24-A M.R.S. § 2405 — ME Code / Title 24-A / Chapter 27 / Section 2405
24-A §2405. Insurable interest -- exception when certain institutions designated beneficiary
Status: in_force

1. Life insurance contracts may be entered into in which the person, trust or trustee paying the consideration for the insurance has no insurable interest in the life of the individual insured, where charitable, benevolent, educational or religious institutions, or their agencies, are designated irrevocably as the beneficiaries thereof. [PL 1993, c. 320, §3 (AMD); PL 1993, c. 320, §5 (AFF).]

2. In making such contracts, the person paying the premium shall make and sign the application therefor as owner or as settlor of a trust, and shall designate a charitable, benevolent, educational or religious institution, or any agency thereof, irrevocably as the beneficiary or beneficiaries of such contract. The application must be signed also by the individual whose life is to be insured. [PL 1993, c. 320, §3 (AMD); PL 1993, c. 320, §5 (AFF).]

3. Nothing in this section shall be deemed to prohibit any combination of the applicant, premium payer, owner, and beneficiary from being the same person. [PL 1969, c. 132, §1 (NEW).]

4. Such a contract shall be valid and binding among the parties thereto, notwithstanding the absence otherwise of an insurable interest in the life of the individual insured. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2915 — ME Code / Title 24-A / Chapter 39 / Section 2915
24-A §2915. Delivery of notice
Status: in_force

A notice of cancellation of a policy is not effective unless received by the named insured at least 20 days prior to the effective date of cancellation, or, when the cancellation is for nonpayment of premium, at least 10 days prior to the effective date of cancellation. In the event the policy provides automobile physical damage coverage, like notice of cancellation must also be given to any party mentioned in the loss payable clause. A postal service certificate of mailing to the named insured at the insured's last known address is conclusive proof of receipt on the 5th calendar day after mailing. [PL 2007, c. 188, Pt. C, §5 (AMD).]

Except for a policy that has been in effect for less than 60 days at the time notice of cancellation is received by the named insured, the reason for cancellation must accompany the notice, together with a notice of the right to apply for a hearing before the superintendent within 30 days, as provided in section 2920 . [PL 2007, c. 188, Pt. C, §5 (AMD).]
24-A M.R.S. § 2004 — ME Code / Title 24-A / Chapter 19 / Section 2004
24-A §2004. Conditions for export
Status: in_force

If certain insurance coverages cannot be procured from authorized insurers, such coverages, hereinafter designated "surplus lines," may be procured from nonadmitted insurers, subject to the following conditions: [PL 2025, c. 348, §15 (AMD).]

1. The insurance must be procured through a licensed producer with surplus lines authority. [PL 1997, c. 592, §50 (AMD).]

2. The desired coverage is necessary for the adequate protection of a risk in the State. [PL 1969, c. 132, §1 (NEW).]

3. It may be written under the laws of this State by an authorized insurer. [PL 1969, c. 132, §1 (NEW).]

4. The insurance is not available after diligent effort has been made to place the coverage with authorized insurers. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 4209 — ME Code / Title 24-A / Chapter 56 / Section 4209
24-A §4209. Information to enrollees
Status: in_force

1. Information provided annually. Every health maintenance organization must annually provide to its enrollees: A. The most recent annual statement of financial condition including a balance sheet and a statement of operations; [PL 1989, c. 842, §15 (NEW).] B. A description of the organizational structure and operation of the health maintenance organization, including the kind and extent of enrollee participation and a summary of any material changes since the issuance of the last report; and [PL 1995, c. 673, Pt. D, §4 (AMD).] C. [PL 1995, c. 673, Pt. D, §5 (RP).] D. [PL 1995, c. 673, Pt. D, §5 (RP).] E. A description of the plan as required under section 4302, subsection 1 . [PL 1995, c. 673, Pt. D, §6 (NEW).] [PL 1995, c. 673, Pt. D, §4-6 (AMD).]

2. List of providers. The health maintenance organization must provide to its subscribers, upon enrollment and reenrollment, a list of providers. [PL 1989, c. 842, §15 (RPR).]

3. Notice of material change. Every health maintenance organization must provide 30 days' advance notice to its subscribers of any material change in the operation of the organization that will directly affect the subscribers. [PL 1989, c. 842, §15 (RPR).]

4. Notice of termination of primary care provider. An enrollee must be notified in writing by the health maintenance organization of the termination of the primary care provider that provided health care services to that enrollee. The health maintenance organization must provide assistance to the enrollee in transferring to another participating primary care provider. [PL 1989, c. 842, §15 (RPR).]

5. Access to services. The health maintenance organization shall provide to its subscribers information on how services may be obtained, where additional information on access to services is obtained and a toll free telephone number for calls within the service area of the health maintenance organization. [PL 1989, c. 842, §15 (NEW).]

6. Notification of cancellation. A health maintenance organization may not cancel or refuse to renew any group contract until it has provided by first class mail at least 10 days' prior notification according to this section. The notice must include the date of cancellation of coverage and the time period for exercising contract conversion rights. The notice also must include an explanation of any applicable grace period. Notification is not required when the health maintenance organization has received written notice from the group contract holder that replacement coverage has been obtained. A. Notice must be mailed to the group contract holder or subgroup sponsor. [PL 1995, c. 189, §3 (NEW); PL 1995, c. 189, §4 (AFF).] B. [PL 2003, c. 156, §5 (RP).] B-1. At the time of notification under paragraph A , notice must be mailed to the individual enrollee at the last address provided to the health maintenance organization by the subgroup sponsor, the group contract holder or the individual enrollee. If the health maintenance organization does not have an address on file for the individual enrollee, the notice must be mailed to the office of the subgroup sponsor, if any, or the group contract holder. The notice must also include information to the individual enrollee about the availability of individual coverage as described in section 2809‑A, subsection 1‑B . [PL 2003, c. 428, Pt. B, §3 (AMD).] C. [PL 2003, c. 428, Pt. B, §3 (RP).] [PL 2003, c. 428, Pt. B, §3 (AMD).]
24-A M.R.S. § 2185 — ME Code / Title 24-A / Chapter 23 / Section 2185
24-A §2185. Calculation of health benefits based on actual cost
Status: in_force

All health insurance policies, health maintenance organization plans and subscriber contracts or certificates of nonprofit hospital or medical service organizations with respect to which the insurer or organization has negotiated discounts with providers must provide for the calculation of all covered health benefits, including without limitation all coinsurance, deductibles and lifetime maximum benefits, on the basis of the net negotiated cost and must fully reflect any discounts or differentials from charges otherwise applicable to the services provided. With respect to policies or plans involving risk-sharing compensation arrangements, net negotiated costs may be calculated at the time services are rendered on the basis of reasonably anticipated compensation levels and are not subject to retrospective adjustment at the time a cost settlement between a provider and the insurer or organization is finalized. [PL 1997, c. 197, §1 (NEW).]
24-A M.R.S. § 3151 — ME Code / Title 24-A / Chapter 44 / Section 3151
24-A §3151. Short title
Status: in_force

This chapter may be known and cited as "the Pet Insurance Act." [PL 2021, c. 562, §1 (NEW).]
24-A M.R.S. § 4256 — ME Code / Title 24-A / Chapter 56 / Section 4256
24-A §4256. Coverage for medically necessary infant formula (REALLOCATED FROM TITLE 24-A, SECTION 4254)
Status: in_force

(REALLOCATED FROM TITLE 24-A, SECTION 4254)

All individual and group health maintenance organization policies, contracts and certificates must provide coverage for amino acid-based elemental infant formula for children 2 years of age and under in accordance with this section. [PL 2007, c. 695, Pt. C, §16 (RAL).]

1. Determination of medical necessity. Coverage for amino acid-based elemental infant formula must be provided when a licensed physician has submitted documentation that the amino acid-based elemental infant formula is medically necessary health care as defined in section 4301‑A, subsection 10‑A , that the amino acid-based elemental infant formula is the predominant source of nutritional intake at a rate of 50% or greater and that other commercial infant formulas, including cow milk-based and soy milk-based formulas have been tried and have failed or are contraindicated. A licensed physician may be required to confirm and document ongoing medical necessity at least annually. [PL 2007, c. 695, Pt. C, §16 (RAL).]

2. Method of delivery. Coverage for amino acid-based elemental infant formula must be provided without regard to the method of delivery of the formula. [PL 2007, c. 695, Pt. C, §16 (RAL).]

3. Required diagnosis. Coverage for amino acid-based elemental infant formula must be provided when a licensed physician has diagnosed and through medical evaluation has documented one of the following conditions: A. Symptomatic allergic colitis or proctitis; [PL 2007, c. 695, Pt. C, §16 (RAL).] B. Laboratory- or biopsy-proven allergic or eosinophilic gastroenteritis; [PL 2007, c. 695, Pt. C, §16 (RAL).] C. A history of anaphylaxis; [PL 2007, c. 695, Pt. C, §16 (RAL).] D. Gastroesophageal reflux disease that is nonresponsive to standard medical therapies; [PL 2007, c. 695, Pt. C, §16 (RAL).] E. Severe vomiting or diarrhea resulting in clinically significant dehydration requiring treatment by a medical provider; [PL 2007, c. 695, Pt. C, §16 (RAL).] F. Cystic fibrosis; or [PL 2007, c. 695, Pt. C, §16 (RAL).] G. Malabsorption of cow milk-based or soy milk-based infant formula. [PL 2007, c. 695, Pt. C, §16 (RAL).] [PL 2007, c. 695, Pt. C, §16 (RAL).]

4. Health savings accounts. Coverage for amino acid-based elemental infant formula under a health insurance policy, contract or certificate issued in connection with a health savings account as authorized under Title XII of the federal Medicare Prescription Drug, Improvement, and Modernization Act of 2003 may be subject to the same deductible and out-of-pocket limits that apply to overall benefits under the policy, contract or certificate. [PL 2007, c. 695, Pt. C, §16 (RAL).]
24-A M.R.S. § 1904 — ME Code / Title 24-A / Chapter 18 / Section 1904
24-A §1904. Bond requirements for administrators
Status: in_force

1. Every applicant for an administrator's license shall file with the application, and shall maintain in force while licensed, a fidelity bond, and at the superintendent's discretion, a surety bond, in favor of the Treasurer of State, for the benefit of covered persons or plan sponsors as their interest may appear, executed by a surety company authorized to do business in this State and payable to any party injured under the terms of the bond. The bond must be continuous in form and in one of the following amounts: A. For an administrator that maintains an ATF but does not maintain a CASA, the greater of $50,000 or 5% of contributions and premiums projected to be received or collected in the ATF for the following plan year from residents of the State, but not to exceed $1,000,000; [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] B. For an administrator that maintains a CASA but does not maintain an ATF, the greater of $50,000 or 5% of the claims and claim expenses projected to be held in the CASA for the following year to pay claims and claim expenses for residents of the State, but not to exceed $1,000,000; or [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] C. For an administrator that maintains an ATF and a CASA, the greater of $50,000 or 5% of contributions and premiums projected to be received or collected in the ATF for the following plan year from residents of the State plus 5% of the claims and claim expenses projected to be held in the CASA accounts for the following year to pay claims and claim expenses for residents of the State, but not to exceed $1,000,000. [PL 1993, c. 171, Pt. A, §1 (AMD).] This subsection applies to an administrator who is required to maintain funds in a fiduciary capacity as set forth in section 1909 . [PL 1995, c. 329, §27 (AMD).]

2. The bond must remain in force and effect until the surety is released from liability by the superintendent or until the bond is cancelled by the surety. The surety may cancel the bond and be released from further liability under the bond upon 30 days' written notice in advance to the superintendent. The cancellation does not affect any liability incurred or accrued under the bond before the 30-day period expires. Upon receiving any notice of cancellation, the superintendent shall immediately notify the licensee. [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]

3. The administrator's license automatically terminates if the bond required by this section is not in force. Within 30 days after the bond ceases to be in force, the administrator shall return the license to the superintendent for cancellation. [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]
24-A M.R.S. § 706 — ME Code / Title 24-A / Chapter 9 / Section 706
24-A §706. "Bonds" defined
Status: in_force

The definition of "bonds" includes: [PL 1995, c. 329, §4 (AMD).]

1. Fidelity insurance, which is insurance guaranteeing the honesty of persons holding positions of public or private trust; [PL 1995, c. 329, §4 (AMD).]

2. Surety insurance guaranteeing the performance of contracts, other than insurance policies, and guaranteeing and executing bonds, undertakings and contracts of suretyship; and [PL 1995, c. 329, §4 (AMD).]

3. Insurance indemnifying banks, bankers, brokers, financial or moneyed corporations or associations against loss, resulting from any cause, of bills of exchange, notes, bonds, securities, evidences of debt, deeds, mortgages, warehouse receipts or other valuable papers, documents, money, precious metals and articles made therefrom, jewelry, watches, gems, precious and semiprecious stones, including any loss while the same are being transported in armored motor vehicles, or by messenger, but not including any other risks of transportation or navigation; also insurance against loss or damage to such an insured's premises or to the insured's furnishings, fixtures, equipment, safes and vaults therein, caused by burglary, robbery, theft, vandalism or malicious mischief, or any attempt thereat. [RR 2021, c. 1, Pt. B, §187 (COR).]
24-A M.R.S. § 754 — ME Code / Title 24-A / Chapter 9 / Section 754
24-A §754. Effective date
Status: in_force

This subchapter takes effect January 1, 1993. An insurer or reinsurer may not continue to utilize the services of a reinsurance intermediary on and after February 1, 1993 unless utilization is in compliance with this subchapter. [PL 1991, c. 828, §20 (NEW).]
24-A M.R.S. § 762 — ME Code / Title 24-A / Chapter 9 / Section 762
24-A §762. Scope
Status: in_force

1. Application. This subchapter applies to an insurer authorized in this State that either assumes or transfers the obligations or risks on contracts of insurance pursuant to an assumption reinsurance agreement. [PL 1993, c. 603 (NEW).]

2. Exceptions. This subchapter does not apply to the following: A. A reinsurance agreement or transaction in which the ceding insurer continues to remain directly liable for its insurance obligations or risks under the contracts of insurance subject to the reinsurance agreement; [PL 1993, c. 603 (NEW).] B. The substitution of one insurer for another upon the expiration of insurance coverage pursuant to statutory or contractual requirements and the issuance of a new contract of insurance by another insurer; [PL 1993, c. 603 (NEW).] C. The transfer of contracts of insurance pursuant to mergers or consolidations of 2 or more insurers to the extent that those transactions are regulated by law; [PL 1993, c. 603 (NEW).] D. An insurer subject to a judicial order of liquidation or rehabilitation; [PL 1993, c. 603 (NEW).] E. A reinsurance agreement or transaction to which a state insurance guaranty association is a party, except that policyholders do not lose any rights or claims afforded under their original policies pursuant to chapter 57, subchapter III and chapter 62 ; or [PL 1993, c. 603 (NEW).] F. The transfer of liabilities from one insurer to another under a single group policy upon the request of the group policyholder, unless the certificateholder pays all or substantially all of the premium. [PL 1993, c. 603 (NEW).] [PL 1993, c. 603 (NEW).]
24-A M.R.S. § 2501 — ME Code / Title 24-A / Chapter 29 / Section 2501
24-A §2501. Scope of chapter
Status: in_force

This chapter applies only to contracts of life insurance and annuities, other than reinsurance, group life insurance and group annuities, except that: [PL 2009, c. 244, Pt. I, §1 (AMD).]

1. Section 2537 also applies as to group life insurance and group annuity contracts; and [PL 2009, c. 244, Pt. I, §1 (NEW).]

2. Sections 2541 to 2551 apply to group annuities other than those exempted by section 2542 . [PL 2009, c. 244, Pt. I, §1 (NEW).]
24-A M.R.S. § 4434 — ME Code / Title 24-A / Chapter 57 / Section 4434
24-A §4434. Construction
Status: in_force

This subchapter shall be liberally construed to effect the purpose stated under section 4432 , which shall constitute an aid and guide to interpretation. [PL 1969, c. 561 (NEW).]
24-A M.R.S. § 1121 — ME Code / Title 24-A / Chapter 13 / Section 1121
24-A §1121. Hydrocarbon production payments
Status: in_force

An insurer may invest in production payments, or interests therein evidenced by trust certificates or other instruments, payable from oil, gas or other hydrocarbons in producing properties located in the United States or the adjacent continental shelf if an obligation secured by and payable from such production payment or interest therein would qualify for investment under section 1109, subsection 1 , (corporate obligations) as an obligation which is adequately secured and has investment qualities and characteristics wherein the speculative elements are not predominant. "Production payments" means rights to oil, gas or other hydrocarbons in place or as produced which entitle the owner thereof to a specified fraction or percentage of production until a specified sum of money has been received. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 741 — ME Code / Title 24-A / Chapter 9 / Section 741
24-A §741. Definitions
Status: in_force

As used in this subchapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 1991, c. 828, §20 (NEW).]

1. Actuary. "Actuary" means a person who is a member in good standing of the American Academy of Actuaries. [PL 1991, c. 828, §20 (NEW).]

2. Cession. "Cession" means a transfer by a policy originating insurer to a reinsurer of the whole or a portion of a single risk, defined policy or defined division of business as set out in a reinsurance contract. [PL 1991, c. 828, §20 (NEW).]

3. Controlling person. "Controlling person" means any person who directly or indirectly has the power to direct or cause to be directed the management, control or activities of the reinsurance intermediary. [PL 1991, c. 828, §20 (NEW).]

4. Insurer. "Insurer" means every person engaged as principal and as indemnitor, surety or contractor in the business of entering into contracts of insurance who holds an existing certificate of authority to transact insurance in this State pursuant to section 404 . [PL 1991, c. 828, §20 (NEW).]

5. Reinsurance intermediary. "Reinsurance intermediary" means a reinsurance intermediary-broker or a reinsurance intermediary-manager as these terms are defined in subsections 6 and 7 . [PL 1991, c. 828, §20 (NEW).]

6. Reinsurance intermediary-broker. "Reinsurance intermediary-broker" means any person, other than an officer or employee of the ceding insurer who solicits, negotiates or places reinsurance cessions or retrocessions on behalf of a ceding insurer without the authority or power to bind reinsurance on behalf of the insurer. [PL 1991, c. 828, §20 (NEW).]

7. Reinsurance intermediary-manager. "Reinsurance intermediary-manager" means any person who has authority to bind or manages all or part of the assumed reinsurance business of a reinsurer, including the management of a separate division, department or underwriting office, and acts as an agent for such a reinsurer whether known as a reinsurance intermediary-manager, manager or other similar term. The term does not include: A. An employee of the reinsurer; [PL 1991, c. 828, §20 (NEW).] B. A manager of a branch of an alien reinsurer that is located in the United States; [PL 1991, c. 828, §20 (NEW).] C. An underwriting manager that, pursuant to contract, manages all the reinsurance operations of the reinsurer, is under common control with the reinsurer subject to section 222 and whose compensation is not based on the volume of premiums written; and [PL 1991, c. 828, §20 (NEW).] D. The manager of a group, association, pool or organization of insurers that engages in joint underwriting or joint reinsurance and who is subject to examination by the public insurance regulatory official of the state or country in which the manager's principal business office is located. [PL 1991, c. 828, §20 (NEW).] [PL 1991, c. 828, §20 (NEW).]

8. Reinsurer. "Reinsurer" means any person who operates as an insurer in any manner under applicable provisions of this Title in the assumption of reinsurance risks. [PL 1991, c. 828, §20 (NEW).]

9. Retrocession. "Retrocession" means a transfer by a reinsurer to another reinsurer of those risks defined in subsection 2 . [PL 1991, c. 828, §20 (NEW).]

10. Retrocessionaire. "Retrocessionaire" means an insurer or reinsurer assuming reinsurance risks under a retrocession. [PL 1991, c. 828, §20 (NEW).]

11. Qualified United States financial institution. For purposes of this section, a "qualified United States financial institution" means an institution that: A. Is organized or, in the case of a United States branch or agency office of a foreign banking organization, is licensed under the laws of the United States or any state of the United States and has been granted authority to operate with fiduciary powers; [PL 1991, c. 828, §20 (NEW).] B. Is regulated, supervised and examined by federal or state authorities having regulatory authority over banks and trust companies; and [PL 1991, c. 828, §20 (NEW).] C. Has been determined by the superintendent or the Securities Valuation Office of the National Association of Insurance Commissioners to meet standards of financial condition and standing that are considered necessary and appropriate to regulate the quality of financial institutions whose letters of credit will be acceptable to the superintendent. [PL 1991, c. 828, §20 (NEW).] [PL 1991, c. 828, §20 (NEW).]

12. Qualified United States financial institution. "Qualified United States financial institution" means for the purposes of those provisions of this section specifying those institutions that are eligible to act as a fiduciary of a trust an institution that: A. Is organized or in the case of a United States branch or agency office of a foreign banking organization licensed under laws of the United States or any state of the United States and has been granted authority to operate with fiduciary powers; and [PL 1991, c. 828, §20 (NEW).] B. Is regulated, supervised and examined by federal or state authorities having regulatory authority over banks and trust companies. [PL 1991, c. 828, §20 (NEW).] [PL 1991, c. 828, §20 (NEW).]
24-A M.R.S. § 1155 — ME Code / Title 24-A / Chapter 13-A / Section 1155
24-A §1155. Diversification
Status: in_force

Investments of an insurer shall be subject to the following diversification requirements and limitations. [PL 1987, c. 399, §14 (NEW).]

1. Real estate; personal property; equity interests; subsidiaries. Not more than 40% of the insurer's assets in aggregate amount may consist of investments described in the following paragraphs: A. Real estate, section 1156, subsection 2, paragraph D , subparagraph (1); [PL 1987, c. 399, §14 (NEW).] B. Personal property, section 1156, subsection 2, paragraph E ; [PL 1987, c. 399, §14 (NEW).] C. Equity interests, section 1156, subsection 2, paragraph F ; and [PL 1987, c. 399, §14 (NEW).] D. Subsidiaries, section 1157 , except as provided in that section. [PL 1987, c. 399, §14 (NEW).] If, on or after the effective date of this subsection, the insurer makes investments of those types in institutions or property located within the State aggregating 1% or more of its assets, the 40% limitation in this subsection must be increased by an equal amount up to 45%, exclusive of those investments in institutions or property located within the State, thus providing for a maximum limit on the investments described in those paragraphs of 50% of the insurer's assets. [PL 2023, c. 59, §3 (AMD).]

2. Counter-party limitations. Except as otherwise expressly provided, an insurer may not invest in or may not incur counter-party exposure to any one person if, after giving effect to those investments and that counter-party exposure, the aggregate of those investments in and that counter-party exposure to that person would exceed 10% of the insurer's admitted assets, with the following exceptions: A. Government obligations pursuant to section 1156, subsection 2, paragraph A ; [PL 2001, c. 524, §3 (AMD).] B. Policy loans pursuant to section 1158 ; and [PL 2001, c. 524, §3 (AMD).] C. Index mutual funds, but as to this exception, only with the prior approval of the superintendent and limited to 20% of the insurer's admitted assets. [PL 2001, c. 524, §3 (NEW).] [PL 2023, c. 59, §3 (AMD).]

3. Other investment limitations. Other investment limitations are as provided in particular sections of this chapter. [PL 2023, c. 59, §3 (AMD).]
24-A M.R.S. § 1113 — ME Code / Title 24-A / Chapter 13 / Section 1113
24-A §1113. Common stocks
Status: in_force

An insurer may invest in nonassessable, except as to bank or trust company stocks, and except for taxes, common stocks, other than insurance stocks, of any solvent corporation organized and existing under the laws of the United States or Canada, or of any state or province thereof, if such corporation has had net earnings available for dividends on such stock in at least 5 of the 7 fiscal years next preceding acquisition by the insurer. If the issuing corporation has not been in legal existence for the whole of such 7 fiscal years but was formed as a consolidation or merger of 2 or more businesses of which at least one was in operation on a date 7 years prior to the investment, eligibility of its common stock under this section shall be based upon consolidated pro-forma statements of the predecessor or constituent institutions. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2811 — ME Code / Title 24-A / Chapter 35 / Section 2811
24-A §2811. Payment of expenses
Status: in_force

Any policy or contract of group health insurance may include provisions for the payment by the insurer of benefits for expenses incurred, by the employee or other member of the insured group, on account of hospitalization or medical or surgical aid for the employee, the employee's spouse, the employee's child or children, or other persons chiefly dependent upon the employee for support and maintenance. [RR 2021, c. 1, Pt. B, §244 (COR).]
24-A M.R.S. § 7606 — ME Code / Title 24-A / Chapter 99 / Section 7606
24-A §7606. Application for license and fees
Status: in_force

1. Application for license to be filed with superintendent. A self-storage provider must file a sworn application for a license under this chapter with the superintendent on forms prescribed and furnished by the superintendent. [PL 2021, c. 676, Pt. A, §42 (NEW).]

2. Contents of application. In addition to other information required by the superintendent, the application for a license under this chapter must: A. Provide the name, residence address and other information required by the superintendent for an employee or authorized representative of the self-storage provider who is designated by the applicant as the person responsible for the self-storage provider's compliance with the requirements of this chapter. If the self-storage provider derives more than 50% of its revenue from the sale of self-storage 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 2021, c. 676, Pt. A, §42 (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 2021, c. 676, Pt. A, §42 (NEW).] C. Provide the location of the applicant's home office. [PL 2021, c. 676, Pt. A, §42 (NEW).] [PL 2021, c. 676, Pt. A, §42 (NEW).]

3. Time of application. An application for a license under this chapter must be made within 90 days of the application's being made available by the superintendent. [PL 2021, c. 676, Pt. A, §42 (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 2021, c. 676, Pt. A, §42 (NEW).]

5. Fee. Each self-storage provider licensed under this chapter shall pay to the superintendent a fee equal to the amount prescribed by section 601, subsection 33 . [PL 2021, c. 676, Pt. A, §42 (NEW).]
24-A M.R.S. § 5075-A — ME Code / Title 24-A / Chapter 68-A / Section 5075-A
24-A §5075-A. Certification by superintendent
Status: in_force

1. Filing of form. An insurer, nonprofit hospital or medical service organization or nonprofit health care plan may request, at the time it files a policy or contract for approval for issuance or delivery in the State or at any time thereafter, that the superintendent certify the policy or contract as a long-term care insurance policy. [PL 2001, c. 679, §1 (NEW); PL 2001, c. 679, §6 (AFF).]

2. Determination. Within 60 days after receipt of a request for certification, the superintendent shall in writing: A. Certify that the policy or contract complies with this section; [PL 2001, c. 679, §1 (NEW); PL 2001, c. 679, §6 (AFF).] B. Deny the request and state the reasons for the denial; or [PL 2001, c. 679, §1 (NEW); PL 2001, c. 679, §6 (AFF).] C. Notify the insurer, nonprofit hospital or medical service organization or nonprofit health care plan that an insufficient basis exists for determining whether a certification should be made and indicate the nature of the insufficiency. [PL 2001, c. 679, §1 (NEW); PL 2001, c. 679, §6 (AFF).] [PL 2001, c. 679, §1 (NEW); PL 2001, c. 679, §6 (AFF).]

3. Standards for compliance. The superintendent shall certify a policy or contract submitted for review under this section as a long-term care insurance policy if the superintendent finds that the policy or contract complies with all the standards applicable to long-term care policies set forth in this chapter and in chapters 27 , 33 and 35 and rules adopted pursuant to those chapters by the superintendent. Waivers granted under the rules must be taken into consideration. [PL 2001, c. 679, §1 (NEW); PL 2001, c. 679, §6 (AFF).]
24-A M.R.S. § 6461 — ME Code / Title 24-A / Chapter 79 / Section 6461
24-A §6461. Notices
Status: in_force

A notice by the superintendent to an insurer that may result in regulatory action under this chapter is effective upon dispatch if transmitted by registered or certified mail or, in the case of any other transmission, is effective upon the insurer's receipt of the notice. [PL 1993, c. 634, Pt. A, §1 (NEW).]
24-A M.R.S. § 2516 — ME Code / Title 24-A / Chapter 29 / Section 2516
24-A §2516. Excluded or restricted coverage
Status: in_force

A clause in any policy of life insurance policy or annuity contract providing that such policy or contract shall be incontestable after a specified period shall preclude only a contest of the validity of the policy or contract, and shall not preclude the assertion at any time of defenses based upon provisions in the policy or contract which exclude or restrict coverage, whether or not such restrictions or exclusions are excepted in such clause. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 6709 — ME Code / Title 24-A / Chapter 83 / Section 6709
24-A §6709. Grounds and procedures for suspension and revocation of license
Status: in_force

1. Grounds for suspension or revocation. The superintendent may suspend or revoke the license of a captive insurance company for any of the following reasons: A. Insolvency or impairment of capital or surplus; [PL 1997, c. 435, §1 (NEW).] B. Failure to meet the requirements of section 6704 ; [PL 2009, c. 335, §14 (AMD).] C. Refusal or failure to submit an annual report required by section 6707 or any other report or statement required by law or by lawful order of the superintendent; [PL 1997, c. 435, §1 (NEW).] D. Failure to comply with the provisions of the company's charter or bylaws or other organizational document; [PL 2009, c. 335, §15 (AMD).] E. Failure to submit to examination or any legal obligation as required by section 6708 ; [PL 1997, c. 435, §1 (NEW).] F. Refusal or failure to pay the cost of examination required by sections 228 and 6708 ; [PL 1997, c. 435, §1 (NEW).] G. Use of methods that, although not otherwise specifically prohibited by law, nevertheless render the company's operation detrimental or the company's condition unsound with respect to the public or to its policyholders; [PL 1997, c. 435, §1 (NEW).] H. Failure to maintain actuarially appropriate loss reserves as determined by the superintendent, except that the superintendent shall issue at least one warning to the captive insurance company requiring it to correct the problem prior to suspending or revoking the license; and [PL 1997, c. 435, §1 (NEW).] I. Failure otherwise to comply with the laws of this State. [PL 1997, c. 435, §1 (NEW).] [PL 2009, c. 335, §§14, 15 (AMD).]

2. Procedure. Notwithstanding any other law, if the superintendent, upon examination, hearing or other evidence, finds that a captive insurance company has committed any of the acts specified in subsection 1 , the superintendent may suspend or revoke the license if the superintendent determines that it is in the best interest of the public and the policyholders of the captive insurance company. [PL 1997, c. 435, §1 (NEW).]
24-A M.R.S. § 1447 — ME Code / Title 24-A / Chapter 16 / Section 1447
24-A §1447. Records
Status: in_force

1. Records. The insurance producer or business entity shall keep or make accessible at the producer's or business entity's place of business a copy of the written appointment or designation from each insurer, health maintenance organization, fraternal benefit society or nonprofit hospital or medical service organization with which the insurance producer or business entity has an appointment. The insurance producer or business entity shall keep at the producer's or business entity's place of business complete records of transactions under the license. If a producer engages in transactions on behalf of a business entity and subsequently maintains a different place of business, the business entity shall maintain the records of those transactions. If a producer engages in transactions independent of any business entity, the producer shall maintain the records of those transactions. For the purpose of examination or investigation by the superintendent, records may be maintained in electronic form. As to each insurance policy or contract placed through or sold by the licensee, the records must show: A. The names of the insurer, health maintenance organization, fraternal benefit society or nonprofit hospital or medical service organization; [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] B. The number and expiration date of the policy or contract; [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] C. The premium payable as to the policy or contract; [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] D. The name and address of the insured; [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] E. The date and time of every binder made by the insurance producer; and [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] F. Such other information as the superintendent may reasonably require. [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] [PL 2001, c. 259, §41 (AMD).]

2. Retention. The records must be kept available for inspection by the superintendent for a period of at least 3 years after completion of the respective transactions. [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).]
24-A M.R.S. § 3058 — ME Code / Title 24-A / Chapter 41 / Section 3058
24-A §3058. Refusal based on previous owner's losses
Status: in_force

An insurance company authorized to transact business in this State may not refuse to issue a property insurance policy subject to this subchapter for the sole reason that a previous owner of the property submitted claims for losses to the property. [PL 2003, c. 671, Pt. A, §10 (NEW).]
24-A M.R.S. § 4110 — ME Code / Title 24-A / Chapter 55 / Section 4110
24-A §4110. Qualifications for membership
Status: in_force

A society may admit to benefit membership any person not less than 15 years of age, nearest birthday, who has furnished evidence of insurability acceptable to the society. Any such member who shall apply for additional benefits more than 6 months after becoming a benefit member shall furnish additional evidence of insurability acceptable to the society unless such additional benefits are issued pursuant to an existing contract under the terms of which such member is entitled to purchase such additional benefits without furnishing evidence of insurability. [PL 1969, c. 132, §1 (NEW).]

Any person admitted prior to attaining the full age of 18 years shall be bound by the terms of the application and certificate and by all the laws and rules of the society and shall be entitled to all the rights and privileges of membership therein to the same extent as though the age of majority had been attained at the time of application. A society may also admit general or social members who shall have no voice or vote in the management of its insurance affairs. [PL 1971, c. 598, §51 (AMD).]
24-A M.R.S. § 2914 — ME Code / Title 24-A / Chapter 39 / Section 2914
24-A §2914. Notice of cancellation -- reasons
Status: in_force

No policy may be cancelled except by notice to the insured and any other person mentioned in the loss payable clause of an automobile physical damage policy, as provided in this subchapter. [PL 1973, c. 339, §1 (NEW).]

No notice of cancellation of a policy shall be effective unless it is based on one or more of the following reasons: [PL 1973, c. 339, §1 (NEW).]

1. Nonpayment of premium. No notice of cancellation for nonpayment of premium shall be effective unless deemed received under section 2915 after the premium due date; [PL 1979, c. 347, §1 (AMD).]

2. Fraud or material misrepresentation affecting the policy or the presentation of a claim; [PL 1973, c. 339, §1 (NEW).]

3. Violation of terms or conditions of the policy; [PL 1973, c. 339, §1 (NEW).]

4. The named insured or any operator who either resides in the same household or customarily operates an automobile insured under the policy has a driver's license suspended, other than a first or 2nd suspension under Title 29‑A, section 2471, subsection 2 or section 2472, subsection 2 or a suspension under Title 28‑A, section 2052 , or revoked during the policy term or, if the policy is a renewal, during its term or the 180 days immediately preceding its effective date. [PL 1995, c. 65, Pt. A, §71 (AMD); PL 1995, c. 65, Pt. A, §153 (AFF); PL 1995, c. 65, Pt. C, §15 (AFF).]

During the policy period, an automobile insurance policy may not be modified except by agreement between the insured and the insurer. Modification agreed upon between the insured and the insurer shall not be deemed a cancellation of the coverage or of the policy. [PL 1977, c. 403, §2 (RPR).]

This section shall not apply to any policy or coverage which has been in effect less than 60 days at the time notice of cancellation is received by the named insured nor shall section 2920 apply to any policy or coverage that has been in effect less than 60 days. [PL 1979, c. 347, §2 (AMD).]

This section shall not apply to nonrenewal of an automobile insurance policy. [PL 1977, c. 403, §2 (NEW).]
24-A M.R.S. § 2736-B — ME Code / Title 24-A / Chapter 33 / Section 2736-B
24-A §2736-B. Order
Status: in_force

The superintendent shall issue an order or decision within 30 days after the close of the hearing, or of any rehearing or reargument or within such other period as the superintendent for good cause may require, but not to exceed an additional 30 days. In the order or decision, the superintendent shall either approve or disapprove the rate filing. If the superintendent disapproves the rate filing, the superintendent shall establish the date on which the filing is no longer effective, specify the filing the superintendent would approve and authorize the insurer to submit a new filing in accordance with the terms of the order or decision. [PL 1989, c. 269, §14 (AMD).]
24-A M.R.S. § 2623 — ME Code / Title 24-A / Chapter 31 / Section 2623
24-A §2623. Death pending conversion
Status: in_force

The group life insurance policy must contain a provision that if a person insured under the policy, or the insured dependent of a covered person, dies during the period within which the person would have been entitled to have an individual policy issued to the person in accordance with section 2621 or 2622 and before such an individual policy becomes effective, the amount of life insurance that the person would have been entitled to have issued to the person under such individual policy is payable as a claim under the group policy, whether or not application for the individual policy or the payment of the first premium therefor has been made. [RR 2021, c. 2, Pt. A, §74 (COR).]
24-A M.R.S. § 3873 — ME Code / Title 24-A / Chapter 53 / Section 3873
24-A §3873. Nonassessable policies
Status: in_force

1. If a reciprocal insurer has a surplus of assets over all liabilities at least equal to the minimum capital stock and surplus required to be maintained by a domestic stock insurer authorized to transact like kinds of insurance, upon application of the attorney and as approved by the subscribers' advisory committee the superintendent shall issue a certificate authorizing the insurer to extinguish the contingent liability of subscribers under its policies then in force in this State, and to omit provisions imposing contingent liability in all policies delivered or issued for delivery in this State for so long as all such surplus remains unimpaired. [RR 2021, c. 1, Pt. B, §320 (COR).]

2. Upon impairment of such surplus, the superintendent shall forthwith revoke the certificate. Such revocation shall not render subject to contingent liability any policy then in force and for the remainder of the period for which the premium has theretofore been paid; but after such revocation no policy shall be issued or renewed without providing for contingent assessment liability of the subscriber. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

3. The superintendent shall not authorize a domestic reciprocal insurer so to extinguish the contingent liability of any of its subscribers or in any of its policies to be issued, unless it qualified to and does extinguish such liability of all its subscribers and in all such policies for all kinds of insurance transacted by it. Except, that if required by the laws of another state in which the insurer is transacting insurance as an authorized insurer, the insurer may issue policies providing for the contingent liability of such of its subscribers as may acquire such policies in such state, and need not extinguish the contingent liability applicable to policies theretofore in force in such state. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 1475 — ME Code / Title 24-A / Chapter 16 / Section 1475
24-A §1475. Catastrophe investigations and adjustments
Status: in_force

An adjuster license is not required for an adjuster sent into this State on behalf of an authorized insurer or fraternal benefit society for the investigation or adjustment of a particularly unusual or extraordinary loss or of a series of losses resulting from a catastrophe common to all such losses. [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).]
24-A M.R.S. § 4433 — ME Code / Title 24-A / Chapter 57 / Section 4433
24-A §4433. Scope
Status: in_force

1. Application. This subchapter shall apply only as to the following kinds of insurance: A. Property insurance, as defined in section 705 ; [PL 1969, c. 561 (NEW).] B. Surety insurance, as defined in section 706 ; [PL 1969, c. 561 (NEW).] C. Casualty insurance, as defined in section 707 ; and [PL 1969, c. 561 (NEW).] D. Marine and transportation insurance, as defined in section 708 , excluding wet marine insurance, as defined in section 708, subsection 2 , but not excluding marine protection and indemnity insurance. [PL 1989, c. 751, §1 (AMD).] [PL 1989, c. 751, §1 (AMD).]

2. Exceptions. This subchapter shall not apply as to: A. Contracts of reinsurance; [PL 1969, c. 561 (NEW).] B. Mortgage guaranty insurance; [PL 1985, c. 279, §1 (AMD).] C. Credit insurance, vendors single-interest insurance, collateral protection insurance or any similar insurance protecting the interests of a creditor arising out of a creditor-debtor transaction; [PL 2001, c. 478, §1 (AMD); PL 2001, c. 478, §11 (AFF).] D. Insurance contracts procured as surplus lines coverage pursuant to chapter 19 ; [PL 1987, c. 707, §5 (AMD).] E. Title insurance; [PL 1989, c. 67, §1 (AMD).] F. Financial guaranty insurance or other forms of insurance offering protection against investment risks; [PL 2001, c. 478, §2 (AMD); PL 2001, c. 478, §11 (AFF).] G. Contracts of workers' compensation excess insurance issued to workers' compensation self-insurers approved under former Title 39, section 23 or under Title 39‑A, section 403 by any insurer after the effective date of this paragraph, or in the case of a contract that automatically renews, not later than one year after the effective date of this paragraph; [PL 2001, c. 478, §3 (AMD); PL 2001, c. 478, §11 (AFF).] H. Life, annuity, health or disability insurance; [PL 2001, c. 478, §4 (NEW); PL 2001, c. 478, §11 (AFF).] I. Other than coverages that may be set forth in a cybersecurity insurance policy, insurance of warranties or service contracts, including insurance that provides for the repair, replacement or service of goods or property, or indemnification of repair, replacement or service; for the operational or structural failure of the goods or property due to a defect in materials, workmanship or normal wear and tear; or for reimbursement for the liability incurred by the issuer of agreements or service contracts that provide such benefits; [PL 2025, c. 348, §37 (AMD).] J. A transaction or combination of transactions between a person, including affiliates of that person, and an insurer, including affiliates of that insurer, that involves the transfer of investment or credit risk unaccompanied by transfer of insurance risk; and [PL 2001, c. 478, §4 (NEW); PL 2001, c. 478, §11 (AFF).] K. Insurance provided by or guaranteed by a governmental entity. [PL 2001, c. 478, §4 (NEW); PL 2001, c. 478, §11 (AFF).] [PL 2025, c. 348, §37 (AMD).]
24-A M.R.S. § 6804 — ME Code / Title 24-A / Chapter 85 / Section 6804
24-A §6804. License revocation and administrative assessments
Status: in_force

1. Superintendent's authority. [PL 2003, c. 636, §7 (RP).]

1-A. Superintendent's authority. The superintendent may deny, suspend, revoke or refuse to renew the license of a settlement provider if the superintendent finds just cause to do so, which may include, but is not limited to, a finding that: A. There was any material misrepresentation in the application for the license or other information submitted to the superintendent; [PL 2003, c. 636, §7 (NEW).] B. The licensee or any officer, partner, director, member or key management personnel of the licensee has been convicted of fraudulent or dishonest practices, is subject to a final administrative action to suspend or revoke a settlement provider license or is otherwise shown to be untrustworthy or incompetent to act as a settlement provider; [PL 2003, c. 636, §7 (NEW).] C. The licensee as a settlement provider demonstrates an unreasonable pattern of payments to viators; [PL 2003, c. 636, §7 (NEW).] D. The licensee or any officer, partner, director, member or key management personnel of the licensee has been found guilty of, or has pleaded guilty or nolo contendere to, any crime involving fraud or moral turpitude, regardless of whether a judgment of conviction has been entered by the court; [PL 2003, c. 636, §7 (NEW).] E. The settlement provider has entered into any settlement contract that has not been approved pursuant to this chapter; [PL 2003, c. 636, §7 (NEW).] F. The settlement provider has failed to honor contractual obligations set out in a settlement contract; [PL 2003, c. 636, §7 (NEW).] G. The settlement provider no longer meets the requirements for initial licensure; [PL 2003, c. 636, §7 (NEW).] H. The settlement provider has assigned, transferred or pledged a policy acquired pursuant to a settlement contract to a person other than a settlement provider licensed in this State, an accredited investor or qualified institutional buyer as defined respectively in Regulation D, Rule 501 and Rule 144A of the Federal Securities Act of 1933, as amended, a financing entity, a special purpose entity or a related provider trust; or [PL 2003, c. 636, §7 (NEW).] I. The licensee has violated any of the provisions of this chapter or any rules adopted pursuant to this chapter. [PL 2003, c. 636, §7 (NEW).] [PL 2003, c. 636, §7 (NEW).]

2. Hearing. Before the superintendent may deny a license application or suspend, revoke or refuse to renew the license of a settlement provider, the licensee or applicant has an opportunity for a hearing in accordance with Title 5, chapter 375, subchapter 4 . [PL 2003, c. 636, §7 (AMD).]

3. Administrative penalty. The superintendent may, in addition to denying a license application or suspending or revoking a license, assess an administrative civil forfeiture of $500 for each willful violation of this chapter. This section may not be construed to diminish the penalties available for any violation of chapter 23 , in addition to any penalties authorized under section 12‑A . [PL 1997, c. 430, §1 (NEW); PL 1997, c. 430, §2 (AFF).]
24-A M.R.S. § 2164-C — ME Code / Title 24-A / Chapter 23 / Section 2164-C
24-A §2164-C. Free competition
Status: in_force

1. Appraisals or repairs to motor vehicle glass. A domestic or foreign insurer or its agent or employee may not require, directly or indirectly, that appraisals or repairs to motor vehicle glass be made or not be made in a specified place of business. A domestic or foreign insurer or its agent or employee may not contract with any person to act as its agent for purposes of managing, handling or arranging repair or replacement of motor vehicle glass when that person is compensated by payment of a portion of the difference between the list price of the product or services provided and the amount paid to the person providing repair and replacement service. [PL 2005, c. 101, §1 (NEW).]

2. Appraisals or repairs to motor vehicles for collision damage. A domestic or foreign insurer or its agent or employee may not require, directly or indirectly, that appraisals or repairs to motor vehicles with collision damage be made or not be made in a specified place of business. A domestic or foreign insurer or its agent or employee may not contract with any person to act as its agent for purposes of managing, handling or arranging repair or replacement of motor vehicles for collision damage when that person is compensated by payment of a portion of the difference between the list price of the product or services provided and the amount paid to the person providing repair and replacement service. A domestic or foreign insurer or its agent or employee may not recommend the use of a particular motor vehicle repair service or network of repair services without informing the claimant that the claimant is under no obligation to use the recommended repair service or network of repair services. [PL 2005, c. 101, §1 (NEW).]
24-A M.R.S. § 3853 — ME Code / Title 24-A / Chapter 53 / Section 3853
24-A §3853. Insuring powers of reciprocals
Status: in_force

1. A reciprocal insurer may, upon qualifying therefore as provided for by this Title, transact any kind or kinds of insurance defined by this Title, other than life or title insurances. [PL 1969, c. 132, §1 (NEW).]

2. Such an insurer may purchase reinsurance upon the risk of any subscriber, and may grant reinsurance as to any kind of insurance it is authorized to transact direct. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 1416-A — ME Code / Title 24-A / Chapter 16 / Section 1416-A
24-A §1416-A. License continuation or termination
Status: in_force

1. License for indefinite term. Each license issued under this chapter continues in force continuously, unless suspended, revoked or otherwise terminated by the superintendent, as long as any applicable fee set forth in section 601 is paid and education requirements for resident licensees are met by the due date. [PL 2001, c. 259, §18 (NEW).]

2. Biennial license continuation fees. Each nonresident adjuster and consultant must be billed by the superintendent a biennial fee as provided in section 601 and shall pay the fee due by January 1st of even-numbered years. Each nonresident business entity must be billed by the superintendent a biennial fee as provided in section 601 and shall pay the fee due by April 1st of odd-numbered years. Each resident adjuster must be billed by the superintendent a biennial fee as provided in section 601 and shall pay the fee due by October 1st of even-numbered years. Each resident consultant must be billed by the superintendent a biennial fee as provided in section 601 and shall pay the fee due by the date the completion of the consultant's biennial education requirements is due in accordance with section 1482 . Each resident business entity must be billed by the superintendent a biennial fee as provided in section 601 and shall pay the fee due by December 1st of even-numbered years. [PL 2015, c. 49, §1 (AMD).]

3. Suspension or revocation. Failure to pay the required fees by a licensee within 90 days from the due date results in suspension or revocation of the license pursuant to section 1417 , for violating the insurance laws pursuant to section 1420‑K, subsection 1, paragraph B . [PL 2001, c. 259, §18 (NEW).]
24-A M.R.S. § 6981 — ME Code / Title 24-A / Chapter 87 / Section 6981
24-A §6981. Dirigo Health Self-administered Plan
Status: in_force

Notwithstanding section 6910, subsection 2 , Dirigo Health may provide access to health benefits coverage by establishing the Dirigo Health Self-administered Plan, referred to in this subchapter as "the self-administered plan," pursuant to this section. [PL 2007, c. 447, §11 (NEW).]

1. Establishment. Dirigo Health may provide access to health benefits coverage through the self-administered plan subject to the requirements of this section. The board may make a determination that Dirigo Health will provide access to health benefits coverage through the self-administered plan after the board evaluates competitive bids for health benefits coverage for self-administered and fully underwritten health benefits coverage. If the board determines that Dirigo Health will provide access to health coverage through the self-administered plan as authorized under this section, the board shall submit a report explaining the reasons for the decision to the joint standing committee of the Legislature having jurisdiction over health insurance matters within 30 days of the decision. Upon receipt of a report from the board, the chairs of the joint standing committee of the Legislature having jurisdiction over health insurance matters may call a meeting of the committee. Following receipt of such a report, the joint standing committee of the Legislature having jurisdiction over health insurance matters may report out legislation to the next regular or special session of the Legislature relating to the establishment of the self-administered plan. [PL 2007, c. 447, §11 (NEW).]

2. Cooperative agreements. Dirigo Health may enter into voluntary cooperative agreements with a public purchaser for purchasing purposes and administrative functions. If a cooperative agreement is entered into pursuant to this subsection, the self-administered plan and any public purchaser shall maintain separate and distinct risk pools and reserves and may not commingle risk pools or reserve funds under any circumstances. For the purposes of this subsection, "public purchaser" means an entity that purchases health coverage in whole or in part with public funds, including, but not limited to, the state employee health insurance program, the University of Maine System, the Maine Community College System, the Maine Education Association benefits trust, the Maine School Management Association benefits trust and municipal and county governments. For the purposes of this subsection, "public purchaser" does not mean the Department of Health and Human Services, Office of MaineCare Services. [PL 2009, c. 369, Pt. A, §33 (AMD).]

3. Additional responsibilities of board. In addition to the duties and responsibilities set out in sections 6908 and 6910 , the board is authorized to: A. Operate the self-administered plan pursuant to a trust instrument in accordance with Title 18‑B ; [PL 2007, c. 447, §11 (NEW).] B. Develop, maintain and modify a business plan for the self-administered plan as appropriate in consultation with the executive director; [PL 2007, c. 447, §11 (NEW).] C. Establish an operating budget for the self-administered plan subject to legislative approval in the biennial budget process in accordance with section 6908, subsection 3 ; [PL 2007, c. 447, §11 (NEW).] D. Ensure the ongoing fiscal integrity and stability of the self-administered plan in accordance with subsections 5 and 11 and monitor statistics provided by the executive director relating to the number of plan enrollees, working rates, utilization of benefits, operating costs and reimbursement for losses related to excess or stop loss coverage; [PL 2007, c. 447, §11 (NEW).] E. Establish administrative and accounting procedures in accordance with section 6908, subsection 2, paragraph A and develop financial statements that are consistent with generally accepted accounting principles; [PL 2007, c. 447, §11 (NEW).] F. Obtain necessary contracts for services, including, but not limited to, actuarial services, accounting services, auditing services, investment advice and counsel and custodial services for financial assets in accordance with subsection 4; [PL 2007, c. 447, §11 (NEW).] G. Take any actions necessary to comply with federal and state Medicaid rules regarding Dirigo Health plan members eligible for MaineCare; [PL 2007, c. 447, §11 (NEW).] H. Take any actions necessary to comply with federal Medicaid managed care organization contract requirements as provided in 42 Code of Federal Regulations, Part 438 (2002); and [PL 2007, c. 447, §11 (NEW).] I. Have and exercise all powers necessary and appropriate to carry out the purposes of this section. [PL 2007, c. 447, §11 (NEW).] [PL 2007, c. 447, §11 (NEW).]

4. Services. If the board determines that Dirigo Health will provide access to health coverage through the self-administered plan pursuant to subsection 2 , the board shall contract for the following services through a competitive bidding process unless the requirement for competitive bidding is waived pursuant to Title 5, section 1825‑B, subsection 2 or a carrier contracted by Dirigo Health to fully underwrite health benefits coverage terminates that contract. A. The board shall secure the services of an actuary for technical advice on matters regarding the operation of the self-administered plan in accordance with this paragraph. The board shall contract for actuarial services after a competitive bidding process at least every 3 years and may award a bid only to an actuary who is a member in good standing of the American Academy of Actuaries or a successor organization. The contract must require the actuary to: (1) Act as a technical advisor to the board on matters regarding the operation of the self-administered plan in accordance with this paragraph; (2) Certify the amounts of the benefits paid and payable under this section; (3) Analyze the year's operations and results and the experience of the self-administered plan; (4) Determine appropriate actuarial assumptions for recommendation to the board; and (5) Determine the appropriate level of reserves needed to sustain the self-administered plan and pay benefits. [PL 2007, c. 447, §11 (NEW).] B. The board shall secure the services of one or more fiduciaries or registered investment advisors through negotiated contractual arrangements. The contract must require the fiduciary or registered investment advisor to: (1) Invest and reinvest the funds in accordance with appropriate financial and trust standards; (2) Advise the board as to reasonable investment philosophy; and (3) Submit regular reports of investments and changes to the board. [PL 2007, c. 447, §11 (NEW).] C. The board shall contract with an appropriate financial institution for custodial services for the securities and other investment assets of the self-administered plan. The contract must require the custodian to meet financial safeguards and other qualifications determined by the board, including restrictions on the manner in which deposits and withdrawals of funds are completed. [PL 2007, c. 447, §11 (NEW).] D. When the self-administered plan is established, the board shall purchase, through contracts from one or more 3rd-party administrators or any organization necessary to administer and provide a health plan, a policy or policies or a contract to provide the benefits specified by this section. The purchase of policies by the board must be accomplished by use of a written contract for a term determined by the board. [PL 2007, c. 447, §11 (NEW).] The board may contract for any other applicable services necessary to comply with federal law. [PL 2007, c. 447, §11 (NEW).]

5. Administration. The following provisions govern the administration of the self-administered plan. A. The assets and liabilities of the self-administered plan are solely the assets and liabilities of Dirigo Health. [PL 2007, c. 447, §11 (NEW).] B. The actuary under contract with the board pursuant to subsection 4 shall determine: (1) The appropriate level of reserves estimated to be sufficient to pay claims and administrative costs according to subsection 11, paragraph B ; (2) Whether the program is operating on an actuarially sound basis and any recommendations based on that determination; (3) A rate structure for the self-administered plan, including working rates actuarially sufficient to pay anticipated claims for the current claims year as well as to provide sufficient reserves for incurred but not reported claims; (4) Recommendations as to the purchase of excess or stop loss insurance including suggested attachment levels and limits; and (5) Recommendations as to the need for a security deposit or surety bond to protect against insolvency. The actuary shall annually present information to the board on the determinations made pursuant to this paragraph as well as the method of distribution of any accumulations above the reserves including use of excess reserves to moderate the working rates. [PL 2007, c. 447, §11 (NEW).] C. The superintendent shall complete a detailed review of the financial and actuarial aspects of the self-administered plan, including, but not limited to, the presentation and recommendations of the actuary and the audited financial statements of the self-administered plan. The superintendent shall report the superintendent's findings and any recommendations to the board and at a public meeting of the joint standing committee of the Legislature having jurisdiction over insurance matters on or before March 1st of each year. [PL 2007, c. 447, §11 (NEW).] D. The self-administered plan may not obligate the General Fund beyond that amount appropriated by the Legislature. [PL 2007, c. 447, §11 (NEW).] [PL 2007, c. 447, §11 (NEW).]

6. Audits; financial statements. The board shall arrange for an annual audit of its financial statements by an independent certified public accounting firm. Within 30 days of the completion of the audit, a copy of the audited financial statements must be distributed to the Legislature in the same manner as required by section 6908, subsection 4 . A copy of the audited financial statements must also be made available for public inspection. [PL 2007, c. 447, §11 (NEW).]

7. Public entity. The self-administered plan is a public entity for the purposes of 42 Code of Federal Regulations, Section 438.116. [PL 2007, c. 447, §11 (NEW).]

8. Health benefit coverage. Health benefits coverage provided under the self-administered plan in accordance with this subchapter must be comprehensive and include a low deductible plan option for enrollees in the Dirigo Health Program. [PL 2007, c. 447, §11 (NEW).]

9. Application of certain insurance provisions. The self-administered plan must meet or exceed the following requirements in the same manner as when health benefits coverage is provided by a health insurance carrier: A. The requirements for rating practices pursuant to section 2736‑C, subsection 2 and section 2808‑B, subsection 2 ; [PL 2007, c. 447, §11 (NEW).] B. The requirements for guaranteed issuance pursuant to section 2736‑C, subsection 3 and section 2808‑B, subsection 4 ; [PL 2007, c. 447, §11 (NEW).] C. The requirements for guaranteed renewal pursuant to section 2736‑C, subsection 3 and section 2808‑B, subsection 4 subject to the limitations of available funds maintained by the self-administered plan in accordance with subsection 11 ; [PL 2007, c. 447, §11 (NEW).] D. The requirements for continuity of coverage, coverage of late enrollees and preexisting condition exclusions pursuant to chapter 36 ; [PL 2007, c. 447, §11 (NEW).] E. The requirements for mandated coverage of specific health care services and for specific diseases and for certain providers of health care services pursuant to Title 24 and this Title; [PL 2007, c. 447, §11 (NEW).] F. The requirements for the benefits, rights and protections for individuals enrolled in health plans pursuant to chapter 56‑A and Bureau of Insurance Rule Chapter 850. Notwithstanding any statute or common law to the contrary, an individual enrolled in the self-administered plan may maintain a cause of action against the self-administered plan subject to the requirements of section 4313 . This paragraph is a waiver of the State's defense of immunity under Title 14, chapter 741 ; [PL 2007, c. 447, §11 (NEW).] G. The requirements of the Insurance Information and Privacy Protection Act pursuant to chapter 24 ; and [PL 2007, c. 447, §11 (NEW).] H. The provisions of sections 2159‑B and 2159‑C relating to discrimination against victims of domestic abuse and discrimination on the basis of genetic information or testing. [PL 2007, c. 447, §11 (NEW).] The self-administered plan may not enter into any contract with a 3rd-party administrator, carrier or other organization to administer and provide health coverage that has not demonstrated compliance with all applicable state laws. [PL 2007, c. 447, §11 (NEW).]

10. Self-administered plan not an insurer. The self-administered plan is not an insurer, reciprocal insurer or joint underwriting association under the laws of the State. The administration of the self-administered plan by the board does not constitute doing the business of insurance. [PL 2007, c. 447, §11 (NEW).]

11. Reserves. This subsection applies to reserves of the self-administered plan. A. The Dirigo Health Reserve is created as an account within the Dirigo Health Enterprise Fund, as established pursuant to section 6915 , for the deposit of reserves as required by paragraph B . [PL 2007, c. 447, §11 (NEW).] B. The self-administered plan shall maintain a reserve at least equal to the sum of: (1) An amount estimated by a qualified actuary under subsection 5 to be necessary to pay claims and administrative costs for the assumed risk for 2 1/2 months; and (2) The amount determined annually by a qualified actuary under subsection 5 to be necessary to fund the unpaid portion of ultimate expected losses, including incurred but not reported claims, and related expenses incurred in the provision of benefits for eligible participants, less any credit, as determined by a qualified actuary, for excess or stop loss insurance. [PL 2007, c. 447, §11 (NEW).] C. The Dirigo Health Reserve must be adjusted on a quarterly basis in order to maintain a reserve at least equal to the amount determined in paragraph B . [PL 2007, c. 447, §11 (NEW).] D. The Dirigo Health Reserve is capitalized by money from the Dirigo Health Enterprise Fund, as established pursuant to section 6915 , and any other fund advanced for initial operating expenses, monthly enrollee payments, any funds received from any public or private source, legislative appropriations, payments from state departments and agencies and such other means as the Legislature may approve. All money in the Dirigo Health Reserve is deemed to be the commingled assets of all covered enrollees and may be used only for the purposes of this section. [PL 2007, c. 447, §11 (NEW).] [PL 2007, c. 447, §11 (NEW).]

12. Stop loss insurance. The board may purchase excess or stop loss insurance for the self-administered plan, with attachment levels and limits as recommended by a qualified actuary pursuant to subsection 5 . If the board is unable to purchase excess or stop loss insurance at the recommended attachment levels and limits, the board does not have the authority to establish a self-administered plan as provided in this section. [PL 2007, c. 447, §11 (NEW).]

13. Marketing and distribution. The board may contract for the marketing and distribution of the self-administered plan in accordance with the requirements of this subsection. Any entity or individual that contracts with the self-administered plan shall successfully complete all training offered by Dirigo Health for the solicitation, negotiation and sale of health benefits coverage. Training must be completed annually, and any certificate establishing successful completion of training is valid for one year from the date of issuance. If an entity or individual fails to obtain certification following the expiration of the prior year's certification, the entity or individual may not continue to solicit, negotiate and sell health benefits coverage under the self-administered plan. [PL 2007, c. 447, §11 (NEW).]

14. Provider reimbursement. In any contract with a 3rd-party administrator, carrier or other organization to administer and provide health coverage to enrollees of the self-administered plan, the board shall ensure that: A. Providers contracting to provide health coverage to plan enrollees are reimbursed at a rate comparable to current market reimbursement rates among commercial carriers in the State; [PL 2007, c. 447, §11 (NEW).] B. Providers contracting to provide health coverage to plan enrollees are paid in a timely manner in accordance with the same requirements that would be required under state law for health insurance carriers pursuant to section 2436 ; and [PL 2007, c. 447, §11 (NEW).] C. If the self-administered plan fails to pay for health care services as set forth in the contract, providers are governed by the standards required pursuant to section 4204, subsection 6 . This paragraph does not prohibit a provider from collecting or attempting to collect from a plan enrollee any amount for services not normally payable to the self-administered plan, including any applicable copayments and deductibles. [PL 2007, c. 447, §11 (NEW).] [PL 2007, c. 447, §11 (NEW).]

15. No liability for plan enrollees. This section does not create any liability on the part of eligible employers, eligible employees or eligible individuals enrolled in Dirigo Health in the event that the self-administered plan becomes insolvent or fails to pay claims. [PL 2007, c. 447, §11 (NEW).]
24-A M.R.S. § 2834-C — ME Code / Title 24-A / Chapter 35 / Section 2834-C
24-A §2834-C. Compliance with federal law
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, accidental injury, specified disease and long-term care policies. [PL 2009, c. 244, Pt. E, §1 (NEW).]

2. Requirement. Policies subject to this section must comply with the federal Children's Health Insurance Program Reauthorization Act of 2009, Section 311 concerning special enrollment periods in case of termination of coverage under a Medicaid plan or a state child health plan or eligibility for assistance in the purchase of employment-based coverage. [PL 2009, c. 244, Pt. E, §1 (NEW).]
24-A M.R.S. § 4115 — ME Code / Title 24-A / Chapter 55 / Section 4115
24-A §4115. Benefits on lives of children
Status: in_force

A society may provide for benefits on the lives of children under the minimum age for adult membership but not greater than 18 years of age at time of application therefor, upon the application of some adult person, as its laws or rules may provide, which benefits shall be in accordance with the provisions of section 4114, subsection 1 . A society may, at its option, organize and operate branches for such children. Membership and initiation in local lodges shall not be required of such children, nor shall they have a voice in the management of the society. [PL 1971, c. 598, §52 (AMD).]

A society shall have power to provide for the designation and changing of designation of beneficiaries in the certificates providing for such benefits and to provide in all other respects for the regulation, government and control of such certificates and all rights, obligations and liabilities incident thereto and connected therewith. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2520 — ME Code / Title 24-A / Chapter 29 / Section 2520
24-A §2520. Entire contract -- annuities
Status: in_force

In an annuity or pure endowment contract, other than a reversionary, survivorship, or group annuity, there shall be provision that the contract shall constitute the entire contract between the parties or, if a copy of the application is endorsed upon or attached to the contract when issued, a provision that the contract and the application therefor shall constitute the entire contract between the parties. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2858 — ME Code / Title 24-A / Chapter 37 / Section 2858
24-A §2858. Filing, approval and withdrawal of forms, rates; appeals
Status: in_force

1. Forms filed. All policies, certificates of insurance, notices of proposed insurance, applications for insurance, endorsements and riders delivered or issued for delivery in this State and the schedules of premium rates pertaining thereto shall be filed with the superintendent. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

2. Approval of forms and rates. The superintendent shall, within 30 days after the filing of any such policies, certificates of insurance, notices of proposed insurance, applications for insurance, endorsements and riders, disapprove any such form, if the benefits provided therein are not reasonable in relation to the premium charge or if it contains provisions which are unjust, unfair, inequitable, misleading, deceptive or encourage misrepresentation of the coverage, or are contrary to any provision of the insurance laws or of any regulation promulgated thereunder. In determining whether to disapprove any such form or premium rates, the superintendent shall give due consideration to past and prospective loss experience and mortality or morbidity rates, based on an appropriate mortality or morbidity table, and claim adjustment expenses, general administrative expenses, including handling cost for return premiums, commissions to agents, cost and compensation to the creditor, branch and field expenses and other acquisition costs, federal, state and local taxes, profit to the insurer, reasonable underwriting judgment, and any and all other factors and trends demonstrated to be relevant. The insurer may support these factors by statistical information, experience, actuarial computations and estimates certified by an executive officer of the insurer, and the superintendent shall give due consideration to such supporting data. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

3. Notice of disapproval; waiting period. If the superintendent notifies the insurer that the form or rates are disapproved, it is unlawful thereafter for such insurer to issue or use such form or rates. In such notice, the superintendent shall specify the reason for the superintendent's disapproval and state that a hearing will be granted within 20 days after request in writing by the insurer. Any such policy, certificate of insurance, notice of proposed insurance, or any application, endorsement or rider or rate may not be issued or used until the expiration of 30 days after it has been so filed, unless the superintendent gives prior written approval thereto. [RR 2021, c. 1, Pt. B, §250 (COR).]

4. Approval withdrawn. The superintendent may, at any time after a hearing held not less than 20 days after written notice to the insurer, withdraw the superintendent's approval of any such form or rate on any ground set forth in subsection 2 . The written notice of such hearing must state the reason for the proposed withdrawal. The insurer may not use a form or rate after withdrawal of approval thereof. [RR 2021, c. 1, Pt. B, §251 (COR).]

5. Group certificate filing. If a group policy of consumer credit insurance has been delivered in this State before September 16, 1961, or has been or is delivered in another state before or after such date, the insurer shall file only the group certificate and notice of proposed insurance delivered or issued for delivery in this State as specified in section 2857, subsections 2 and 4 , and such forms must be approved by the superintendent, if they conform with the requirements specified in such subsections and if the schedules of premium rates applicable to the insurance evidenced by such certificate or notice are not in excess of the insurer's schedules of premium rates filed with the superintendent. [PL 2001, c. 138, §11 (AMD).]

All hearings held under this section shall be conducted in accordance with the Maine Administrative Procedure Act, Title 5, chapter 375, subchapter IV . [PL 1977, c. 694, §423 (NEW).]
24-A M.R.S. § 7406 — ME Code / Title 24-A / Chapter 95 / Section 7406
24-A §7406. Enforcement provisions
Status: in_force

1. Investigation and examination by superintendent. The superintendent may conduct investigations and examinations of insurers or other persons to enforce the provisions of this chapter. Upon request of the superintendent, a person subject to this chapter shall make available to the superintendent all accounts, books and records that are necessary to enable the superintendent to determine compliance or noncompliance with this chapter. [PL 2019, c. 367, §1 (NEW).]

2. Enforcement actions. The superintendent may assess civil penalties or take any other action permitted under section 12‑A against any person who violates any provision of this chapter or the superintendent's rules and orders, and nothing in this section may be construed as limiting the superintendent's authority to take enforcement action under section 12‑A in connection with violations of applicable provisions of this Title. [PL 2019, c. 367, §1 (NEW).]

3. Administrative procedures. Any person aggrieved by an order of the superintendent under this chapter may submit an application for a hearing as provided in section 229 , upon which the procedures set forth in section 229 apply. [PL 2019, c. 367, §1 (NEW).]
24-A M.R.S. § 3352 — ME Code / Title 24-A / Chapter 47 / Section 3352
24-A §3352. Mutual insurers, initial qualifications
Status: in_force

1. When hereafter newly organized, a mutual insurer may be authorized to transact any one of the kinds of insurance listed in the schedule contained in subsection 2 or any combination of such kinds as provided in subsection 3 . [PL 1969, c. 132, §1 (NEW).]

2. When applying for an original certificate of authority, the insurer must be otherwise qualified therefor under this Title, and must have received and accepted bona fide applications as to substantial insurable subjects for insurance coverage of a substantial character of the kind of insurance proposed to be transacted, must have collected in cash the full premium therefor at a rate not less than that usually charged by other insurers for comparable coverages, must have surplus funds on hand and deposited as of the date such insurance coverages are to become effective, or, in lieu of such applications, premiums and surplus, may deposit and thereafter maintain surplus, all in accordance with that part of the following schedule which applies to each kind of insurance the insurer proposes to transact: (A) (B) (C) (D) (E) (F) (G) (H) Kind of Ins. Min. No. of Apps. Accepted Min. No. Subjects Covered Minimum Premium Collected Minimum Amount Ins. Ea. Subject Maximum Amount Ins. Ea. Subject (5) Deposit Minimum Surplus Fund (6) Deposit Surplus in Lieu (7) ______ _______ _______ ________ _______ _______ ________ _________ Life (1) 500 500 Annual $2,500 $50,000 $1,000,000 $1,250,000 Health (2) 500 500 Quarterly 100 (wkly. indem.) 300 (wkly. indem.) 500,000 750,000 Property (3) 100 250 Annual 10,000 100,000 500,000 750,000 Casualty (4) 250 500 Annual 25,000 100,000 750,000 1,000,000 The following provisions are respectively applicable to the foregoing schedule and provisions as indicated by like numerals appearing in such schedule. (1) No group insurance or term policies for terms of less than 10 years may be included. (2) No group, blanket or family plans of insurance may be included. In lieu of weekly indemnity, a like premium value in medical, surgical and hospital benefits may be provided. Any accidental death or dismemberment benefit provided shall not exceed $15,000. (3) Only insurance of the owner's interest in real property may be included. (4) Such insurance must include coverage of legal liability for bodily injury and property damage, to which the maximum and minimum insured amounts apply. (5) The maximums provided for in column (F) are net of applicable reinsurance. (6) The deposit of surplus in the amount specified in columns (G) and (H) must thereafter be maintained unimpaired. The deposit is subject to chapter 15 (administration of deposits). (7) Deposit surplus, when utilized, in lieu of the alternative procedure of accepting deposit application funds shall be in those amounts enumerated for each identified kind of insurance. Expendable surplus: In addition to surplus deposited and thereafter to be maintained as shown in columns (G) or (H), the insurer when first authorized must have on hand surplus funds, which it can thereafter expend in the conduct of its business, in amount not less than 50% of the applicable deposited and maintained surplus required of it under the schedule set up in this subsection. Notwithstanding the requirements for expendable surplus otherwise required by this section for newly organized insurance companies seeking a certificate of authority in this State, any such insurer may transact legal services insurance, to the extent provided for in chapter 38 , without additional expendable funds, if the corporation is otherwise qualified for a certificate of authority to transact the business of health, life and health or multiple lines insurance, and possesses and thereafter maintains, in addition to the amounts enumerated in the table in this subsection, an additional amount of unimpaired basic surplus of not less than $500,000. [PL 1983, c. 801, §12 (AMD).]

3. An insurer may initially qualify for authority to transact both life and health insurances by fulfilling the foregoing requirements as to each such kind of insurance; and may in like manner initially qualify for authority to transact both property and casualty insurance. An insurer shall not, however, so qualify to transact any other combination of such insurances, except as provided in section 3357 . [PL 1969, c. 132, §1 (NEW).]

4. Domestic mutual insurers, possessing a certificate of authority to conduct business solely on an assessment plan upon the effective date of this subsection, and newly organized assessment plan mutual insurers authorized after the effective date of this subsection shall be governed as to surplus funds requirements by the provisions of chapter 51 . [PL 1983, c. 709, §3 (NEW).]
24-A M.R.S. § 6817 — ME Code / Title 24-A / Chapter 85 / Section 6817
24-A §6817. Advertising of settlements
Status: in_force

1. Advertising for settlements. Every settlement provider licensee shall establish and at all times maintain a system of control over the content, form and method of dissemination of all advertisements of its contracts, products and services. All advertisements, regardless of by whom written, created, designed or presented, are the responsibility of the settlement provider licensee, as well as the individual who created or presented the advertisement. A system of control must include providing regular routine notification, at least once a year, to agents and others authorized by the settlement licensee to disseminate advertisements; the notification must include the requirements and procedures for approval of any advertisements not furnished by the settlement provider licensee prior to the advertisements' use. [PL 2003, c. 636, §18 (NEW).]

2. Form and content. Advertisements must be truthful and not misleading in fact or by implication. The form and content of an advertisement of a settlement contract must be sufficiently complete and clear so as to avoid deception. It may not have the capacity or tendency to mislead or deceive. Whether an advertisement has the capacity or tendency to mislead or deceive must be determined by the superintendent from the overall impression that the advertisement may be reasonably expected to create upon a person of average education or intelligence within the segment of the public to which it is directed. [PL 2003, c. 636, §18 (NEW).]

3. Standards for disclosure. An advertisement must comply with standards for disclosure determined by rule by the superintendent. [PL 2003, c. 636, §18 (NEW).]

4. Applicability. This section applies to any advertisement of settlement contracts or related products or services intended for dissemination in this State, including advertising on the Internet viewed by persons located in this State. If disclosure requirements are established pursuant to federal regulation, this section must be interpreted so as to minimize or eliminate conflict with federal regulation whenever possible. [PL 2003, c. 636, §18 (NEW).]
24-A M.R.S. § 4252 — ME Code / Title 24-A / Chapter 56 / Section 4252
24-A §4252. Offer of coverage for breast reduction surgery and symptomatic varicose vein surgery
Status: in_force

All health maintenance organization individual and group health insurance policies, contracts and certificates must make available coverage for breast reduction surgery and symptomatic varicose vein surgery determined to be medically necessary health care as defined in section 4301‑A, subsection 10‑A . [PL 2005, c. 128, §4 (NEW); PL 2005, c. 128, §5 (AFF).]
24-A M.R.S. § 416 — ME Code / Title 24-A / Chapter 5 / Section 416
24-A §416. Petition for suspension or revocation of certificate of authority; mandatory grounds
Status: in_force

1. Notwithstanding Title 4, chapter 5 , and Title 5, section 10051 , the superintendent shall refuse to continue or shall suspend or revoke an insurer's certificate of authority: A. If such action is required by any provision of this Title; [PL 1983, c. 419, §1 (AMD).] B. If a foreign insurer and it no longer meets the requirements for a certificate of authority, on account of deficiency of capital or surplus or otherwise; [PL 1983, c. 419, §1 (AMD).] C. If a domestic insurer and it has failed to cure an impairment of capital or surplus within the time allowed therefor by the superintendent under this Title or is otherwise no longer qualified for the certificate of authority; [PL 1983, c. 419, §1 (AMD).] D. If the insurer's certificate of authority to transact insurance therein is suspended or revoked by its state of domicile, or state of entry into the United States, if an alien insurer; or [PL 1969, c. 132, §1 (NEW).] E. For failure of the insurer to pay taxes on its premiums as required by law. [PL 1969, c. 132, §1 (NEW).] [PL 1999, c. 547, Pt. B, §44 (AMD); PL 1999, c. 547, Pt. B, §80 (AFF).]

2. Except in case of insolvency or impairment of required capital or surplus, or suspension or revocation by another state as referred to in subsection 1, paragraph D , the superintendent shall give the insurer at least 20 days notice in advance of any such refusal, suspension or revocation under this section and of the particulars of the reasons therefor. If the insurer requests a hearing thereon within the 20 days, the request automatically stays the superintendent's proposed action until the superintendent's order is made on that hearing. Hearings held pursuant to this subsection must be held in conformity with Title 5, chapter 375, subchapter 4 . [RR 2021, c. 1, Pt. B, §180 (COR).]

3. If an action initiated by the superintendent to suspend or revoke an insurer's certificate of authority is based on subsection 1, paragraphs B or C , a sworn statement of financial condition of the insurer signed by an officer of the insurer which indicates that the insurer no longer meets the requirements for a certificate of authority shall be prima facie proof that the requirements for a certificate of authority are not met. [PL 1983, c. 419, §1 (NEW).]
24-A M.R.S. § 3057 — ME Code / Title 24-A / Chapter 41 / Section 3057
24-A §3057. Actions related to age of dwelling prohibited
Status: in_force

An insurance company authorized to transact business in this State may not cancel or refuse to issue or renew a property insurance policy subject to this subchapter solely on the basis of the age of the dwelling and without consideration of the current condition of the property. [PL 2003, c. 671, Pt. A, §10 (NEW).]
24-A M.R.S. § 1417 — ME Code / Title 24-A / Chapter 16 / Section 1417
24-A §1417. Suspension; revocation; cancellation; refusal of license
Status: in_force

1. Suspension, revocation, probation, denial. Notwithstanding Title 5, chapter 375, subchapter VI , the superintendent may, after notice and opportunity for hearing, deny, revoke, suspend, place on probation or limit the permissible activities under any license issued under this chapter, including business entity licenses, or any surplus lines broker license if the superintendent finds that, as to the applicant or licensee, any of the causes exist that are listed in section 1420‑K , and that for purposes of this section apply to adjusters and consultants as well as producers. A. [PL 2001, c. 259, §19 (RP).] B. [PL 2001, c. 259, §19 (RP).] C. [PL 2001, c. 259, §19 (RP).] D. [PL 2001, c. 259, §19 (RP).] E. [PL 2001, c. 259, §19 (RP).] F. [PL 2001, c. 259, §19 (RP).] G. [PL 2001, c. 259, §19 (RP).] H. [PL 2001, c. 259, §19 (RP).] [PL 2001, c. 259, §19 (AMD).]

1-A. Nonresident licensing, loss of home state authority. The superintendent may verify the home state license status of any nonresident licensee through the producer database maintained by the National Association of Insurance Commissioners, its affiliates or subsidiaries or any successor, or by contacting the licensee's home state regulator. If a nonresident licensee's license or authority in the licensee's home state is no longer active, whether as a result of suspension, revocation, termination, lapse, voluntary surrender or other action by the home state regulator, the superintendent may cancel the nonresident licensee's license or authority granted pursuant to section 1420‑G, section 1427‑A, subsection 1 or section 1477 30 days after the final action taken with respect to the home state license. [PL 2019, c. 382, §2 (NEW).]

2. Agency suspension. [PL 2001, c. 259, §20 (RP).]

3. Voluntary surrender. The superintendent may, after notice and opportunity for a hearing under this section, deem the license suspended or revoked of a previously licensed person who voluntarily surrendered an insurance license. [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).]

4. Exceptional circumstances. [PL 2001, c. 259, §21 (RP).]
24-A M.R.S. § 1134 — ME Code / Title 24-A / Chapter 13 / Section 1134
24-A §1134. Time limit for disposal of other ineligible property and securities
Status: in_force

Any personal property or securities lawfully acquired by an insurer which it could not otherwise have invested in or loaned its funds upon at the time of such acquisition, shall be disposed of within 3 years from date of acquisition unless within such period the security has attained to the standard of eligibility; except, that any security or personal property acquired under any agreement of bulk reinsurance, merger or consolidation, may be retained for a longer period if so provided in the plan for such reinsurance, merger, or consolidation as approved by the superintendent under chapter 47 . Upon application by the insurer and proof that forced sale of any such property or security would materially injure the interests of the insurer, the superintendent may extend the disposal period for an additional reasonable time. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 1260 — ME Code / Title 24-A / Chapter 15 / Section 1260
24-A §1260. Rights of insurer during solvency
Status: in_force

So long as the insurer remains solvent and is in compliance with this Title it may: [PL 1969, c. 132, §1 (NEW).]

1. Demand, receive, sue for and recover the income from the securities deposited; [PL 1969, c. 132, §1 (NEW).]

2. Exchange and substitute for the deposited securities, eligible securities of equivalent or greater fair market value; and [PL 1969, c. 132, §1 (NEW).]

3. At any reasonable time inspect any such deposit. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2807-A — ME Code / Title 24-A / Chapter 35 / Section 2807-A
24-A §2807-A. Credit union groups
Status: in_force

A group of individuals may be insured under a policy issued to a credit union or to a trustee or trustees or agent designated by 2 or more credit unions, which credit union, trustee, trustees or agent is considered the policyholder, to insure members of the credit union or credit unions for the benefit of persons other than the credit union or credit unions, trustee or trustees or agent or any of their officials, subject to the following requirements. [PL 1981, c. 147, §7 (NEW).]

1. The members eligible for insurance are all of the members of the credit union or credit unions or all of any class or classes thereof. [PL 1981, c. 147, §7 (NEW).]

2. The premium for the policy shall be paid either from funds of the credit union or from funds contributed by the insured members specifically for their insurance, or from both. Except as provided in subsection 3 , a policy on which no part of the premium is to be derived from funds contributed by the insured members specifically for their insurance must insure all eligible members, except those who reject the coverage in writing. [PL 1981, c. 147, §7 (NEW).]

3. Except as provided in section 2736‑C , section 2808‑B and chapter 36 , an insurer may exclude or limit the coverage on any member as to whom evidence of individual insurability is not satisfactory to the insurer. [PL 1999, c. 256, Pt. G, §5 (AMD).]
24-A M.R.S. § 4437 — ME Code / Title 24-A / Chapter 57 / Section 4437
24-A §4437. Board of directors
Status: in_force

The board of directors of the association must consist of not less than 7 persons serving terms as established in the plan of operation, and not less than 3 of the persons must represent members of the association that are domiciled in the State. The members of the board must be selected by member insurers subject to the approval of the superintendent. A member insurer serving on the board must resign if the member insurer ceases writing new insurance business in the State. Vacancies on the board must be filled for the remaining period of the term by a majority vote of the remaining board members, subject to the approval of the superintendent. [PL 2009, c. 116, §1 (AMD).]

In approving selections to the board, the superintendent shall consider among other things whether all member insurers are fairly represented. [PL 1969, c. 561 (NEW); PL 1973, c. 585, §12 (AMD).]

Members of the board may be reimbursed from the assets of the association for expenses incurred by them as members of the board of directors. [PL 1969, c. 561 (NEW).]
24-A M.R.S. § 2502 — ME Code / Title 24-A / Chapter 29 / Section 2502
24-A §2502. Industrial life insurance defined
Status: in_force

For the purposes of this Title "industrial life insurance" is that form of life insurance written under policies of face amount of $2,500 or less bearing the words "industrial policy," or "weekly premium policy" or words of similar import imprinted on the face thereof as part of the descriptive matter, and under which premiums are payable monthly or more often. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 5072 — ME Code / Title 24-A / Chapter 68-A / Section 5072
24-A §5072. Definitions
Status: in_force

As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 1999, c. 292, §2 (NEW).]

1. Applicant. "Applicant" means: A. In the case of an individual long-term care insurance policy, the person who seeks to contract for benefits; or [PL 1999, c. 292, §2 (NEW).] B. In the case of a group long-term care insurance policy, the proposed certificate holder. [PL 1999, c. 292, §2 (NEW).] [PL 1999, c. 292, §2 (NEW).]

2. Certificate. "Certificate" means any certificate issued under a group long-term care insurance policy. [PL 1999, c. 292, §2 (NEW).]

3. Group long-term care insurance policy. "Group long-term care insurance policy" means a long-term care insurance policy that is delivered or issued for delivery in this State to an employer group, private purchasing alliance, labor union group, association group, trustee group, credit union group or other group as described in chapter 35 . [PL 1999, c. 292, §2 (NEW).]

4. Long-term care insurance policy. "Long-term care insurance policy" means any individual or group insurance policy or rider offered by a life or health insurer, fraternal benefit society, nonprofit hospital and medical service organization, nonprofit health care service organization, prepaid health plan organization, health maintenance organization or other similar organization authorized to issue life or health insurance that is advertised, marketed, offered or designed to provide coverage for not less than 12 consecutive months for each covered person on an expense-incurred basis, indemnity basis, prepaid or other basis for one or more necessary or medically necessary diagnostic, preventive, therapeutic, rehabilitative, maintenance or personal care services provided in a setting other than an acute care unit of a hospital. "Long-term care insurance policy" includes individual and group annuities and life insurance policies or riders that directly provide or that supplement coverage for long-term care insurance and a policy or rider that provides for payment of benefits based upon cognitive impairment or the loss of functional capacity. "Long-term care insurance policy" does not include: A. An insurance policy or contract described as Medicare supplement insurance under chapter 67 ; [PL 1999, c. 292, §2 (NEW).] B. An insurance policy or contract offered primarily to provide basic hospital expense coverage, basic medical surgical expense coverage, hospital confinement indemnity coverage, major medical expense coverage, disability income or related asset-protection coverage, accident only coverage, specified disease or specified accident coverage or limited benefit health coverage; and [PL 1999, c. 292, §2 (NEW).] C. With regard to life insurance, an insurance policy or contract that accelerates the death benefit specifically for one or more of the qualifying events of terminal illness, medical conditions requiring extraordinary medical intervention or permanent institutional confinement and that provides the option of a lump sum payment for those benefits and does not condition the benefits or the eligibility for those benefits upon the receipt of long-term care. [PL 1999, c. 292, §2 (NEW).] [PL 1999, c. 292, §2 (NEW).]
24-A M.R.S. § 2189 — ME Code / Title 24-A / Chapter 23 / Section 2189
24-A §2189. Requirements related to enrollment in health plans
Status: in_force

1. Definition. As used in this section, unless the context otherwise indicates, "exchange" has the same meaning as in section 2188, subsection 1, paragraph A . [PL 2017, c. 60, §1 (NEW); PL 2017, c. 60, §2 (AFF).]

2. Requirements. An insurer that offers a health plan in this State through the exchange or outside of the exchange shall pay a commission to a licensed insurance producer appointed by or contracted with the insurer for the enrollment of an individual or employee in a health plan during any annual or special enrollment period. A commission paid to a licensed insurance producer appointed by or contracted with the insurer for enrollment in a health plan during any special enrollment period must be equal to the commission paid for enrollment during the insurer's annual enrollment period. [PL 2017, c. 60, §1 (NEW); PL 2017, c. 60, §2 (AFF).]

3. Commission on health plan enrollment initially completed during special enrollment period. An insurer may not eliminate, restrict or limit the payment of a commission to a licensed insurance producer appointed by or contracted with the insurer for the enrollment of an individual or employee in a health plan during any annual enrollment period on the basis that the producer was not paid a commission for the enrollment of the same individual or employee by the producer in a prior plan year during a special enrollment period. [PL 2017, c. 60, §1 (NEW); PL 2017, c. 60, §2 (AFF).]
24-A M.R.S. § 2384-C — ME Code / Title 24-A / Chapter 25 / Section 2384-C
24-A §2384-C. Data collection
Status: in_force

1. Collection and reporting system. The superintendent shall adopt rules implementing a data collection system for the purpose of evaluating the costs and operation of the workers' compensation benefit delivery process. The rules must establish reasonable sampling procedures to identify and track a sufficient number of claims to provide reliable information in a cost-effective manner. The superintendent shall, by rule, establish a cost-effective procedure to designate organizations to collect and compile data for insurers, except that an insurer able to demonstrate its ability to collect, compile and report data on its own claims is permitted to act as its own statistical organization for the purposes of this section. In this section, "statistical organization" includes an insurer acting as its own statistical organization. [PL 2011, c. 83, §2 (AMD).]

2. Data collected. The data collection and reporting system must contain, at a minimum, the following: A. Basic information on each surveyed claim, including: (1) The name and identification information of the employee, employer and insurer or self-insurer; and (2) The file identification number or numbers, insurance policy number and classification claim history; [PL 1993, c. 610, §2 (NEW).] B. Claim history information on each claim surveyed, including: (1) The date of injury or exposures to disease, type of injury or exposure disclosure and affected body part; (2) The preinjury wage history, date of initial payment and whether claim is controverted; and (3) Identification of claim status, whether open, closed or reopened; [PL 1993, c. 610, §2 (NEW).] C. Information concerning Workers' Compensation Board proceedings, including: (1) For each mediation and arbitration, the date, hearing officer, mediator or arbitrator for the proceeding and the resolution; and (2) For each hearing, the date, hearing officer and the decision of the hearing officer. If a disputed claim results in multiple hearing dates, the decision must be reported for the last hearing date; and [PL 1993, c. 610, §2 (NEW).] D. Payment information on each claim, identified as open or closed, including: (1) Aggregate payments to date to physicians, hospitals or other medical providers; (2) Payments made to date for weekly compensation, impairment benefits, death benefits and funeral expenses, employee legal expenses, employer legal expenses, lump sums and vocational rehabilitation services; (3) With respect to all claims, separately stated incurred liability for medical care, indemnity and vocational rehabilitation; and (4) Identification as to whether there are benefit offsets for social security, unemployment insurance, employer-provided pensions or any other sources. [PL 1993, c. 610, §2 (NEW).] [PL 1993, c. 610, §2 (NEW).]

3. Special data calls. The superintendent may, with prior notice, require the insurer and self-insurer statistical organizations to conduct special data calls or studies to collect information to evaluate the costs or operations of the workers' compensation system and to evaluate medical injury or disease outcomes of compensable claims. In any special data call imposed by the superintendent under this subsection, consideration must be given to the information collected and maintained by insurers and self-insurers. Requests for information not being collected on the effective date of this subsection must be prospective. [PL 1993, c. 610, §2 (NEW).]

4. Other data collection systems. The statistical organizations may rely on data collected and reported by other data-gathering organizations or agencies, such as the Workers' Compensation Board or the Department of Labor, and shall coordinate with any other statutorily created medical data collection systems. If a statistical organization is to incorporate data from other sources, it must satisfy itself that the data is sufficiently complete and accurate for the purpose for which it is to be used. The Workers' Compensation Board and the Department of Labor shall assist the statistical organizations in the development and maintenance of a comprehensive data base by recording and making available information within the custody and control of each, respectively, pursuant to the request of the statistical organization. The superintendent may suspend the reporting requirements of specific items for periods when information that is to be obtained from the Workers' Compensation Board is temporarily unavailable or information is found to be unreliable and the unreliability is not a result of the reporting practices of the carriers or self-insurers. The superintendent may accept an established data collection mechanism that is substantially in compliance with the data elements specified in this section and otherwise meets the requirements of this section. [PL 1993, c. 610, §2 (NEW).]

5. Noncompliance penalties. A statistical organization must include as part of its plan a means of monitoring member or subscriber compliance with the reporting requirements and must include a schedule of monetary penalties for failure to comply with reporting requirements. The statistical agent and companies are responsible for the accuracy of the data maintained and reported to the superintendent in the data base. [PL 1993, c. 610, §2 (NEW).]

6. Reports. The superintendent shall prescribe the frequency of and schedule for reports by the statistical organization. Reports must be required on at least an annual basis. [PL 1993, c. 610, §2 (NEW).]

7. Confidentiality. Any report of information relating to a particular claim is confidential and may not be revealed by the superintendent, except that the superintendent may make compilations including this information. Any information provided to the superintendent regarding self-insurance is confidential to the extent protected by Title 39‑A, section 403 . [PL 1993, c. 610, §2 (NEW).]

8. Accuracy. The statistical organization shall take all reasonable steps to ensure the accuracy of the information provided to it and reported by it. [PL 1993, c. 610, §2 (NEW).]

9. Retention of records. Each insurer or self-insurer shall retain its workers' compensation medical claim records for a period not less than 3 years from the date of injury or reported illness. Records may be retained through original source documents or electronic file storage. [PL 1993, c. 610, §2 (NEW).]

10. Application. This section applies to all claims occurring on or after January 1, 1993. [PL 1993, c. 610, §2 (NEW).]
24-A M.R.S. § 5013 — ME Code / Title 24-A / Chapter 67 / Section 5013
24-A §5013. Notice regarding policies that are not Medicare supplement policies
Status: in_force

Any individual accident and sickness insurance policy or group insurance certificate, including the contract of a nonprofit hospital and medical service or health care plan issued for delivery in this State to persons eligible for Medicare, must notify insureds that the policy or certificate is not a Medicare supplement policy or certificate. The notice must be either printed on or attached to the first page of the outline of coverage delivered to insureds or, if no outline of coverage is delivered, to the first page of the policy or certificate. The notice must be in no less than 12-point type and must contain the following language: "THIS (POLICY OR CERTIFICATE) IS NOT A MEDICARE SUPPLEMENT (POLICY OR CERTIFICATE). If you are eligible for Medicare, review the Medicare Supplement Buyer's Guide available from the company. If you have a Medicare supplement policy or major medical policy, this coverage may be more than you need. For information call the Bureau of Insurance at (toll-free phone number)." [PL 1995, c. 570, §8 (AMD).]

This section does not apply to a Medicare supplement policy; a policy issued pursuant to a contract under the Federal Social Security Act, 42 United States Code, Section 1395, et seq., Section 1876; a disability income policy; or a policy identified in section 5001‑A, subsection 2 . [PL 1995, c. 570, §8 (AMD).]
24 M.R.S. § 2342 — ME Code / Title 24 / Chapter 19 / Section 2342
24 §2342. Review entities
Status: in_force

1. Licensure. A person, partnership or corporation, other than an insurer or nonprofit service organization, health maintenance organization, preferred provider organization or an employee of those exempt organizations, that performs medical utilization review services on behalf of commercial insurers, nonprofit service organizations, 3rd-party administrators, health maintenance organizations, preferred provider organizations or employers, shall apply for licensure by the Bureau of Insurance and pay an application fee of not more than $400 and an annual license fee of not more than $100; except that programs of review of medical services for occupational claims compensated under Title 39-A are subject only to the certification requirements of that Title and are not subject to licensure under this section. A person, partnership or corporation, other than an insurer or nonprofit service organization, health maintenance organization, preferred provider organization or the employees of exempt organizations, may not perform utilization review services or medical utilization review services unless the person, partnership or corporation has received a license to perform those activities. [PL 1995, c. 332, Pt. M, §3 (AMD).]

2. Listing. The Bureau of Insurance shall compile and maintain a current listing of persons, partnerships or corporations licensed pursuant to this section. [PL 1989, c. 556, Pt. C, §1 (NEW).]

3. Information required. Each person, partnership or corporation licensed pursuant to this section shall, at the time of initial licensure and on or before April 1st of each succeeding year, provide the Bureau of Insurance with the following information: A. The process by which the entity carries out its utilization review services, including the categories of health care personnel that perform any activities coming under the definition of utilization review and whether or not these individuals are licensed in the State; [PL 1989, c. 556, Pt. C, §1 (NEW).] B. The process used by the entity for addressing beneficiary or provider complaints; [PL 1989, c. 556, Pt. C, §1 (NEW).] C. The types of utilization review programs offered by the entity, such as: (1) Second opinion programs; (2) Prehospital admission certification; (3) Preinpatient service eligibility determination; or (4) Concurrent hospital review to determine appropriate length of stay; and [PL 1989, c. 556, Pt. C, §1 (NEW).] D. The process chosen by the entity to preserve beneficiary confidentiality of medical information. [PL 1989, c. 556, Pt. C, §1 (NEW).] As part of its initial application, the entity shall submit copies of all materials to be used to inform beneficiaries and providers of the requirements of its utilization review plans and their rights and responsibilities under the plan. [PL 1991, c. 200, Pt. A, §1 (AMD).]

4. Transition for existing entities. Notwithstanding subsection 1 , persons, partnerships or corporations performing utilization review services on the effective date of this section shall have 90 days from its effective date to submit an application to the superintendent. The superintendent shall act upon those applications within 6 months of the date of receipt of the application, during which time the review entities may continue to perform medical utilization review services. [PL 1989, c. 556, Pt. C, §1 (NEW).]
24-A M.R.S. § 6301 — ME Code / Title 24-A / Chapter 75 / Section 6301
24-A §6301. Short title
Status: in_force

This chapter is known and may be cited as the "Rural Medical Access Program." [PL 1989, c. 931, §5 (NEW).]
24-A M.R.S. § 3160 — ME Code / Title 24-A / Chapter 44 / Section 3160
24-A §3160. Rules
Status: in_force

The superintendent may adopt rules to implement this chapter. Rules adopted pursuant to this section are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2021, c. 562, §1 (NEW).]
24-A M.R.S. § 955 — ME Code / Title 24-A / Chapter 11 / Section 955
24-A §955. Minimum reserves
Status: in_force

1. Minimum aggregate reserves for life insurance policies. An insurer's aggregate reserves for all life insurance policies, excluding disability and accidental death benefits, that are subject to section 953, subsection 2 may not be less than the aggregate reserves calculated in accordance with the method set forth in sections 954 and 957‑A and the mortality table or tables and rate or rates of interest used in calculating nonforfeiture benefits for these policies. [PL 1993, c. 634, Pt. B, §2 (NEW).]

2. Minimum aggregate reserves for all policies. The aggregate reserves for all policies, contracts and benefits may not be less than the aggregate reserves determined necessary by the appointed actuary in the opinion required by section 952‑A . [PL 2013, c. 238, Pt. C, §7 (AMD).]
24-A M.R.S. § 2847-N — ME Code / Title 24-A / Chapter 35 / Section 2847-N
24-A §2847-N. Coverage for colorectal cancer screening
Status: in_force

1. Colorectal cancer screening. For the purposes of this section, "colorectal cancer screening" means all colorectal cancer examinations and laboratory tests recommended by a health care provider in accordance with the most recently published colorectal cancer screening guidelines of a national cancer society. [PL 2019, c. 86, §4 (AMD); PL 2019, c. 86, §10 (AFF).]

2. Required coverage. All group health insurance policies, contracts and certificates must provide coverage for colorectal cancer screening for asymptomatic individuals who are: A. At average risk for colorectal cancer according to the most recently published colorectal cancer screening guidelines of a national cancer society; or [PL 2019, c. 86, §5 (AMD); PL 2019, c. 86, §10 (AFF).] B. At high risk for colorectal cancer. [PL 2019, c. 86, §6 (AMD); PL 2019, c. 86, §10 (AFF).] [PL 2019, c. 86, §§5, 6 (AMD); PL 2019, c. 86, §10 (AFF).]

3. Billing. If a colonoscopy is recommended by a health care provider as the colorectal cancer screening test in accordance with this section and a lesion is discovered and removed during that colonoscopy, the health care provider must bill the insurance company for a screening colonoscopy as the primary procedure. [PL 2007, c. 516, §3 (NEW); PL 2007, c. 516, §5 (AFF).]

Revisor's Note: §2847-N. Coverage for medically necessary infant formula (As enacted by PL 2007, c. 595, §3 is REALLOCATED TO TITLE 24-A, SECTION 2847-P)
24-A M.R.S. § 4207 — ME Code / Title 24-A / Chapter 56 / Section 4207
24-A §4207. Evidence of coverage and charges for health care services
Status: in_force

1. Every person who has enrolled as a legal resident of this State in a health maintenance organization is entitled to evidence of coverage. If the enrollee obtains coverage under a health maintenance organization through an insurance policy or contract whether by option or otherwise, the insurer, nonprofit hospital and medical service corporation shall issue the evidence of coverage. Otherwise, the health maintenance organization shall issue the evidence of coverage. [PL 1975, c. 503 (NEW).]

2. No evidence of coverage, or amendment thereto, or underlying contract may be issued or delivered to any person in this State until a copy of the form of the evidence of coverage, amendment thereto and any underlying contract, has been filed with and approved by the superintendent. A filing required under this section must be made electronically in a format required by the superintendent unless exempted by rule adopted by the superintendent. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2009, c. 14, §6 (AMD).]

3. An evidence of coverage shall contain: A. No provisions or statements which are unjust, unfair, inequitable, misleading, deceptive, which encourage misrepresentation, or which are untrue, misleading or deceptive as defined in section 4212 ; and [PL 1975, c. 503 (NEW).] B. A clear and complete statement, if a contract, or a reasonably complete summary, if a certificate, of: (1) The health care services and the insurance or other benefits, if any, to which the enrollee is entitled; (2) Any limitations on the services, kind of services, benefits, or kind of benefits, to be provided, including any deductible or copayment feature; (3) Where and in what manner information is available as to how services may be obtained; (4) The total amount of payment for health care services and the indemnity or service benefits, if any, which the enrollee is obligated to pay with respect to individual contracts or an indication whether the plan is contributory or noncontributory with respect to group certificates; and (5) A clear and understandable description of the health maintenance organization's method of resolving enrollee complaints. Any subsequent change shall be evidenced in a separate document issued to the enrollee prior to the change. [PL 1975, c. 503 (NEW).] [PL 1975, c. 503 (NEW).]

4. A copy of the form of the evidence of coverage to be used in this State, and any amendment thereto shall be subject to the filing and approval requirements of this section unless it is subject to the jurisdiction of the superintendent under the laws governing health insurance, or nonprofit hospital or medical service organization, in which event the filing and approval provisions of such laws shall apply. [PL 1975, c. 503 (NEW).]

5. A schedule or an amendment to a schedule of charge for enrollee health coverage for health care services may not be used by any health maintenance organization unless it complies with section 2736 , 2808‑B or 2839 , whichever is applicable. [PL 2003, c. 469, Pt. E, §19 (AMD).]

6. Such charges may be established in accordance with actuarial principles for various categories of enrollees, as long as charges applicable to an enrollee are not individually determined based on the status of the enrollee's health. However, the charges may not be excessive, inadequate or unfairly discriminatory. A certification, by a qualified actuary, to the appropriateness of the charges, based on reasonable assumptions, must accompany the filing along with adequate supporting information. [RR 2021, c. 1, Pt. B, §343 (COR).]

7. The superintendent shall, within a reasonable period, approve any form and any schedule of charges if the requirements of this section are met. It is unlawful to issue such form or to use such schedule of charges until approved. If the superintendent disapproves such filing, the superintendent shall notify the filer. In the notice, the superintendent shall specify the reasons for the superintendent's disapproval. A hearing will be granted within 10 days after a request in writing by the person filing. If the superintendent does not disapprove any form or schedule of charges within 30 days of the filing of such form or charges, they must be deemed approved. [RR 2021, c. 1, Pt. B, §344 (COR).]

8. The superintendent may require the submission of whatever relevant information the superintendent considers necessary in determining whether to approve or disapprove a filing made pursuant to this section. [RR 2021, c. 1, Pt. B, §345 (COR).]

9. A health maintenance organization may issue a Medicare supplement policy. Chapter 67 and any rules adopted pursuant to that chapter shall apply to health maintenance organizations issuing Medicare supplement policies, except when that application is inconsistent with that chapter. [PL 1989, c. 27, §2 (NEW).]
24-A M.R.S. § 1444-A — ME Code / Title 24-A / Chapter 16 / Section 1444-A
24-A §1444-A. Insurance vending machines
Status: in_force

1. Vending machines. A licensed insurance producer may solicit and issue personal travel accident insurance policies by means of a mechanical vending machine supervised by the insurance producer and placed at an airport or similar place of convenience to the traveling public if the superintendent finds: A. That the policy to be sold provides reasonable coverage and benefits, is reasonably suited for sale and issuance through a vending machine and that use of such a machine in a proposed location would be of convenience to the public; [PL 2001, c. 259, §39 (NEW).] B. That the type of vending machine proposed to be used is reasonably suitable for the purpose; [PL 2001, c. 259, §39 (NEW).] C. That reasonable means are provided for informing prospective purchasers of policy coverages and restrictions; and [PL 2001, c. 259, §39 (NEW).] D. That reasonable means are provided for refund of money inserted in a defective machine when no insurance or a lesser amount than that paid for is actually received. [PL 2001, c. 259, §39 (NEW).] [PL 2001, c. 259, §39 (NEW).]

2. Special license. For each machine to be used, the superintendent may issue to the insurance producer a special vending machine license. The license must specify the name and address of the insurer, health maintenance organization, fraternal benefit society or nonprofit hospital or medical service organization and the name and address of the insurance producer, the name of the policy to be sold, the serial number of the machine and the place where the machine is to be in operation. The license is subject to termination, suspension or revocation coincidentally with the license of the insurance producer. The superintendent shall also revoke the license for any machine for which the superintendent finds that the license qualifications no longer exist. The license fee for each respective vending machine is established in section 601 . Proof of the existence of a license must be displayed on or about each machine in use in the manner that the superintendent reasonably requires. [PL 2001, c. 259, §39 (NEW).]
24-A M.R.S. § 4401 — ME Code / Title 24-A / Chapter 57 / Section 4401
24-A §4401. Summary proceedings; superintendent's corrective orders authorized
Status: in_force

1. If the superintendent determines after a hearing that any insurer has committed or engaged in, or is committing or engaging in, or is about to commit or engage in any act, practice or transaction that would subject it to formal delinquency proceedings under sections 4351 to 4407 , the superintendent may make and serve upon the insurer and other persons involved such orders, other than seizure orders under sections 4404 and 4405 , as the superintendent considers reasonably necessary to correct, eliminate or remedy such conduct, condition or ground. Orders to cure impairment of capital or surplus of a domestic insurer are subject to sections 3423 and 3424 . [RR 2021, c. 2, Pt. A, §85 (COR).]

2. If the superintendent believes that irreparable harm to the insurer or its policyholders, creditors or the public may occur unless the superintendent's order is issued with immediate effect, the superintendent may make and serve the superintendent's order without notice and before hearing, and shall simultaneously therewith serve upon the insurer and other persons involved the notice of hearing as required under subsection 3 . [RR 2021, c. 1, Pt. B, §382 (COR).]

3. The superintendent's order and notice of hearing thereunder shall be served in such a manner as conforms with the notice provisions of the Maine Administrative Procedure Act, Title 5, chapter 375, subchapter IV . [PL 1977, c. 694, §438 (RPR).]
24 M.R.S. § 2326 — ME Code / Title 24 / Chapter 19 / Section 2326
24 §2326. Appeals from order or decision of the superintendent
Status: in_force

Any person whose interests are substantially and directly affected and aggrieved by an order or decision of the superintendent or any party to a hearing held pursuant to section 2322 may appeal therefrom as provided in Title 24-A, section 236 . [PL 1979, c. 558, §5 (NEW).]
24-A M.R.S. § 2727 — ME Code / Title 24-A / Chapter 33 / Section 2727
24-A §2727. Illegal occupation
Status: in_force

There may be a provision as follows: Illegal occupation: The insurer shall not be liable for any loss to which a contributing cause was the insured's commission of or attempt to commit a felony or to which a contributing cause was the insured's being engaged in an illegal occupation [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2823-A — ME Code / Title 24-A / Chapter 35 / Section 2823-A
24-A §2823-A. Explanation and notice to parent
Status: in_force

If the insured is covered as a dependent child, and if the insurer is so requested by a parent of the insured, the insurer shall provide that parent with: [PL 2009, c. 244, Pt. B, §2 (AMD).]

1. Payment or denial of claim. An explanation of the payment or denial of any claim filed on behalf of the insured, except to the extent that the insured has the right to withhold consent and does not affirmatively consent to notifying the parent; [PL 2009, c. 244, Pt. B, §2 (AMD).]

2. Change in terms and conditions. An explanation of any proposed change in the terms and conditions of the policy; or [PL 1989, c. 556, Pt. D, §3 (NEW).]

3. Notice of lapse. Reasonable notice that the policy may lapse, but only if the parent has provided the insurer with the address at which the parent may be notified. [PL 1989, c. 556, Pt. D, §3 (NEW).]

In addition, any parent who is able to provide the information necessary for the insurer to process a claim must be permitted to authorize the filing of any claims under the policy. [PL 2009, c. 244, Pt. B, §2 (AMD).]
24 M.R.S. § 2301-A — ME Code / Title 24 / Chapter 19 / Section 2301-A
24 §2301-A. Continuity of licensure; business combinations
Status: in_force

When a health maintenance organization authorized pursuant to Title 24‑A, chapter 56 merges or consolidates with a nonprofit hospital, medical or health care service organization and operations of the surviving entity include those of a health maintenance organization, the surviving entity succeeds on a continuing basis to the authority possessed by the merging entities if: [PL 1993, c. 702, Pt. A, §2 (NEW).]

1. Plan approved. The Superintendent has approved the plan of merger or consolidation pursuant to Title 24‑A, section 4203 ; [PL 1993, c. 702, Pt. A, §2 (NEW).]

2. Entity financially qualified. The entity is financially qualified pursuant to the provisions of Title 24‑A, sections 410 and 4204‑A ; and [PL 1993, c. 702, Pt. A, §2 (NEW).]

3. Entity otherwise qualified. The entity is otherwise qualified pursuant to this Title and Title 24‑A, chapter 56 . [PL 1993, c. 702, Pt. A, §2 (NEW).]
24-A M.R.S. § 2382-B — ME Code / Title 24-A / Chapter 25 / Section 2382-B
24-A §2382-B. Uniform administration of classifications; reporting of rating and other information; membership in advisory organization
Status: in_force

1. Uniform classification system; uniform experience rating plan. Every workers' compensation insurer, including self-insurers, shall adhere to a uniform classification system and uniform experience rating plan filed with the superintendent by an advisory organization designated by the superintendent and subject to the superintendent's disapproval. An insurer may develop subclassifications of the uniform classification system upon which a rate may be made; provided, however, that such subclassifications must be filed with the superintendent 30 days prior to their use. The superintendent shall disapprove a subclassification if: A. The insurer fails to demonstrate that the data produced can be reported consistently with the uniform statistical plan and classification system; or [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).] B. The proposed subclassification: (1) Is not reasonably related to the exposure to claim; (2) Is not adequately defined; (3) Has not been shown to distinguish among insureds based on the potential for or hazard of loss; or (4) Is or will be unfairly discriminatory. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).] [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

2. Designation of advisory organization. The superintendent shall designate an advisory organization to assist the superintendent in gathering, compiling and reporting relevant statistical information. Every workers' compensation insurer shall record and report its workers' compensation experience to the designated advisory organization as set forth in the uniform statistical plan approved by the superintendent. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

3. Filing of manual rules. The designated advisory organization shall develop and file manual rules, subject to the approval of the superintendent, reasonably related to the recording and reporting of data pursuant to the uniform statistical plan, uniform experience rating plan, and the uniform classification system. Every workers' compensation insurer shall adhere to the approved manual rules and experience rating plan in writing and reporting its business. An insurer may not agree with any other insurer or with an advisory organization to adhere to manual rules that are not reasonably related to the recording and reporting of data pursuant to the uniform classification system or the uniform statistical plan. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

4. Advisory organization membership. Each workers' compensation insurer shall be a member or subscriber of the workers' compensation advisory organization designated by the superintendent. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]
24-A M.R.S. § 4502 — ME Code / Title 24-A / Chapter 59 / Section 4502
24-A §4502. Tax sheltered annuities for school employees
Status: in_force

1. In order to extend to the employees of any school administrative unit, school or educational institution located in the State and to certified employees of the Department of Education the benefits of tax sheltered annuities available under the Internal Revenue Code, it is declared to be the policy of the Legislature that any such school administrative unit, school, institution or the Department of Education may contract with any insurer authorized to contract such business within the State to provide one or more individual or group annuities for the pensioning of any employees of such unit, school, institution or Department of Education and for such purposes may agree to pay part or all of the premiums or charges for carrying such contracts, raise money by taxation therefor where otherwise lawful and appropriate out of its treasury money necessary to pay such premiums or charges or portions thereof. [PL 1989, c. 700, Pt. A, §99 (AMD).]

2. It is the intent of the Legislature that employees of any school administrative unit, school, educational institution or Department of Education located in the State shall be extended the opportunity to share in the benefits of tax sheltered annuities and all laws and regulations of the State shall be construed liberally to enable such employees to come within the Internal Revenue Code, section 403(b) without loss to themselves, or to the school administrative unit, school, educational institution or Department of Education to which they belong, of any benefits, subsidies or opportunities therefor that they might otherwise be entitled to under the laws of the State of Maine. [PL 1989, c. 700, Pt. A, §99 (AMD).]
24-A M.R.S. § 3951 — ME Code / Title 24-A / Chapter 54-A / Section 3951
24-A §3951. Short title
Status: in_force

This chapter may be known and cited as "the Maine Guaranteed Access Reinsurance Association Act." [PL 2011, c. 90, Pt. B, §8 (NEW).]
24-A M.R.S. § 2442 — ME Code / Title 24-A / Chapter 27 / Section 2442
24-A §2442. Construction
Status: in_force

Nothing in this Act shall be construed to negate any law of this State permitting the issuance of any policy form after it has been on file for the time period specified. [PL 1979, c. 267, §2 (NEW).]
24-A M.R.S. § 3061 — ME Code / Title 24-A / Chapter 41 / Section 3061
24-A §3061. Uniform policy standards concerning hurricane deductible programs
Status: in_force

The superintendent shall adopt rules establishing procedures and standards for an insurer that uses a hurricane deductible program or programs regarding the applicability of hurricane deductibles. Procedures and standards must include without limitation uniform policy standards and the form of notice that the insurer must provide to the named insured under a policy subject to this subchapter issued by the insurer. Rules adopted pursuant to this section are routine technical rules as defined by Title 5, chapter 375, subchapter 2‑A . [PL 2013, c. 38, §1 (NEW).]
24-A M.R.S. § 1426 — ME Code / Title 24-A / Chapter 16 / Section 1426
24-A §1426. Issuance; refusal of license; refunds of fees
Status: in_force

1. Issuance. If the superintendent finds that the application is complete, the applicant has passed any required examination and that the applicant is otherwise qualified for the license applied for, the superintendent shall promptly issue the license; otherwise, the superintendent may not issue the license and shall promptly notify the applicant of such refusal stating the grounds for denial. [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).]

2. Fees. [PL 2001, c. 259, §30 (RP).]
24-A M.R.S. § 2007 — ME Code / Title 24-A / Chapter 19 / Section 2007
24-A §2007. Eligible surplus lines insurers
Status: in_force

1. A producer may not knowingly place surplus lines insurance with an insurer that is unsound financially or that is ineligible under this section. [PL 1997, c. 592, §54 (AMD).]

2. The superintendent shall from time to time publish a list of all surplus lines insurers determined by the superintendent to be eligible currently, and shall mail a copy of such list to each producer at the producer's office last of record with the superintendent. This subsection may not be construed to cast upon the superintendent the duty of determining the actual financial condition or claims practices of any nonadmitted insurer; and the status of eligibility, if granted by the superintendent, may indicate only that the insurer appears to be sound financially and to have satisfactory claims practices, and that the superintendent has no credible evidence to the contrary. While any such list is in effect, the producer shall restrict to the insurers so listed all surplus lines business placed by the producer. [PL 2025, c. 348, §17 (AMD).]

3. The superintendent shall approve a United States insurer's request for eligibility if the insurer: A. Is authorized to write such insurance in its domiciliary jurisdiction; and [PL 2025, c. 348, §18 (AMD).] B. [PL 2025, c. 348, §19 (RP).] C. Maintains capital and surplus, or its equivalent under the laws of its state of domicile, in an amount at least equal to the greater of: (1) The minimum capital and surplus that would be required if the insurer were licensed in this State; and (2) $15,000,000. [PL 2011, c. 331, §4 (NEW); PL 2011, c. 331, §§16, 17 (AFF).] [PL 2025, c. 348, §§18, 19 (AMD).]

4. The superintendent may list an insurer as eligible if it does not meet the minimum capital and surplus requirements of subsection 3 upon an affirmative finding of acceptability by the superintendent. The finding must be based upon such factors as quality of management, capital and surplus of any parent company, company underwriting profit and investment income trends, market availability and company record and reputation within the industry. The superintendent may not make an affirmative finding of acceptability if the nonadmitted insurer's capital and surplus is less than $4,500,000. [PL 2011, c. 331, §4 (NEW); PL 2011, c. 331, §§16, 17 (AFF).]

5. A non-United States insurer is considered eligible to write insurance on a nonadmitted basis in this State if it is listed on the quarterly listing of alien insurers maintained by the National Association of Insurance Commissioners. [PL 2025, c. 348, §20 (AMD).]
24-A M.R.S. § 2418 — ME Code / Title 24-A / Chapter 27 / Section 2418
24-A §2418. Validity and construction of noncomplying forms
Status: in_force

1. A policy hereafter delivered or issued for delivery to any person in this State in violation of this Title but otherwise binding on the insurer, shall be held valid, but shall be construed as provided in this Title. [PL 1969, c. 132, §1 (NEW).]

2. Any condition, omission or provision not in compliance with the requirements of this Title and contained in any policy, rider, or endorsement hereafter issued and otherwise valid, shall not thereby be rendered invalid but shall be construed and applied in accordance with such condition, omission or provision as would have applied had the same been in full compliance with this Title. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 3042 — ME Code / Title 24-A / Chapter 41 / Section 3042
24-A §3042. Loss information to be supplied
Status: reserved

1. Request for information. Every insurer shall provide loss information concerning an insurance policy to its insured within 30 calendar days of the receipt of a written request from the insured or an insurance agent or other authorized representative of the insured. An insurer may not cancel or refuse to renew an insurance policy for the nonpayment of premium during any period within which the insurer fails to provide the loss information requested under this section, unless the insured requests that information fewer than 45 calendar days prior to the expiration date of the insurance policy. [PL 1989, c. 696, §2 (NEW).]

2. Transmittal of request. If an insured requests loss information from an insurance agent or an authorized representative of the insured, the representative or agent shall transmit the request for loss information to the insurer within 4 working days. [PL 1989, c. 696, §2 (NEW).]

3. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Insurance policy" means the insurance policy relating to the loss information requested pursuant to this section. [PL 1989, c. 696, §2 (NEW).] B. "Loss information" means the following items: the name of the insured, the date of the loss, the date the claim was received by the insurer, a description of the loss, any amount paid by the insurer on account of the loss, any amount reserved for the loss and whether the claim is open or closed. [PL 1989, c. 696, §2 (NEW).] [PL 1989, c. 696, §2 (NEW).]
24-A M.R.S. § 4103 — ME Code / Title 24-A / Chapter 55 / Section 4103
24-A §4103. Representative form of government defined
Status: in_force

A society shall be deemed to have a representative form of government when: [PL 1969, c. 132, §1 (NEW).]

1. It provides in its constitution or laws for a supreme legislative or governing body, composed of representatives elected either by the members or by delegates elected directly or indirectly by the members, together with such other members of such body as may be prescribed by the society's constitution and laws; [PL 1969, c. 132, §1 (NEW).]

2. The representatives elected constitute a majority in number and have not less than 2/3 of the votes nor less than the votes required to amend its constitution and laws; [PL 1969, c. 132, §1 (NEW).]

3. The meetings of the supreme legislative or governing body and the election of officers, representatives or delegates are held as often as once in 4 calendar years; [PL 1969, c. 132, §1 (NEW).]

4. The society has a board of directors charged with the responsibility for managing its affairs in the interim between meetings of its supreme legislative or governing body, subject to control by such body and having powers and duties delegated to it in the constitution or laws of the society; [PL 1969, c. 132, §1 (NEW).]

5. Such board of directors is elected by the supreme legislative or governing body, except in case of filling a vacancy in the interim between meetings of such body; [PL 1969, c. 132, §1 (NEW).]

6. The officers are elected either by the supreme legislative governing body or by the board of directors; and [PL 1969, c. 132, §1 (NEW).]

7. The members, officers, representatives or delegates shall not vote by proxy. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 3031 — ME Code / Title 24-A / Chapter 41 / Section 3031
24-A §3031. Enforcement of lien
Status: in_force

If the mortgagor does not consent as provided for in section 3030 , the mortgagee of any real estate may, at any time within 60 days after a loss, and the mortgagee of any personal property may at any time within 30 days after a loss, enforce the mortgagee's lien by a civil action against the mortgagor, and the insurer as the mortgagor's trustee, in which judgment may be rendered for what is found due from the insurer upon the policy, notwithstanding the time of payment of the whole sum secured by the mortgage has not arrived, and which action must be commenced and service made on the trustee within such 60 or 30 days. [RR 2021, c. 1, Pt. B, §264 (COR).]
24-A M.R.S. § 2305 — ME Code / Title 24-A / Chapter 25 / Section 2305
24-A §2305. Exemption from filing
Status: in_force

Under such rules and regulations as may be adopted, the superintendent may, by written order, suspend or modify the requirement of filing as to any kind of insurance, subdivision or combination thereof, or as to classes of risks, the rates for which cannot practicably be filed before they are used. Such orders, rules and regulations shall be made known to insurers and advisory organizations affected thereby. The superintendent may make such examination as determined advisable to ascertain whether any rates affected by such order meet the standards set forth in section 2303, subsection 1, paragraph B . [PL 1989, c. 797, §9 (AMD); PL 1989, c. 797, §§37, 38 (AFF).]
24-A M.R.S. § 783 — ME Code / Title 24-A / Chapter 9 / Section 783
24-A §783. Limited purpose of special purpose reinsurance vehicle
Status: in_force

Special purpose reinsurance vehicles authorized under this subchapter are created for the limited purpose of entering into insurance securitization transactions with investors and related agreements to pay one or more ceding insurers agreed-upon amounts under a special purpose reinsurance vehicle contract upon the occurrence of triggering events related to the insurance business of the ceding insurer. A special purpose reinsurance vehicle may not issue a contract for assumption of risk or indemnification of loss other than a special purpose reinsurance vehicle contract. [PL 2003, c. 249, §2 (NEW).]
24-A M.R.S. § 4233-A — ME Code / Title 24-A / Chapter 56 / Section 4233-A
24-A §4233-A. Extension of coverage for dependent children
Status: in_force

An individual or group health maintenance organization contract that provides coverage for a dependent child at certain ages only if the child is a student must continue that coverage if the child is unable to remain enrolled in school on a full-time basis due to a mental or physical illness or an accidental injury. This coverage may be terminated at the age at which coverage for students terminates under the terms of the contract. A health maintenance organization may require, as a condition of eligibility for continued coverage in accordance with this section, that the student provide written documentation from a health care provider and the student's school that the student is no longer enrolled in school on a full-time basis due to a mental or physical illness or accidental injury. [PL 2007, c. 115, §3 (AMD); PL 2007, c. 115, §5 (AFF).]
24 M.R.S. § 2320 — ME Code / Title 24 / Chapter 19 / Section 2320
24 §2320. Home health care coverage
Status: in_force

Every nonprofit hospital and medical service organization which issues group and individual health care contracts providing coverage for inpatient hospital care to residents of this State shall make available coverage for home health services by a home health care provider which has contracted with the nonprofit hospital or medical service organization under terms and conditions which the organization deems satisfactory to its membership. [PL 1977, c. 696, §201 (AMD).]

The contract providing coverage for home health care services may contain reasonable limitation on the number of home care visits and other services provided, but the number of such visits shall not be less than 90 in any continuous period of 12 months for each person covered under the contract. Each visit by an individual member of a home health care provider shall be considered as one home care visit. [PL 1977, c. 470, §1 (NEW).]

1. Home health care services. "Home health care services" means those health care services rendered in a place of residence on a part-time basis to a covered person only if: A. Hospitalization or confinement in a skilled nursing facility as defined in Title XVIII of the Social Security Act, 42 U.S.C. § 1395, et seq., would otherwise have been required if home health care was not provided; and [PL 1977, c. 470, §1 (NEW).] B. The plan covering the home health services is established as prescribed in writing by a physician. [PL 1977, c. 470, §1 (NEW).] There may not be a requirement that hospitalization be an antecedent to coverage under the policy. [RR 2019, c. 2, Pt. B, §76 (COR).]

2. Home health care services included. Home health care services shall include: A. Visits by a registered nurse or licensed practical nurse to carry out treatments prescribed, or supportive nursing care and observation as indicated; [PL 1977, c. 470, §1 (NEW).] B. A physician's home or office visits or both; [PL 1977, c. 470, §1 (NEW).] C. Visits by a registered physical, speech, occupational, inhalation or dietary therapist for services or for evaluation of consultation with and instruction of nurses in carrying out such therapy prescribed by the attending physician, or both; [PL 1977, c. 470, §1 (NEW).] D. Any prescribed laboratory tests and x-ray examination using hospital or community facilities, drugs, dressings, oxygen or medical appliances and equipment as prescribed by a physician but only to the extent that such charges would have been covered under the contract if the covered person had remained in the hospital; and [PL 1977, c. 470, §1 (NEW).] E. Visits by persons who have completed a home health aide training course under the supervision of a registered nurse for the purpose of giving personal care to the patient and performing light household tasks as required by the plan of care, but not including services. [PL 1977, c. 470, §1 (NEW).] [PL 1977, c. 470, §1 (NEW).]

3. Home health care provider. "Home health care provider" means a home health care agency which is certified under Title XVIII of the Social Security Act of 1965, as amended, which: A. Is primarily engaged in and licensed or certified to provide skilled nursing and other therapeutic services; [PL 1977, c. 470, §1 (NEW).] B. Has standards, policies and rules established by a professional group, associated with the agency or organization, which professional group must include at least one physician and one registered nurse; [PL 1977, c. 470, §1 (NEW).] C. Is available to provide the care needed in the home 7 days a week and has telephone answering service available 24 hours per day; [PL 1977, c. 470, §1 (NEW).] D. Has the ability to and does provide, either directly or through contract, the services of a coordinator responsible for case discovery and planning and assuring that the covered person receives the services ordered by the physician; [PL 1977, c. 470, §1 (NEW).] E. Has under contract the services of a physician-advisor licensed by the State or a physician; [PL 1977, c. 470, §1 (NEW).] F. Conducts periodic case conferences for the purpose of individualized patient care planning and utilization review; and [PL 1977, c. 470, §1 (NEW).] G. Maintains a complete medical record on each patient. [PL 1977, c. 470, §1 (NEW).] [PL 1977, c. 470, §1 (NEW).]

4. Exclusions. A. No contract shall require home health care coverage to persons eligible for medicare; and [PL 1977, c. 470, §1 (NEW).] B. No payment shall be made for services provided by a person who resides in the covered person's residence or who is a member of the covered person's family. [PL 1977, c. 470, §1 (NEW).] [PL 1977, c. 470, §1 (NEW).]
24-A M.R.S. § 1419 — ME Code / Title 24-A / Chapter 16 / Section 1419
24-A §1419. Duty to notify of changes; payment of late fee
Status: in_force

Unless a different time is set by another provision of law, any change of address, telephone number, e-mail address, name or other material change in the conditions or qualifications set forth in the original application of a licensee must be reported to the superintendent no later than 30 days after the change. This requirement includes any conviction of a crime other than a traffic violation or any disciplinary action brought by an insurance regulatory official of any other jurisdiction against the licensee or against any officer, director, member or partner in a business entity. A licensee shall report to the superintendent any administrative action taken against the licensee in another jurisdiction or by another governmental agency in this State within 30 days of the final disposition of the matter. This report must include a copy of the order, consent to order or other relevant legal documents. Within 30 days of the initial pretrial hearing date, a licensee shall report to the superintendent any criminal prosecution of the licensee taken in any jurisdiction. The report must include a copy of the initial complaint filed, the order resulting from the hearing and any other relevant legal documents. If any notice required under this section is received after the prescribed time period, the licensee shall pay the late fee for filing as prescribed in section 601 . [PL 2015, c. 49, §2 (AMD).]
24-A M.R.S. § 2173 — ME Code / Title 24-A / Chapter 23 / Section 2173
24-A §2173. Interlocking ownership; management
Status: in_force

1. Any insurer may retain, invest in or acquire the whole or any part of the capital stock of any other insurer or insurers, or have a common management with any other insurer or insurers, unless such retention, investment, acquisition or common management is inconsistent with any other provision of this Title, or unless by reason thereof the business of such insurers with the public is conducted in a manner which substantially lessens competition generally in the insurance business or tends to create any monopoly therein. [PL 1969, c. 132, §1 (NEW).]

2. Any person otherwise qualified may be a director of 2 or more insurers which are competitors, unless the effect thereof is to lessen substantially competition between insurers generally or tends materially to create any monopoly. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 6712 — ME Code / Title 24-A / Chapter 83 / Section 6712
24-A §6712. Rating organizations
Status: in_force

A captive insurance company is not required to become a member of a rating organization. [PL 1997, c. 435, §1 (NEW).]
24-A M.R.S. § 6406 — ME Code / Title 24-A / Chapter 77 / Section 6406
24-A §6406. Penalties
Status: in_force

1. Civil action by superintendent. If the superintendent has good cause to believe that a controlled insurer or any policyholder of the controlled insurer has suffered any loss or damage resulting from a violation of this chapter, the superintendent may maintain a civil action or intervene in an action brought by or on behalf of the insurer or policyholder for recovery of compensatory damages or other appropriate relief for the benefit of the insurer or policyholder. A. [PL 2017, c. 169, Pt. E, §11 (RP).] B. [PL 2017, c. 169, Pt. E, §11 (RP).] [PL 2017, c. 169, Pt. E, §11 (RPR).]

2. Civil action by receiver. If an order for liquidation or rehabilitation of a controlled insurer is entered pursuant to chapter 57 and a receiver is appointed, and the receiver has good cause to believe that the controlling producer or any other person has not complied with this chapter or any rule or order made under this chapter and that the insurer suffered any loss or damage because of that noncompliance, the receiver may maintain a civil action for recovery of damages or other appropriate sanctions for the benefit of the insurer. [PL 2017, c. 169, Pt. E, §12 (AMD).]

3. Other action. Nothing contained in this section affects the right of the superintendent to impose any penalties or other remedies authorized under section 12‑A or other applicable law. [PL 2017, c. 169, Pt. E, §13 (AMD).]

4. Other parties. Nothing contained in this section in any manner alters or affects the rights of policyholders, claimants, creditors or other 3rd parties. [PL 1991, c. 828, §33 (NEW).]
24-A M.R.S. § 2486 — ME Code / Title 24-A / Chapter 28 / Section 2486
24-A §2486. Construction -- Article 15
Status: in_force

The provisions of this compact must be liberally construed to effectuate its purposes. [PL 2003, c. 680, §1 (NEW).]
24-A M.R.S. § 1420-B — ME Code / Title 24-A / Chapter 16 / Section 1420-B
24-A §1420-B. License required
Status: in_force

A person may not sell, solicit or negotiate insurance in this State for any class or classes of insurance unless the person is licensed for that line of authority in accordance with this subchapter. [PL 2001, c. 259, §24 (NEW).]
24-A M.R.S. § 1951 — ME Code / Title 24-A / Chapter 18-A / Section 1951
24-A §1951. Definitions
Status: in_force

As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 1995, c. 673, Pt. A, §3 (NEW).]

1. Carrier. "Carrier" means any insurance company, nonprofit hospital and medical service organization or health maintenance organization authorized to issue health plans in this State. For the purposes of this chapter, carriers that are affiliated companies or that are eligible to file consolidated tax returns are treated as one carrier and any restrictions or limitations imposed by this chapter apply as if all health plans delivered or issued for delivery in this State by affiliated carriers were issued by one carrier. For purposes of this chapter, health maintenance organizations are treated as separate organizations from affiliated insurance companies and nonprofit hospital and medical service organizations. [PL 1995, c. 673, Pt. A, §3 (NEW).]

2. Private purchasing alliance. "Private purchasing alliance" or "alliance" means a corporation established under former Title 13‑A , Title 13‑B or Title 13‑C to provide health insurance to its members through one or more participating carriers. [PL 2003, c. 428, Pt. H, §1 (AMD).]
24-A M.R.S. § 3105 — ME Code / Title 24-A / Chapter 43 / Section 3105
24-A §3105. Estoppel to deny corporate power
Status: in_force

An insurer must attach a power of attorney to every bond it executes through an attorney-in-fact in this State; except that bonds executed by an officer of this insurer are exempt from this requirement. The power of attorney must identify the name and address of its attorney-in-fact who is authorized to act for the insurer within this State together with the scope of authority of the attorney-in-fact. Any insurer which shall execute any bond as surety under section 3102 shall be estopped in any proceedings to enforce the liability which it shall have assumed to incur, to deny its corporate power or the authority of its attorney in fact within the scope of the power of attorney filed in accordance with this section, to execute such instrument or assume such liability or the authority of any licensed agent to countersign such instrument. [PL 1993, c. 637, §35 (AMD).]
24-A M.R.S. § 2920 — ME Code / Title 24-A / Chapter 39 / Section 2920
24-A §2920. Hearing before superintendent
Status: in_force

Any named insured who has received a statement of reason for cancellation, or of reason for an insurer's intent not to renew a policy, may, within 30 days of the receipt of a statement of reason, request a hearing before the Superintendent of Insurance. The purpose of this hearing shall be limited to establishing the existence of the proof or evidence given by the insurer in its reason for cancellation or intent not to renew. The burden of proof of the reason for cancellation or intent not to renew shall be upon the insurer. The superintendent shall have the authority to order that a policy continue in effect both pending and, if the superintendent finds in favor of the insured, subsequent to a hearing. If the superintendent finds in favor of the insurer at a hearing, the superintendent may order the policy to remain in force for 14 days to allow the insured to obtain other coverage. Acting in conformity with the Maine Administrative Procedure Act, Title 5, chapter 375, subchapter II , the superintendent may adopt rules for carrying out this section. [PL 1989, c. 172, §5 (AMD).]
24-A M.R.S. § 401 — ME Code / Title 24-A / Chapter 5 / Section 401
24-A §401. "Mutual" insurer defined
Status: in_force

A "mutual" insurer is an incorporated insurer without permanent capital stock, and the governing body of which is elected by its policyholders or those policyholders specified in its charter, or by any reasonable combination of its policyholders, guaranty fund stockholders, or guaranty fund certificate holders, or by other reasonable method. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2847-A — ME Code / Title 24-A / Chapter 35 / Section 2847-A
24-A §2847-A. Penalty for failure to notify of hospitalization
Status: in_force

An insurance policy may not include a provision permitting the insurer to impose a penalty for the failure of any person to notify the insurer of an insured person's hospitalization for emergency treatment. For purposes of this section, "emergency treatment" has the same meaning as defined in Title 22, section 1829 . [PL 1991, c. 695, §5 (NEW); PL 1991, c. 824, Pt. A, §51 (NEW).]

This section applies to policies and certificates executed, delivered, issued for delivery, continued or renewed in this State after the effective date of this section. For purposes of this section, all policies are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 1991, c. 695, §5 (NEW); PL 1991, c. 824, Pt. A, §51 (NEW).]
24-A M.R.S. § 2114 — ME Code / Title 24-A / Chapter 21 / Section 2114
24-A §2114. Penalty
Status: in_force

Any person who in this State represents an unauthorized insurer in the transaction of business in this State in violation of law, shall, in addition to any other applicable penalty, be liable for the full amount of any loss sustained on any insurance contract made by or through him, directly or indirectly, and for any premium taxes which may become due under any law of this State by reason of such contract. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 6703 — ME Code / Title 24-A / Chapter 83 / Section 6703
24-A §6703. Names of companies
Status: in_force

A captive insurance company may not adopt a name that is the same as, deceptively similar to or likely to be confused with or mistaken for any other existing business name registered in the State. [PL 1997, c. 435, §1 (NEW).]
24-A M.R.S. § 2770 — ME Code / Title 24-A / Chapter 33 / Section 2770
24-A §2770. Absolute discretion clauses
Status: in_force

An individual health insurance policy, contract or certificate, including, but not limited to, a disability income insurance policy, contract or certificate, may not contain a provision purporting to reserve sole or absolute discretion to the insurer to interpret the terms of the contract, to provide standards of interpretation or review, to determine eligibility for benefits, to determine the amount of benefits or to resolve factual disputes. An insurer may not enforce a provision in a policy, contract or certificate that was offered, executed, delivered or issued for delivery in this State and has been continued or renewed by an individual policy holder in this State that purports to reserve sole or absolute discretion to the insurer to interpret the terms of the contract, to provide standards of interpretation or review, to determine eligibility for benefits, to determine the amount of benefits or to resolve factual disputes. [PL 2019, c. 179, §1 (NEW).]
24-A M.R.S. § 2847-J — ME Code / Title 24-A / Chapter 35 / Section 2847-J
24-A §2847-J. Coverage for hospice care services
Status: in_force

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Hospice care services" means services provided on a 24-hours-a-day, 7-days-a-week basis to a person who is terminally ill and that person's family. "Hospice care services" includes, but is not limited to, physician services; nursing care; respite care; medical and social work services; counseling services; nutritional counseling; pain and symptom management; medical supplies and durable medical equipment; occupational, physical or speech therapies; volunteer services; home health care services; and bereavement services. [PL 2001, c. 358, Pt. LL, §3 (NEW); PL 2001, c. 358, Pt. LL, §5 (AFF).] B. "Person who is terminally ill" means a person that has a medical prognosis that the person's life expectancy is 12 months or less if the illness runs its normal course. [PL 2001, c. 358, Pt. LL, §3 (NEW); PL 2001, c. 358, Pt. LL, §5 (AFF).] [PL 2001, c. 358, Pt. LL, §3 (NEW); PL 2001, c. 358, Pt. LL, §5 (AFF).]

2. Coverage for hospice care services. All group insurance policies and contracts must provide coverage for hospice care services to a person who is terminally ill. Hospice care services must be provided according to a written care delivery plan developed by a hospice care provider and the recipient of hospice care services. Coverage for hospice care services must be provided whether the services are provided in a home setting or an inpatient setting. [PL 2001, c. 358, Pt. LL, §3 (NEW); PL 2001, c. 358, Pt. LL, §5 (AFF).]

3. Application. The requirements of this section apply to all group policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 2003, c. 517, Pt. B, §21 (NEW).]

Revisor's Note: §2847-J. Coverage for general anesthesia for dentistry (As enacted by PL 2001, c. 423, §3 and affected by §5 is REALLOCATED TO TITLE 24-A, SECTION 2847-K)
24-A M.R.S. § 2217 — ME Code / Title 24-A / Chapter 24 / Section 2217
24-A §2217. Individual remedies
Status: in_force

1. Appeal to superintendent. Any insurance consumer aggrieved by a regulated insurance entity's or insurance support organization's response or failure to respond to a request made pursuant to sections 2210 , 2211 and 2212 may appeal to the superintendent, who may convene an adjudicatory hearing to determine whether there has been a violation of this chapter and may order the regulated insurance entity or insurance support organization to take such measures as are necessary to comply with this chapter. [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]

2. Superior Court action. An insurance consumer who is injured by a disclosure of information relating to the consumer in violation of section 2215 may bring an action in the Superior Court against the regulated insurance entity or insurance support organization within 2 years after the disclosure is or should have been discovered. The consumer may recover damages, together with costs and disbursements, reasonable attorney's fees and interest on damages at the rate of 1 1/2% per month. [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]

3. No private right of action. Except as specifically provided in this section, this chapter provides no express or implied private right of action. [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]
24-A M.R.S. § 7752 — ME Code / Title 24-A / Chapter 103 / Section 7752
24-A §7752. Definitions
Status: in_force

As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 2025, c. 388, Pt. P, §5 (NEW).]

1. Health insurance issuer. "Health insurance issuer" has the same meaning as "carrier" as defined in section 4301‑A, subsection 3 . [PL 2025, c. 388, Pt. P, §5 (NEW).]

2. Manufacturer. "Manufacturer" has the same meaning as in Title 32, section 13702‑A, subsection 19 . [PL 2025, c. 388, Pt. P, §5 (NEW).]

3. Pharmacy. "Pharmacy" has the same meaning as in Title 32, section 13702‑A, subsection 24 . [PL 2025, c. 388, Pt. P, §5 (NEW).]

4. Pharmacy benefits manager. "Pharmacy benefits manager" has the same meaning as in section 4347, subsection 17. [PL 2025, c. 388, Pt. P, §5 (NEW).]

5. 340B contract pharmacy. "340B contract pharmacy" means a pharmacy that has a contract with a 340B entity to receive and dispense 340B drugs to the 340B entity's patients on behalf of the 340B entity. For the purposes of this chapter, a record of a current 340B contract pharmacy relationship between the 340B entity and the 340B contract pharmacy that is on the 340B United States Department of Health and Human Services, Health Resources and Services Administration, Office of Pharmacy Affairs 340B Information System website, or such publicly accessible successor website maintained by the United States Department of Health and Human Services, is prima facie evidence of such a contract. [PL 2025, c. 388, Pt. P, §5 (NEW).]

6. 340B drug. "340B drug" means a drug that is purchased or eligible for purchase under Section 340B of the federal Public Health Service Act, 42 United States Code, Section 256b(a)(3). [PL 2025, c. 388, Pt. P, §5 (NEW).]

7. 340B entity. "340B entity" means an entity participating or authorized to participate in the federal 340B drug discount program, as described in 42 United States Code, Section 256b, including its pharmacy, or any pharmacy contracted with the participating entity to dispense drugs purchased through the federal 340B drug discount program. [PL 2025, c. 388, Pt. P, §5 (NEW).]
24-A M.R.S. § 2938-A — ME Code / Title 24-A / Chapter 40 / Section 2938-A
24-A §2938-A. Availability
Status: in_force

The insurer shall file with the superintendent its underwriting rules pertaining to eligibility for the mass marketing plan. No insurer may use underwriting standards for individual risk selection in a mass marketing plan that are, on the whole, more restrictive than the standards used by that insurer for individual risk selection in the sale of the same kind of insurance in this State other than pursuant to mass marketing plans. If an insurer does not sell that kind of insurance in this State other than pursuant to mass marketing plans, its underwriting standards for individual risk selection in those plans, on the whole, may be no more restrictive than the standards used by its principal affiliate, if any, for individual risk selection in the sale of that kind of insurance in this State other than pursuant to mass marketing plans. With respect to motor vehicle insurance, all policies issued under the mass marketing plans must provide at least the financial responsibility limits of coverage stated in Title 29‑A, section 1605, subsection 1 . [PL 1995, c. 65, Pt. A, §72 (AMD); PL 1995, c. 65, Pt. A, §153 (AFF); PL 1995, c. 65, Pt. C, §15 (AFF).]

If an insurer rejects an applicant for coverage pursuant to a mass marketing plan, the insurer shall provide a notice of rejection to the applicant. Explanations such as "underwriting reasons," "loss record," "location of risk" and similar insurance terms are not by themselves acceptable explanations of an insurer's rejection. [PL 1989, c. 192, §4 (NEW).]

The insurance shall be offered without discrimination against any eligible member of the plan as to rates, forms or coverages. Nothing in this section shall preclude the establishment of different classes of risk. [PL 1989, c. 192, §4 (NEW).]

Insurers may not cancel, fail to renew or change the rating classification of insureds who have coverage in force under existing plans as of the effective date of this section for the sole reason that the insured fails to meet underwriting standards which are applicable to persons enrolling in the plans after the effective date of this section. [PL 1989, c. 192, §4 (NEW).]
24-A M.R.S. § 2839-B — ME Code / Title 24-A / Chapter 35 / Section 2839-B
24-A §2839-B. Large group rates
Status: in_force

1. Application. This section applies to group health insurance offered in the large group market as defined in section 2850‑B , except insurance covering only accidental injury, specified disease, hospital indemnity, dental, vision, disability income, long-term care, Medicare supplement or other limited benefit health insurance. [PL 2003, c. 469, Pt. E, §17 (NEW).]

2. Annual filing. Every carrier offering group health insurance specified in subsection 1 shall annually file with the superintendent on or before April 30th a certification signed by a member in good standing of the American Academy of Actuaries or a successor organization that the carrier's rating methods and practices are in accordance with generally accepted actuarial principles and with the applicable actuarial standards of practice as promulgated by an actuarial standards board. The filing also must state the number of policyholders, certificate holders and dependents, as of the close of the preceding calendar year, enrolled in large group health insurance plans offered by the carrier. A filing and supporting information are public records except as provided by Title 1, section 402, subsection 3 . [PL 2023, c. 59, §8 (AMD).]

3. Documentation. Every carrier shall maintain at its principal place of business a complete and detailed description of its rating practices, including information and documentation that demonstrates that its rating methods and practices are in accordance with generally accepted actuarial principles and with the applicable actuarial standards of practice as promulgated by an actuarial standards board. [PL 2003, c. 469, Pt. E, §17 (NEW).]
24-A M.R.S. § 2745-A — ME Code / Title 24-A / Chapter 33 / Section 2745-A
24-A §2745-A.  Coverage for screening mammograms and diagnostic and supplemental breast examinations
Status: in_force

1. Definition. [PL 2023, c. 338, §2 (RP); PL 2023, c. 338, §13 (AFF).]

1-A. Definitions. For the purposes of this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Cost-sharing requirements" means a deductible, coinsurance, copayment or out-of-pocket expense and any maximum limitation on the deductible, coinsurance, copayment or other out-of-pocket expense. [PL 2023, c. 338, §3 (NEW); PL 2023, c. 338, §13 (AFF).] B. "Diagnostic breast examination" means a medically necessary examination of the breast, including an examination using diagnostic mammography, magnetic resonance imaging or ultrasound, that is: (1) Used to evaluate an abnormality seen on or suspected from a screening mammogram; or (2) Used to evaluate an abnormality detected by another means of examination. [PL 2023, c. 338, §3 (NEW); PL 2023, c. 338, §13 (AFF).] C. "Screening mammogram" means a radiologic procedure that is provided to an asymptomatic individual for the purpose of early detection of breast cancer and that consists of 2 radiographic views per breast. A screening mammogram also includes an additional radiologic procedure recommended by a provider when the results of an initial radiologic procedure are not definitive. [PL 2023, c. 338, §3 (NEW); PL 2023, c. 338, §13 (AFF).] D. "Supplemental breast examination" means a medical examination of the breast, including an examination using diagnostic mammography, magnetic resonance imaging or ultrasound, to screen for breast cancer when there is no abnormality seen or suspected, but, based on personal or family medical history or other additional factors, the individual has an increased risk of breast cancer. [PL 2023, c. 338, §3 (NEW); PL 2023, c. 338, §13 (AFF).] [PL 2023, c. 338, §3 (NEW); PL 2023, c. 338, §13 (AFF).]

2. Required coverage. All individual insurance policies that cover radiologic procedures, except those designed to cover only specific diseases, accidental injury or dental procedures, must provide coverage for screening mammograms performed by providers that meet the standards established by the Department of Health and Human Services rules relating to radiation protection. The policies must reimburse for screening mammograms performed at least once a year for women 40 years of age and over. A. [PL 1997, c. 408, §3 (RP); PL 1997, c. 408, §8 (AFF).] B. [PL 1997, c. 408, §3 (RP); PL 1997, c. 408, §8 (AFF).] [PL 1997, c. 408, §3 (RPR); PL 1997, c. 408, §8 (AFF); PL 2003, c. 689, Pt. B, §6 (REV).]

2-A. No cost-sharing requirements. An individual insurance policy may not impose any cost-sharing requirements on a screening mammogram, diagnostic breast examination or supplemental breast examination performed by a provider in accordance with this section. This subsection does not apply to an individual policy 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. 338, §4 (NEW); PL 2023, c. 338, §13 (AFF).]

3. Application. This section applies to all policies, contracts and certificates that cover radiologic procedures, except those policies that cover only dental procedures, accidental injury or specific diseases, executed, delivered, issued for delivery, continued or renewed in this State on or after March 1, 1991. For purposes of this section, all policies and contracts are deemed to be renewed no later than the next yearly anniversary of the policy or contract date. [PL 1991, c. 156, §1 (AMD).]

4. Reports. Each insurer that issues policies subject to this section shall report to the superintendent its experience for each calendar year beginning with 1991 not later than April 30th of the following calendar year. The report must include the information required and be presented in the form prescribed by the superintendent. The report must include the amount of claims paid in this State for services required by this section. The superintendent shall compile this data in an annual report and submit the report to the joint standing committee of the Legislature having jurisdiction over banking and insurance matters. [PL 1991, c. 701, §6 (AMD).]
24-A M.R.S. § 4365 — ME Code / Title 24-A / Chapter 57 / Section 4365
24-A §4365. Conduct of delinquency proceedings against foreign insurers
Status: in_force

1. Whenever under this chapter an ancillary receiver is to be appointed in delinquency proceedings for an insurer not domiciled in this State, the court shall appoint the superintendent as ancillary receiver. The superintendent shall file a petition requesting the appointment on the grounds set forth in section 4358 or 4359 : A. If the superintendent finds that there are sufficient assets of the insurer located in this State to justify the appointment of an ancillary receiver; or [RR 2021, c. 1, Pt. B, §360 (COR).] B. If 10 or more persons resident in this State having claims against such insurer file a petition with the superintendent requesting the appointment of such ancillary receiver. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).] [RR 2021, c. 2, Pt. A, §83 (COR).]

2. The domiciliary receiver for the purpose of liquidating an insurer domiciled in a reciprocal state is vested by operation of law with the title to all of the property, contracts and rights of action, and all of the books and records of the insurer located in this State and the domiciliary receiver has the immediate right to recover balances due from local agents and to obtain possession of any books and records of the insurer found in this State. The domiciliary receiver is also entitled to recover the other assets of the insurer located in this State, except that upon the appointment of an ancillary receiver in this State, the ancillary receiver during the ancillary receivership proceedings has the sole right to recover such other assets. The ancillary receiver shall, as soon as practicable, liquidate from their respective securities those special deposit claims and secured claims that are proved and allowed in the ancillary proceedings in this State, and shall pay the necessary expenses of the proceedings. All remaining assets the ancillary receiver shall promptly transfer to the domiciliary receiver. Subject to the foregoing provisions, the ancillary receiver and the ancillary receiver's deputies have the same powers and are subject to the same duties with respect to the administration of such assets as a receiver of an insurer domiciled in this State. [RR 2021, c. 1, Pt. B, §361 (COR).]

3. The domiciliary receiver of an insurer domiciled in a reciprocal state may sue in this State to recover any assets of such insurer to which the domiciliary receiver may be entitled under the laws of this State. [RR 2021, c. 1, Pt. B, §362 (COR).]
24-A M.R.S. § 3412 — ME Code / Title 24-A / Chapter 47 / Section 3412
24-A §3412. Officers; notice of change
Status: in_force

1. An insurer's board of directors shall elect one of their number as president, and shall elect a corporate secretary and such other officers as may be provided for in the bylaws or otherwise required by law. Any such officer shall serve for such term as may be fixed in the bylaws or by the board of directors, but shall be subject to removal as an officer by the board of directors at any time. [PL 1969, c. 132, §1 (NEW).]

2. Each officer shall have such powers and duties as may be prescribed by or pursuant to the insurer's charter or bylaws. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 1253 — ME Code / Title 24-A / Chapter 15 / Section 1253
24-A §1253. Securities eligible for deposit
Status: in_force

1. All such deposits required under section 412 for authority to transact insurance in this State and hereafter made shall consist of securities in negotiable form of kinds eligible for investment of funds of domestic insurers under chapter 13 , other than real estate mortgages, and approved by the superintendent for deposit. Deposits heretofore made shall consist of such assets as were then eligible for deposit. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

2. All other deposits of a domestic insurer held in this State pursuant to the laws of another state, province or country shall be comprised of securities of the kinds described in subsection 1 , and of such additional kind or kinds of securities required or permitted by the laws of such state, province or country. [PL 1969, c. 132, §1 (NEW).]

3. Deposits of foreign insurers made in this State under the retaliatory provision, section 428 , shall consist of such assets as are required by the superintendent pursuant to such provision. [PL 1969, c. 177, §26 (AMD); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 2924 — ME Code / Title 24-A / Chapter 39 / Section 2924
24-A §2924. Assigned risk insurance plan
Status: in_force

If no payment for renewal of a policy has been received by the insurer 15 days prior to the expiration date of the policy, the insurer shall notify the insured in accordance with this section. Written notice shall be mailed or delivered to the named insured no less than 10 days prior to the expiration date. The notice shall state that the policy will terminate on the expiration date if the insurer does not receive payment by that date. A post-office department certificate of mailing is proof of mailing. [PL 1989, c. 354 (NEW).]
24-A M.R.S. § 7112 — ME Code / Title 24-A / Chapter 91 / Section 7112
24-A §7112. Transition
Status: in_force

The exemptions in section 7101, subsection 3 are effective immediately upon the effective date of this chapter and extend to contracts that are already in force. All other service contracts entered into, renewed or offered for sale in this State on or after January 1, 2012 must comply with this chapter. The exemptions in section 7101, subsection 4 apply to all service contracts entered into, renewed or offered for sale on or after the provider's registration date. [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).]
24-A M.R.S. § 407 — ME Code / Title 24-A / Chapter 5 / Section 407
24-A §407. Same; ownership, management
Status: in_force

1. No foreign insurer which is directly or indirectly owned or controlled in whole or substantial part by any government or governmental agency, other than of the Government of the United States of America, shall be authorized to transact insurance in Maine. Membership in a mutual insurer, or subscribership in a reciprocal insurer, or ownership of stock of an insurer by the alien property custodian or similar official of the United States, or ownership of stock or other security which does not have voting rights with respect to the management of the insurer, or supervision of an insurer by public authority, shall not be deemed to be an ownership or control of the insurer for the purposes of this provision. [PL 1969, c. 132, §1 (NEW).]

2. The superintendent may not grant or continue authority to transact insurance in this State as to any insurer or proposed insurer, any director, officer or other individual materially part of the management of which is found by the superintendent after investigation or upon reliable information to be incompetent, or dishonest, or untrustworthy, or of unfavorable business repute, or the managers of which are so lacking in insurance company managerial experience in operations of the kind proposed in this State as to make such operation, currently or prospectively, hazardous to, or contrary to the best interests of, the insurance-buying or investing public of this State; or which the superintendent has good reason to believe is affiliated directly or indirectly through ownership, control, management, reinsurance transactions or other business relations, with any person or persons of unfavorable business repute, or whose business operations in this State or elsewhere are or have been marked, to the injury of insurers, stockholders, policyholders, creditors or the public, by illegality, or by manipulation of assets, or of accounts, or of reinsurance or by bad faith. [RR 2021, c. 1, Pt. B, §177 (COR).]
24-A M.R.S. § 2710 — ME Code / Title 24-A / Chapter 33 / Section 2710
24-A §2710. Claim forms
Status: in_force

There shall be a provision as follows: Claim forms: The insurer, upon receipt of a notice of claim, will furnish to the claimant such forms as are usually furnished by it for filing proofs of loss. If such forms are not furnished within 15 days after the giving of such notice the claimant shall be deemed to have complied with the requirements of this policy as to proof of loss upon submitting, within the time fixed in the policy for filing proofs of loss, written proof covering the occurrence, the character and the extent of the loss for which claim is made. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2676 — ME Code / Title 24-A / Chapter 32 / Section 2676
24-A §2676. Risk transfer
Status: in_force

Preferred provider arrangements may include capitated payments that are limited to the health services provided by the provider. [PL 1999, c. 609, §12 (AMD).]

Preferred provider arrangements may embody risk transfer between carriers and providers in accordance with the provisions of chapter 56‑A, subchapter III . Any other acceptance of insurance risk by a person that does not hold a valid certificate of authority or license and is not exempt by law from licensure constitutes the unauthorized transaction of insurance within the meaning of section 404 and chapter 21 . [PL 1999, c. 609, §12 (NEW).]
24-A M.R.S. § 2919 — ME Code / Title 24-A / Chapter 39 / Section 2919
24-A §2919. Renewal not a waiver or estoppel
Status: in_force

Renewal of a policy shall not constitute a waiver or estoppel with respect to grounds for cancellation which existed before the effective date of renewal. [PL 1973, c. 339, §1 (NEW).]
24-A M.R.S. § 6906 — ME Code / Title 24-A / Chapter 87 / Section 6906
24-A §6906. Prohibited interests of board members and employees
Status: in_force

Board members and employees of Dirigo Health and their spouses and dependent children may not receive any direct personal benefit from the activities of Dirigo Health in assisting any private entity, except that they may participate in the Dirigo Health Program on the same terms as others may under this chapter. This section does not prohibit corporations or other entities with which board members are associated by reason of ownership or employment from participating in activities of Dirigo Health or receiving services offered by Dirigo Health as long as the ownership or employment is made known to the board and, if applicable, the board members abstain from voting on matters relating to that participation. [PL 2005, c. 400, Pt. C, §4 (AMD).]
24-A M.R.S. § 2187 — ME Code / Title 24-A / Chapter 23 / Section 2187
24-A §2187. Insurance fraud reporting immunity
Status: in_force

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Action" includes nonaction or the failure to take action. [PL 1997, c. 675, §2 (NEW).] B. "Authorized agency" or "authorized agencies" means: (1) The Attorney General; (2) A district attorney responsible for prosecution in the municipality where the fraud occurred; (3) The Federal Bureau of Investigation, or any other federal agency, only for the purposes of subsection 2 ; (4) The State Fire Marshal; (5) The Superintendent of Insurance; (6) The Superintendent of Financial Institutions; (7) The United States Attorney's office when authorized or charged with investigation or prosecution of the insurance fraud in question, only for the purposes of subsection 2 ; (8) The State Police, state law enforcement officials or local law enforcement officials; or (9) The National Association of Insurance Commissioners. [PL 2005, c. 433, §1 (AMD); PL 2005, c. 433, §28 (AFF).] C. "Fraudulent insurance act" has the same meaning as in section 2186, subsection 1, paragraph A . [PL 1997, c. 675, §2 (NEW).] D. "Insurer" has the same meaning as in section 2186, subsection 1, paragraph B . [PL 1997, c. 675, §2 (NEW).] [PL 2005, c. 433, §1 (AMD); PL 2005, c. 433, §28 (AFF).]

2. Information disclosed. An authorized agency investigating insurance fraud may, in writing, require the insurance company at interest to release to the requesting agency any relevant information or evidence determined to be important to the authorized agency that the company may have in its possession relating to the insurance fraud in question. This information includes, but is not limited to: A. A history of previous claims made by the insured; [PL 1997, c. 675, §2 (NEW).] B. Insurance policy information relevant to fraud under investigation and any application for that policy; [PL 1997, c. 675, §2 (NEW).] C. Material relating to the investigation of the loss including statements and proof of loss; and [PL 1997, c. 675, §2 (NEW).] D. Policy premium payment records. [PL 1997, c. 675, §2 (NEW).] [PL 1997, c. 675, §2 (NEW).]

3. Exchange of information. An authorized agency or insurer provided with information pursuant to this section may release or provide that information to any other authorized agency or insurer with an interest in the insurance fraud under investigation. [PL 1997, c. 675, §2 (NEW).]

4. Right to receive upon request. Any insurer providing information to an authorized agency pursuant to this section has the right, upon request, to receive other information relevant to the fraud from that authorized agency within 30 days. [PL 1997, c. 675, §2 (NEW).]

5. Immunity. In the absence of fraud, malice or bad faith, any person, including, but not limited to, an insurer or authorized agency, that furnished information relating to suspected, anticipated or completed fraudulent insurance acts is not liable for any damages in any civil action for furnishing the information if that information is furnished to or received from an authorized agency. Nothing in this subsection is intended to abrogate or modify in any way any common law or statutory privilege or immunity previously enjoyed by any person. [PL 1997, c. 675, §2 (NEW).]

6. Confidentiality. An authorized agency or insurer that receives any information pursuant to this section shall hold it in confidence and may not release the information, except to another authorized agency, until its release is required for a criminal or civil proceeding. [PL 1997, c. 675, §2 (NEW).]
24-A M.R.S. § 7601 — ME Code / Title 24-A / Chapter 99 / Section 7601
24-A §7601. Definitions
Status: in_force

As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 2021, c. 676, Pt. A, §42 (NEW).]

1. Customer. "Customer" means a person who rents or leases a storage space within a self-storage facility under a rental agreement with a self-storage provider. "Customer" includes the sublessee, assignee or successor in interest of the person originally a party to a rental agreement with a self-storage provider. [PL 2021, c. 676, Pt. A, §42 (NEW).]

2. Covered customer. "Covered customer" means a customer who elects to receive coverage under a self-storage insurance policy. [PL 2021, c. 676, Pt. A, §42 (NEW).]

3. Limited lines license. "Limited lines license" means a license to sell or offer a policy for self-storage insurance. [PL 2021, c. 676, Pt. A, §42 (NEW).]

4. Location. "Location" means any physical location of a self-storage facility in the State or any publicly accessible website, call center or similar operation directed to residents of the State. [PL 2021, c. 676, Pt. A, §42 (NEW).]

5. Rental agreement. "Rental agreement" means a written agreement between a customer and self-storage provider that establishes or modifies the terms, conditions or other provisions governing a customer's occupancy and use of a storage space within a self-storage facility owned or operated by the self-storage provider. [PL 2021, c. 676, Pt. A, §42 (NEW).]

6. Self-storage facility. "Self-storage facility" means any real property or facility in which individual storage spaces rented or leased by a self-storage provider to a customer are located and within which a customer is generally responsible for placing and removing property the customer stores within a rented or leased storage space. [PL 2021, c. 676, Pt. A, §42 (NEW).]

7. Self-storage insurance. "Self-storage insurance" means personal property insurance authorized under section 705 providing coverage for the repair or replacement of personal property of a covered customer stored at a self-storage facility or in transit to or from a self-storage facility against various causes of loss, including loss or damage. "Self-storage insurance" does not include a homeowner's or renter's insurance, private passenger automobile insurance, commercial multiple peril insurance or any similar policy. [PL 2021, c. 676, Pt. A, §42 (NEW).]

8. Self-storage provider. "Self-storage provider" means a person or business entity, as defined in section 1151‑A, subsection 4 , that is the owner, operator, lessor or sublessor of a self-storage facility. [PL 2021, c. 676, Pt. A, §42 (NEW).]

9. Supervising entity. "Supervising entity" means a business entity that is a licensed insurance producer or insurer. [PL 2021, c. 676, Pt. A, §42 (NEW).]
24-A M.R.S. § 2833-C — ME Code / Title 24-A / Chapter 35 / Section 2833-C
24-A §2833-C. Mandatory offer of coverage for certain adults with disabilities
Status: in_force

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Dependent child" has the same meaning as in section 2833‑B, subsection 1 . [PL 2021, c. 520, §4 (NEW).] B. "Disability" means a physical, mental, intellectual or developmental disability that renders a person incapable of self-sustaining employment. [PL 2021, c. 520, §4 (NEW).] [PL 2021, c. 520, §4 (NEW).]

2. Offer of coverage. A group health insurance policy that offers coverage for a dependent child must offer such coverage, at the option of the parent, for a dependent child with a disability, regardless of age. [PL 2021, c. 520, §4 (NEW).]

3. Proof of disability. A parent shall furnish proof of a dependent child's disability to the insurer within 31 days of the dependent child's attainment of the limiting age established in section 2833‑B, subsection 2 and subsequently as may be required by the insurer, but the insurer may not require proof more frequently than annually after the 2-year period following the dependent child's attainment of the limiting age. [PL 2021, c. 520, §4 (NEW).]
24 M.R.S. § 2309 — ME Code / Title 24 / Chapter 19 / Section 2309
24 §2309. Disputes
Status: in_force

Any dispute arising between a corporation subject to this chapter and any provider of health care with which such corporation has a contract for health care may be submitted to the superintendent for the superintendent's decision with respect thereto. Any decision and findings of the superintendent made under this chapter are not a bar to constituted legal procedure for the review of such proceedings in a court of competent jurisdiction. [RR 2019, c. 2, Pt. B, §74 (COR).]