid only insofar as that parent or legal guardian has the exclusive authority to consent for the health care services received by a minor for which the authorization for payment is sought and only as to those disclosures when the holder of the information can reasonably infer that the parent's or legal guardian's interest in disclosure is not adverse to the consumer's; or [PL 2017, c. 402, Pt. C, §75 (AMD); PL 2019, c. 417, Pt. B, §14 (AFF).] B. A consumer may authorize disclosure in electronic or telephonic form if a unique identifier of the insurance consumer is provided and the insurance consumer authenticates the electronic or telephonic authorization; [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] [PL 2017, c. 402, Pt. C, §75 (AMD); PL 2019, c. 417, Pt. B, §14 (AFF).]

2. Plain language. Is written in plain language; [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]

3. Dated. Is dated; [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]

4. Persons authorized to disclose. Specifies the types of persons authorized to disclose information about the consumer; [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]

5. Nature of information. Specifies the nature of the information authorized to be disclosed; [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]

6. Name of regulated insurance entity. Names the regulated insurance entity and identifies by generic reference representatives of the carrier to whom the consumer is authorizing information to be disclosed; [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]

7. Purpose. Specifies the purposes for which the information is collected; [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]

8. Time period of authorization. Specifies the period of time the authorization remains valid. The period of time may be no longer than: A. In the case of life, disability or long-term care insurance: (1) Thirty months from the date the authorization is signed if the authorization is signed for the purpose of collecting information in connection with an application for an insurance policy, a policy reinstatement or a request for change in policy benefits; or (2) The duration of the claim if the authorization is signed for the purpose of collecting information in connection with a claim for benefits under an insurance policy; or [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] B. In the case of health or medical insurance, the term of coverage of the policy and any renewals of that policy; [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]

9. Right to copy. Advises the consumer or a person authorized to act on behalf of the consumer that the consumer or the consumer's authorized representative is entitled to receive a copy of the authorization form; [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]

10. Revocation. Advises the consumer how to revoke the authorization and that the revocation may be a basis for denying insurance benefits; and [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]

11. Failure to sign. Advises the consumer that failure to sign an authorization form may impair the ability of a regulated insurance entity to evaluate or process an application or claim and may be a basis for denying an application or claims for benefits. [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]
24-A M.R.S. § 3867 — ME Code / Title 24-A / Chapter 53 / Section 3867
24-A §3867. Subscribers' advisory committee
Status: in_force

1. The advisory committee of a domestic reciprocal insurer exercising the subscribers' rights shall be selected under such rules as the subscribers adopt. [PL 1969, c. 132, §1 (NEW).]

2. Not less than 2/3 of such committee shall be subscribers other than the attorney, or any person employed by, representing, or having a financial interest in the attorney. [PL 1969, c. 132, §1 (NEW).]

3. The committee shall: A. Supervise the finances of the insurer; [PL 1969, c. 132, §1 (NEW).] B. Supervise the insurer's operations to such extent as to assure conformity with the subscribers' agreement and power of attorney; [PL 1969, c. 132, §1 (NEW).] C. Procure the audit of the accounts and records of the insurer and of the attorney at the expense of the insurer; and [PL 1969, c. 132, §1 (NEW).] D. Have such additional powers and functions as may be conferred by the subscribers' agreement. [PL 1969, c. 132, §1 (NEW).] [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 6805 — ME Code / Title 24-A / Chapter 85 / Section 6805
24-A §6805. Approval of settlements contracts; disclosure statements and applications
Status: in_force

A settlement contract must be in writing and signed by all parties to the contract. A person may not use any contract, disclosure statement or application form with a viator who is a resident of this State unless it has been filed with and approved by the superintendent, pursuant to sections 2412 and 2413 . The superintendent shall disapprove a settlement contract form or disclosure statement form if, in the superintendent's opinion, the contract or provisions contained therein are unreasonable, contrary to the interests of the public or otherwise misleading or unfair to the viator. All such forms must be approved or denied by the superintendent within 60 calendar days following receipt of submission by the superintendent. [PL 2009, c. 376, §7 (AMD).]
24-A M.R.S. § 1420-C — ME Code / Title 24-A / Chapter 16 / Section 1420-C
24-A §1420-C. Exceptions to licensing
Status: in_force

1. Insurers. This subchapter may not be construed to require an insurer to obtain an insurance producer license. In this section, "insurer" does not include an insurer's officers, directors, employees, subsidiaries or affiliates. [PL 2001, c. 259, §24 (NEW).]

2. Exceptions. A license as an insurance producer is not required of the following: A. An officer, director or employee of an insurer or of an insurance producer, only if that officer, director or employee does not receive any commission on policies written or sold to insure risks residing, located or to be performed in this State and: (1) The activities of the officer, director or employee are executive, administrative, managerial, clerical or a combination of these and are only indirectly related to the sale, solicitation or negotiation of insurance; (2) The functions of officer, director or employee relate to underwriting, loss control, inspection or the processing, adjusting, investigating or settling of a claim on a contract of insurance; or (3) The officer, director or employee is acting in the capacity of a special agent or agency supervisor assisting insurance producers when the person's activities are limited to providing technical advice and assistance to licensed insurance producers and do not include the sale, solicitation or negotiation of insurance; [PL 2001, c. 259, §24 (NEW).] B. A person who secures and furnishes information for the purpose of group life insurance, group property and casualty insurance, group annuities, group or blanket accident and health insurance; a person who secures and furnishes information for the purpose of enrolling individuals under plans, issuing certificates under plans or otherwise assisting in administering plans; or a person who performs administrative services related to mass marketed property and casualty insurance without being paid a commission for the service; [PL 2001, c. 259, §24 (NEW).] C. An employer or association or its officers, directors or employees, or the trustees of an employee trust plan, to the extent that the employer, officers, employees, directors or trustees are engaged in the administration or operation of a program of employee benefits for the employer's or association's own employees or the employees of its subsidiaries or affiliates, which program involves the use of insurance issued by an insurer, as long as the employer, association, officers, directors, employees or trustees are not in any manner compensated, directly or indirectly, by the company issuing the contracts; [PL 2001, c. 259, §24 (NEW).] D. Employees of insurers or organizations employed by insurers who are engaging in the inspection, rating or classification of risks, or in the supervision of the training of insurance producers, and who are not individually engaged in the sale, solicitation or negotiation of insurance; [PL 2001, c. 259, §24 (NEW).] E. A person whose activities in this State are limited to advertising without the intent to solicit insurance in this State through communications in printed publications or other forms of electronic mass media, whose distribution is not limited to residents of the State, if the person does not sell, solicit or negotiate insurance that would insure risks residing, located or to be performed in this State; [PL 2001, c. 259, §24 (NEW).] F. A person who is not a resident of this State who sells, solicits or negotiates a contract of insurance for commercial property and casualty risks to an insured with risks located in more than one state insured under that contract, if that person is otherwise licensed as an insurance producer to sell, solicit or negotiate that insurance in the state where the insured maintains its principal place of business and the contract of insurance insures risks located in that state; [PL 2011, c. 297, §2 (AMD).] G. A salaried full-time employee who counsels or advises that person's employer relative to the insurance interests of the employer or of the subsidiaries or business affiliates of the employer if the employee does not sell or solicit insurance or receive a commission; [PL 2021, c. 218, §2 (AMD).] H. A person who offers to sell or sells portable electronic device insurance pursuant to a license issued by the superintendent under chapter 89 ; or [PL 2021, c. 218, §3 (AMD).] I. A person who offers to sell or sells self-storage insurance pursuant to a license issued by the superintendent under chapter 99 . [PL 2021, c. 676, Pt. A, §36 (AMD).] [PL 2021, c. 676, Pt. A, §36 (AMD).]
24-A M.R.S. § 4307 — ME Code / Title 24-A / Chapter 56-A / Section 4307
24-A §4307. Construction
Status: in_force

Nothing in this chapter may be construed to: [PL 1995, c. 673, Pt. C, §1 (NEW); PL 1995, c. 673, Pt. C, §2 (AFF).]

1. Purchase services with own funds. Prohibit an individual from purchasing any health care services with that individual's own funds, whether these services are covered within the individual's benefit package or from another health care provider or plan, except as otherwise provided by federal or state law; [PL 1995, c. 673, Pt. C, §1 (NEW); PL 1995, c. 673, Pt. C, §2 (AFF).]

2. Additional benefits. Prohibit any plan sponsor from providing additional coverage for benefits, rights or protections not set out in this chapter; [PL 1999, c. 742, §16 (AMD).]

3. Provider participation. Require a carrier to admit to a managed care plan a provider willing to abide by the terms and conditions of the managed care plan; or [PL 1999, c. 742, §16 (AMD).]

4. Treatment by religious nonmedical providers. With respect to coverage of treatment by religious nonmedical providers: A. Restrict or limit the right of a carrier to include a religious nonmedical provider as a participating provider in a managed care plan; [PL 1999, c. 742, §17 (NEW).] B. Require a carrier to: (1) Utilize medically based eligibility standards or criteria in deciding provider status of religious nonmedical providers; (2) Use medical professionals or criteria to decide enrollee access to religious nonmedical providers; (3) Utilize medical professionals or criteria in making decisions in internal or external appeals regarding coverage for care by religious nonmedical providers; or (4) Compel an enrollee to undergo a medical examination or test as a condition of receiving coverage for treatment by a religious nonmedical provider; or [PL 1999, c. 742, §17 (NEW).] C. Require a carrier to exclude religious nonmedical providers because the providers do not provide medical or other required data, if such data is inconsistent with the religious nonmedical treatment or nursing care provided by the provider. [PL 1999, c. 742, §17 (NEW).] [PL 1999, c. 742, §17 (NEW).]
24-A M.R.S. § 2837-B — ME Code / Title 24-A / Chapter 35 / Section 2837-B
24-A §2837-B. Acupuncture services
Status: in_force

All group insurance policies and certificates providing coverage for acupuncture must provide coverage for those services when performed by an acupuncturist licensed pursuant to Title 32, chapter 113‑B, subchapter 2 , under the same conditions that apply to the services of a licensed physician. [PL 2003, c. 517, Pt. B, §14 (AMD).]
24-A M.R.S. § 3490 — ME Code / Title 24-A / Chapter 47 / Section 3490
24-A §3490. Conversion of mutual holding company
Status: in_force

1. Approval of reorganization plan. A mutual holding company may be reorganized in accordance with a plan of reorganization: A. Approved by the superintendent, if the superintendent finds the plan to be fair and equitable, after a hearing of which notice has been given to the company's members pursuant to section 230 ; and [PL 1999, c. 656, §5 (NEW).] B. Approved by vote of not less than 2/3 of the company's members voting on the plan in person, by proxy or by mail at a meeting of members called by the company for that purpose. The mutual holding company shall provide reasonable notice to its members and determine the procedure for the meeting, subject to approval by the superintendent. The plan must specify that only persons who were members both at least one year before the submission of the plan and on a subsequent date before the vote found reasonable by the superintendent are entitled to vote. Each member is entitled to one vote. [PL 1999, c. 656, §5 (NEW).] [PL 1999, c. 656, §5 (NEW).]

2. Membership interests disposition. A plan of reorganization pursuant to subsection 1 must provide for extinguishment of the membership interests in the mutual holding company and may provide for either: A. The conversion of the mutual holding company into a stock corporation, in which event the consideration, if any, distributed to members of the mutual holding company must be equal to that required under section 3477 ; or [PL 1999, c. 656, §5 (NEW).] B. The distribution to eligible members of the mutual holding company of consideration consisting of all assets of the mutual holding company, including all stock of the reorganized insurer or any stock holding company owned by the mutual holding company, or other consideration having equivalent aggregate value. The form of the other consideration may be cash, securities, additional insurance or annuity benefits or policy credits, increased dividends or other consideration. All such consideration must be allocated among eligible members of the mutual holding company in a manner that is fair and equitable to the company's members. [PL 1999, c. 656, §5 (NEW).] [PL 1999, c. 656, §5 (NEW).]
24-A M.R.S. § 2441 — ME Code / Title 24-A / Chapter 27 / Section 2441
24-A §2441. Minimum policy language simplification standards
Status: in_force

1. Delivery. In addition to any other requirements of law, no policy forms, except as stated in section 2440 , shall be delivered or issued for delivery in this State on or after the dates the forms must be approved under this Act unless: A. The text achieves a minimum score of 50 on the Flesch reading ease test or an equivalent score on any other comparable test as provided in subsection 3 ; [PL 1979, c. 267, §2 (NEW).] B. It is printed, except for specification pages, schedules and tables, in not less than 10-point type, one-point leaded; [PL 1979, c. 267, §2 (NEW).] C. The style, arrangement and overall appearance of the policy give no undue prominence to any portion of the text of the policy or to any endorsements or riders; and [PL 1979, c. 267, §2 (NEW).] D. It contains a table of contents or an index of the principal sections of the policy, if the policy has more than 3,000 words printed on 3 or fewer pages of text, or if the policy has more than 3 pages regardless of the number of words. [PL 1979, c. 267, §2 (NEW).] [PL 1979, c. 267, §2 (NEW).]

2. Test score measured. For the purposes of this section, a Flesch reading ease test score shall be measured by the following method: A. For policy forms containing 10,000 words or less of text, the entire form shall be analyzed. For policy forms containing more than 10,000 words, the readability of two 200-word samples per page may be analyzed instead of the entire form. The samples shall be separated by at least 20 printed lines; [PL 1979, c. 267, §2 (NEW).] B. The number of words and sentences in the text shall be counted and the total number of words divided by the total number of sentences. The figure obtained shall be multiplied by a factor of 1.015; [PL 1979, c. 267, §2 (NEW).] C. The total number of syllables shall be counted and divided by the total number of words. The figure obtained shall be multiplied by a factor of 84.6; [PL 1979, c. 267, §2 (NEW).] D. The sum of the figures computed under paragraphs B and C subtracted from 206.835 equals the Flesch reading ease score for the policy form; [PL 1979, c. 267, §2 (NEW).] E. For purposes of this subsection, paragraphs B , C and D , the following procedures shall be used: (1) A contraction, hyphenated word or numbers and letters, when separated by space, shall be counted as one word; (2) A unit of words ending with a period, semicolon, or colon, but excluding headings and captions, shall be counted as a sentence; and (3) A syllable means a unit of spoken language consisting of one or more letters of a word as divided by an accepted dictionary. Where the dictionary shows 2 or more equally acceptable pronunciations of a word, the pronunciation containing fewer syllables may be used; and [PL 1979, c. 267, §2 (NEW).] F. The term "text" as used in this subsection shall include all printed matter except the following: (1) The name and address of the insurer; the name, number or title of the policy; the table of contents or index; captions and subcaptions; specification pages, schedules or tables; and (2) Any policy language which is drafted to conform to the requirements of any federal law, regulation or agency interpretation; any policy language required by any collectively bargained agreement; any medical terminology; any words which are defined in the policy; and any policy language required by law or regulation; provided, the insurer identifies the language or terminology excepted by this paragraph and certifies, in writing, that the language or terminology is entitled to be excepted by this subparagraph. [PL 1979, c. 267, §2 (NEW).] [PL 1979, c. 267, §2 (NEW).]

3. Test approval. Any other reading test may be approved by the superintendent for use as an alternative to the Flesch reading ease test if it is comparable in result to the Flesch reading ease test. [PL 1979, c. 267, §2 (NEW).]

4. Filings. Filings subject to this Act shall be accompanied by a certificate signed by an officer of the insurer stating that it meets the minimum reading ease score on the test used or stating that the score is lower than the minimum required but should be approved in accordance with section 2443 . To confirm the accuracy of any certification, the superintendent may require the submission of further information to verify the certification in question. Notwithstanding any other provision of this Act, rating organizations may act on behalf of their members and subscribers in complying with the requirements of this subsection. A member or subscriber shall be responsible for the actions of a rating organization on behalf of that member or subscriber under this subsection in the same manner as if the member or subscriber had acted on its own behalf. [PL 1979, c. 267, §2 (NEW).]

5. Scoring. At the option of the insurer, riders, endorsements, applications and other forms made a part of the policy may be scored as separate forms or as part of the policy with which they may be used. [PL 1979, c. 267, §2 (NEW).]
24-A M.R.S. § 2306 — ME Code / Title 24-A / Chapter 25 / Section 2306
24-A §2306. Disapproval of filing
Status: in_force

1. If at any time the superintendent has reason to believe that a filing does not meet the requirements of this chapter, or violates any of the provisions of chapter 23 , the superintendent shall, after a hearing held upon not less than 10 days' written notice, specifying the matters to be considered at such hearing, to every insurer and advisory organization which made such filing, issue an order specifying in what respects the superintendent finds that such filing fails to meet the requirements of this chapter, and stating when, within a reasonable period thereafter, such filing shall be deemed no longer effective. Copies of the order shall be sent to every such insurer and advisory organization. The order shall not affect any contract or policy made or issued prior to the expiration of the period set forth in the order. [PL 1989, c. 797, §10 (AMD); PL 1989, c. 797, §§37, 38 (AFF).]

2. No such order shall be issued by the superintendent with respect to the rate of an insurer, if such rate is one used by any other insurer, unless such order applies equally to all insurers using such rate. Such order may be issued to an insurer without being applicable to all other insurers using the same rate, if the basis for such order is that the insurer affected thereby could not otherwise, with safety to the public and to its policyholders, be permitted to continue to transact business. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 2265 — ME Code / Title 24-A / Chapter 24-B / Section 2265
24-A §2265. Investigation of cybersecurity event
Status: in_force

1. Investigation. If a licensee learns that a cybersecurity event has or may have occurred, the licensee or an outside vendor or service provider designated to act on behalf of the licensee shall conduct a prompt investigation. During the investigation, the licensee or an outside vendor or service provider designated to act on behalf of the licensee, at a minimum, shall: A. Determine whether a cybersecurity event has occurred; [PL 2021, c. 24, §1 (NEW).] B. Assess the nature and scope of the cybersecurity event; [PL 2021, c. 24, §1 (NEW).] C. Identify any nonpublic information that may have been involved in the cybersecurity event; and [PL 2021, c. 24, §1 (NEW).] D. Perform or oversee the performance of reasonable measures to restore the security of the information systems compromised in the cybersecurity event in order to prevent further unauthorized acquisition, release or use of nonpublic information in the licensee's possession, custody or control. [PL 2021, c. 24, §1 (NEW).] [PL 2021, c. 24, §1 (NEW).]

2. System maintained by 3rd-party service provider. If a licensee learns that a cybersecurity event has or may have occurred in an information system maintained by a 3rd-party service provider, the licensee shall either use its best efforts to complete the steps listed in subsection 1 or confirm that the 3rd-party service provider has completed those steps. [PL 2021, c. 24, §1 (NEW).]

3. Maintenance of records. A licensee shall maintain records concerning a cybersecurity event for a period of at least 5 years from the date of the cybersecurity event and shall produce those records upon demand of the superintendent. [PL 2021, c. 24, §1 (NEW).]
24-A M.R.S. § 3032 — ME Code / Title 24-A / Chapter 41 / Section 3032
24-A §3032. Application of amount recovered
Status: in_force

The amount recovered under section 3031 shall be applied first to the payment of the costs of the civil action and officer's fees on the execution and next to the payment of the amount due on the mortgage. The balance, if any, shall be retained by the insurer and paid to the mortgagor. If the insurer assumes the defense, it shall be liable to the plaintiff for costs in the same manner as the principal defendant, defending the action, would be. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2888 — ME Code / Title 24-A / Chapter 38 / Section 2888
24-A §2888. Authority of superintendent to adopt additional rules
Status: in_force

The superintendent may also issue rules regarding the content of legal services insurance policies and marketing arrangements, including delivery of legal services by licensed professionals. [PL 1983, c. 801, §11 (NEW).]

Nothing in this chapter may be construed to authorize the practice of law by any person in violation of Title 4, section 807 , or to authorize the superintendent to infringe upon the authority of the Supreme Judicial Court to regulate the practice of law. [PL 1983, c. 801, §11 (NEW).]
24-A M.R.S. § 2847-Q — ME Code / Title 24-A / Chapter 35 / Section 2847-Q
24-A §2847-Q. Coverage for services provided by independent practice dental hygienist or dental hygienist
Status: in_force

1. Services provided by independent practice dental hygienist or dental hygienist. An insurer that issues group dental insurance or health insurance that includes coverage for dental services shall provide coverage for dental services performed by an independent practice dental hygienist or dental hygienist licensed under Title 32, chapter 143 when those services are covered services under the contract and when they are within the lawful scope of practice of the independent practice dental hygienist or dental hygienist. [PL 2025, c. 478, §5 (AMD).]

2. Limits; coinsurance; deductibles. A contract that provides coverage for the services required by this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section. [PL 2009, c. 307, §3 (NEW); PL 2009, c. 307, §6 (AFF).]

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

4. Application. The requirements of this section apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 2009, c. 307, §3 (NEW); PL 2009, c. 307, §6 (AFF).]
24-A M.R.S. § 2556 — ME Code / Title 24-A / Chapter 29 / Section 2556
24-A §2556. Notification prior to lapse or termination
Status: in_force

1. Notice to 3rd party. An individual life insurance policy that has been in force for at least one year may not be terminated for nonpayment of premium unless, at least 21 days prior to the expiration of the grace period, the insurer has mailed a notice of cancellation to the policyholder and any 3rd party designated by the policyholder by name and address in writing. The bureau shall adopt rules to implement the notice requirements under this subsection. [PL 2007, c. 40, §1 (NEW).]

2. Restrictions on lapse or termination; cognitive impairment or functional incapacity. Notwithstanding any other provision of this chapter, an insurer shall provide restrictions on cancellation, termination or lapse of individual life insurance policies in accordance with this subsection to reduce the danger that a life insurance policyholder will lose life insurance coverage when the policyholder suffers from cognitive impairment or functional incapacity and the loss of coverage is due to that cognitive impairment or functional incapacity. Within 90 days after cancellation, termination or lapse of coverage 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 life insurance policy 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 request a medical demonstration that the policyholder suffered from cognitive impairment or functional incapacity at the time of cancellation, termination or lapse. The medical demonstration may be at the expense of the policyholder. A policy reinstated pursuant to this subsection must cover any loss or claim occurring from the date of the termination, cancellation or lapse and must be issued without any evidence of insurability. Within 15 days after request from an insurer, a policyholder of a policy reinstated pursuant to this subsection 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, termination or lapse of coverage. 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, §1 (AMD); PL 2011, c. 123, §5 (AFF).]

3. Rulemaking. The bureau may adopt rules to implement the requirements of this section. The rules adopted pursuant to this subsection apply to all life insurance policies and riders delivered or issued for delivery, continued or renewed in this State. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2011, c. 123, §1 (AMD); PL 2011, c. 123, §5 (AFF).]
24-A M.R.S. § 1472 — ME Code / Title 24-A / Chapter 16 / Section 1472
24-A §1472. Qualifications for adjuster license
Status: in_force

1. Issuance of license. The superintendent may not issue, continue or permit to exist any license as an adjuster, except in compliance with this chapter or unless the person meets the requirements of subsection 2 . [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).]

2. Qualifications. In order to be licensed as an insurance adjuster, a person: A. Must be at least 18 years of age; [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] B. Must be competent, trustworthy, financially responsible, and of good personal and business reputation; and [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] C. Must pass any written examination required for the license under subchapter 2 or maintain federal crop insurance certification in the case of multiple peril crop insurance adjusters who established license qualification through such certification. [PL 2009, c. 511, Pt. C, §6 (AMD).] [PL 2009, c. 511, Pt. C, §6 (AMD).]
24-A M.R.S. § 228 — ME Code / Title 24-A / Chapter 3 / Section 228
24-A §228. Examination expense
Status: in_force

1. The expense of examination of an insurer or of any person regulated under section 222 , must be borne by the person examined. Such expense may include only the reasonable and proper hotel and travel expenses of the superintendent and the superintendent's examiners and assistants, including expert assistance, and examiners furnished for the purpose by other states in which the insurer is authorized to transact insurance, reasonable compensation as to such examiners and assistants and incidental expenses as necessarily incurred in the examination. As to expense and compensation, involved in any such examination the superintendent may give due consideration to scales and limitations recommended by the National Association of Insurance Commissioners and outlined in the examination manual sponsored by that association. [RR 2021, c. 1, Pt. B, §170 (COR).]

2. Such person examined shall promptly pay to the superintendent the expenses of the examination upon presentation by the superintendent of a reasonably detailed written statement thereof. Any insurer with total admitted assets as of the end of the preceding calendar year of $50,000,000 or greater must comply with this section in satisfaction of the examination assessment. [PL 1997, c. 660, Pt. B, §1 (AMD).]

3. Except that in lieu of payment of examination expense as above required, a domestic insurer with total admitted assets of less than $50,000,000 has the right, at its option, of making an annual payment to the superintendent of an examination expense allotment in an amount equal to .001 of its total admitted assets as of the end of the preceding calendar year, which must be made on March 1st with the filing of the insurer's annual statement with the superintendent; or, if the insurer's admitted assets exceed $10,000,000, but do not exceed $50,000,000, the insurer has the right, at its further option, to pay to the superintendent with respect to any examination the lesser of: A. The expense of the examination as determined pursuant to subsections 1 and 2 above; or [PL 1969, c. 132, §1 (NEW).] B. An annual amount equal to .001 of the first $10,000,000 of the insurer's admitted assets plus .0002 of the remainder of such assets, limited, however, to insurers whose admitted assets do not exceed $25,000,000 as such assets are shown by the insurer's financial statement filed with the superintendent for the year-end next preceding the commencement of the examination, such payment to be made on March 1st with the filing of the insurer's annual statement with the superintendent; or [PL 1997, c. 660, Pt. B, §2 (AMD).] C. If the admitted assets of the insurer exceed $25,000,000, but do not exceed $50,000,000, an annual payment of an examination expense allotment of an amount equal to .001 of the first $10,000,000 of the insurer's admitted assets, plus .0002 of the next $15,000,000 of such assets, plus .000175 of the remainder of such assets as are shown by the insurer's financial statement filed with the superintendent for the preceding calendar year. The payment must be made on March 1st with the filing of the insurer's annual statement with the superintendent. [PL 1997, c. 660, Pt. B, §2 (AMD).] [PL 1997, c. 660, Pt. B, §2 (AMD).]
24-A M.R.S. § 1411 — ME Code / Title 24-A / Chapter 16 / Section 1411
24-A §1411. License required
Status: in_force

1. Producer. A person may not act as or purport to be an insurance producer or limited insurance producer or engage in producer activities with respect to insurance risks resident, located or to be performed in this State or elsewhere for any kind or kinds of insurance unless licensed for such a kind or kinds in accordance with subchapter II‑A . [PL 2001, c. 259, §12 (AMD).]

2. Consultant; adjuster. A person may not act as or purport to be a consultant with respect to insurance risks resident, located or to be performed in this State or elsewhere unless licensed as a consultant under this chapter. A person may not act as or purport to be an adjuster unless licensed as an adjuster under this chapter, except as provided in section 1475 . [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).]

3. Insurance business. A person may not for a fee or commission engage in the business of offering any advice, counsel, opinion or similar service with respect to the benefits, advantages or disadvantages under any policy of insurance that is issued in this State unless that person is: A. Engaged or employed as an attorney licensed in this State to practice law; [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] B. A licensed insurance producer offering advice concerning a kind of insurance for which the insurance producer is licensed to transact business and does not receive a separate fee for rendering such advice other than commissions or fees for the sale of an insurance or annuity policy, except that this paragraph does not apply to a licensed insurance producer who is also authorized to act as or on behalf of an investment advisor pursuant to section 1402, subsection 4, paragraph D , subparagraph (6); [PL 1999, c. 225, §3 (AMD).] C. An actuary or a certified public accountant engaged or employed in a consulting capacity, performing duties incidental to that position; [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] D. A licensed adjuster acting within the scope of the license; or [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] E. A licensed insurance consultant acting within the scope of the license. [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] [PL 1999, c. 225, §3 (AMD).]

4. Liability. A licensee is personally liable under any insurance contract made by or through the licensee that is outside the scope of the license authority. An insurance contract issued on an application solicited, received or forwarded by an unlicensed person and otherwise valid is not thereby rendered invalid. [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).]
24-A M.R.S. § 3874 — ME Code / Title 24-A / Chapter 53 / Section 3874
24-A §3874. Subscribers' share in assets
Status: in_force

Upon the liquidation of a domestic reciprocal insurer, its assets remaining after discharge of its indebtedness and policy obligations, the return of any contributions of the attorney or other persons to its surplus, and the return of any unused premium, savings or credits then standing on subscribers' accounts, shall be distributed to its subscribers who were such within the 12 months prior to the last termination of its certificate of authority, according to such reasonable formula as the superintendent may approve. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 5053 — ME Code / Title 24-A / Chapter 68 / Section 5053
24-A §5053. Rulemaking, disclosure standards, compensation
Status: in_force

The superintendent may adopt reasonable rules to provide for the full and fair disclosure of information in connection with the sale of long-term care, home health care and nursing home care policies, including, but not limited to, an outline of coverage requirements and requirements relating to the replacement sale of the policies and compensation or commission to an agent or representative for the sale of a nursing home care, home health care or long-term care policy or certificate. [PL 1997, c. 604, Pt. D, §5 (AMD).]

The superintendent may adopt reasonable rules setting or limiting the rate of compensation or commission to an agent or other representative for the sale of a nursing home care, home health care or long-term care policy or certificate and regarding replacement sale of a nursing home care, home health care or long-term care policy or certificate. [PL 1997, c. 604, Pt. D, §5 (AMD).]
24-A M.R.S. § 4604 — ME Code / Title 24-A / Chapter 62 / Section 4604
24-A §4604. Construction
Status: in_force

This chapter must be construed to effect the purpose under section 4602 . [PL 2005, c. 346, §3 (AMD); PL 2005, c. 346, §16 (AFF).]
24-A M.R.S. § 2743 — ME Code / Title 24-A / Chapter 33 / Section 2743
24-A §2743. Newborn children coverage
Status: in_force

All individual health insurance policies providing coverage on an expense-incurred basis must provide that health insurance benefits are payable with respect to a newly born child of the insured or subscriber from the moment of birth. [PL 1997, c. 604, Pt. C, §2 (AMD).]

The coverage for newly born children must consist of coverage of injury, sickness or other benefits provided by the policy, including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities. [PL 1997, c. 604, Pt. C, §2 (AMD).]

If payment of a specific premium or subscription fee is required to provide coverage for a child, the policy or contract may require that notification of birth of a newly born child and payment of the required premium or fees must be furnished to the insurer or nonprofit service or indemnity corporation within 31 days after the date of birth in order to have the coverage continue beyond that 31-day period. The payment may be required to be retroactive to the date of birth. Benefits required by section 2743‑A must be paid regardless of whether coverage under this section is elected. [PL 1997, c. 604, Pt. C, §2 (AMD).]

The requirements of this section apply to all policies delivered or issued for delivery in this State more than 120 days after the effective date of this Act. [PL 1997, c. 604, Pt. C, §2 (AMD).]
24-A M.R.S. § 4217 — ME Code / Title 24-A / Chapter 56 / Section 4217
24-A §4217. Rehabilitation, liquidation or conservation of health maintenance organizations
Status: in_force

Any rehabilitation, liquidation or conservation of a health maintenance organization must be deemed to be the rehabilitation, liquidation or conservation of an insurance company and must be conducted under the supervision of the superintendent pursuant to the laws governing the rehabilitation, liquidation or conservation of insurance companies. The superintendent may institute summary proceedings in the same manner as provided in the laws governing delinquent insurers, and the superintendent may apply for an order directing the superintendent to rehabilitate, liquidate or conserve a health maintenance organization when in the superintendent's opinion the continued operation of the health maintenance organization would be hazardous either to the enrollees or to the people of this State. [RR 2021, c. 1, Pt. B, §348 (COR).]
24-A M.R.S. § 4251 — ME Code / Title 24-A / Chapter 56 / Section 4251
24-A §4251. Coverage for general anesthesia for dentistry (REALLOCATED FROM TITLE 24-A, SECTION 4249)
Status: in_force

(REALLOCATED FROM TITLE 24-A, SECTION 4249)

1. Enrollee defined. For the purposes of this section, unless the context otherwise indicates, "enrollee" means a person who is covered under an individual or group contract provided by a health maintenance organization. [RR 2001, c. 1, §37 (RAL).]

2. General anesthesia and associated facility charges. All individual and group health maintenance organization contracts must provide coverage for general anesthesia and associated facility charges for dental procedures rendered in a hospital when the clinical status or underlying medical condition of an enrollee requires dental procedures that ordinarily would not require general anesthesia to be rendered in a hospital. The insurer may require prior authorization of general anesthesia and associated charges required for dental care procedures in the same manner that prior authorization is required for other covered diseases or conditions. [RR 2001, c. 1, §37 (RAL).]

3. Limitations on coverage. This section applies only to general anesthesia and associated facility charges for only the following enrollees if the enrollees meet the criteria in subsection 2 : A. Enrollees, including infants, exhibiting physical, intellectual or medically compromising conditions for which dental treatment under local anesthesia, with or without additional adjunctive techniques and modalities, can not be expected to provide a successful result and for which dental treatment under general anesthesia can be expected to produce a superior result; [RR 2001, c. 1, §37 (RAL).] B. Enrollees demonstrating dental treatment needs for which local anesthesia is ineffective because of acute infection, anatomic variation or allergy; [RR 2001, c. 1, §37 (RAL).] C. Extremely uncooperative, fearful, anxious or uncommunicative children or adolescents with dental needs of such magnitude that treatment should not be postponed or deferred and for whom lack of treatment can be expected to result in dental or oral pain or infection, loss of teeth or other increased oral or dental morbidity; and [RR 2001, c. 1, §37 (RAL).] D. Enrollees who have sustained extensive oral-facial or dental trauma for which treatment under local anesthesia would be ineffective or compromised. [RR 2001, c. 1, §37 (RAL).] [RR 2001, c. 1, §37 (RAL).]

4. Dental procedures and dentist's fee not covered. This section does not require a health maintenance organization to cover any charges for the dental procedure itself, including, but not limited to, the professional fee of the dentist. Coverage for anesthesia and associated facility charges pursuant to this section is subject to all other terms and conditions of the individual or group contract that apply generally to other benefits. [RR 2001, c. 1, §37 (RAL).]

5. Coordination of benefits with dental insurance. If an enrollee eligible for coverage under this section is also eligible for coverage for general anesthesia and associated facility charges under a dental insurance policy or contract, the nonprofit health care service organization or insurer providing dental insurance is the primary payer responsible for those charges and the health maintenance organization providing health coverage is the secondary payer. [RR 2001, c. 1, §37 (RAL).]

6. Application. The requirements of this section apply to all individual and group policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 2003, c. 517, Pt. B, §30 (NEW).]
24-A M.R.S. § 1127 — ME Code / Title 24-A / Chapter 13 / Section 1127
24-A §1127. Leased property and noncorporate obligations
Status: in_force

1. An insurer may invest in personal or real property owned either by the insurer, or a trustee, while under lease to a lessee able to meet any one of the earnings tests provided by section 1109 . [PL 1979, c. 458, §11 (NEW).]

2. In addition to investments otherwise permitted under this chapter, an insurer may invest in obligations, other than those of institutions as defined in section 1110, subsection 1‑A, paragraph H , which are secured by: A. An assignment of a right to receive rental, charter, hire, purchase or other payments for the use or purchase of real or personal property adequate to return the investments and payable or guaranteed by one or more governmental units or instrumentalities, whose obligations would qualify for investment under section 1107 or section 1108 , or by one or more institutions whose obligations would qualify for investment under section 1109 . The aggregate amount of investments made or acquired under this subsection may not exceed 2% of an insurer's total admitted assets; and [PL 2001, c. 471, Pt. B, §13 (AMD).] B. A mortgage or a security interest in that real or personal property. [PL 1979, c. 458, §11 (NEW).] [PL 2001, c. 471, Pt. B, §13 (AMD).]
24-A M.R.S. § 3619 — ME Code / Title 24-A / Chapter 51 / Section 3619
24-A §3619. Proceedings before master or auditor
Status: in_force

Whenever the court appoints a master or auditor to make the apportionment or calculation for an assessment, such master or auditor shall appoint a time and place to hear all parties interested in the assessment or call, and shall give personal notice thereof, in writing, to the superintendent, and through the post office or in such other manner as the court directs, so far as the master or auditor is able, to all persons liable upon the assessment or call. The auditor or master shall hear the parties and make report to the court of all the master's or auditor's doings respecting such assessment or call and all matters connected therewith, and all parties interested in such report or assessment have a right to be heard by the court respecting the same, in the same manner as is provided. [RR 2021, c. 1, Pt. B, §310 (COR).]
24-A M.R.S. § 2745-F — ME Code / Title 24-A / Chapter 33 / Section 2745-F
24-A §2745-F. Off-label use of prescription drugs for HIV or AIDS
Status: in_force

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Off-label use" means the prescription and use of drugs for indications other than those stated in the labeling approved by the federal Food and Drug Administration. [PL 1997, c. 701, §2 (NEW).] B. "Peer-reviewed medical literature" means scientific studies published in at least 2 articles from major peer-reviewed medical journals that present data that supports the proposed off-label use as generally safe and effective. [PL 1997, c. 701, §2 (NEW).] C. "Standard reference compendia" means: (1) The United States Pharmacopeia Drug Information or information published by its successor organization; or (2) The American Hospital Formulary Service Drug Information or information published by its successor organization. [PL 1997, c. 701, §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 HIV or AIDS on the grounds that the drug has not been approved by the federal Food and Drug Administration for that indication, as long as that drug is recognized for the treatment of that indication in one of the standard reference compendia or in peer-reviewed medical literature. [PL 1997, c. 701, §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).]
24-A M.R.S. § 2834-B — ME Code / Title 24-A / Chapter 35 / Section 2834-B
24-A §2834-B. Dependent special enrollment period
Status: in_force

1. Application. This section applies to all group and blanket medical insurance policies issued by nonprofit hospital or medical service organizations, insurers or health maintenance organizations except hospital indemnity, specified accident, specified disease and long-term care policies. [PL 1997, c. 445, §19 (NEW); PL 1997, c. 445, §32 (AFF).]

2. Definition. For purposes of this section, an "eligible individual" is a person who is a certificate holder under the policy or who has met any waiting period applicable to becoming a certificate holder and is eligible to be enrolled under the policy but for a failure to enroll during a previous enrollment period. [PL 1997, c. 445, §19 (NEW); PL 1997, c. 445, §32 (AFF).]

3. Requirement. If a policy makes coverage available with respect to dependents of certificate holders, the policy must provide for a dependent special enrollment period when a person becomes a dependent of an eligible individual through marriage, birth or adoption or placement for adoption, if a court order is issued changing custody of a child or if a dependent who has other coverage loses eligibility under that coverage. During this period, the dependent may be enrolled under the plan as a dependent of the eligible individual and, in the case of the birth or adoption of a child, the spouse of the eligible individual may be enrolled as a dependent if otherwise eligible for coverage. If the eligible individual is not already enrolled or is enrolled in a different benefit package, the individual may enroll during this period. [PL 2007, c. 199, Pt. A, §1 (AMD).]

4. Length of period. A dependent special enrollment period under this section must be a period of not less than 30 days and must begin on the latest of: A. The date dependent coverage is made available; [PL 2007, c. 199, Pt. A, §2 (AMD).] B. The date of the marriage, birth or adoption or placement for adoption or the date of the court order; and [PL 2007, c. 199, Pt. A, §2 (AMD).] C. The date a dependent loses other coverage. [PL 2007, c. 199, Pt. A, §2 (NEW).] [PL 2007, c. 199, Pt. A, §2 (AMD).]

5. No waiting period. If an individual seeks to enroll a dependent during the first 30 days of a dependent special enrollment period, the coverage of the dependent becomes effective: A. In the case of marriage, no later than the first day of the first month beginning after the date the completed request for enrollment is received; [PL 1997, c. 445, §19 (NEW); PL 1997, c. 445, §32 (AFF).] B. In the case of a dependent's birth, as of the date of the birth; [PL 1999, c. 256, Pt. B, §3 (AMD).] C. In the case of a dependent's adoption or placement for adoption, as of the date of the adoption or placement for adoption; [PL 2007, c. 199, Pt. A, §3 (AMD).] D. In the case of a court order changing custody of a child, as of the date of the order; or [PL 2007, c. 199, Pt. A, §3 (AMD).] E. In the case of a dependent who loses other coverage, as of the date of application for enrollment. [PL 2007, c. 199, Pt. A, §3 (NEW).] [PL 2007, c. 199, Pt. A, §3 (AMD).]
24-A M.R.S. § 3478 — ME Code / Title 24-A / Chapter 47 / Section 3478
24-A §3478. Merger, consolidation of mutual insurers authorized
Status: in_force

1. Any one or more mutual insurers existing under any of the laws of this State, may absorb by merger or consolidation, or be merged into or consolidate with, any one or more domestic or foreign mutual insurers either authorized to transact insurance in this State or qualified for such authority. The procedure for effectuation of such merger or consolidation shall be as set forth in sections 3479 to 3482 . [PL 1969, c. 132, §1 (NEW).]

2. Nothing in this section shall authorize the merger or consolidation of a mutual insurer with a stock insurer. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 751 — ME Code / Title 24-A / Chapter 9 / Section 751
24-A §751. Examination authority
Status: in_force

1. Authority. A reinsurance intermediary is subject to examination by the superintendent. The superintendent must have access to all books, bank accounts and records of the reinsurance intermediary in a usable form. [PL 1991, c. 828, §20 (NEW).]

2. Status. A reinsurance intermediary-manager may be examined as if it were the reinsurer. [PL 1991, c. 828, §20 (NEW).]
24-A M.R.S. § 2171 — ME Code / Title 24-A / Chapter 23 / Section 2171
24-A §2171. Using insurance information to detriment of another
Status: in_force

Whenever the instrument requires that the purchaser, mortgagor or borrower furnish insurance of any kind on real or personal property being conveyed or as collateral security to a loan, the mortgagee or lender shall refrain from selling, transferring or otherwise disclosing or using any and all such insurance information to the mortgagee's or lender's own advantage and to the detriment of either the borrower, purchaser, mortgagor, insurer or company or agency complying with the requirements relating to insurance. [PL 1989, c. 449 (AMD).]
24 M.R.S. § 2320-B — ME Code / Title 24 / Chapter 19 / Section 2320-B
24 §2320-B. Acupuncture services
Status: in_force

All individual and group nonprofit medical services plan contracts and certificates and all nonprofit health care plan contracts and certificates providing coverage for acupuncture must provide coverage for those services when performed by an acupuncturist licensed pursuant to Title 32, chapter 113-B, subchapter 2 , under the same conditions that apply to the services of a licensed physician. [PL 2003, c. 517, Pt. B, §4 (AMD).]
24-A M.R.S. § 3606 — ME Code / Title 24-A / Chapter 51 / Section 3606
24-A §3606. Certificate of authority required
Status: in_force

No such insurer shall transact insurance in this State except as authorized by a subsisting certificate of authority issued to the insurer by the superintendent. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 2847-E — ME Code / Title 24-A / Chapter 35 / Section 2847-E
24-A §2847-E. Coverage for diabetes supplies
Status: in_force

All group insurance policies, contracts and certificates must provide coverage for the medically appropriate and necessary equipment, limited to insulin, oral hypoglycemic agents, monitors, test strips, syringes and lancets, and the out-patient self-management training and educational services used to treat diabetes, if: [PL 2003, c. 517, Pt. A, §8 (AMD); PL 2003, c. 517, Pt. A, §13 (AFF).]

1. Certification of medical necessity. The insured's treating physician or a physician who specializes in the treatment of diabetes certifies that the equipment and services are necessary; and [PL 1995, c. 592, §3 (NEW).]

2. Provision of medical services. The diabetes out-patient self-management training and educational services are provided through ambulatory diabetes education facilities authorized by the State's Diabetes Control Project within the Bureau of Health. [PL 1995, c. 592, §3 (NEW).]

The requirements of this section apply to all group policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 2003, c. 517, Pt. A, §8 (NEW); PL 2003, c. 517, Pt. A, §13 (AFF).]
24-A M.R.S. § 2475 — ME Code / Title 24-A / Chapter 28 / Section 2475
24-A §2475. Powers of the commission -- Article 4
Status: in_force

The commission has the power: [PL 2003, c. 680, §1 (NEW).]

1. Promulgate rules. To promulgate rules, pursuant to section 2478 , that have the force of law and are binding in the compacting states to the extent and in the manner provided in the compact; [PL 2003, c. 680, §1 (NEW).]

2. Uniform standards. To exercise its rule-making authority and establish reasonable uniform standards for products and advertisements, which have the force of law and are binding in the compacting states, but only for those products filed with the commission. A compacting state has the right to opt out of the uniform standard pursuant to section 2478 to the extent and in the manner provided in the compact. A uniform standard established by the commission for long-term care insurance products may provide either the same or greater protections for consumers as, but may not provide less than, those protections set forth in the National Association of Insurance Commissioners' Long-term Care Insurance Model Act and Long-term Care Insurance Model Regulation, adopted by the National Association of Insurance Commissioners as of 2001. The commission shall consider whether any subsequent amendments to the National Association of Insurance Commissioners' Long-term Care Insurance Model Act or Long-term Care Insurance Model Regulation adopted as of 2001 by the National Association of Insurance Commissioners require the amendment of the uniform standards established by the commission for long-term care insurance products; [PL 2003, c. 680, §1 (NEW).]

3. Products; receive and review. To receive and review in an expeditious manner products filed with the commission and rate filings for disability income and long-term care insurance products and to give approval of those products and rate filings that satisfy the applicable uniform standard. Approval by the commission has the force of law and is binding on the compacting states to the extent and in the manner provided in the compact; [PL 2003, c. 680, §1 (NEW).]

4. Advertisements. To receive and review in an expeditious manner advertisements relating to long-term care insurance products for which uniform standards have been adopted by the commission and give approval to all advertisements that satisfy the applicable uniform standard. For any product covered under the compact, other than long-term care insurance products, the commission has the authority to require an insurer to submit all or any part of its advertisement with respect to that product for review or approval prior to use, if the commission determines that the nature of the product is such that an advertisement of the product could mislead the public. The actions of commission as provided in this section have the force of law and are binding in the compacting states to the extent and in the manner provided in the compact; [PL 2003, c. 680, §1 (NEW).]

5. Self-certification process. To exercise its rule-making authority and designate products and advertisements that may be subject to a self-certification process without the need for prior approval by the commission; [PL 2003, c. 680, §1 (NEW).]

6. Operating procedures. To promulgate operating procedures pursuant to section 2478 that are binding in the compacting states to the extent and in the manner provided in the compact; [PL 2003, c. 680, §1 (NEW).]

7. Legal proceedings. To bring and prosecute legal proceedings or actions in its name as the commission. The standing of a state insurance department to sue or be sued under applicable law is not affected by this subsection; [PL 2003, c. 680, §1 (NEW).]

8. Subpoenas. To issue subpoenas requiring the attendance and testimony of witnesses and the production of evidence; [PL 2003, c. 680, §1 (NEW).]

9. Establish and maintain offices. To establish and maintain offices; [PL 2003, c. 680, §1 (NEW).]

10. Insurance; bonds. To purchase and maintain insurance and bonds; [PL 2003, c. 680, §1 (NEW).]

11. Personnel services. To borrow, accept or contract for services of personnel, including, but not limited to, employees of a compacting state; [PL 2003, c. 680, §1 (NEW).]

12. Employees; professionals; specialists. To hire employees, professionals or specialists and elect or appoint officers and to fix their compensation, define their duties and give them appropriate authority to carry out the purposes of the compact and determine their qualifications. To establish the commission's personnel policies and programs relating to, but not limited to conflicts of interest, rates of compensation and qualifications of personnel; [PL 2003, c. 680, §1 (NEW).]

13. Accept donations. To accept any and all appropriate donations and grants of money, equipment, supplies, materials and services and to receive, utilize and dispose of the same, striving to avoid any appearance of impropriety; [PL 2003, c. 680, §1 (NEW).]

14. Hold property. To lease, purchase, accept appropriate gifts or donations of or otherwise to own, hold, improve or use any property, real, personal or mixed, striving at all times to avoid any appearance of impropriety; [PL 2003, c. 680, §1 (NEW).]

15. Sell property. To sell, convey, mortgage, pledge, lease, exchange, abandon or otherwise dispose of any property, real, personal or mixed; [PL 2003, c. 680, §1 (NEW).]

16. Filing fees. To remit filing fees to compacting states as may be set forth in the bylaws, rules or operating procedures; [PL 2003, c. 680, §1 (NEW).]

17. Enforce compliance. To enforce compliance of compacting states with rules, uniform standards, operating procedures and bylaws; [PL 2003, c. 680, §1 (NEW).]

18. Provide for dispute resolution. To provide for dispute resolution among compacting states; [PL 2003, c. 680, §1 (NEW).]

19. Advice relating to business in noncompacting jurisdictions. To advise compacting states on issues relating to insurers domiciled or doing business in noncompacting jurisdictions, consistent with the purposes of the compact; [PL 2003, c. 680, §1 (NEW).]

20. Advice and training. To provide advice and training to those personnel in state insurance departments responsible for product review and to be a resource for state insurance departments; [PL 2003, c. 680, §1 (NEW).]

21. Establish budget. To establish a budget and make expenditures; [PL 2003, c. 680, §1 (NEW).]

22. Borrow money. To borrow money; [PL 2003, c. 680, §1 (NEW).]

23. Appoint committees. To appoint committees, including advisory committees of members, state insurance regulators, state legislators or their representatives, insurance industry and consumer representatives and any other interested persons as may be designated in the bylaws; [PL 2003, c. 680, §1 (NEW).]

24. Cooperation with law enforcement agencies. To provide information to and receive information from, and to cooperate with, law enforcement agencies; [PL 2003, c. 680, §1 (NEW).]

25. Corporate seal. To adopt and use a corporate seal; and [PL 2003, c. 680, §1 (NEW).]

26. Perform other functions. To perform functions other than those set out explicitly in this section as necessary or appropriate to achieve the purposes of the compact consistent with the state regulation of the business of insurance. [PL 2003, c. 680, §1 (NEW).]
24-A M.R.S. § 4320-M — ME Code / Title 24-A / Chapter 56-A / Section 4320-M
24-A §4320-M. Coverage for abortion services
Status: in_force

1. Required coverage. A carrier offering a health plan in this State that provides coverage for maternity services shall provide coverage for abortion services for an enrollee in accordance with this section. [PL 2019, c. 274, §5 (NEW); PL 2019, c. 274, §9 (AFF).]

2. Limits; copayment. A health plan that provides coverage for the services required by this section may contain provisions for maximum benefits and reasonable limitations and exclusions to the extent that these provisions are not inconsistent with the requirements of this section. [PL 2023, c. 347, §1 (AMD); PL 2023, c. 347, §3 (AFF).]

2-A. Cost sharing prohibited. Notwithstanding subsection 2 , a health plan with an effective date on or after January 1, 2024 may not impose any deductible, copayment, coinsurance or other cost-sharing requirement for the costs of abortion services. This subsection does not apply to a health plan offered for use with a health savings account unless the federal Internal Revenue Service determines that the requirements in this subsection are permissible in a high deductible health plan as defined in the federal Internal Revenue Code, Section 223(c)(2). [PL 2023, c. 347, §2 (NEW); PL 2023, c. 347, §3 (AFF).]

3. Application. Except for a religious employer granted an exclusion as provided in subsection 4 , the requirements of this section apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 2019, c. 274, §5 (NEW); PL 2019, c. 274, §9 (AFF).]

4. Exclusion for religious employer. A religious employer may request and a carrier shall grant an exclusion under the policy or contract for the coverage required by this section if the required coverage conflicts with the religious employer's bona fide religious beliefs and practices. A religious employer that obtains an exclusion under this subsection shall provide prospective enrollees and those individuals insured under its policy written notice of the exclusion. This section may not be construed as authorizing a carrier to exclude coverage for abortion services that are necessary to preserve the life or health of a covered enrollee. For the purposes of this section, "religious employer" means an employer that is a church, a convention or association of churches or an elementary or secondary school that is controlled, operated or principally supported by a church or by a convention or association of churches as defined in 26 United States Code, Section 3121(w)(3)(A) and that qualifies as a tax-exempt organization under 26 United States Code, Section 501(c)(3). [PL 2019, c. 274, §5 (NEW); PL 2019, c. 274, §9 (AFF).]

5. Protection of federal funds. If the superintendent determines enforcement of this section may adversely affect the allocation of federal funds to the State, the superintendent may grant an exemption from the requirements of this section, but only to the minimum extent necessary to ensure the continued receipt of federal funds. [PL 2019, c. 274, §5 (NEW); PL 2019, c. 274, §9 (AFF).]

Revisor's Note: §4320-M. Step therapy as enacted by PL 2019, c. 295, §1 is REALLOCATED TO TITLE 24-A, SECTION 4320-N
24-A M.R.S. § 6811 — ME Code / Title 24-A / Chapter 85 / Section 6811
24-A §6811. Prohibited practices and provisions under policies
Status: in_force

1. Assignment. The following provisions govern assignment. A. A policy of individual or group life insurance that permits assignment issued or delivered in this State may not, in any way, restrict a person from making an absolute assignment of rights for consideration. Prohibited restrictions include, but are not limited to, assignments only as a gift and without consideration, assignments only to a limited class of persons and assignments only to a natural person and not to a legal entity. [PL 2003, c. 636, §13 (AMD).] B. A life insurance company that acknowledges and records an absolute assignment of life insurance policy or rights under a group life insurance policy may rely solely on the authorization of the assignor to make the assignment and the life insurance company is not obligated to inquire into the validity, sufficiency or terms of the assignment. In acknowledging and recording an assignment, a life insurance company acting in good faith and reliance on the presentation of the absolute assignment, acts in a ministerial capacity and may exhibit no discretion as to whether an assignor may make the assignment or whether the assignment conforms with applicable law. [PL 1997, c. 430, §1 (NEW); PL 1997, c. 430, §2 (AFF).] [PL 2003, c. 636, §13 (AMD).]

2. Rights under an assignment. The following provisions apply to an assignment. A. For life insurance contracts that permit assignment: (1) A person has the right to assign, transfer, sell or bequeath the ownership of or death benefit payable under a life insurance policy or certificate at any time for any remaining portion of that coverage after exercising any option for accelerated benefits; (2) A person also has the right to assign, transfer, sell, devise or bequeath the ownership of or death benefit payable under a life insurance policy or certificate if that coverage is on disability waiver of premium at any time; and (3) The absolute assignee of an individual life insurance policy or of all rights under a group life insurance policy has all rights at law or in equity as the assignor held under that policy, including, but not limited to, the right to convert the coverage to an individual policy, the right to timely notice of the right to that conversion at the time that right accrues, the right to make premium payments or take such other action as may be necessary under the policy in order to preserve the value of the coverage assigned, the right to receive information concerning the coverage, the right to receive notice of a lapse or discontinuation of coverage, the exclusive right to exercise any options concerning the assigned coverage during an open enrollment period and all such other rights and privileges initially granted to a person under the terms of the individual or group life insurance policy. [PL 2003, c. 636, §13 (AMD).] B. A person has the right to exercise any option for accelerated benefits under the terms of any individual or group life insurance policy at any time for any unassigned portion of that policy or certificate. [PL 2003, c. 636, §13 (AMD).] [PL 2003, c. 636, §13 (AMD).]

3. Failure to give notice under group life insurance policy. If the rights under a group life insurance policy have been assigned and the administrator of the policy fails to give notice to the assignee that a person is no longer a covered person under the group and of the right to convert the policy to an individual life insurance policy, the period of time during which the assignee must make application for conversion under the terms of the group life insurance policy begins from the date the notice is given to the assignee. [PL 2003, c. 636, §13 (AMD).]

4. Riders and postsettlement increases or additions. With respect to policies containing a provision for double or additional indemnity for accidental death or any other riders or additional death benefits, including the increase in the death benefit in excess of the amount of the death benefits of the date the settlement contract is effected at the time the policy is assigned, transferred, sold, devised or bequeathed, unless otherwise mutually agreed to in writing by the viator and the settlement provider, the additional amount remains payable to the beneficiary last named by the viator prior to entering into the settlement contract or to such other beneficiary other than the settlement provider as the viator may thereafter designate or, in the absence of a designation, to the estate of the viator. [PL 2003, c. 636, §13 (AMD).]

5. Prohibition on settlements. It is a violation of this chapter for any person to enter into a settlement contract at any time prior to, or at the time of the application for, the issuance of a policy or within a 2-year period commencing with the date of issuance of the insurance policy or certificate unless the viator certifies to the settlement provider that one or more of the following conditions have been met within the 2-year period: A. The policy was issued upon the viator's exercise of conversion rights arising out of a group or individual policy, as long as the total of the time covered under the conversion policy plus the time covered under the prior policy is at least 24 months. The time covered under a group policy must be calculated without regard to any change in insurance carriers, as long as the coverage has been continuous and under the same group sponsorship; and [PL 2003, c. 636, §13 (NEW).] B. The viator submits independent evidence to the settlement provider that one or more of the following conditions have been met within the 2-year period: (1) The viator or insured is terminally ill or chronically ill; or (2) The viator or insured disposes of the viator's entire ownership interest in a closely held corporation pursuant to the terms of a buyout or other similar agreement in effect at the time the insurance policy was initially issued. [PL 2003, c. 636, §13 (NEW).] [PL 2007, c. 543, §6 (AMD).]

6. Submission of certification. If the settlement provider submits to the insurer a copy of the owner's or insured's certification described in subsection 5 when the settlement provider submits a request to the insurer to effect the transfer of the policy or certificate to the settlement provider, the copy is deemed to conclusively establish that the settlement contract satisfies the requirements of this section and the insurer shall timely respond to the request. [PL 2003, c. 636, §13 (NEW).]
24-A M.R.S. § 2781 — ME Code / Title 24-A / Chapter 34-A / Section 2781
24-A §2781. State-federal health coverage partnerships
Status: in_force

1. Partnerships authorized. The State may enter into state-federal health coverage partnerships that support the availability of affordable health coverage in the State in accordance with this section. As used in this chapter, "state-federal health coverage partnership" means a program established or authorized under federal law that provides or reallocates federal funding or that provides for the waiver or modification of otherwise applicable provisions of federal laws governing health insurance. "State-federal health coverage partnership" includes, but is not limited to, innovation waivers under Section 1332 of the federal Affordable Care Act. [PL 2019, c. 653, Pt. B, §1 (NEW).]

2. Application. Unless the applicable federal laws, regulations or administrative guidelines require a different state official to be the applicant, the superintendent may apply to the appropriate federal agency or agencies to establish or participate in a state-federal health coverage partnership or to modify the terms and conditions of an existing partnership if the superintendent determines that the application, if approved, is likely to improve the affordability, availability or quality of health coverage in this State and the Governor approves the submission of the application. [PL 2019, c. 653, Pt. B, §1 (NEW).]

3. Notice and consultation. The superintendent shall ensure that all federally required notices and opportunities for consultation with respect to a state-federal health coverage partnership or proposed partnership are provided. The superintendent shall take any additional measures that may be necessary to identify persons and constituencies likely to be materially affected by a state-federal health coverage partnership or proposed partnership and to provide such persons and constituencies with reasonable notice and opportunity for input. [PL 2019, c. 653, Pt. B, §1 (NEW).]

4. MaineCare program and Maine Health Insurance Marketplace. A state-federal health coverage partnership may coordinate with the MaineCare program or the Maine Health Insurance Marketplace established in Title 22, chapter 1479 and incorporate provisions affecting these programs, including but not limited to a joint Medicaid Section 1115 demonstration waiver and state innovation waiver, with the approval or joint application of the Commissioner of Health and Human Services. [PL 2019, c. 653, Pt. B, §1 (NEW).]
24-A M.R.S. § 2774 — ME Code / Title 24-A / Chapter 34 / Section 2774
24-A §2774. Enforcement
Status: in_force

The following provisions govern enforcement of this chapter. [PL 1989, c. 556, Pt. C, §2 (NEW).]

1. Periodic reviews. The superintendent may conduct periodic reviews of the operations of the entities licensed pursuant to this chapter to ensure that they continue to meet the minimum standards set forth in section 2772 and any applicable rules adopted by the superintendent. The superintendent may perform periodic telephone audits of licensees to determine if representatives of the licensee are reasonably accessible, as required by section 2772 . [PL 1989, c. 556, Pt. C, §2 (NEW).]

2. Action against licensee. The superintendent is authorized to take appropriate action against a licensee which fails to meet the standards of this chapter or any rules adopted by the superintendent, or who fails to respond in a timely manner to corrective actions ordered by the superintendent. The superintendent may impose a civil penalty not to exceed $1,000 for each violation, as permitted by section 12‑A , or may deny, suspend or revoke the license. [PL 1989, c. 556, Pt. C, §2 (NEW).]

3. Opportunity to provide information and request hearing. Before taking the actions authorized by this section to deny, suspend or revoke the license, the superintendent shall provide the licensee with reasonable time to supply additional information demonstrating compliance with the requirements of this chapter and the opportunity to request a hearing to be held consistent with the provisions of the Maine Administrative Procedure Act, Title 5, chapter 375 . [PL 1989, c. 556, Pt. C, §2 (NEW).]

4. Authority to adopt rules. The superintendent may adopt rules necessary to implement the provisions of this chapter. [PL 1989, c. 556, Pt. C, §2 (NEW).]

5. Rulings on appropriateness of medical judgments not authorized. Nothing in this chapter requires or authorizes the superintendent to rule on the appropriateness of medical decisions or judgments rendered by review entities and their agents. [PL 1989, c. 556, Pt. C, §2 (NEW).]
24-A M.R.S. § 2105 — ME Code / Title 24-A / Chapter 21 / Section 2105
24-A §2105. Service of process
Status: in_force

1. Service of process upon any such insurer pursuant to section 2104 must be made by delivering to and leaving with the superintendent or some person in apparent charge of the superintendent's office 2 copies thereof and the payment to the superintendent of the fees as prescribed by section 601 . The superintendent shall forthwith mail by registered or certified mail one of the copies of such process to the defendant at its principal place of business last known to the superintendent, and shall keep a record of all process so served upon the defendant. Such service of process is sufficient, as long as notice of such service and a copy of the process are sent within 10 days thereafter by registered or certified mail by plaintiff's attorney to the defendant at its last known principal place of business, and the defendant's receipt or receipt issued by the post office with which the letter is registered or certified, showing the name of the sender of the letter and the name and address of the person to whom the letter is addressed, and the affidavit of the plaintiff's attorney showing a compliance herewith are filed with the clerk of the court in which such action is pending on or before the date the defendant is required to appear, or within such further time as the court may allow. [RR 2021, c. 1, Pt. B, §203 (COR).]

2. Service of process in any such action, suit or proceeding shall in addition to the manner provided in subsection 1 be valid if served upon any person within this State, who in this State on behalf of such insurer, is: A. Soliciting insurance; or [PL 1969, c. 132, §1 (NEW).] B. Making any contract of insurance or issuing or delivering any policies or written contracts of insurance; or [PL 1969, c. 132, §1 (NEW).] C. Collecting or receiving any premium for insurance; and a copy of such process is sent within 10 days thereafter by registered or certified mail by the plaintiff's attorney to the defendant at the last known principal place of business of the defendant, and the defendant's receipt, or the receipt issued by the post office with which the letter is registered or certified, showing the name of the sender of the letter and the name and address of the person to whom the letter is addressed, and the affidavit of the plaintiff's attorney showing a compliance herewith are filed with the clerk of the court in which such action is pending on or before the date the defendant is required to appear, or within such further time as the court may allow. [PL 1969, c. 132, §1 (NEW).] [PL 1969, c. 132, §1 (NEW).]

3. A plaintiff or complainant is not entitled to a judgment or to have the plaintiff's or complainant's complaint taken pro confesso under this section until the expiration of 30 days from the date of the filing of the affidavit of compliance. [RR 2021, c. 1, Pt. B, §204 (COR).]

4. Nothing in this section shall limit or abridge the right to serve any process, notice or demand upon any insurer in any other manner now or hereafter permitted by law. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 4314 — ME Code / Title 24-A / Chapter 56-A / Section 4314
24-A §4314. Access to eye care providers
Status: in_force

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Eye care provider" means a participating provider who is an optometrist licensed to practice optometry pursuant to Title 32, chapter 151 , or an ophthalmologist licensed to practice medicine pursuant to Title 32, chapter 36 , 48 or 145 . [PL 2023, c. 580, §3 (AMD).] B. "Eye care services" means those urgent health care services related to the examination, diagnosis, treatment and management of conditions, illnesses and diseases of the eye and related structures that are provided to treat conditions, illnesses or diseases of the eye that if not treated within 24 hours present a serious risk of harm. [PL 2001, c. 408, §1 (NEW); PL 2001, c. 408, §2 (AFF).] C. "Contractual discount" means a percentage or other reduction from a provider's usual and customary rate for a covered service or covered material required under a participating provider agreement. [PL 2015, c. 171, §1 (NEW); PL 2015, c. 171, §4 (AFF).] D. "Covered material" means a material for which benefits are provided under a health plan that provides coverage for vision care or eye care services or a limited benefit vision insurance plan. [PL 2015, c. 171, §1 (NEW); PL 2015, c. 171, §4 (AFF).] E. "Covered service" means a service for which benefits are provided under a health plan that provides coverage for vision care or eye care services or a limited benefit vision insurance plan. [PL 2015, c. 171, §1 (NEW); PL 2015, c. 171, §4 (AFF).] F. "Limited benefit vision insurance plan" means a plan offered or administered by a carrier that covers only vision care or any other plan offered or administered by a carrier that includes vision care benefits and is not a health plan. [PL 2015, c. 171, §1 (NEW); PL 2015, c. 171, §4 (AFF).] G. "Materials" means ophthalmic devices, including, but not limited to, lenses, devices containing lenses, artificial intraocular lenses, ophthalmic frames and other lens mounting apparatuses, prisms, lens treatments and coating, contact lenses and prosthetic devices to correct, relieve or treat defects or abnormal conditions of the human eye or its adnexa. [PL 2015, c. 171, §1 (NEW); PL 2015, c. 171, §4 (AFF).] H. "Services" means the professional work performed by an eye care provider. [PL 2015, c. 171, §1 (NEW); PL 2015, c. 171, §4 (AFF).] I. "Vision insurance" means a health plan that provides coverage for vision care or eye care services or a limited benefit vision insurance plan. [PL 2015, c. 171, §1 (NEW); PL 2015, c. 171, §4 (AFF).] [PL 2023, c. 580, §3 (AMD).]

2. Coverage of eye care services. A carrier that provides coverage for eye care services as part of a health plan shall provide coverage for eye care services in accordance with the following. A. An enrollee may receive eye care services from an eye care provider participating in the enrollee's health plan without the prior approval or authorization of the enrollee's primary care provider for a maximum of 2 visits, one initial visit and one follow-up visit, for each occurrence requiring urgent care as described in subsection 1, paragraph B. A carrier may not retrospectively deny coverage under this section on the basis that the eye care services received by the enrollee did not meet the requirements of subsection 1, paragraph B . In order to receive continuing benefits for treatment related to the initial visit, an enrollee must receive the approval of the enrollee's primary care provider for any visit after the 2nd visit. Within 3 working days of the initial visit, the eye care provider shall send to the enrollee's primary care provider a report containing the enrollee's complaint, related history, examination results, initial diagnosis and recommendations for treatment. If the eye care provider does not send a report to the primary care provider within 3 working days, the carrier is not obligated to provide benefits for the self-referred visits under this paragraph and the enrollee is not liable to the eye care provider for any unpaid fees. [PL 2001, c. 408, §1 (NEW); PL 2001, c. 408, §2 (AFF).] B. A carrier shall ensure that all eye care providers participating in the carrier's health plans are included on any publicly accessible list of participating providers for the carrier. [PL 2001, c. 408, §1 (NEW); PL 2001, c. 408, §2 (AFF).] C. A carrier shall allow each eye care provider participating in the carrier's health plans to furnish covered eye care services to enrollees without discrimination between classes of eye care providers and to provide the eye care services permitted by the eye care provider's license. [PL 2001, c. 408, §1 (NEW); PL 2001, c. 408, §2 (AFF).] [PL 2001, c. 408, §1 (NEW); PL 2001, c. 408, §2 (AFF).]

3. Prohibitions. A carrier or a subsidiary or subcontractor of a carrier may not: A. Impose a deductible or coinsurance for eye care services that is greater than the deductible or coinsurance imposed for other health care services under a health plan; [PL 2015, c. 171, §2 (AMD); PL 2015, c. 171, §4 (AFF).] B. Require an eye care provider to hold hospital privileges as a condition of participation as a provider under a health plan; [PL 2015, c. 171, §2 (AMD); PL 2015, c. 171, §4 (AFF).] C. Require in an agreement with an eye care provider that the eye care provider provide services or materials to an enrollee in a health plan that provides coverage for vision care or eye care services or a limited benefit vision insurance plan at a specified or limited fee unless the services or materials are a covered service or a covered material under the health plan or limited benefit vision insurance plan; [PL 2015, c. 171, §2 (NEW); PL 2015, c. 171, §4 (AFF).] D. Restrict or limit, directly or indirectly, in an agreement with an eye care provider, the eye care provider's choice of sources and suppliers of services or materials provided by the eye care provider to an enrollee or the optical laboratories used by the eye care provider; [PL 2015, c. 171, §2 (NEW); PL 2015, c. 171, §4 (AFF).] E. Change any term, contractual discount or reimbursement rate contained in an agreement with an eye care provider without notice to the eye care provider at least 60 days before the change is implemented; [PL 2015, c. 171, §2 (NEW); PL 2015, c. 171, §4 (AFF).] F. Require in an agreement with an eye care provider that the eye care provider participate in other vision insurance as a condition of joining an insurer's provider network for a health plan that provides coverage for vision care or eye care services or a limited benefit vision insurance plan; or [PL 2015, c. 171, §2 (NEW); PL 2015, c. 171, §4 (AFF).] G. Enter into an agreement with an eye care provider that is longer than 2 years from the date the agreement is first signed. [PL 2015, c. 171, §2 (NEW); PL 2015, c. 171, §4 (AFF).] [PL 2015, c. 171, §2 (AMD); PL 2015, c. 171, §4 (AFF).]

4. Construction. This section may not be construed as: A. Requiring coverage for routine eye examinations; [PL 2001, c. 408, §1 (NEW); PL 2001, c. 408, §2 (AFF).] B. Creating coverage for any health care service that is not otherwise covered under the terms of a health plan; [PL 2001, c. 408, §1 (NEW); PL 2001, c. 408, §2 (AFF).] C. Requiring a carrier to include as a participating provider every willing provider or health care professional who meets the terms and conditions of a health plan; [PL 2001, c. 408, §1 (NEW); PL 2001, c. 408, §2 (AFF).] D. Preventing an enrollee from seeking eye care services from the enrollee's primary care provider in accordance with the terms of the enrollee's health plan; [PL 2001, c. 408, §1 (NEW); PL 2001, c. 408, §2 (AFF).] E. Increasing or decreasing the scope of practice of optometry or ophthalmology as defined in Title 32 ; [PL 2001, c. 408, §1 (NEW); PL 2001, c. 408, §2 (AFF).] F. Requiring eye care services to be provided in a hospital or similar health care facility; or [PL 2001, c. 408, §1 (NEW); PL 2001, c. 408, §2 (AFF).] G. Notwithstanding the definition of eye care services in subsection 1, paragraph B , prohibiting a carrier from requiring an enrollee to receive prior approval or authorization from a primary care provider for any subsequent surgical procedures. [PL 2001, c. 408, §1 (NEW); PL 2001, c. 408, §2 (AFF).] [PL 2001, c. 408, §1 (NEW); PL 2001, c. 408, §2 (AFF).]

5. Application. The requirements of this section apply to all individual and group policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 2003, c. 517, Pt. B, §33 (NEW).]

6. Enforcement. A violation of this section by a carrier or a subsidiary or subcontractor of a carrier is enforced by the superintendent under the authority granted by section 12‑A . [PL 2015, c. 171, §3 (NEW); PL 2015, c. 171, §4 (AFF).]
24-A M.R.S. § 734 — ME Code / Title 24-A / Chapter 9 / Section 734
24-A §734. Minimum surplus regarding policyholders to assume property and casualty reinsurance
Status: in_force

1. Prohibition. Notwithstanding section 731‑B, subsection 1, paragraph B , a domestic property or domestic casualty insurer, other than mutual assessment insurers operating pursuant to chapter 51 , possessing less than $10,000,000 in surplus regarding policyholders may not, without the prior written approval of the superintendent, assume reinsurance on any risk that it is otherwise permitted to assume except when the reinsurance is: A. Required by applicable law or rule; or [PL 1991, c. 828, §19 (NEW).] B. Assumed pursuant to pooling arrangements among members of the same holding company system. [PL 1991, c. 828, §19 (NEW).] [PL 1991, c. 828, §19 (NEW).]

2. Application. This section applies to contracts of reinsurance entered into or renewed after the effective date of this section. [PL 1991, c. 828, §19 (NEW).]

3. Effect. The performance of an activity prohibited by this section does not invalidate any reinsurance contract between the parties to the contract. [PL 1991, c. 828, §19 (NEW).]
24-A M.R.S. § 1905 — ME Code / Title 24-A / Chapter 18 / Section 1905
24-A §1905. License
Status: in_force

1. Upon receipt of a complete application for an administrator license, the superintendent shall investigate, to the extent the superintendent considers advisable, the applicant's experience, background and fitness for the license. The superintendent may obtain a credit and investigative report relative to the applicant from a recognized and established independent investigation and reporting agency. The superintendent may establish from time to time a reasonable uniform flat amount that the applicant must pay for the report. The report cost must be included with the application. The contents of the report are confidential. [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]

2. If the superintendent finds that the applicant is qualified for an administrator license, the superintendent shall promptly issue the license, which identifies the types of business in which the applicant may engage; otherwise the superintendent shall refuse to issue the license and promptly notify the applicant. [PL 2003, c. 469, Pt. E, §6 (AMD).]

3. Sections 1417 and 1418 apply to licenses issued under this chapter. [PL 1997, c. 457, §29 (AMD); PL 1997, c. 457, §55 (AFF).]

4. Unless revoked or suspended under section 1907 , an administrator license remains in effect as long as the holder of the license maintains in force and effect the bond required by section 1904 and pays the annual fee required by section 601 before the anniversary date of the license. [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]

5. An administrator shall submit an application to amend its license if the administrator desires to amend the types of business on its then-current license. [PL 2003, c. 469, Pt. E, §7 (NEW).]
24-A M.R.S. § 229 — ME Code / Title 24-A / Chapter 3 / Section 229
24-A §229. Administrative procedures; hearings in general
Status: in_force

1. The superintendent may hold a hearing without request of others for any purpose within the scope of this Title. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

2. The superintendent shall hold a hearing: A. If required by any provision of this Title, or [PL 1969, c. 132, §1 (NEW).] B. Upon written application for a hearing by a person aggrieved by any act or impending act, or by any report or order of the superintendent, other than an order for the holding of a hearing, or order on a hearing, or pursuant to such order, of which hearing such person had notice. [PL 1987, c. 220, §1 (AMD).] [PL 1987, c. 220, §1 (AMD).]

3. Any such application must be filed with the superintendent within 30 days after such person knew or reasonably should have known of such act, impending act, failure, report or order, unless a different period is provided for by other applicable law, and in which case such other law shall govern. The application shall briefly state the respects in which the applicant is so aggrieved, together with the ground to be relied upon for the relief to be demanded at the hearing. The superintendent may require that the application be signed and sworn to. [PL 1987, c. 220, §2 (AMD).]

4. If the superintendent finds that the application is timely and made in good faith, that the applicant would be so aggrieved if the applicant's grounds are established and that such grounds otherwise justify the hearing, the superintendent shall hold the hearing within 30 days after filing of the application, or within 30 days after the application has been sworn to, whichever is the later date, unless in either case the hearing is postponed by mutual consent. The hearing must be held in conformity with the provisions contained in the Maine Administrative Procedure Act. [RR 2021, c. 1, Pt. B, §171 (COR).]

5. Failure to hold the hearing upon application therefor of a person entitled thereto as provided shall constitute a denial of the relief sought, and shall be the equivalent of a final order of the superintendent on hearing for the purpose of an appeal under section 236 . [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

6. Pending the hearing and decision thereon, the superintendent may suspend or postpone the effective date of the superintendent's previous action. [RR 2021, c. 1, Pt. B, §172 (COR).]
24-A M.R.S. § 2436-A — ME Code / Title 24-A / Chapter 27 / Section 2436-A
24-A §2436-A. Unfair claims settlement practices
Status: in_force

1. Civil actions. A person injured by any of the following actions taken by that person's own insurer may bring a civil action and recover damages, together with costs and disbursements, reasonable attorney's fees and interest on damages at the rate of 1 1/2% per month: A. Knowingly misrepresenting to an insured pertinent facts or policy provisions relating to coverage at issue; [PL 1997, c. 621, §1 (RPR).] B. Failing to acknowledge and review claims, which may include payment or denial of a claim, within a reasonable time following receipt of written notice by the insurer of a claim by an insured arising under a policy; [PL 1997, c. 621, §1 (RPR).] C. Threatening to appeal from an arbitration award in favor of an insured for the sole purpose of compelling the insured to accept a settlement less than the arbitration award; [PL 1997, c. 621, §1 (RPR).] D. Failing to affirm or deny coverage, reserving any appropriate defenses, within a reasonable time after having completed its investigation related to a claim; or [PL 1997, c. 621, §1 (RPR).] E. Without just cause, failing to effectuate prompt, fair and equitable settlement of claims submitted in which liability has become reasonably clear. [PL 1997, c. 621, §1 (NEW).] [PL 1997, c. 621, §1 (RPR).]

2. Without just cause. For the purposes of this section, an insurer acts without just cause if it refuses to settle claims without a reasonable basis to contest liability, the amount of any damages or the extent of any injuries claimed. [PL 1997, c. 621, §1 (RPR).]

3. No limitation on other cause of action. Nothing in this section prohibits any other claim or cause of action a person has against an insurer. [PL 1997, c. 621, §1 (NEW).]

4. Application. This section does not apply to workers' compensation claims. [PL 1997, c. 621, §1 (NEW).]
24-A M.R.S. § 226 — ME Code / Title 24-A / Chapter 3 / Section 226
24-A §226. Examination reports; distribution, hearing; as evidence
Status: in_force

1. Within 60 days after completion of the examination, the superintendent shall deliver a copy of the verified examination report to the person examined, together with a notice affording that person 20 days or an additional reasonable period as the superintendent for good cause may allow, within which to review the report and recommend changes to the report. [PL 1999, c. 113, §15 (AMD).]

2. If requested by the person examined, within the period allowed under subsection 1 , or if determined advisable by the superintendent without such request, the superintendent shall hold a hearing relative to the report and may not file the report in the bureau until after the hearing and the superintendent's order on the report; except that the superintendent may furnish a copy of the report to the Governor, Attorney General or Treasurer of State pending final decision and, if the copies are so furnished, they are confidential until the other requirements of this section with regard to examination reports have been satisfied. In lieu of convening a hearing, the superintendent may reopen the examination or, if supported by the information obtained, may adopt some or all of the modifications proposed by the person examined. [PL 2011, c. 320, Pt. A, §4 (AMD).]

3. If no such hearing has been requested or held, the examination report, with such modifications, if any, thereof as the superintendent deems proper, shall be accepted by the superintendent and filed in the bureau upon expiration of the review period provided for in subsection 1 . The report shall in any event be so accepted and filed within 6 months after final hearing thereon. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

4. The superintendent shall forward to the person examined a copy of the examination report as filed, together with any recommendations or statements relating thereto that the superintendent considers proper. [RR 2021, c. 1, Pt. B, §167 (COR).]

5. If the report is as to examination of a domestic insurer, a copy of the report, or a summary thereof approved by the superintendent, when filed in the bureau, together with the recommendations or statements of the superintendent or the superintendent's examiner, must be presented by the insurer's chief executive officer to the insurer's board of directors or similar governing body at a meeting thereof that must be held within 30 days next following receipt of the report in final form by the insurer. A copy of the report must also be furnished by the secretary of the insurer, if incorporated, or by the attorney-in-fact, if a reciprocal insurer, to each member of the insurer's board of directors or board of governors, if a reciprocal insurer, and the certificate of the secretary or attorney-in-fact that a copy of the examination report has been so furnished must be deemed to constitute knowledge of the contents of the report by each such member. [RR 2021, c. 1, Pt. B, §168 (COR).]

6. The report when so filed in the bureau is admissible in evidence in any action or proceeding brought by the superintendent against the person examined, or against its officers, employees or agents. In any such action or proceeding, the superintendent or the superintendent's examiners may at any time testify and offer proper evidence as to information secured or matters discovered during the course of an examination, whether or not a written report of the examination has been either made, furnished or filed in the bureau. [RR 2021, c. 1, Pt. B, §169 (COR).]

7. The Maine Insurance Code does not prevent and may not be construed to prohibit the superintendent from disclosing the content of an examination report, preliminary examination report or the results, or any matter related to a report or results, to the Bureau of Insurance of this State or the insurance department of any other state or country, or to law enforcement officials of this State, any other state agency or the federal government at any time. Any such disclosure must be subject to a protective order of confidentiality issued by the superintendent. [PL 1991, c. 828, §11 (NEW).]
24-A M.R.S. § 7703 — ME Code / Title 24-A / Chapter 101 / Section 7703
24-A §7703. Date of grants
Status: in_force

The bureau and the administrator are not required to award a grant before May 1, 2026. [PL 2025, c. 33, Pt. A, §1 (NEW).]
24-A M.R.S. § 4612-A — ME Code / Title 24-A / Chapter 62 / Section 4612-A
24-A §4612-A. Prevention of impairments and insolvencies
Status: in_force

To aid in the detection and prevention of insurer impairments and insolvencies, the following provisions apply. [PL 2005, c. 346, §11 (NEW); PL 2005, c. 346, §16 (AFF).]

1. Action by superintendent. The superintendent shall: A. Notify the insurance commissioners of all the other states, territories of the United States and the District of Columbia, within 30 days following the action taken or the date the action occurs, when the superintendent takes any of the following actions against a member insurer: (1) Revokes a license; (2) Suspends a license; or (3) Makes a formal order that the member insurer restrict its premium writing, obtain additional contributions to surplus, withdraw from the State, reinsure all or any part of its business or increase capital, surplus or any other account for the security of policy owners or creditors. [PL 2005, c. 346, §11 (NEW); PL 2005, c. 346, §16 (AFF).] B. Report to the board of directors when the superintendent has taken any of the actions set forth in paragraph A or has received a report from any other insurance commissioner indicating that any such action has been taken in another state. The report to the board of directors must contain all significant details of the action taken or the report received from another commissioner. [PL 2005, c. 346, §11 (NEW); PL 2005, c. 346, §16 (AFF).] C. Report to the board of directors when the superintendent has reasonable cause to believe from an examination, whether completed or in process, of any member insurer that the insurer may be an impaired or insolvent insurer. [PL 2005, c. 346, §11 (NEW); PL 2005, c. 346, §16 (AFF).] D. Furnish to the board of directors the National Association of Insurance Commissioners Insurance Regulatory Information System ratios and listings of companies not included in the ratios. The board may use the information contained therein in carrying out its duties and responsibilities under this section. The report and the information contained therein must be kept confidential by the board until such time as made public by the superintendent or other lawful authority. [PL 2005, c. 346, §11 (NEW); PL 2005, c. 346, §16 (AFF).] [PL 2005, c. 346, §11 (NEW); PL 2005, c. 346, §16 (AFF).]

2. Advice and recommendations. The superintendent may seek the advice and recommendations of the board of directors concerning any matter affecting the duties and responsibilities of the superintendent regarding the financial condition of member insurers and companies seeking admission to transact insurance or health maintenance organization business in this State. [PL 2017, c. 382, §27 (AMD).]

3. Action by board of directors. The board of directors, upon majority ballot vote, shall: A. Notify the superintendent of any information indicating that any member insurer may be impaired or insolvent; [PL 2017, c. 382, §27 (AMD).] B. Make reports and recommendations to the superintendent upon any matter germane to the solvency, liquidation, rehabilitation or conservation of any member insurer or germane to the solvency of any company seeking to do insurance or health maintenance organization business in this State. These reports and recommendations must be treated as confidential by the superintendent; and [PL 2017, c. 382, §27 (AMD).] C. Make recommendations to the superintendent for the detection and prevention of insolvencies. [PL 2017, c. 382, §27 (AMD).] [PL 2017, c. 382, §27 (AMD).]
24-A M.R.S. § 203 — ME Code / Title 24-A / Chapter 3 / Section 203
24-A §203. Compensation
Status: in_force

The State shall pay to the superintendent an annual salary in amount as provided by law as full compensation for all duties required of the superintendent. [PL 1989, c. 702, Pt. E, §12 (AMD).]
24-A M.R.S. § 3621 — ME Code / Title 24-A / Chapter 51 / Section 3621
24-A §3621. -- assessment not sufficient; collection stayed by court
Status: in_force

Whenever it shall appear to the court before which the complaint provided for in section 3617 is pending, that the net proceeds of any assessment or call will not be sufficient to furnish substantial relief to those having claims against the insurer, it may decree that no assessment shall be collected. When, on application of the superintendent or any person interested, the court is of opinion that further attempts to collect an assessment then partially collected will not benefit those having claims against the insurer, it may stay its further collection. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (NEW).]
24-A M.R.S. § 2428 — ME Code / Title 24-A / Chapter 27 / Section 2428
24-A §2428. Exemption of proceeds -- life, endowment, annuity, accident contracts
Status: reserved

1. Certain policies of insurance shall be exempt from claims of creditors, and the rights of beneficiaries and assignees thereof shall be protected, as set forth. [PL 1969, c. 132, §1 (NEW).]

2. Except in cases of transfers with intent to defraud creditors, if a contract of life, endowment, annuity or accident insurance, whether heretofore or hereafter issued, is effected by any person on that person's own life or on another life, in favor of a person other than the person effecting that contract, or is assigned or in any way made payable to any other person, the lawful beneficiary or assignee thereof, other than the insured or the person so effecting such contract of insurance or executors or administrators of such insured or of the person so effecting such contract of insurance, is entitled to its proceeds and avails against the creditors and representatives of the insured and of the person effecting the same, whether or not the right to change the beneficiary is reserved or permitted and whether or not the contract of insurance is made payable to the person whose life is insured or to the executor or administrator of such person if the beneficiary or assignee predeceases such person, and such proceeds and avails are exempt from all liability for any debt of the beneficiary existing at the time the proceeds and avails are made available for the beneficiary's use. Subject to the statutes of limitations, the amount of any premiums for such contract of insurance paid with intent to defraud creditors, with interest thereon, inures to the benefit of the creditors from the proceeds of the contract of insurance; but the insurer issuing the contract must be discharged of all liability thereon by payment of its proceeds in accordance with its terms, unless before such payment the insurer has received written notice, by or in behalf of a creditor with specifications of the amount claimed along with such facts as will assist the insurer to ascertain the particular policy, of a claim to recover for transfer made or premiums paid with intent to defraud creditors, and unless such insurer has been served with trustee process for the cash surrender value of any such contract of insurance as required by law prior to making payment of the proceeds in accordance with the terms of the contract of insurance. [RR 2013, c. 2, §37 (COR).]

3. For the purpose of subsection 2 , a contract of insurance shall also be deemed to be payable to a person other than the insured if and to the extent that a facility-of-payment clause or similar clause in the contract permits the insurer to discharge its obligation after the death of the individual insured by paying the death benefits to a person as permitted by such clause. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 1262 — ME Code / Title 24-A / Chapter 15 / Section 1262
24-A §1262. Deficiency of deposit
Status: in_force

If for any reason the market value of securities of an insurer held on deposit in this State as required under this Title falls below the required amount, the insurer shall promptly deposit other or additional assets eligible for deposit sufficient to cure the deficiency. If the insurer has failed to cure the deficiency within 20 days after receipt of notice thereof by registered mail from the superintendent, the superintendent shall forthwith revoke the insurer's certificate of authority. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 6912 — ME Code / Title 24-A / Chapter 87 / Section 6912
24-A §6912. Subsidies
Status: in_force

Dirigo Health may establish sliding-scale subsidies for the purchase of Dirigo Health Program coverage paid by eligible individuals or employees whose income is under 300% of the federal poverty level. Dirigo Health may also establish sliding-scale subsidies for the purchase of employer-sponsored health coverage paid by employees of businesses with more than 50 employees, whose income is under 300% of the federal poverty level. [PL 2005, c. 400, Pt. A, §7 (AMD).]

1. Administration. Dirigo Health shall, by rule, establish procedures to administer this section. [PL 2003, c. 469, Pt. A, §8 (NEW).]

2. Eligibility for subsidy. To be eligible for a subsidy an individual or employee must: A. Be enrolled in the Dirigo Health Program, have an income under 300% of the federal poverty level and be a resident of the State; or [PL 2005, c. 400, Pt. A, §8 (AMD).] B. Be enrolled in a health plan of an employer with more than 50 employees and have an income under 300% of the federal poverty level. The health plan must meet any criteria established by Dirigo Health. The individual must meet other eligibility criteria established by Dirigo Health. [PL 2005, c. 400, Pt. A, §8 (AMD).] [PL 2005, c. 400, Pt. A, §8 (AMD).]

3. Limitation of subsidies. Dirigo Health shall limit the availability of subsidies to reflect limitations of available funds. [PL 2003, c. 469, Pt. A, §8 (NEW).]

4. Limitation on amount subsidized. [PL 2007, c. 629, Pt. B, §1 (RP).]

5. Notification of subsidy. Dirigo Health shall notify applicants and their employers in writing of their eligibility and approved level of subsidy. [PL 2003, c. 469, Pt. A, §8 (NEW).]

6. Report. Within 30 days after any subsidies are established pursuant to this section, the board shall report on the amount of the subsidies, the funding required for the subsidies and the estimated number of Dirigo Health Program enrollees eligible for the subsidies and submit the report to the joint standing committee of the Legislature having jurisdiction over appropriations and financial affairs, the joint standing committee of the Legislature having jurisdiction over insurance and financial services matters and the joint standing committee of the Legislature having jurisdiction over health and human services matters. [PL 2005, c. 400, Pt. A, §9 (AMD).]
24-A M.R.S. § 473 — ME Code / Title 24-A / Chapter 5 / Section 473
24-A §473. Insurers regulated; suspended
Status: in_force

During any insurance emergency period as described in sections 471 and 472 , the superintendent is empowered to suspend for such time or times as the superintendent may determine the transaction of insurance functions of any authorized insurer, whether domestic or foreign, solvent or otherwise, and to limit its insurance business in volume or character to such particular amounts or classifications and for such time or times as the superintendent considers advisable. [RR 2021, c. 1, Pt. B, §183 (COR).]
24-A M.R.S. § 4104 — ME Code / Title 24-A / Chapter 55 / Section 4104
24-A §4104. Organization
Status: in_force

The organization of a society shall be governed as follows. [PL 1969, c. 132, §1 (NEW).]

1. Seven or more citizens of the United States, a majority of whom are citizens of this State, who desire to form a fraternal benefit society, may make, sign and acknowledge before some officer competent to take acknowledgment of deeds, articles of incorporation, in which shall be stated: A. The proposed corporate name of the society, which shall not so closely resemble the name of any society or insurance company as to be misleading or confusing; [PL 1969, c. 132, §1 (NEW).] B. The purposes for which it is being formed and the mode in which its corporate powers are to be exercised. Such purposes shall not include more liberal powers than are granted by this chapter, provided that any lawful, social, intellectual, educational, charitable, benevolent, moral, fraternal or religious advantages may be set forth among the purposes of the society; and [PL 1969, c. 132, §1 (NEW).] C. The names and residences of the incorporators and the names, residences and official titles of all the officers, trustees, directors or other persons who are to have and exercise the general control of the management of the affairs and funds of the society for the first year or until the ensuing election at which all such officers shall be elected by the supreme legislative or governing body, which election shall be held not later than one year from the date of the issuance of the permanent certificate. [PL 1969, c. 132, §1 (NEW).] [PL 1969, c. 132, §1 (NEW).]

2. Such articles of incorporation, duly certified copies of the constitution, laws and rules, copies of all proposed forms of certificates, applications therefor, and circulars to be issued by the society and a bond conditioned upon the return to applicants of the advanced payments if the organization is not completed within one year must be filed with the superintendent, who may require such further information as the superintendent considers necessary. The bond with sureties approved by the superintendent must be in such amount, not less than $5,000 nor more than $25,000, as required by the superintendent. All documents filed are to be in the English language. If the purposes of the society conform to the requirements of this chapter and all provisions of law have been complied with, the superintendent shall so certify, retain and file the articles of incorporation and furnish the incorporators a preliminary certificate authorizing the society to solicit members as hereinafter provided. [RR 2021, c. 1, Pt. B, §323 (COR).]

3. No preliminary certificate granted under this section shall be valid after one year from its date or after such further period, not exceeding one year, as may be authorized by the superintendent upon cause shown, unless the 500 applicants hereinafter required have been secured and the organization has been completed as herein provided. The articles of incorporation and all other proceedings thereunder shall become null and void in one year from the date of the preliminary certificate, or at the expiration of the extended period, unless the society shall have completed its organization and received a certificate of authority to do business as hereinafter provided. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

4. Upon receipt of a preliminary certificate from the superintendent, the society may solicit members for the purpose of completing its organization, shall collect from each applicant the amount of not less than one regular monthly premium in accordance with its table of rates as provided by its constitution and laws, and shall issue to each such applicant a receipt for the amount so collected. No society shall incur any liability other than for the return of such advance premium, nor issue any certificate, nor pay, allow or offer or promise to pay or allow, any death or disability benefit to any person until: A. Actual bona fide applications for death benefits have been secured aggregating at least $500,000 on not less than 500 lives; [PL 1969, c. 132, §1 (NEW).] B. All such applicants for death benefits shall have furnished evidence of insurability satisfactory to the society; [PL 1969, c. 132, §1 (NEW).] C. Certificates of examinations or acceptable declarations of insurability have been duly filed and approved by the chief medical examiner of the society; [PL 1969, c. 132, §1 (NEW).] D. Ten subordinate lodges or branches have been established into which the 500 applicants have been admitted; [PL 1969, c. 132, §1 (NEW).] E. There has been submitted to the superintendent, under oath of the president or secretary, or corresponding officer of the society, a list of such applicants, giving their names, addresses, date each was admitted, name and number of the subordinate branch of which each applicant is a member, amount of benefits to be granted and premiums therefor; and [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).] F. It shall have been shown to the superintendent by sworn statement of the treasurer, or corresponding officer of such society, that at least 500 applicants have each paid in cash at least one regular monthly premium as herein provided, which premiums in the aggregate shall amount to at least $2,500, all of which shall be credited to the fund or funds from which benefits are to be paid and no part of which may be used for expenses. The advance premiums shall be held in trust during the period of organization and if the society has not qualified for a certificate of authority within one year, as herein provided, such premiums shall be returned to the applicants. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).] [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

5. The superintendent may make such examination and require such further information as the superintendent considers advisable. Upon presentation of satisfactory evidence that the society has complied with all the provisions of law, the superintendent shall issue to the society a certificate to that effect and that the society is authorized to transact business pursuant to the provisions of this chapter. The certificate is prima facie evidence of the existence of the society at the date of such certificate. The superintendent shall cause a record of such certificate to be made. A certified copy of such record may be given in evidence with like effect as the original certificate. [RR 2021, c. 1, Pt. B, §324 (COR).]

6. Every society shall have the power to adopt a constitution and laws for the government of the society, the admission of its members, the management of its affairs and the fixing and readjusting of the rates of its members from time to time. It shall have the power to change, alter, add to or amend such constitution and laws and shall have such powers as are necessary and incidental to carrying into effect the objects and purposes of the society. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 4363 — ME Code / Title 24-A / Chapter 57 / Section 4363
24-A §4363. Uniform Insurers Liquidation Act; severability; interpretation
Status: in_force

1. This section, section 4353 (definitions), and sections 4364 to 4369 comprise and may be cited as the Uniform Insurers Liquidation Act. [PL 1969, c. 132, §1 (NEW).]

2. If any provision of the Uniform Insurers Liquidation Act or the application thereof to any person or circumstances is held invalid, such invalidity shall not affect other provisions or applications of the Act which can be given effect without the invalid provision or application, and to this end the provisions of the Act are declared to be severable. [PL 1969, c. 132, §1 (NEW).]

3. This Uniform Insurers Liquidation Act shall be so interpreted as to effectuate its general purpose to make uniform the laws of those states which enact it. To the extent that its provisions, when applicable, conflict with other provisions of this Title, the Uniform Insurers Liquidation Act shall control. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 234 — ME Code / Title 24-A / Chapter 3 / Section 234
24-A §234. Witnesses; immunity from prosecution
Status: in_force

If any individual asks to be excused from testifying or from producing evidence of any kind in connection with any examination, hearing or investigation being conducted by the superintendent on the ground that the testimony or evidence required of that individual may tend to incriminate the individual or subject the individual to a penalty or forfeiture, and the Attorney General directs that individual to give testimony or produce evidence, the individual must comply with the directive. No testimony or other evidence so compelled, or any information directly or indirectly derived from that testimony or other evidence, may be used against the offering individual in any criminal, juvenile or civil violation proceeding, except that the testimony or other evidence may be used in a prosecution for perjury, false swearing, contempt or otherwise failing to comply with the directive to testify or produce evidence, or in a proceeding in which the individual has waived the immunity or privilege. [PL 1989, c. 269, §8 (NEW).]

1. [PL 1989, c. 269, §8 (RP).]

2. [PL 1989, c. 269, §8 (RP).]
24-A M.R.S. § 2677-A — ME Code / Title 24-A / Chapter 32 / Section 2677-A
24-A §2677-A. Payment for nonpreferred providers
Status: in_force

1. Nonpreferred providers. A carrier incorporating a preferred provider arrangement into a health plan shall provide for payment of covered health care services rendered by providers that are not preferred providers. [PL 1999, c. 609, §14 (NEW).]

2. Benefit level. The benefit level differential between services rendered by preferred providers and nonpreferred providers may not exceed 20% of the allowable charge for the service rendered, except that the superintendent may waive this requirement for a given benefit plan. Compliance with this requirement for a given benefit plan may be demonstrated on an aggregate basis. This demonstration of compliance must be based on a reasonably anticipated mix of claims certified by a qualified actuary who is a member of the American Academy of Actuaries or a successor organization. As used in this subsection, "allowable charge" means the amount that would be payable for services under the preferred provider arrangement including deductible and coinsurance amounts. [PL 2001, c. 369, §3 (AMD).]
24-A M.R.S. § 4404 — ME Code / Title 24-A / Chapter 57 / Section 4404
24-A §4404. -- seizure under court order
Status: in_force

1. Upon filing by the superintendent in any Superior Court of this State of the superintendent's verified petition alleging any ground for a formal delinquency proceeding against an insurer under sections 4351 to 4385 and that the interests of the insurer's policyholders or creditors or the public will be jeopardized by delay, and setting forth the order considered necessary by the superintendent, the court shall, ex parte and without notice or hearing, issue the requested order. The requested order may: A. Direct the superintendent to take possession and control of all or part of the property, books, accounts and records of the insurer and the premises occupied by it for transaction of its business; and [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).] B. Until further order of court, enjoin the insurer and its officers, managers, agents and employees from removal, concealment or other disposition of its property, and from transaction of its business, except with the superintendent's written consent. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).] [RR 2021, c. 1, Pt. B, §383 (COR).]

2. The court's order shall be for such duration, specified in the order, as the court deems necessary to enable the superintendent to ascertain the insurer's condition. On motion of any party or on its own motion, the court may hold such hearings as it deems desirable after such notice as it deems appropriate, and extend or shorten the duration or modify the terms of the order. The court shall vacate the seizure order if the superintendent fails to commence a formal proceeding under sections 4351 to 4385 after reasonable opportunity to do so; and a seizure order is automatically vacated by issuance of the court's order pursuant to formal delinquency proceedings under such sections of this chapter. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

3. Entry of a seizure order under this section does not constitute an anticipatory breach of any contract of the insurer. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 4360 — ME Code / Title 24-A / Chapter 57 / Section 4360
24-A §4360. Commencement of proceeding
Status: in_force

1. The superintendent shall commence a delinquency proceeding authorized under this chapter, the Attorney General representing him, by filing a petition in a court of proper jurisdiction praying for appointment of the superintendent as receiver of the insurer. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

2. Upon the filing of the petition, the court shall issue an order directing the insurer to appear in court on the day fixed in the order and show cause why the petition should not be granted. Unless good cause is shown for a shorter period, the order shall require the insurer to so show cause not less than 15 or more than 30 days from date of the order. [PL 1969, c. 132, §1 (NEW).]

3. The order to show cause and service thereof on the insurer shall constitute due and legal process and shall be in lieu of any other process otherwise provided by law. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 4311 — ME Code / Title 24-A / Chapter 56-A / Section 4311
24-A §4311. Access to prescription drugs
Status: in_force

1. Formulary. If a health plan provides coverage for prescription drugs but the coverage limits such benefits to drugs included in a formulary, a carrier shall: A. Ensure participation of participating physicians and pharmacists in the development of the formulary; [PL 2017, c. 429, Pt. A, §1 (AMD); PL 2017, c. 429, Pt. A, §2 (AFF).] B. Provide exceptions to the formulary limitation when a nonformulary alternative is medically indicated, consistent with the utilization review standards in section 4304 ; [PL 2017, c. 429, Pt. A, §1 (AMD); PL 2017, c. 429, Pt. A, §2 (AFF).] C. Provide an enrollee with at least 60 days' written notice of an adverse change to a formulary, except that a carrier may provide less than 60 days' notice when a prescription drug is being removed from the formulary because of concerns about safety. The notice must use a conspicuous font and inform the enrollee of the adverse change to the formulary and advise the enrollee to consult with the enrollee's provider about the change. For the purposes of this paragraph, "adverse change to a formulary" means a change that removes a drug currently prescribed for that enrollee from the formulary applicable to the enrollee's health plan or a change that moves the prescribed drug to a tier with a higher cost-sharing requirement if the carrier uses a formulary with tiers; [PL 2017, c. 429, Pt. A, §1 (NEW); PL 2017, c. 429, Pt. A, §2 (AFF).] D. If a prescription drug is removed from a formulary, notify an enrollee affected by the change of the enrollee's ability to request an exception to the formulary limitation pursuant to paragraph B and provide a form for the enrollee to use to request an exception. If an enrollee has already received prior authorization for that drug, the carrier shall continue to honor the existing authorization until it expires, as long as the enrollee continues to be covered under the same health plan and the drug has not been removed from the formulary because of concerns about safety; and [PL 2017, c. 429, Pt. A, §1 (NEW); PL 2017, c. 429, Pt. A, §2 (AFF).] E. Except when a drug has been removed because of concerns about safety, if a drug has been removed from a formulary and a request for an exception to a formulary limitation submitted by or on behalf of an enrollee is received prior to the effective date of the proposed change, continue to provide coverage for that drug until the carrier has rendered a decision on the enrollee's request for an exception to the formulary limitation. [PL 2017, c. 429, Pt. A, §1 (NEW); PL 2017, c. 429, Pt. A, §2 (AFF).] [PL 2017, c. 429, Pt. A, §1 (AMD); PL 2017, c. 429, Pt. A, §2 (AFF).]

1-A. Request for clinically appropriate prescription drugs. For plan years beginning on or after March 19, 2019, a carrier must allow an enrollee, the enrollee's designee or the person who has issued a valid prescription for the enrollee to request a clinically appropriate drug not otherwise covered by the health plan. The carrier's process must comply with section 4304 and with this subsection. If the carrier approves a request under this subsection for a drug not otherwise covered by the health plan, the carrier must treat the drug as an essential health benefit, including counting any cost sharing toward the plan's annual limit on cost sharing and including it when calculating the plan's actuarial value. A. The carrier must determine whether it will cover the drug requested and notify the enrollee, the enrollee's designee, if applicable, and the person who has issued the valid prescription for the enrollee of its coverage decision within 72 hours or 2 business days, whichever is less, following receipt of the request. A carrier that grants coverage under this paragraph must provide coverage of the drug for the duration of the prescription, including refills. [PL 2019, c. 273, §3 (AMD).] B. The carrier must have a process by which an expedited review may be requested in exigent circumstances. Exigent circumstances exist when an enrollee is suffering from a health condition that may seriously jeopardize the enrollee's life, health or ability to regain maximum function or when an enrollee is undergoing a current course of treatment using a nonformulary drug. When an expedited review has been requested, the carrier must determine whether it will cover the drug requested and notify the enrollee, the enrollee's designee, if applicable, and the person who has provided a valid prescription for the enrollee of its coverage decision within 24 hours following receipt of the request. A carrier that grants coverage under this paragraph must provide coverage of the drug for the duration of the exigency. [PL 2019, c. 5, Pt. A, §21 (NEW).] [PL 2025, c. 473, §2 (AMD).]

2. Coverage of approved drugs and medical devices. A carrier that provides coverage for prescription drugs and medical devices may not deny coverage of a prescribed drug or medical device on the basis that the use of the drug or device is investigational if the intended use of the drug or device is included in the labeling authorized by the federal Food and Drug Administration or if the use of the drug or device is recognized in one of the standard reference compendia or in peer-reviewed medical literature. [PL 1999, c. 742, §19 (NEW); PL 1999, c. 742, §21 (AFF).]

2-A. Coverage of prescription during emergency declared by the Governor. Except as provided in this subsection, a carrier shall provide coverage for the furnishing or dispensing of a prescription drug in accordance with a valid prescription issued by a provider in a quantity sufficient for an extended period of time, not to exceed a 180-day supply, during a statewide state of emergency declared by the Governor in accordance with Title 37‑B, section 742 . This subsection does not apply to coverage of prescribed contraceptive supplies furnished and dispensed pursuant to section 2756 , 2847‑G or 4247 or coverage of opioids prescribed in accordance with limits set forth in Title 32 . [PL 2021, c. 28, Pt. B, §1 (NEW).]

3. Construction. This section may not be construed to require a carrier to provide coverage of prescription drugs or medical devices. [PL 1999, c. 742, §19 (NEW); PL 1999, c. 742, §21 (AFF).]

4. Application. The requirements of this section apply to all individual and group policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 2003, c. 517, Pt. B, §32 (NEW).]
24-A M.R.S. § 6401 — ME Code / Title 24-A / Chapter 77 / Section 6401
24-A §6401. Short title
Status: in_force

This chapter may be known and cited as the "Maine Business Transacted with Producer-controlled Insurer Act." [PL 2017, c. 169, Pt. E, §1 (AMD).]
24-A M.R.S. § 6305 — ME Code / Title 24-A / Chapter 75 / Section 6305
24-A §6305. Amount of assessment determined
Status: in_force

1. Determination of assessment based on anticipated savings. The amount of the assessment is calculated as follows. A. For policy years beginning on or after July 1, 1990, the superintendent shall determine the amount of the savings in professional liability insurance claims and claim settlement costs to insurers anticipated in each 12-month period as a result of the Medical Liability Demonstration Project established in Title 24, chapter 21, subchapter IX and reform of the collateral source rule. [PL 1989, c. 931, §5 (NEW).] B. The amount of the assessment for policy years beginning on or after July 1, 1990, but before July 1, 1991, is equal to the total of: (1) One hundred percent of the first $250,000 of savings determined under paragraph A ; (2) No portion of the savings determined under paragraph A that exceeds $250,000 but does not exceed $500,000; and (3) Fifty percent of the portion of the savings determined under paragraph A that exceeds $500,000 but does not exceed $1,000,000. [PL 1989, c. 931, §5 (NEW).] C. [PL 2005, c. 122, §4 (AMD); MRSA T. 24-A §6305, sub-§1, ¶ C (RP).] D. [PL 2005, c. 122, §5 (RP).] E. Each insurer shall assess the surcharge against its insureds as a percentage of premium unless the superintendent prescribes a different basis by rule or order. [PL 1989, c. 931, §5 (NEW).] F. Every self-insured physician or physician's employer and every self-insured hospital shall remit the assessment required by this section to the principal writer of physicians malpractice insurance in this State. Remittance by self-insured physicians or hospitals may be made on their behalf by a self-insurer. The superintendent shall prescribe by rule a method to calculate and collect the assessment from self-insured physicians, hospitals and physicians' employers. [PL 1989, c. 931, §5 (NEW).] [PL 2005, c. 122, §§4, 5 (AMD).]

2. Final evaluation of savings. [PL 2005, c. 122, §6 (RP).]

3. Assessment rates; program fund balance. For assessment years prior to July 1, 2006, the assessment is 1.25% of premium. For assessment years commencing July 1, 2006 and after, the assessment is 0.75% of premium unless adjusted pursuant to rules adopted in accordance with subsection 4 . The assessment rate is intended to result in collections no greater than $500,000 per assessment year. The superintendent shall notify affected parties of any assessment rate adjustment and the effective date of that adjustment. The program fund balance may be used to pay assistance to qualified eligible physicians in prior years for which there were insufficient funds. If all prior years' eligible qualified physicians have received assistance, any excess funds must be carried forward to subsequent plan years as part of the program fund balance. Excess funds must be applied first to the assessment year commencing July 1, 1998 and then to each successive assessment year. For the purposes of this section, "program fund balance" means the total funds collected in excess of assistance paid for all years. [PL 2013, c. 170, §1 (AMD).]

4. Establishment of assessment rate by rule. The superintendent may adopt rules pursuant to section 6311 establishing an assessment rate or a methodology for calculating an assessment rate designed to provide an adequate and reliable funding source for the program and allow for the orderly and prudent drawdown of any long-term fund balance in excess of reasonable program needs. The assessment rate may not result in expected collections exceeding $500,000 per assessment year and may not exceed 0.75% of premium unless the program fund balance is $50,000 or less, in which case the assessment rate must be set to a higher rate but may not exceed 1% of premium. [PL 2013, c. 170, §2 (NEW).]
24-A M.R.S. § 2807 — ME Code / Title 24-A / Chapter 35 / Section 2807
24-A §2807. Debtor groups
Status: in_force

A group of individuals may be insured under a policy issued to a creditor, or its parent holding company or to a trustee or trustees or agent designated by 2 or more creditors, which creditor, holding company, affiliate, trustee, trustees or agent shall be deemed the policyholder, to insure debtors of the creditor or creditors, as the case may be, all as defined and set forth under section 2604‑A , provided that the amount of indemnity payable with respect to any person insured thereunder shall not at any time exceed the aggregate of the periodic scheduled unpaid installments, including, with respect to mortgage indebtedness, such real estate taxes and insurance costs incident to the mortgaged property as may become due during the scheduled period and provided that nothing in this paragraph may be construed or deemed to apply to or affect disability benefit provisions in group credit life insurance policies as authorized under section 2604‑A . [PL 1981, c. 698, §109 (AMD).]
24-A M.R.S. § 7753 — ME Code / Title 24-A / Chapter 103 / Section 7753
24-A §7753. Prohibition of certain discriminatory actions by manufacturer or agent related to 340B entities
Status: in_force

1. Interference with acquisition or delivery of 340B drugs prohibited. A manufacturer or its agent may not deny, restrict, prohibit or otherwise interfere with, either directly or indirectly, the acquisition of a 340B drug by, or delivery of a 340B drug to, a 340B contract pharmacy on behalf of a 340B entity unless receipt of that 340B drug is prohibited by the United States Department of Health and Human Services. [PL 2025, c. 388, Pt. P, §5 (NEW).]

2. Submission of claims or utilization data prohibited. A manufacturer or its agent may not, either directly or indirectly, require a 340B entity to submit any claims or utilization data as a condition for allowing the acquisition of a 340B drug by, or delivery of a 340B drug to, a 340B entity unless the claims or utilization data sharing is required by the United States Department of Health and Human Services. [PL 2025, c. 388, Pt. P, §5 (NEW).]

3. Other interference prohibited. A manufacturer may not otherwise interfere directly or indirectly with a 340B entity unless expressly authorized by the United States Department of Health and Human Services. [PL 2025, c. 388, Pt. P, §5 (NEW).]
24-A M.R.S. § 3864 — ME Code / Title 24-A / Chapter 53 / Section 3864
24-A §3864. Contributions to insurer
Status: in_force

The attorney or other parties may advance to a domestic reciprocal insurer upon reasonable terms such funds as it may require from time to time in its operations. Sums so advanced shall not be treated as a liability of the insurer, and, except upon liquidation of the insurer, shall not be withdrawn or repaid except out of the insurer's realized earned surplus in excess of its minimum required surplus. No such withdrawal or repayment shall be made without the advance approval of the superintendent. This section does not apply to bank loans, or to other loans made upon security. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 6803-A — ME Code / Title 24-A / Chapter 85 / Section 6803-A
24-A §6803-A. Fiduciary obligation of settlement producer
Status: in_force

Irrespective of the manner in which the settlement producer is compensated, a settlement producer may represent only the interests of the viator and owes a fiduciary duty to the viator. [PL 2009, c. 376, §6 (NEW).]
24-A M.R.S. § 2618 — ME Code / Title 24-A / Chapter 31 / Section 2618
24-A §2618. Misstatement of age
Status: in_force

The group life insurance policy shall contain a provision specifying an equitable adjustment of premiums or of benefits or both to be made in the event the age of a person insured has been misstated, such provision to contain a clear statement of the method of adjustment to be used. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2539 — ME Code / Title 24-A / Chapter 29 / Section 2539
24-A §2539. Holding proceeds of policies in trust
Status: in_force

1. Any domestic life insurer shall have power to hold the proceeds of any policy issued by it under a trust or other agreement upon such terms and restrictions as to revocation by the policyholder and control by the beneficiaries and with such exemptions from the claims of creditors of beneficiaries other than the policyholder as shall have been agreed to in writing by the insurer and the policyholder. [PL 1969, c. 132, §1 (NEW).]

2. The insurer shall not be required to segregate funds so held but may hold them as a part of its general corporate assets. [PL 1969, c. 132, §1 (NEW).]

3. A foreign or alien insurer, when authorized by its charter or the laws of its domicile, may exercise any such powers with respect to policies issued to or held by residents of this State. [PL 1969, c. 132, §1 (NEW).]

4. Nothing in this section shall be construed to subject any such insurer to any other laws or requirements of this State which would not be deemed applicable in the absence of this section. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2408 — ME Code / Title 24-A / Chapter 27 / Section 2408
24-A §2408. Consent of insured for health and life insurance
Status: in_force

1. No life or health insurance contract upon an individual, including contracts which may arise under section 2404, subsection 3, paragraph D , may be made or effectuated, unless at the time of the making of the contract the individual insured, being of competent legal capacity to contract, applies for coverage or has provided written consent, except under the following circumstances. A. A spouse may effectuate insurance upon the other spouse. [PL 1989, c. 353, §3 (NEW).] B. Any person having an insurable interest in the life of a minor, or any person upon whom a minor is dependent for support and maintenance, may effectuate insurance upon the life of the minor. [PL 1989, c. 353, §3 (NEW).] C. Family policies may be issued insuring 2 or more members of a family on an application signed by either parent, a stepparent or a spouse. [PL 1989, c. 353, §3 (NEW).] [PL 1989, c. 353, §3 (RPR).]

2. This section does not apply to: A. Group life insurance contracts other than group contracts which may arise under section 2404, subsection 3, paragraph D ; [PL 1989, c. 353, §3 (NEW).] B. Group annuity contracts; or [PL 1989, c. 353, §3 (NEW).] C. Group or blanket health insurance contracts. [PL 1989, c. 353, §3 (NEW).] [PL 1989, c. 353, §3 (RPR).]
24-A M.R.S. § 3955 — ME Code / Title 24-A / Chapter 54-A / Section 3955
24-A §3955. Duties and powers of association
Status: in_force

1. Duties. The association shall: A. Establish administrative and accounting procedures for the operation of the association; [PL 2011, c. 90, Pt. B, §8 (NEW).] B. Select an association administrator in accordance with section 3956 ; [PL 2011, c. 90, Pt. B, §8 (NEW).] C. Collect the assessments provided in section 3957 . The level of payments must be established by the board. Assessments must be collected pursuant to the plan of operation approved by the board and adopted pursuant to section 3953, subsection 3 . In addition to the collection of such assessments, the association shall collect an organizational assessment or assessments from all insurers as necessary to provide for expenses that have been incurred or are estimated to be incurred before receipt of the first calendar year assessments; [PL 2011, c. 90, Pt. B, §8 (NEW).] D. Establish procedures for the handling and accounting of association assets; and [PL 2019, c. 653, Pt. B, §13 (AMD).] E. [PL 2019, c. 653, Pt. B, §14 (RP).] F. Provide for reinsurance for member insurers pursuant to section 3958 . [PL 2011, c. 90, Pt. B, §8 (NEW).] [PL 2019, c. 653, Pt. B, §§13, 14 (AMD).]

2. Powers. The association may: A. Exercise powers granted to nonprofit corporations under the laws of this State; [PL 2011, c. 90, Pt. B, §8 (NEW).] B. Enter into contracts as necessary or proper to carry out the provisions and purposes of this chapter and may, with the approval of the superintendent, enter into contracts with similar organizations of other states for the joint performance of common administrative functions or with persons or other organizations for the performance of administrative functions; [PL 2011, c. 90, Pt. B, §8 (NEW).] C. Sue or be sued and may take legal actions necessary or proper to recover or collect assessments provided in section 3957 due the association; [PL 2011, c. 90, Pt. B, §8 (NEW).] D. Take legal actions necessary to avoid the payment of improper claims against the association or the coverage provided by or through the association, to recover any amounts erroneously or improperly paid by the association, to recover amounts paid by the association as a result of mistake of fact or law or to recover other amounts due the association; [PL 2011, c. 90, Pt. B, §8 (NEW).] E. Appoint appropriate legal, actuarial and other committees as necessary to provide technical assistance and any other function within the authority of the association; [PL 2011, c. 90, Pt. B, §8 (NEW).] F. Borrow money to effect the purposes of the association. Notes or other evidence of indebtedness of the association not in default must be legal investments for insurers and may be carried as admitted assets; [PL 2011, c. 90, Pt. B, §8 (NEW).] G. Provide for reinsurance of risks incurred by members of the association and purchase reinsurance retroceding those risks to the extent the board determines appropriate. The provision of reinsurance may not subject the association to any of the capital or surplus requirements, if any, otherwise applicable to reinsurers; and [PL 2011, c. 90, Pt. B, §8 (NEW).] H. Accept and administer funds or grants from public or private sources, including federal grants, and apply for such funding. [PL 2019, c. 653, Pt. B, §15 (AMD).] [PL 2019, c. 653, Pt. B, §15 (AMD).]

3. Additional duties and powers. The superintendent may, by rule, establish additional powers and duties of the board and may adopt such rules as are necessary and proper to implement this chapter. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2011, c. 90, Pt. B, §8 (NEW).]

4. Review for solvency. An annual review of the association for solvency must be performed by an independent certified public accountant using generally accepted accounting principles. The association shall submit the annual review to the superintendent. If the superintendent determines that the funds of the association are insufficient to support the need for reinsurance, the superintendent may order the association to increase its assessments. If the superintendent determines that the funds of the association are insufficient, the superintendent may order the association to charge additional assessments. [PL 2011, c. 90, Pt. B, §8 (NEW).]

5. Annual report. The association shall report annually to the joint standing committee of the Legislature having jurisdiction over health insurance matters by March 15th. The report must include information on the financial solvency of the association and the administrative expenses of the association. [PL 2011, c. 90, Pt. B, §8 (NEW).]

6. Audit. The association must be audited at least annually by an independent certified public auditor. A copy of the audit must be provided to the superintendent and to the joint standing committee of the Legislature having jurisdiction over health insurance matters. [PL 2011, c. 90, Pt. B, §8 (NEW).]
24-A M.R.S. § 4378 — ME Code / Title 24-A / Chapter 57 / Section 4378
24-A §4378. Allowance of contingent and other claims
Status: in_force

1. No contingent claim shall share in a distribution of assets of an insurer which has been adjudicated to be insolvent by an order made pursuant to section 4377 , except that such claims shall be considered, if properly presented, and may be allowed to share where: A. The claim becomes absolute against the insurer on or before the last day fixed for filing of proofs of claim against the assets of the insurer, or [PL 1969, c. 132, §1 (NEW).] B. There is a surplus and the liquidation is thereafter conducted upon the basis that the insurer is solvent. [PL 1969, c. 132, §1 (NEW).] [PL 1969, c. 132, §1 (NEW).]

2. Where an insurer has been so adjudicated to be insolvent, any person who has a cause of action against an insured of the insurer, shall have the right to file a claim in the liquidation proceeding, regardless of the fact that the claim may be contingent, and the claim may be allowed: A. If it may be reasonably inferred from the proof presented upon the claim that such person would be able to obtain a judgment upon such cause of action against such insured; and [PL 1969, c. 132, §1 (NEW).] B. If such person furnishes suitable proof, unless the court for good cause shown otherwise directs, that no further valid claims against the insurer arising out of the person's cause of action other than those already presented can be made; and [RR 2021, c. 1, Pt. B, §371 (COR).] C. If the total liability of the insurer to all claimants arising out of the same act of its insured shall be no greater than its maximum liability would be were it not in liquidation. [PL 1969, c. 132, §1 (NEW).] [RR 2021, c. 1, Pt. B, §371 (COR).]

3. No judgment against such an insurer, referred to in subsection 2 , taken after the date of the entry of the liquidation order shall be considered in the liquidation proceedings as evidence of liability, or of the amount of damages, and no judgment against an insured taken by default, inquest or by collusion prior to the entry of the liquidation order shall be considered as conclusive evidence in the liquidation proceeding either of the liability of the insured to such person upon such cause of action or of the amount of damages to which such person is therein entitled. [PL 1969, c. 132, §1 (NEW).]

4. A claim of any secured claimant may not be allowed at a sum greater than the difference between the value of the claim without security and the value of the security itself as of the date of the entry of the order of liquidation or such other date set by the court for the fixation of rights and liabilities as provided in section 4376 unless the claimant surrenders the claimant's security to the liquidator and in which event the claim must be allowed in the full amount for which it is valued. [RR 2021, c. 1, Pt. B, §372 (COR).]
24-A M.R.S. § 2755 — ME Code / Title 24-A / Chapter 33 / Section 2755
24-A §2755. Assignment of benefits
Status: in_force

All policies providing benefits for medical or dental care on an expense-incurred basis must contain a provision permitting the insured to assign benefits for such care to the provider of the care. An assignment of benefits under this section does not affect or limit the payment of benefits otherwise payable under the policy. [PL 1999, c. 21, §2 (AMD).]
24-A M.R.S. § 4241 — ME Code / Title 24-A / Chapter 56 / Section 4241
24-A §4241. Gynecological and obstetrical services
Status: in_force

1. Coverage in managed care plans. With respect to managed care plans that require enrollees to select primary care physicians, a health maintenance organization that issues group policies, contracts and certificates must meet the following requirements. A. The health maintenance organization must permit a physician who specializes in obstetrics and gynecology to serve as a primary care physician if the physician qualifies under the organization's credentialling policy. [PL 1995, c. 617, §5 (NEW); PL 1995, c. 617, §6 (AFF).] B. All group plan contracts must provide coverage for an annual gynecological examination, including routine pelvic and clinical breast examinations, performed by a physician, certified nurse practitioner or certified nurse midwife participating in the plan, without requiring the prior approval of the primary care physician. [PL 1995, c. 617, §5 (NEW); PL 1995, c. 617, §6 (AFF).] C. If the examination specified in paragraph B reveals a gynecological condition for which another visit to the physician participating in the plan is medically required and appropriate, or for any gynecological care beyond the annual examination, the carrier may require the patient or the examining physician, certified nurse practitioner or certified nurse midwife to secure from the patient's primary care physician a referral to the participating physician, certified nurse practitioner or certified nurse midwife from whom such care may be obtained. [PL 1995, c. 617, §5 (NEW); PL 1995, c. 617, §6 (AFF).] [PL 2003, c. 517, Pt. A, §11 (AMD); PL 2003, c. 517, Pt. A, §13 (AFF).]

2. Application. This section applies to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 2003, c. 517, Pt. A, §11 (AMD); PL 2003, c. 517, Pt. A, §13 (AFF).]

This section does not prohibit a carrier from requiring a physician, certified nurse practitioner or certified nurse midwife participating in the plan to inform a woman's primary care physician prior to each treatment pursuant to this section. [PL 1995, c. 617, §5 (NEW); PL 1995, c. 617, §6 (AFF).]
24 M.R.S. § 2311 — ME Code / Title 24 / Chapter 19 / Section 2311
24 §2311. Taxation
Status: in_force

Every corporation subject to this chapter is declared to be a charitable and benevolent institution and its funds and property shall be exempt from taxation.
24-A M.R.S. § 1132 — ME Code / Title 24-A / Chapter 13 / Section 1132
24-A §1132. Conversion and incidental rights
Status: in_force

Nothing in this chapter shall be deemed to prohibit an insurer from making an investment otherwise authorized under this chapter, because the investment is convertible into other securities in which the insurer is not permitted to invest under this chapter, or because the insurer receives in connection with such investment stock warrants, whether or not detachable, stock options, stock, property interests or other assets of any kind. Anything so received by the insurer and in which the insurer is otherwise not authorized to invest shall be carried on its books at no value. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2218 — ME Code / Title 24-A / Chapter 24 / Section 2218
24-A §2218. Immunity
Status: in_force

No cause of action in the nature of defamation, invasion of privacy or negligence arises against any person for disclosing personal information in accordance with this chapter, nor does such a cause of action arise against any person for furnishing personal information to a regulated insurance entity or insurance support organization. This section provides no immunity for disclosing or furnishing false information with malice or willful intent to injure any person. [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]
24-A M.R.S. § 3201 — ME Code / Title 24-A / Chapter 45 / Section 3201
24-A §3201. Contracts subject to general provisions
Status: in_force

All contracts of title insurance delivered or issued for delivery in this State and covering subjects located in this State are subject to the applicable provisions of chapter 27 (the insurance contract) and to other applicable provisions of this Title. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2182 — ME Code / Title 24-A / Chapter 23 / Section 2182
24-A §2182. Application
Status: in_force

All provisions in any invitation for bids, or in any of the contract documents, in conflict with sections 2180 and 2181 are declared to be contrary to the public policy of this State. [PL 1969, c. 504, §40-A (NEW).]
24-A M.R.S. § 6104 — ME Code / Title 24-A / Chapter 72-A / Section 6104
24-A §6104. Rules
Status: in_force

The superintendent may establish and from time to time amend such rules relating to risk retention groups as may be necessary or desirable to carry out the provisions of this Act. [PL 1987, c. 481, §3 (NEW).]
24-A M.R.S. § 2485 — ME Code / Title 24-A / Chapter 28 / Section 2485
24-A §2485. Withdrawal, default and termination -- Article 14
Status: in_force

1. Withdrawal. The following provisions govern withdrawal from the compact. A. Once effective, the compact continues in force and remains binding upon each compacting state. A compacting state may withdraw from the compact by enacting a statute specifically repealing the statute that enacted the compact. [PL 2003, c. 680, §1 (NEW).] B. The effective date of withdrawal is the effective date of the repealing law. However, the withdrawal does not apply to any product filings approved or self-certified, or any advertisement of such products, on the date the repealing statute becomes effective, except by mutual agreement of the commission and the withdrawing state unless the approval is rescinded by the withdrawing state as provided in paragraph E . [PL 2003, c. 680, §1 (NEW).] C. The commissioner of the withdrawing state shall immediately notify the management committee in writing upon the introduction of legislation repealing this compact in the withdrawing state. [PL 2003, c. 680, §1 (NEW).] D. The commission shall notify the other compacting states of the introduction of such legislation within 10 days after it receives notice under paragraph C . [PL 2003, c. 680, §1 (NEW).] E. The withdrawing state is responsible for all obligations, duties and liabilities incurred through the effective date of withdrawal, including any obligations the performance of which extend beyond the effective date of withdrawal, except to the extent those obligations may have been released or relinquished by mutual agreement of the commission and the withdrawing state. The commission's approval of products and advertisements prior to the effective date of withdrawal continues to be effective and must be given full force and effect in the withdrawing state unless formally rescinded by the withdrawing state in the same manner as provided by the laws of the withdrawing state for the prospective disapproval of products or advertisements previously approved under state law. [PL 2003, c. 680, §1 (NEW).] F. Reinstatement following withdrawal of any compacting state occurs upon the effective date of the withdrawing state's reenacting the compact. [PL 2003, c. 680, §1 (NEW).] [PL 2003, c. 680, §1 (NEW).]

2. Default. The following provisions govern default. A. If the commission determines that a compacting state has defaulted in the performance of any of its obligations or responsibilities under this compact, the bylaws or duly promulgated rules or operating procedures, then, after notice and hearing as set forth in the bylaws, all rights, privileges and benefits conferred by this compact on the defaulting state are suspended from the effective date of default as fixed by the commission. The grounds for default include, but are not limited to, failure of a compacting state to perform its obligations or responsibilities, and any other grounds designated in commission rules. The commission shall immediately notify the defaulting state in writing of the defaulting state's suspension pending a cure of the default. The commission shall stipulate the conditions and the time period within which the defaulting state must cure its default. If the defaulting state fails to cure the default within the time period specified by the commission, the defaulting state must be terminated from the compact and all rights, privileges and benefits conferred by this compact are terminated from the effective date of termination. [PL 2003, c. 680, §1 (NEW).] B. Product approvals by the commission or product self-certifications, or any advertisement in connection with such a product, that are in force on the effective date of termination remain in force in the defaulting state in the same manner as if the defaulting state had withdrawn voluntarily pursuant to subsection 1 . [PL 2003, c. 680, §1 (NEW).] C. Reinstatement following termination of a compacting state requires a reenactment of the compact. [PL 2003, c. 680, §1 (NEW).] [PL 2003, c. 680, §1 (NEW).]

3. Dissolution of compact. The following provisions govern the dissolution of the compact. A. The compact dissolves upon the date of the withdrawal or default of the compacting state that reduces membership in the compact to one compacting state. [PL 2003, c. 680, §1 (NEW).] B. Upon the dissolution of this compact, the compact becomes void and is of no further effect, and the business and affairs of the commission must be wound up and any surplus funds must be distributed in accordance with the bylaws. [PL 2003, c. 680, §1 (NEW).] [PL 2003, c. 680, §1 (NEW).]
24-A M.R.S. § 4616 — ME Code / Title 24-A / Chapter 62 / Section 4616
24-A §4616. Tax exemptions
Status: in_force

The association shall be exempt from payment of all fees and all taxes levied by this State or any of its subdivisions, except taxes levied on real or personal property. [PL 1983, c. 846 (NEW).]
24 M.R.S. § 2370 — ME Code / Title 24 / Chapter 19 / Section 2370
24 §2370. Notification prior to cancellation
Status: in_force

The superintendent shall, by January 1, 1991, adopt rules in accordance with the Maine Administrative Procedure Act, to provide for notification of the subscriber and another person, if designated by the subscriber, prior to cancellation of health care coverage for nonpayment of premiums, and to provide restrictions on cancellation of coverage when a subscriber suffers from organic brain disease. [PL 1989, c. 835, §1 (NEW).]

The rules may include, but are not limited to, definitions, minimum disclosure requirements, notice provisions and cancellation restrictions. [PL 1989, c. 835, §1 (NEW).]
24-A M.R.S. § 2521 — ME Code / Title 24-A / Chapter 29 / Section 2521
24-A §2521. Misstatement of age or sex -- annuities
Status: in_force

In an annuity or pure endowment contract, other than a reversionary, survivorship, or group annuity, there shall be a provision that if the age or sex of the person or persons upon whose life or lives the contract is made, or of any of them has been misstated, the amount payable or benefits accruing under the contract shall be such as the stipulated payment or payments to the insurer would have purchased according to the correct age or sex and that if the insurer shall make or has made any overpayment or overpayments on account of any such misstatement, the amount thereof with interest at the rate to be specified in the contract but not exceeding 6% per annum, may be charged against the current or next succeeding payment or payments to be made by the insurer under the contract. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2241 — ME Code / Title 24-A / Chapter 24-A / Section 2241
24-A §2241. Definitions
Status: in_force

As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 1999, c. 268, §2 (NEW).]

1. Annuity issuer. "Annuity issuer" means an insurer that has issued an insurance contract used to fund periodic payments under a structured settlement. [PL 1999, c. 268, §2 (NEW).]

2. Applicable law. "Applicable law" means: A. Federal law; [PL 1999, c. 268, §2 (NEW).] B. The laws of this State, including principles of equity applied in the courts of this State; and [PL 1999, c. 268, §2 (NEW).] C. The laws of any other jurisdiction: (1) That is the domicile of the payee or any other interested party; (2) Under whose laws a structured settlement agreement was approved by a court or responsible administrative authority; or (3) In whose courts a settled claim was pending when the parties entered into a structured settlement agreement. [PL 1999, c. 268, §2 (NEW).] [PL 1999, c. 268, §2 (NEW).]

3. Dependents. "Dependents" means a payee's spouse and minor children and all other family members and other persons for whom the payee is legally obligated to provide support, including alimony. [PL 1999, c. 268, §2 (NEW).]

4. Discounted present value. "Discounted present value" means the fair present value of future payments as determined by discounting such payments to the present using the applicable federal rate for determining the present value of an annuity most recently published by the United States Internal Revenue Service. [PL 1999, c. 268, §2 (NEW).]

5. Favorable tax determination. "Favorable tax determination," with respect to a proposed transfer of structured settlement payment rights, means any of the following authorities that definitively establishes that the federal income tax treatment of the structured settlement for the parties, other than the payee, to the structured settlement agreement and any qualified assignment agreement will not be affected by that transfer: A. A provision of the United States Internal Revenue Code or a United States Treasury regulation adopted pursuant to the code; [PL 1999, c. 268, §2 (NEW).] B. A revenue ruling or revenue procedure issued by the United States Internal Revenue Service; [PL 1999, c. 268, §2 (NEW).] C. A private letter ruling by the United States Internal Revenue Service with respect to that transfer; or [PL 1999, c. 268, §2 (NEW).] D. A decision by the United States Supreme Court or a decision of a lower federal court in which the United States Internal Revenue Service has acquiesced. [PL 1999, c. 268, §2 (NEW).] [PL 1999, c. 268, §2 (NEW).]

6. Federal hardship standard. "Federal hardship standard" means a federal standard applicable to transfers of structured settlement payment rights based on findings of a court or responsible administrative authority regarding the payee's needs, as contained in the United States Internal Revenue Code or in a United States Treasury regulation adopted pursuant to the code. [PL 1999, c. 268, §2 (NEW).]

7. Independent professional advice. "Independent professional advice" means advice of an attorney, certified public accountant, actuary or other licensed professional advisor: A. Who is engaged by a payee to render advice concerning the legal, tax and financial implications of a transfer of structured settlement payment rights; [PL 1999, c. 268, §2 (NEW).] B. Who is not in any manner affiliated with or compensated by the transferee of that transfer; and [PL 1999, c. 268, §2 (NEW).] C. Whose compensation for rendering advice is not affected by whether a transfer occurs or does not occur. [PL 1999, c. 268, §2 (NEW).] [PL 1999, c. 268, §2 (NEW).]

8. Interested parties. "Interested parties" means the payee, any beneficiary designated under the annuity contract to receive payments following the payee's death and any other party that has continuing rights or obligations under the contract. For purposes of this chapter, "interested parties" does not include the structured settlement obligor or the annuity issuer. [PL 1999, c. 268, §2 (NEW).]

9. Payee. "Payee" means an individual who is receiving tax-free damage payments under a structured settlement and proposes to make a transfer of payment rights under that settlement. [PL 1999, c. 268, §2 (NEW).]

10. Qualified assignment agreement. "Qualified assignment agreement" means an agreement providing for a qualified assignment within the meaning of Section 130 of the United States Internal Revenue Code, United States Code, Title 26. [PL 1999, c. 268, §2 (NEW).]

11. Responsible administrative authority. "Responsible administrative authority" means any government authority vested by law with exclusive jurisdiction over the settled claim resolved by a structured settlement. [PL 1999, c. 268, §2 (NEW).]

12. Settled claim. "Settled claim" means the original tort claim or workers' compensation claim resolved by a structured settlement. [PL 1999, c. 268, §2 (NEW).]

13. Structured settlement. "Structured settlement" means an arrangement for periodic payment of damages for personal injuries established by settlement or judgment in resolution of a tort claim or for periodic payments in settlement of a workers' compensation claim. [PL 1999, c. 268, §2 (NEW).]

14. Structured settlement agreement. "Structured settlement agreement" means the agreement, judgment, stipulation or release embodying the terms of a structured settlement, including the rights of the payee to receive periodic payments. [PL 1999, c. 268, §2 (NEW).]

15. Structured settlement obligor. "Structured settlement obligor" means the party that has the continuing periodic payment obligation to the payee under a structured settlement agreement or a qualified assignment agreement. [PL 1999, c. 268, §2 (NEW).]

16. Structured settlement payment rights. "Structured settlement payment rights" means rights to receive periodic payments, including lump sum payments, under a structured settlement, whether from the settlement obligor or the annuity issuer, when: A. The payee, structured settlement obligor, annuity issuer or any other interested party is domiciled in this State; [PL 1999, c. 268, §2 (NEW).] B. The structured settlement agreement was approved by a court or responsible administrative authority in this State; or [PL 1999, c. 268, §2 (NEW).] C. The settled claim was pending before the courts of this State when the parties entered into the structured settlement agreement. [PL 1999, c. 268, §2 (NEW).] [PL 1999, c. 268, §2 (NEW).]

17. Terms of structured settlement. "Terms of a structured settlement" means the terms of a structured settlement agreement, an annuity contract, any qualified assignment agreement and any order or approval of any court or responsible administrative authority or other government authority authorizing or approving the structured settlement. [PL 1999, c. 268, §2 (NEW).]

18. Transfer. "Transfer" means any sale, assignment, pledge, hypothecation or other form of alienation or encumbrance made by a payee for consideration. [PL 1999, c. 268, §2 (NEW).]

19. Transfer agreement. "Transfer agreement" means the agreement providing for transfer of structured settlement payment rights from a payee to a transferee. [PL 1999, c. 268, §2 (NEW).]

20. Transferee. "Transferee" means a person that becomes entitled to receive structured settlement payment rights as a result of a transfer agreement. [PL 1999, c. 268, §2 (NEW).]
24-A M.R.S. § 2107 — ME Code / Title 24-A / Chapter 21 / Section 2107
24-A §2107. Defense of action by unauthorized insurer
Status: in_force

1. Before an unauthorized insurer files or causes to be filed any pleading in any action or proceeding instituted against it under sections 2104 and 2105 , such insurer shall: A. Procure a certificate of authority to transact insurance in this State; or [PL 1969, c. 132, §1 (NEW).] B. Deposit with the clerk of the court in which such action or proceeding is pending cash or securities, or file with such clerk a bond with good and sufficient sureties, to be approved by the court, in an amount to be fixed by the court sufficient to secure the payment of any final judgment which may be rendered in such action. The court may in its discretion make an order dispensing with such deposit or bond where the insurer makes a showing satisfactory to the court that it maintains in a state of the United States funds or securities, in trust or otherwise, sufficient and available to satisfy any final judgment which may be entered in such action or proceeding, and that the insurer will pay final judgment entered therein without requiring suit to be brought on such judgment in the state where such funds or securities are located. [PL 1969, c. 132, §1 (NEW).] [PL 1969, c. 132, §1 (NEW).]

2. The court in any action or proceeding in which service is made in the manner provided in section 2105 may, in its discretion, order such postponement as may be necessary to afford the defendant reasonable opportunity to comply with the provisions of subsection 1 , and to defend such action. [PL 1969, c. 132, §1 (NEW).]

3. Nothing in subsection 1 is to be construed to prevent an unauthorized insurer from filing a motion to quash or to set aside the service of any process made in the manner provided in section 2105 on the ground either: A. That such unauthorized insurer has not done any of the acts enumerated in section 2104 ; or [PL 1969, c. 132, §1 (NEW).] B. That the person on whom service was made pursuant to subsection 2 of section 2105 was not doing any of the acts therein enumerated. [PL 1969, c. 132, §1 (NEW).] [PL 1969, c. 132, §1 (NEW).]