24-A M.R.S. § 1109 — ME Code / Title 24-A / Chapter 13 / Section 1109
24-A §1109. Investment grade obligations
Status: in_force

An insurer may invest in obligations, other than those eligible for investment under section 1124 (mortgage loans), issued, assumed or guaranteed by any solvent institution created or existing under the laws of the United States or of Canada, or of any state, province, district or territory thereof, provided that the obligations are not in default as to principal or interest, are investment grade obligations as defined in section 1110, subsection 1‑A, paragraph I , and are qualified under any of the following. [PL 1999, c. 715, §2 (AMD).]

1. Obligations secured by adequate collateral security and bearing fixed interest and if during each of any 3, including either of the last 2, fiscal years of a period of not less than 3 nor more than 5 fiscal years next preceding the date of acquisition by the insurer, the net earnings of the issuing, assuming or guaranteeing institution available for its fixed charges, as defined in section 1110 , shall have been not less than 1 1/4 times the total of its fixed charges for such year, or obligations which, at the date of acquisition by the insurer, are adequately secured and have investment qualities and characteristics wherein the speculative elements are not predominant. In determining the adequacy of collateral security, not more than 1/3 of the total value of such required collateral shall consist of stock other than stock meeting the requirements of section 1112 (preferred or guaranteed stock). [PL 1969, c. 132, §1 (NEW).]

2. Obligations secured by one or more leases, whether or not additionally secured by one or more mortgages, provided the following conditions are met: A. The leases are assigned to the insurer or to a trustee acting on behalf of the insurer and are noncancellable by either party, except under provisions specified in the leases and designed to give adequate protection to the insurer's investment. [PL 1979, c. 458, §2 (AMD).] B. The aggregate rentals due under all such leases are sufficient to provide (1) For all expenses (including taxes other than the borrower's income tax) of operation of the leased property during the initial term of such leases and (2) For amortization during the initial term of such leases of not less than 90% of the investment (or 100% thereof if the investment is not also secured by a mortgage) with interest thereon. [PL 1969, c. 132, §1 (NEW).] C. The leases make suitable provisions for continuation of adequate payments throughout the life of the investment. [PL 1969, c. 132, §1 (NEW).] D. The lessees under such leases, or any corporation or instrumentality of government which has assumed or guaranteed the lessees' performance thereunder is such that its obligations would be eligible for investment by an insurer in accordance with section 1107 or the aggregate net earnings of such lessees available for fixed charges, as defined in section 1110 , is at least equal to that required by subsection 1 . [RR 2009, c. 2, §66 (COR).] [RR 2009, c. 2, §66 (COR).]

3. Fixed interest bearing obligations, other than those described in subsection 1 , if the net earnings of the issuing, assuming or guaranteeing institution available for its fixed charges for a period of 5 fiscal years next preceding the date of acquisition by the insurer have averaged per year not less than 1 1/2 times its annual fixed charges applicable to such period and if during either of the last 2 years of such period such net earnings have been not less than 1 1/2 times its fixed charges for such year. [PL 1969, c. 132, §1 (NEW).]

4. Adjustment, income or other contingent interest obligations if the net earnings of the issuing, assuming or guaranteeing institution available for its fixed charges for a period of 5 fiscal years next preceding the date of acquisition by the insurer have averaged per year not less than 1 1/2 times the sum of its average annual fixed charges and its average annual maximum contingent interest applicable to such period and if during either of the last 2 years of such period such net earnings have been not less than 1 1/2 times the sum of its fixed charges and maximum contingent interest for such year. [PL 1969, c. 132, §1 (NEW).]

5. Fixed interest bearing obligations, other than those described in subsections 1 and 3 , if: A. Net earnings of the issuing, assuming or guaranteeing institution available for its fixed charges for a period of 5 fiscal years next preceding the date of acquisition by the insurer have averaged per year not less than 1 1/4 times its average annual fixed charges applicable to such period and if during each of any 4 fiscal years of such period such net earnings have been not less than 1 1/4 times its fixed charges for such year; [PL 1969, c. 132, §1 (NEW).] B. The net earnings of such institution available for its fixed charges during a period of not less than 7 nor more than 10 fiscal years next preceding the date of acquisition by the insurer have been such that for each of any 7 fiscal years of such period such net earnings have been not less than 1 1/4 times its fixed charges for such year; and [PL 1969, c. 132, §1 (NEW).] C. The liquid assets of such institution have been not less than 105% of its liabilities, other than capital stock and surplus. For the purposes of this subsection, "liquid assets" and "liabilities" shall be determined in reliance upon the latest regular financial statement of the issuing, assuming or guaranteeing institution prepared as of a date not more than 15 months prior to the date of acquisition by the insurer; if net earnings are determined in reliance upon consolidated earnings statements of parent and subsidiary institutions, "liquid assets" and "liabilities" shall be determined in reliance upon a consolidated financial statement of parent and subsidiary institutions after treating any minority stock interest in such subsidiary institutions as a liability; and the term "liquid assets" shall mean the sum of cash, receivables or portions thereof, as the case may be, payable on demand or not more than 10 years after the date as of which the determination thereof is made for the purposes of this subsection, and readily marketable securities, in each case less applicable reserves and unearned income. [PL 1969, c. 132, §1 (NEW).] [PL 1969, c. 132, §1 (NEW).]

6. Fixed interest bearing obligations of financial companies, other than those eligible under subsections 1 , 3 and 5 , if either: A. (1) Net earnings of the issuing, assuming or guaranteeing institution available for its fixed charges during each of the 5 fiscal years next preceding the date of acquisition by that insurer shall not have been less than 1 1/4 times its fixed charges for that year; and (2) The liquid assets of that institution as of the end of the fiscal year covered in the latest regular financial statement of that institution prepared as of a date not more than 15 months prior to the date of acquisition by that insurer and as of the end of each of the 4 fiscal years next preceding that fiscal year shall have not been less than 95% of its liabilities, other than deferred income taxes, deferred investment tax credits, capital stock and surplus; or [PL 1979, c. 458, §3 (NEW).] B. (1) Net earnings of the issuing, assuming or guaranteeing institution available for its fixed charges during each of the 5 fiscal years next preceding the date of acquisition by that insurer shall have been not less than 1.15 times its fixed charges for that year; and (2) The liquid assets of that institution as of the end of the fiscal year covered in the latest regular financial statement of that institution prepared as of a date not more than 15 months prior to the date of acquisition by that insurer and as of the end of each of the 4 fiscal years next preceding that fiscal year shall have been not less than 105% of its liabilities, other than deferred income taxes, deferred investment tax credits, capital stock and surplus. [PL 1979, c. 458, §3 (NEW).] A "financial company" is one having an average of at least 50% of its net income, including income derived from subsidiaries, over its last 5 fiscal years next preceding the date of acquisition by that insurer derived from the business of wholesale, retail, installment, mortgage, commercial, industrial or consumer financing, or from banking or factoring or similar or related lines of business. For purposes of paragraph A , subparagraph (2) and paragraph B , subparagraph (2), if net earnings are determined in reliance upon consolidated financial statements of parent and subsidiary institutions, "liquid assets" and "liabilities" shall be determined in reliance upon a consolidated financial statement of parent and subsidiary institution after treating any minority stock interest in that subsidiary institution as a liability; and the term "liquid assets" shall mean the sum of cash, receivables or portions thereof, as the case may be, payable on demand or not more than 12 years following the close of the applicable fiscal year, and readily marketable securities, in each case less applicable reserves and unearned income. [PL 1979, c. 458, §3 (NEW).]
24-A M.R.S. § 2513 — ME Code / Title 24-A / Chapter 29 / Section 2513
24-A §2513. Payment of claims
Status: in_force

There shall be a provision that when the benefits under the policy shall become payable by reason of the death of the insured, settlement shall be made upon receipt of due proof of death and, at the insurer's option, surrender of the policy and proof of the interest of the claimant. If an insurer shall specify a particular period prior to the expiration of which settlement shall be made, such period shall not exceed 2 months from the receipt of such proofs. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 6101 — ME Code / Title 24-A / Chapter 72-A / Section 6101
24-A §6101. Penalties
Status: in_force

A risk retention group which violates any provision of this Act will be subject to fines and penalties applicable to licensed insurers generally, including revocation of its license or the right to do business in this State. [PL 1987, c. 481, §3 (NEW).]
24-A M.R.S. § 2627-A — ME Code / Title 24-A / Chapter 31 / Section 2627-A
24-A §2627-A. Dividends and experience refunds
Status: in_force

The following requirements apply to all group life insurance with the exception of insurance in which the policyholder is subject to the fiduciary standards of the federal Employee Retirement Income Security Act of 1974, ERISA, 29 United States Code, Section 1001‑1381 (1975). [PL 1991, c. 200, Pt. D, §2 (NEW).]

1. Refunds. The amount by which any dividend, experience refund or rate reduction exceeds the amount of premium contributed by the group policyholder for the same period must be refunded to the employees, members or debtors in proportion to their premium contributions for that period, except as provided in subsection 2 . [PL 1991, c. 200, Pt. D, §2 (NEW).]

2. Refund amounts less than $25 per employee, member or debtor. If the refunds required by subsection 1 would average less than $25 per employee, member or debtor, then the group policyholder may request approval from the superintendent to apply those amounts in a different manner. The superintendent shall approve the request if, in the superintendent's opinion, the manner of application proposed would be for the sole benefit of insured employees, members or debtors. [PL 1991, c. 200, Pt. D, §2 (NEW).]
24-A M.R.S. § 3866 — ME Code / Title 24-A / Chapter 53 / Section 3866
24-A §3866. Who may be subscribers
Status: in_force

Individuals, partnerships and corporations of this State may make application, enter into agreement for and hold policies or contracts in or with and be a subscriber of any domestic, foreign or alien reciprocal insurer. Any corporation now or hereafter organized under the laws of this State shall, in addition to the rights, powers, and franchises specified in its articles of incorporation, have full power and authority as a subscriber to exchange insurance contracts through such reciprocal insurer. The right to exchange such contracts is hereby declared to be incidental to the purposes for which such corporations are organized and to be as fully granted as the rights and powers expressly conferred upon such corporations. Government or governmental agencies, state or political subdivisions thereof, boards, associations, estates, trustees or fiduciaries are authorized to exchange nonassessable reciprocal interinsurance contracts with each other and with individuals, partnerships and corporations to the same extent that individuals, partnerships and corporations are herein authorized to exchange reciprocal interinsurance contracts. Any officer, representative, trustee, receiver or legal representative of any such subscriber shall be recognized as acting for or on its behalf for the purpose of such contract but shall not be personally liable upon such contract by reason of acting in such representative capacity. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2723-A — ME Code / Title 24-A / Chapter 33 / Section 2723-A
24-A §2723-A. Coordination of benefits
Status: in_force

1. Authorization. There may be a provision for coordination of benefits payable under the policy and under other plans of insurance or health care coverage, in conformance with rules adopted by the superintendent to establish uniformity in the permissive use of coordination of benefits provisions in order to avoid claim delays and misunderstandings that otherwise result from the use of inconsistent or incompatible provisions among the several insurers and nonprofit hospital or medical service organization plans and nonprofit health care organization plans. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter II‑A . [PL 1999, c. 256, Pt. N, §1 (NEW).]

2. Coordination with Medicare. Coordination of benefits with Medicare is governed by the following provisions. A. The policy may not coordinate benefits with Medicare Part A unless: (1) The insured is enrolled in Medicare Part A; (2) The insured was previously enrolled in Medicare Part A and voluntarily disenrolled; (3) The insured stated on an application or other document that the insured was enrolled in Medicare Part A; or (4) The insured is eligible for Medicare Part A without paying a premium and the policy states that it will not pay benefits that would be payable under Medicare even if the insured fails to exercise the insured's right to premium-free Medicare Part A coverage. [PL 1999, c. 256, Pt. N, §1 (NEW).] B. The policy may not coordinate benefits with Medicare Part B unless: (1) The insured is enrolled in Medicare Part B; (2) The insured was previously enrolled in Medicare Part B and voluntarily disenrolled; (3) The insured stated on an application or other document that the insured was enrolled in Medicare Part B; or (4) The insured is eligible for Medicare Part A without paying a premium and the insurer provided prominent notification to the insured both when the policy was issued and, if applicable, when the insured becomes eligible for Medicare due to age. The content of the notification must be approved by the bureau. The notification must state that the policy will not pay benefits that would be payable under Medicare even if the insured fails to enroll in Medicare Part B and state that the insured may contact the bureau, the Health Insurance Consumer Assistance Program established in section 4326 or another relevant organization or agency for assistance in understanding coordination of benefits with Medicare Part B under the insured's contract. [PL 2023, c. 104, §2 (AMD).] C. Coordination is not permitted with Medicare coverage for which the insured is eligible but not enrolled except as provided in paragraphs A and B . [PL 1999, c. 256, Pt. N, §1 (NEW).] [PL 2023, c. 104, §2 (AMD).]

3. Credit toward deductible. When an insured is covered under more than one expense-incurred health plan, payments made by the primary plan, payments made by the insured and payments made from a health savings account or similar fund for benefits covered under the secondary plan must be credited toward the deductible of the secondary plan. This subsection does not apply if the secondary plan is designed to supplement the primary plan. [PL 2005, c. 121, Pt. D, §2 (NEW).]
24-A M.R.S. § 4320-V — ME Code / Title 24-A / Chapter 56-A / Section 4320-V
24-A §4320-V. Coverage for donor breast milk
Status: in_force

1. Required coverage. A carrier offering a health plan in this State shall provide coverage for pasteurized donor breast milk provided to an infant eligible for coverage under the health plan if a physician or physician associate licensed under Title 32, chapter 36 or 48 or an advanced practice registered nurse licensed under Title 32, chapter 31 signs an order stating that: A. The infant is medically or physically unable to receive maternal breast milk or participate in breastfeeding or the infant's parent is medically or physically unable to produce maternal breast milk in quantities sufficient for the infant; and [PL 2023, c. 229, §1 (NEW); PL 2023, c. 229, §2 (AFF).] B. The infant: (1) Was born at a birth weight of less than 1,500 grams; (2) Has a gastrointestinal anomaly or metabolic or digestive disorder or is recovering from intestinal surgery and the infant's digestive needs require additional support; (3) Is not appropriately gaining weight or growing; (4) Has formula intolerance and is experiencing weight loss or difficulty feeding; (5) Has low blood sugar; (6) Has congenital heart disease; (7) Has received or will receive an organ transplant; or (8) Has another serious medical condition for which donor breast milk is medically necessary. [PL 2023, c. 229, §1 (NEW); PL 2023, c. 229, §2 (AFF).] [PL 2023, c. 229, §1 (NEW); PL 2023, c. 229, §2 (AFF); PL 2025, c. 316, §3 (REV).]
24-A M.R.S. § 2545 — ME Code / Title 24-A / Chapter 29 / Section 2545
24-A §2545. Computation of present value
Status: in_force

Any paid-up annuity benefit available under a contract shall be such that its present value on the date annuity payments are to commence is at least equal to the minimum nonforfeiture amount on that date. The present value shall be computed using the mortality table, if any, and the interest rate specified in the contract for determining the minimum paid-up annuity benefits guaranteed in the contract. [PL 1979, c. 442, §4 (NEW).]
24-A M.R.S. § 4303-C — ME Code / Title 24-A / Chapter 56-A / Section 4303-C
24-A §4303-C. Protection from surprise bills and bills for out-of-network emergency services
Status: repealed

1. Surprise bill defined. As used in this section, unless the context otherwise indicates, "surprise bill" means a bill for health care services, including, but not limited to, emergency services, received by an enrollee for covered services rendered by an out-of-network provider, when such services were rendered by that out-of-network provider at a network provider, during a service or procedure performed by a network provider or during a service or procedure previously approved or authorized by the carrier and the enrollee did not knowingly elect to obtain such services from that out-of-network provider. "Surprise bill" does not include a bill for health care services received by an enrollee when a network provider was available to render the services and the enrollee knowingly elected to obtain the services from another provider who was an out-of-network provider. [PL 2019, c. 668, §2 (AMD).]

1-A. "Knowingly elected to obtain such services from that out-of-network provider" defined. As used in this section, unless the context otherwise indicates, "knowingly elected to obtain such services from that out-of-network provider" means that an enrollee chose the services of a specific provider, with full knowledge that the provider is an out-of-network provider with respect to the enrollee's health plan, under circumstances that indicate that the enrollee had and was informed of the opportunity to receive services from a network provider but instead selected the out-of-network provider. The disclosure by a provider of network status does not render an enrollee's decision to proceed with treatment from that provider a choice made knowingly pursuant to this subsection. [PL 2019, c. 668, §2 (NEW).]

2. Requirements. With respect to a surprise bill or a bill for covered emergency services rendered by an out-of-network provider: A. A carrier shall require an enrollee to pay only the applicable coinsurance, copayment, deductible or other out-of-pocket expense that would be imposed for health care services if the services were rendered by a network provider. For an enrollee subject to coinsurance, the carrier shall calculate the coinsurance amount based on the median network rate for that health care service; [PL 2019, c. 668, §2 (AMD).] B. Except as provided for ambulance services in paragraph D‑1 , unless the carrier and out-of-network provider agree otherwise, a carrier shall reimburse the out-of-network provider or enrollee, as applicable, for health care services rendered at the greater of: (1) The carrier's median network rate paid for that health care service by a similar provider in the geographic area where the service was provided; and (2) The median network rate paid by all carriers for that health care service by a similar provider in the geographic area where the service was provided as determined by the all-payer claims database maintained by the Maine Health Data Organization or, if Maine Health Data Organization claims data is insufficient or otherwise inapplicable, another independent medical claims database specified by the superintendent; [PL 2023, c. 591, §1 (AMD).] C. Notwithstanding paragraph B , if a carrier has an inadequate network, as determined by the superintendent, the carrier shall ensure that the enrollee obtains the covered service at no greater cost to the enrollee than if the service were obtained from a network provider or shall make other arrangements acceptable to the superintendent; [PL 2019, c. 668, §2 (AMD).] D. [PL 2019, c. 668, §2 (NEW); MRSA T. 24-A §4303-C, sub-§2, ¶D (RP).] Revisor's Note: Paragraph D was repealed October 1, 2021. PL 2021, c. 241, §1 attempted to strike the language that repealed the paragraph, but did not take effect in time. D-1. Unless the carrier and out-of-network provider agree otherwise, a carrier shall reimburse an out-of-network provider for ambulance services that are covered emergency services at the rate applicable to the out-of-network provider pursuant to section 4303‑F . [PL 2023, c. 591, §2 (NEW).] E. If an out-of-network provider disagrees with a carrier's payment amount for a surprise bill for emergency services or for covered emergency services as determined in accordance with paragraph B or paragraph D, the carrier and the out-of-network provider have 30 calendar days to negotiate an agreement on the payment amount in good faith. If the carrier and the out-of-network provider do not reach agreement on the payment amount within 30 calendar days, the out-of-network provider may submit a dispute regarding the payment and receive another payment from the carrier determined in accordance with the dispute resolution process in section 4303‑E , including any payment made pursuant to section 4303‑E, subsection 1 , paragraph G; and [PL 2021, c. 241, §2 (AMD).] F. The enrollee's responsibility for payment for covered out-of-network emergency services must be limited so that if the enrollee has paid the enrollee's share of the charge as specified in the plan for in-network services, the carrier shall hold the enrollee harmless from any additional amount owed to an out-of-network provider for covered emergency services and make payment to the out-of-network provider in accordance with this section or, if there is a dispute, in accordance with section 4303‑E . [PL 2019, c. 668, §2 (NEW).] [PL 2023, c. 591, §§1, 2 (AMD).]

3. Payment after resolution of disputes. Following an independent dispute resolution determination pursuant to section 4303‑E , the determination by the independent dispute resolution entity of a reasonable payment for a specific health care service or treatment rendered by an out-of-network provider is binding on a carrier, out-of-network provider and enrollee for 90 days. During that 90-day period, a carrier shall reimburse an out-of-network provider at that same rate for that specific health care service or treatment, and an out-of-network provider may not dispute any bill for that service under section 4303‑E . [PL 2019, c. 668, §2 (NEW).]
24-A M.R.S. § 752 — ME Code / Title 24-A / Chapter 9 / Section 752
24-A §752. Penalties and liabilities
Status: in_force

1. Violation. A reinsurance intermediary, insurer or reinsurer found by the superintendent, after a hearing conducted in accordance with the Maine Administrative Procedure Act, to be in violation of any provision of this Title, is subject to the following. A. For each separate violation, a violator must pay a penalty of not less than $5,000 and not more than $100,000 for each separate violation. [PL 1991, c. 828, §20 (NEW).] B. A violator is subject to revocation or suspension of its license. [PL 1991, c. 828, §20 (NEW).] C. If a violation was committed by the reinsurance intermediary, the reinsurance intermediary shall make restitution to the insurer, reinsurer, rehabilitator or liquidator of the insurer or reinsurer for the net losses incurred by the insurer or reinsurer attributable to such violation. [PL 1991, c. 828, §20 (NEW).] [PL 1991, c. 828, §20 (NEW).]

2. Final agency action. The decision, determination or order of the superintendent pursuant to this section is a final agency action and may be appealed pursuant to section 236 . [PL 1991, c. 828, §20 (NEW).]

3. Nonexclusivity of penalties. Nothing contained in this section affects the right of the superintendent to impose any other penalties provided in this Title. [PL 1991, c. 828, §20 (NEW).]

4. Rights of others. Nothing contained in this subchapter limits or restricts the rights of policyholders, claimants, creditors or other 3rd parties or confers any rights to those persons. [PL 1991, c. 828, §20 (NEW).]
24-A M.R.S. § 4320-C — ME Code / Title 24-A / Chapter 56-A / Section 4320-C
24-A §4320-C. Emergency services
Status: in_force

If a carrier offering a health plan provides or covers any benefits with respect to services in an emergency facility or setting, the plan must cover emergency services without prior authorization. Cost-sharing requirements, such as a deductible, copayment amount or coinsurance rate, for out-of-network services are the same as requirements that would apply if such services were provided in network, and any payment made by an enrollee pursuant to this section must be applied to the enrollee's in-network cost-sharing limit. The enrollee's responsibility for payment for covered out-of-network emergency services must be limited so that if the enrollee has paid the enrollee's share of the charge as specified in the plan for in-network services, the carrier shall hold the enrollee harmless from any additional amount owed to an out-of-network provider for covered emergency services and make payment to the out-of-network provider in accordance with section 4303‑C or, if there is a dispute, in accordance with section 4303‑E . A carrier offering a health plan in this State shall also comply with the requirements of section 4304, subsection 5 . [PL 2019, c. 668, §4 (AMD).]
24-A M.R.S. § 6215-A — ME Code / Title 24-A / Chapter 73 / Section 6215-A
24-A §6215-A. Reserves
Status: in_force

A provider shall establish and maintain the following reserves: [PL 1995, c. 625, Pt. A, §29 (NEW).]

1. Mortgage debt. A liquid amount equal to the aggregate amount of all principal and interest payments due during the fiscal year on any mortgage loan or other long-term financing of the facility, which reserve may be held by a lender, mortgagee or trustee for bondholders in a debt service reserve fund or similar fund, including, without limitation, any reserve fund of the Maine Health and Higher Educational Facilities Authority established pursuant to Title 22, chapter 413 ; [PL 1995, c. 625, Pt. A, §29 (NEW).]

2. Operating reserve. A liquid amount equal to 20% of the total cash operating expenses, other than principal and interest payments on any mortgage loan or other long-term financing of the facility, projected for the forthcoming 12-month period, which reserve may be held by the provider in an operating fund; provided, however, that the percentage of the total cash operating expenses must be increased from 20% to 25% in the case of a provider who offers an extensive health care guarantee. For purposes of this section, "extensive health care guarantee" means a term in a continuing care agreement requiring the provision of health care to the subscriber on a prepaid basis for more than one year; and [PL 1995, c. 625, Pt. A, §29 (NEW).]

3. Reserve liabilities; actuarial value. Each provider shall establish and maintain reserve liabilities that place a sound value on the provider's liabilities under its contracts with subscribers. The reserve must equal the excess of the present value of future benefits promised under the continuing care agreement over the present value of future revenues and any other available resources, based on conservative actuarial assumptions. The provider shall provide every 3 years to the superintendent an actuarial valuation or statement of actuarial opinion as to the adequacy of the reserve, signed by a qualified actuary, that, based on reasonable assumptions, the continuing care retirement community's assets, including the present value of estimated future maintenance fees and any other available resources, are at least equal to the present value of estimated future liabilities. Unless otherwise approved by the superintendent, the actuarial opinion must be based on reasonable assumptions with the following provisions and margins. A. The liabilities of a continuing care retirement community must include, but not be limited to: (1) An amount equal to the present value of future health care expenses guaranteed pursuant to the continuing care contract; and (2) The liabilities under this section must be calculated for the continuing care retirement community population existing on the valuation date under assumptions that, in the actuary's opinion, fairly represent the expected value of future costs and population decrements adjusted by the margins specified in paragraph B . [PL 1995, c. 625, Pt. A, §29 (NEW).] B. Margins required to be included in the valuation assumptions to be added to the actuary's best estimate assumptions are as follows. (1) Health care costs per resident or per health care facility bed must be assumed to increase at a rate at least one percentage point higher than the general inflation rate. (2) A mortality margin of 5% must be subtracted from that assumed for active residents and 10% subtracted from those in the health care facilities. (3) A health care utilization margin of 5% must be added to the assumed rates at which residents require permanent transfer to a health care facility. (4) The discount rate used to calculate present values may not be more than 2 1/2 percentage points higher than the rate used in the valuation of long-term life insurance contracts to be issued in the year of valuation in this State. (5) All other assumptions must include margins that are adequate in the opinion of the actuary. [PL 1995, c. 625, Pt. A, §29 (NEW).] [PL 1995, c. 625, Pt. A, §29 (NEW).]

The superintendent may adopt reasonable rules further defining the standards contained in this section. [PL 1995, c. 625, Pt. A, §29 (NEW).]
24-A M.R.S. § 4333 — ME Code / Title 24-A / Chapter 56-A / Section 4333
24-A §4333. Requirements for downstream risk arrangements
Status: in_force

1. Permissible downstream risk arrangements. Downstream entities that do not exceed the risk threshold described in section 4334 may enter into downstream risk arrangements only if: A. The requirements of section 4332, subsection 1 and sections 4335 and 4336 are met; and [PL 1999, c. 609, §20 (NEW).] B. No specific payment is made directly or indirectly under the plan to a provider as an inducement to reduce or limit medically necessary services furnished to an enrollee. [PL 1999, c. 609, §20 (NEW).] [PL 1999, c. 609, §20 (NEW).]

2. Prohibited downstream risk payments. A specific payment of any kind may not be made directly or indirectly under the incentive plan to a downstream entity as an inducement to reduce or limit covered medically necessary services under the carrier's contract furnished to an enrollee. Indirect payments include offerings of monetary value such as stock options or waivers of debt measured in the present or future. [PL 1999, c. 609, §20 (NEW).]

3. Applicability. This section applies to risk arrangements between carriers and downstream entities with which they contract to provide medical services to enrollees. This section also applies to subcontracting arrangements. [PL 1999, c. 609, §20 (NEW).]
24-A M.R.S. § 3859 — ME Code / Title 24-A / Chapter 53 / Section 3859
24-A §3859. Modifications
Status: in_force

Modifications of the terms of the subscribers' agreement or of the power of attorney of a domestic reciprocal insurer shall be made jointly by the attorney and the subscribers' advisory committee. No such modification shall be effective retroactively, nor as to any insurance contract issued prior thereto. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 423-G — ME Code / Title 24-A / Chapter 5 / Section 423-G
24-A §423-G. Corporate governance annual disclosure
Status: in_force

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Corporate governance annual disclosure" or "CGAD" means a confidential report filed by an insurer or insurance group pursuant to this section. [PL 2017, c. 169, Pt. A, §5 (NEW).] B. "Domestic insurance carrier" means an insurance company, health maintenance organization, fraternal benefit society, nonprofit hospital or medical service organization or nonprofit health plan domiciled in this State. [PL 2017, c. 169, Pt. A, §5 (NEW).] C. "Insurance group" means the insurance carriers and affiliates included within a domestic insurance carrier's insurance holding company system as defined in section 222, subsection 2, paragraph C . [PL 2017, c. 169, Pt. A, §5 (NEW).] D. "Lead state," with respect to an insurance group, means the state designated as the lead state for the insurance group as determined by the procedures outlined in the most recent financial analysis handbook adopted by the NAIC, except that if the designated lead state does not have a corporate governance disclosure law substantially similar to this section, the superintendent shall designate this State or another state with a substantially similar law as the lead state for purposes of this section. [PL 2017, c. 169, Pt. A, §5 (NEW).] E. [PL 2021, c. 521, §23 (RP).] [PL 2021, c. 521, §23 (AMD).]

2. Disclosure requirement. This subsection governs corporate governance annual disclosure filings. A. A domestic insurance carrier shall file a corporate governance annual disclosure in accordance with this subsection no later than June 1st of each calendar year. The carrier's insurance group may file the CGAD on behalf of the carrier. (1) If the CGAD is completed at the insurance group level, and this State is not the group's lead state, the CGAD must be filed with the chief insurance regulator of the lead state in accordance with the laws of the lead state, and a copy must be filed with the superintendent if requested by the superintendent. (2) If the CGAD is completed at the legal entity level or if this State is the group's lead state, the CGAD must be filed with the superintendent. [PL 2017, c. 169, Pt. A, §5 (NEW).] B. The CGAD must contain the information described in subsection 3, paragraph B and must include a signature of the domestic insurance carrier or insurance group's chief executive officer or corporate secretary attesting to the best of that individual's belief and knowledge that the domestic insurance carrier has implemented the corporate governance practices and that a copy of the CGAD has been provided to the domestic insurance carrier's board of directors or the appropriate committee thereof. [PL 2017, c. 169, Pt. A, §5 (NEW).] C. A CGAD may provide information regarding corporate governance at the level of the group's ultimate controlling parent or intermediate holding company, at the individual legal entity level or at any combination of these levels depending upon how the domestic insurance carrier or insurance group has structured its system of corporate governance. The domestic insurance carrier or insurance group is encouraged to make the CGAD at the level: (1) At which the domestic insurance carrier's or insurance group's risk appetite is determined; (2) At which the earnings, capital, liquidity, operations and reputation of the domestic insurance carrier are overseen collectively and at which the supervision of those factors is coordinated and exercised; or (3) At which legal liability for failure of general corporate governance duties is placed. If the domestic insurance carrier or insurance group determines the level of reporting based on the 3 criteria under this paragraph, it shall indicate which of the criteria were used to determine the level or levels of reporting and explain any subsequent changes in the level of reporting. [PL 2017, c. 169, Pt. A, §5 (NEW).] D. If the CGAD is completed at the insurance group level, the lead state shall conduct the review of the CGAD and any additional requests for information must be made through the lead state. [PL 2017, c. 169, Pt. A, §5 (NEW).] E. Domestic insurance carriers providing information substantially similar to the information required by this section in other documents provided to the superintendent, including proxy statements filed in conjunction with Form B requirements or other state or federal filings provided to the bureau, may not be required to duplicate that information in the CGAD, but may only be required to cross-reference the document in which the information is included. [PL 2017, c. 169, Pt. A, §5 (NEW).] [PL 2017, c. 169, Pt. A, §5 (NEW).]

3. Contents of corporate governance annual disclosure. This subsection governs the contents of corporate governance annual disclosure filings. A. The domestic insurance carrier or insurance group shall ensure that the CGAD contains the material information necessary to permit the superintendent to gain an understanding of the domestic insurance carrier's or insurance group's corporate governance structure, policies and practices. The superintendent may require additional information that is determined to be material and necessary to provide a clear understanding of the corporate governance policies, including the reporting or information system or controls implementing those policies. [PL 2017, c. 169, Pt. A, §5 (NEW).] B. The CGAD must be prepared consistent with rules adopted pursuant to subsection 6 . Documentation and supporting information must be maintained and made available upon examination or upon request of the superintendent. [PL 2017, c. 169, Pt. A, §5 (NEW).] C. The domestic insurance carrier or insurance group has discretion over its responses to the CGAD inquiries, as long as those responses meet the requirements of this section. [PL 2017, c. 169, Pt. A, §5 (NEW).] [PL 2017, c. 169, Pt. A, §5 (NEW).]

4. Confidentiality. This subsection governs confidentiality in corporate governance annual disclosure filings. A. Documents, materials or other information in the possession or control of the bureau that are obtained by, created by or disclosed to the superintendent or any other person under this section, including the CGAD, are confidential and privileged, are not public records within the meaning of the Freedom of Access Act, are not subject to subpoena, are not subject to discovery or admissible in evidence in any private civil action and may not be made public without the prior written consent of the domestic insurance carrier. Neither the superintendent nor any person who received information from or under the authority of the superintendent under this section may be permitted or required to testify in any private civil action concerning information that is confidential under this subsection. [PL 2017, c. 169, Pt. A, §5 (NEW).] B. This subsection does not prohibit the superintendent from using information that is confidential under this subsection in the furtherance of any regulatory or legal action brought as a part of the superintendent's official duties. [PL 2017, c. 169, Pt. A, §5 (NEW).] C. The superintendent may share information that is confidential under this subsection only in accordance with the requirements of section 216, subsection 5 . [PL 2017, c. 169, Pt. A, §5 (NEW).] D. The privilege provided by this subsection does not supersede any other applicable privilege or confidentiality protection, nor does disclosure of confidential information to the superintendent pursuant to this section constitute a waiver of any such privilege or protection. [PL 2017, c. 169, Pt. A, §5 (NEW).] [PL 2017, c. 169, Pt. A, §5 (NEW).]

4-A. Sharing CGAD information with the NAIC. The superintendent may share confidential information provided or obtained under this section with the NAIC only in accordance with a written agreement that contains the provisions specified in section 216, subsection 5, paragraph C and the following additional provisions: A. Procedures and protocols for sharing by the NAIC only with other state regulators from states in which the insurance group has domiciled insurance carriers. The agreement must provide that the recipient agrees to maintain the confidentiality and privileged status of the CGAD-related documents, materials or other information and must document the NAIC’s legal authority to maintain confidentiality; [PL 2021, c. 521, §24 (NEW).] B. A provision requiring the NAIC to provide prompt notice to the superintendent, in addition to the notice to the domestic insurance carrier or insurance group required by section 216 , regarding any subpoena, request for disclosure or request for production of the domestic insurance carrier’s or insurance group’s CGAD-related information; and [PL 2021, c. 521, §24 (NEW).] C. A provision expressly requiring the written consent of the domestic insurance carrier before any information shared pursuant to this section may be made public. [PL 2021, c. 521, §24 (NEW).] [PL 2021, c. 521, §24 (NEW).]

5. Independent consultants. This subsection governs independent consultants retained to review corporate governance annual disclosure and compliance with this section. A. The superintendent may retain, at the domestic insurance carrier's expense, independent consultants as provided in section 208 , including attorneys, actuaries, accountants and other experts as may be reasonably necessary to assist the superintendent in reviewing the CGAD and related information or the domestic insurance carrier's compliance with this section. [PL 2017, c. 169, Pt. A, §5 (NEW).] B. Any persons retained under paragraph A are subject to the requirements of section 216, subsection 5, paragraph B‑1 . [PL 2021, c. 521, §25 (AMD).] C. The superintendent may not retain an independent consultant that has not verified to the superintendent, with notice to the domestic insurance carrier, that it is free of a conflict of interest and that it has internal procedures in place to monitor ongoing freedom from conflicts and to comply with the confidentiality standards and requirements of this section. [PL 2017, c. 169, Pt. A, §5 (NEW).] D. [PL 2021, c. 521, §25 (RP).] E. The superintendent may share confidential information provided or obtained under this section with an independent consultant only in accordance with a written agreement that makes compliance with the confidentiality requirements of this section one of the consultant's duties as a state contractor and includes all protections that the NAIC is required to provide in an agreement entered into under subsection 4‑A . [PL 2021, c. 521, §25 (AMD).] [PL 2021, c. 521, §25 (AMD).]

6. Rules. The superintendent may adopt reasonable rules as necessary to implement this section. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2017, c. 169, Pt. A, §5 (NEW).]

7. Severability. If any provision of this section other than subsection 4 , or the application thereof to any person or circumstance, is determined to be invalid, that determination does not affect the provisions or applications of this section that can be given effect without the invalid provision or application, and to that end the provisions of this section with the exception of subsection 4 are severable. [PL 2017, c. 169, Pt. A, §5 (NEW).]

8. Relationship to other laws. This section may not be construed to prescribe or impose corporate governance standards and internal procedures beyond those required of business corporations under Title 13‑C . This section may not be construed to limit the superintendent's examination authority under sections 221 and 222 or the rights or obligations of 3rd parties in connection with examinations conducted under those sections. [PL 2017, c. 169, Pt. A, §5 (NEW).]
24-A M.R.S. § 4320-O — ME Code / Title 24-A / Chapter 56-A / Section 4320-O
24-A §4320-O. Coverage for services provided by a physician associate
Status: in_force

1. Services provided by a physician associate. A carrier offering a health plan in this State shall provide coverage for health care services performed by a physician associate licensed under Title 32, section 2594‑E or 3270‑E when those services are covered services under the health plan when performed by any other health care provider and when those services are within the lawful scope of practice of the physician associate. [PL 2019, c. 627, Pt. A, §2 (NEW); PL 2019, c. 627, Pt. A, §3 (AFF); PL 2025, c. 316, §3 (REV).]

2. Limits; deductible; copayment; coinsurance. A carrier may offer a health plan containing a provision for a deductible, copayment or coinsurance requirement for a health care service provided by a physician associate as long as the deductible, copayment or coinsurance does not exceed the deductible, copayment or coinsurance applicable to the same service provided by other health care providers. [PL 2019, c. 627, Pt. A, §2 (NEW); PL 2019, c. 627, Pt. A, §3 (AFF); PL 2025, c. 316, §3 (REV).]

3. Network participation. A carrier shall demonstrate that the carrier's provider network includes reasonable access, in accordance with section 4303 , to all covered services that are within the lawful scope of practice of a physician associate. A carrier may not exclude a provider from participation in the carrier's provider network solely because the provider is a physician associate as long as the provider is willing to meet the same terms and conditions as other participating providers. This subsection does not require a carrier to contract with all physician associates or require a carrier to provide coverage under a health plan for any service provided by a participating physician associate that is not within the health plan's scope of coverage. [PL 2019, c. 627, Pt. A, §2 (NEW); PL 2019, c. 627, Pt. A, §3 (AFF); PL 2025, c. 316, §3 (REV).]

4. Billing. A carrier shall authorize a physician associate to bill the carrier and receive direct payment for a medically necessary service the physician associate provides to an enrollee and identify the physician associate as provider in the billing and claims process for payment of the service. A carrier may not impose on a physician associate a practice, education or collaboration requirement that is inconsistent with or more restrictive than a requirement of state law or board or agency rules. [PL 2019, c. 627, Pt. A, §2 (NEW); PL 2019, c. 627, Pt. A, §3 (AFF); PL 2025, c. 316, §3 (REV).]
24-A M.R.S. § 6716 — ME Code / Title 24-A / Chapter 83 / Section 6716
24-A §6716. Redomestication; approval as a domestic captive insurer
Status: in_force

1. Procedure. A foreign or alien captive insurance company may become a domestic captive insurance company by: A. Complying with all of the requirements relating to the organization and licensing of a domestic captive insurance company of the same type and any requirements that the superintendent may adopt by rule; [PL 1997, c. 435, §1 (NEW).] B. Amending the articles of incorporation or other organizational document to comply with the laws of this State. The document must be restated in its entirety before its submission to the superintendent. Before the amended and restated articles of incorporation or other organizational document is transmitted to the Secretary of State, the foreign or alien captive insurance company shall petition the superintendent to issue a certificate setting forth the superintendent's finding that the redomestication and maintenance of the corporation satisfies paragraph A and will promote the general good of the State. The company's petition must be accompanied by a redomestication fee of $500. In arriving at the finding, the superintendent shall consider: (1) The character, reputation, financial standing and purposes of the foreign or alien captive insurance company; (2) The character, reputation, financial responsibility, insurance experience and business qualifications of the officers and directors; and (3) Any other aspects the superintendent determines advisable; [PL 1997, c. 435, §1 (NEW).] C. Transmitting the following to the Secretary of State for filing: (1) The articles of redomestication including the filing fee as provided by either Title 13‑B, section 1401, subsection 13 or Title 13‑C, section 123, subsection 1, paragraph L and this information required by a new domestic or domestic nonprofit corporation on a form prescribed by the Secretary of State; (2) The certificate of general good issued by the superintendent; (3) The certificate of good standing duly authenticated by the proper officer of the state or country under the laws of which the foreign or alien captive insurance company is incorporated. The certificate may not be dated earlier than 30 days prior to the filing of the articles of redomestication. If the certificate of good standing is in a foreign language, a translation under oath of the translator must accompany the certificate; (4) Amendments to the articles of incorporation or other organizational document in compliance with the laws of this State; and (5) The restatement of the articles of incorporation or other organizational document in its entirety; and [RR 2001, c. 2, Pt. B, §46 (COR); RR 2001, c. 2, Pt. B, §58 (AFF).] D. Stating in the articles of redomestication: (1) The name of the corporation; (2) The date of incorporation and state or country of incorporation; (3) The street address of the principal office in this State; (4) The names and titles of the officers and directors of the corporation; (5) A statement that the corporation is moving its domicile from its present state or country to this State; (6) A statement that redomestication will occur upon filing the articles of redomestication and that the corporation is subject to the laws of this State; and (7) A statement that copies of the articles of incorporation or other organizational document and any amendments certified by the proper officer of the state or country under the laws of which the corporation is incorporated are attached. If any of these documents are in a foreign language, a translation under oath of the translator must accompany these documents. [PL 1997, c. 435, §1 (NEW).] [RR 2001, c. 2, Pt. B, §46 (COR); RR 2001, c. 2, Pt. B, §58 (AFF).]

2. Licensure. Upon payment to the superintendent of the issuance fee set forth in section 601, subsection 1 , the domestic captive insurance company is entitled to the necessary or appropriate certificates and licenses to do business in this State and is subject to the authority and jurisdiction of this State. A captive insurance company redomesticating into this State need not merge, consolidate, transfer assets or otherwise engage in any other reorganization other than as specified in this section. [PL 1997, c. 435, §1 (NEW).]

3. Rights and privileges; liabilities. Upon redomestication in accordance with this section, the foreign or alien captive insurance company becomes a domestic captive insurance company organized under the laws of this State and has all the rights, privileges, immunities and powers and is subject to all applicable laws, duties and liabilities of a domestic captive insurance company of the same type. The domestic captive insurance company possesses all rights that it had prior to the redomestication to the extent permitted by the laws of this State and is responsible and liable for all the liabilities and obligations that it was subject to prior to the redomestication. All outstanding policies of the captive insurance company remain in full force and effect. [PL 1997, c. 435, §1 (NEW).]
24-A M.R.S. § 4320-J — ME Code / Title 24-A / Chapter 56-A / Section 4320-J
24-A §4320-J. Coverage for abuse-deterrent opioid analgesic drug products
Status: in_force

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Abuse-deterrent opioid analgesic drug product" means a brand or generic opioid analgesic drug product approved by the federal Food and Drug Administration with abuse-deterrent labeling claims that indicate the drug product is expected to result in a meaningful reduction in abuse. [PL 2015, c. 371, §1 (NEW); PL 2015, c. 371, §2 (AFF).] B. "Cost sharing" means any coverage limit, copayment, coinsurance, deductible or other out-of-pocket expense associated with a health plan. [PL 2015, c. 371, §1 (NEW); PL 2015, c. 371, §2 (AFF).] C. "Opioid analgesic drug product" means a drug product in the opioid analgesic drug class prescribed to treat moderate to severe pain or other conditions, whether in immediate release or extended release, long-acting form and whether or not combined with other drug substances to form a single drug product or dosage form. [PL 2015, c. 371, §1 (NEW); PL 2015, c. 371, §2 (AFF).] [PL 2015, c. 371, §1 (NEW); PL 2015, c. 371, §2 (AFF).]

2. Required coverage. A carrier offering a health plan in this State shall provide coverage for abuse-deterrent opioid analgesic drug products listed on any formulary, preferred drug list or other list of drugs used by the carrier on a basis not less favorable than that for opioid analgesic drug products that are not abuse-deterrent and are covered by the health plan. An increase in enrollee cost sharing to achieve compliance with this section may not be implemented. [PL 2015, c. 371, §1 (NEW); PL 2015, c. 371, §2 (AFF).]
24-A M.R.S. § 2555 — ME Code / Title 24-A / Chapter 29 / Section 2555
24-A §2555. Inclusion of nursing home benefits in life insurance policies
Status: in_force

1. In order to offer a life insurance policy providing for acceleration of life insurance or annuity benefits in advance of the time the benefits would otherwise be payable because of confinement to a nursing home or long-term care facility, receipt of home health care or hospice care benefits, diagnosis of terminal illness or for substantially similar reasons, the insurer must have a certificate of authority to transact life or life and health insurance in this State. [PL 1989, c. 26 (NEW).]

2. The superintendent shall promulgate reasonable rules, in accordance with the Maine Administrative Procedure Act, Title 5, chapter 375 , to provide for the full and fair disclosure of information in connection with the sale of the policies referred to in subsection 1 , and may include, but are not limited to, definitions, acceptable restrictions on benefit payments, coverage periods and nonforfeiture requirements. [PL 1989, c. 26 (NEW).]
24-A M.R.S. § 4382 — ME Code / Title 24-A / Chapter 57 / Section 4382
24-A §4382. Report and petition for assessment
Status: in_force

Within 3 years after the date of the entry of an order of rehabilitation or liquidation of a domestic mutual insurer or a domestic reciprocal insurer, the superintendent may make and file the superintendent's report and petition to the court setting forth: [RR 2021, c. 1, Pt. B, §376 (COR).]

1. The reasonable value of the assets of the insurer; [PL 1969, c. 132, §1 (NEW).]

2. The liabilities of the insurer to the extent thus far ascertained by the superintendent; [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

3. The aggregate amount of the assessment, if any, which the superintendent deems reasonably necessary to pay all claims, the costs and expenses of the collection of the assessments and the costs and expenses of the delinquency proceedings in full; and [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

4. Any other information relative to the affairs or property of the insurer that the superintendent deems material. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 1256 — ME Code / Title 24-A / Chapter 15 / Section 1256
24-A §1256. Custodial arrangements
Status: in_force

1. In lieu of deposit with the Treasurer of State as provided in section 1254 , upon the insurer's written request and for its greater convenience, the superintendent may in the superintendent's discretion permit the insurer to make and maintain the deposit under custodial arrangements with the trust department of an established bank located in Maine. [RR 2021, c. 1, Pt. B, §195 (COR).]

2. Where of convenience to the insurer in the buying, selling and exchange of securities comprising its deposit, and in the collection of accruals thereon, the insurer may, with the superintendent's advance written approval, deposit certain of its securities under custodial arrangements with an established bank or trust company located outside this State. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

3. The insurer shall deposit with the Treasurer of State through the superintendent the original receipts issued by the custodian institution for all securities held under such custodial arrangements. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

4. The form and terms of all such custodial arrangements shall be as prescribed or approved by the superintendent consistent with the applicable provisions of this Title. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

5. The insurer shall bear the costs of custodial arrangements, and the State of Maine shall not be responsible for the safekeeping of securities so held. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2242 — ME Code / Title 24-A / Chapter 24-A / Section 2242
24-A §2242. Notice and registration requirements of transferees of structured settlements
Status: in_force

1. Notice. A transferee of structured settlement payment rights that intends to do business in this State shall, prior to doing business, pay the appropriate fee at the rate established in section 601 and furnish notice to the superintendent to: A. Identify the state in which the transferee is domiciled; [PL 1999, c. 268, §2 (NEW).] B. Identify the principal place of business of the group; and [PL 1999, c. 268, §2 (NEW).] C. Provide such other information as may be required by the superintendent. [PL 1999, c. 268, §2 (NEW).] [PL 1999, c. 268, §2 (NEW).]

2. Registration. The transferee shall register with the superintendent and designate an agent solely for the purpose of receiving service of legal documents or process. [PL 1999, c. 268, §2 (NEW).]

3. Application of law. Any transferee that was doing business in this State prior to the effective date of this chapter within 30 days after the effective date of this chapter shall furnish notice to the superintendent pursuant to the requirements of subsection 1 and shall comply with the requirements of subsection 2 . [PL 1999, c. 268, §2 (NEW).]

4. Notice of change. A transferee that intends to do business or is doing business in this State shall notify the superintendent within 10 days of any subsequent changes in any information or other items provided pursuant to this section. [PL 1999, c. 268, §2 (NEW).]
24-A M.R.S. § 7006 — ME Code / Title 24-A / Chapter 89 / Section 7006
24-A §7006. Termination of portable electronic device insurance
Status: in_force

1. Notice. Notwithstanding any other provision of law, an insurer may terminate or otherwise change the terms and conditions of a policy of portable electronic device insurance only upon providing the vendor policyholder and enrolled customers with at least 30 days' notice. [PL 2011, c. 297, §5 (NEW).]

2. Revised documents. Notwithstanding any other provision of law, if the insurer changes the terms and conditions of a policy of portable electronic device insurance, the insurer shall provide the vendor policyholder with a revised policy or endorsement and each enrolled customer with a revised certificate or endorsement, an updated brochure or other evidence indicating that a change in the terms and conditions has occurred and a summary of material changes. [PL 2011, c. 297, §5 (NEW).]

3. Notice in case of fraud or material misrepresentation. Notwithstanding subsection 1 or any other provision of law, an insurer may upon 15 days' notice terminate an enrolled customer's enrollment under a portable electronic device insurance policy for discovery of fraud or material misrepresentation in obtaining coverage or in the presentation of a claim thereunder. [PL 2011, c. 297, §5 (NEW).]

4. Immediate termination of enrollment allowed. Notwithstanding subsection 1 or any other provision of law, an insurer may immediately terminate an enrolled customer's enrollment under a portable electronic device insurance policy: A. For nonpayment of premium; [PL 2011, c. 297, §5 (NEW).] B. If the enrolled customer ceases to have an active service with the vendor; or [PL 2011, c. 297, §5 (NEW).] C. If an enrolled customer exhausts the aggregate limit of liability, if any, under the terms of the portable electronic device insurance policy and the insurer sends notice of termination to the customer within 30 calendar days after exhaustion of the limit. If this notice is not timely sent, enrollment must continue notwithstanding the aggregate limit of liability until the insurer sends notice of termination to the enrolled customer. [PL 2011, c. 297, §5 (NEW).] [PL 2011, c. 297, §5 (NEW).]

5. Policy terminated by vendor policyholder. Notwithstanding any other provision of law, when a portable electronic device insurance policy is terminated by a vendor policyholder, the vendor policyholder shall mail or deliver written notice to each enrolled customer advising the customer of the termination of the policy and the effective date of termination. The written notice must be mailed or delivered to the customer at least 30 days prior to the termination. [PL 2011, c. 297, §5 (NEW).]

6. Method of notice. Notwithstanding any other provision of law, whenever notice is required pursuant to this section, it must be in writing and may be mailed or delivered to the vendor at the vendor's mailing address and to the vendor's affected enrolled customers at the last known mailing addresses on file with the insurer. If notice is mailed, the insurer or vendor, as the case may be, shall maintain proof of mailing in a form authorized or accepted by the United States Postal Service or other commercial mail delivery service. Alternatively, an insurer or vendor policyholder may comply with any notice required by this section by providing notice to a vendor or its affected enrolled customers, as the case may be, by electronic means. If notice is accomplished through electronic means, the insurer or vendor, as the case may be, shall maintain proof that the notice was sent. [PL 2011, c. 297, §5 (NEW).]
24-A M.R.S. § 4613 — ME Code / Title 24-A / Chapter 62 / Section 4613
24-A §4613. Appointment of association nominee
Status: in_force

The association may recommend a natural person to serve as a special deputy to act for the superintendent and under the superintendent's supervision in the liquidation, rehabilitation or conservation of any member insurer. [RR 2021, c. 1, Pt. B, §392 (COR).]
24-A M.R.S. § 2452 — ME Code / Title 24-A / Chapter 27 / Section 2452
24-A §2452. Employee benefit excess insurance; nondiscrimination; prohibited clauses
Status: in_force

1. Discrimination prohibited. A policy of employee benefit excess insurance may not discriminate unfairly among or against beneficiaries of the underlying benefit plan, or treat conditions related to the Human Immunodeficiency Virus, or HIV, more restrictively than other sicknesses or disabling conditions. [PL 1991, c. 385, §11 (NEW).]

2. Commutation clause. A policy of employee benefit excess insurance may not contain a commutation clause that extinguishes the excess carrier's gross claims liability to the insured person through the recapture of loss reserves, unless the policy contains a provision giving the insured the option of requiring that the funds transferred in support of such a commutation have been evaluated by a qualified health actuary who is a member of the American Academy of Actuaries and has certified that the aggregate value of reserves to be recaptured are reasonably adequate to discharge the insured's expected liability for future costs of the health benefits covered by the excess policy. [PL 1991, c. 385, §11 (NEW).]

3. Review. An employee benefit excess insurance form is not exempt from the review provisions otherwise applicable under section 2412 on the ground that the form is designed for insurance on a particular subject. [PL 1991, c. 385, §11 (NEW).]
24-A M.R.S. § 1130 — ME Code / Title 24-A / Chapter 13 / Section 1130
24-A §1130. Investments in foreign countries
Status: in_force

1. An insurer authorized to transact insurance in a foreign country or which has outstanding insurance or reinsurance contracts on risks resident or located in a foreign country may invest in or otherwise acquire or loan upon securities and investments in such foreign country which are substantially of the same kinds, classes and investment grades as those eligible for investment under other sections of this chapter; but the aggregate amount of such investments in a foreign country and of cash in the currency of such country shall not, except as to Canadian investments otherwise authorized under this chapter, exceed 1 1/2 times the amount of its reserves and other obligations under such contracts or the amount which the insurer is required by law to invest in such country, whichever is the greater. [PL 1987, c. 399, §11 (AMD).]

2. In addition to the foreign investments otherwise permitted under this chapter, an insurer may invest in or otherwise acquire or loan upon securities and investments in foreign countries which are substantially of the same kinds, classes and investment grades as those otherwise eligible for investment under this chapter; but the aggregate amount of such investments under this subsection shall not exceed 1% of the insurer's assets. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 6311 — ME Code / Title 24-A / Chapter 75 / Section 6311
24-A §6311. Rules
Status: in_force

The superintendent and the Commissioner of Health and Human Services may adopt rules in accordance with the Maine Administrative Procedure Act to carry out this chapter. Rules adopted pursuant to this section are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2013, c. 170, §3 (AMD).]
24-A M.R.S. § 2178 — ME Code / Title 24-A / Chapter 23 / Section 2178
24-A §2178. False applications, claims, proofs of loss; penalty
Status: in_force

No agent, broker, solicitor, examining physician, applicant or other person may knowingly or wilfully make any false or fraudulent statement or representation in or with reference to any application for insurance; or for the purpose of obtaining any money or benefit, knowingly or wilfully present or cause to be presented a false or fraudulent claim; or any proof in support of such a claim for the payment of the loss upon a contract of insurance; or prepare, make, or subscribe a false or fraudulent account, certificate, affidavit or proof of loss, or other document or writing, with intent that the same may be presented or used in support of such a claim. Persons who violate this section are subject to the penalty provided in section 12‑A , or as provided by any other applicable law that provides a greater penalty. [PL 1991, c. 824, Pt. A, §50 (AMD).]
24-A M.R.S. § 2013 — ME Code / Title 24-A / Chapter 19 / Section 2013
24-A §2013. License suspension or revocation
Status: in_force

1. Notwithstanding Title 5, chapter 375, subchapter VI , the superintendent may, after notice and opportunity for hearing, deny, revoke, suspend or limit the permissible activities under any surplus lines authority: A. If the producer fails to remit the tax as required by section 2018 ; [PL 2001, c. 259, §49 (AMD).] B. If a producer who is required to maintain an office in this State fails to do so, or to keep the records, or to allow the superintendent to examine those records as required by this law, or if the producer removes those records from the State when prohibited; [PL 2001, c. 259, §49 (AMD).] C. If the producer places a surplus lines coverage in an insurer other than as authorized under section 2007 ; [PL 1997, c. 592, §59 (AMD).] D. For any other applicable cause for which a producer's license may be suspended or revoked; or [PL 2001, c. 259, §50 (AMD).] E. If the producer assists any person or persons not licensed as producers with surplus lines authority by serving as a reporting producer for purposes of section 2015 or 2016 with respect to insurance coverage not procured by the producer. [PL 1997, c. 592, §59 (AMD).] [PL 2001, c. 259, §§49, 50 (AMD).]

2. The procedures provided by chapter 16 for suspension or revocation of licenses apply to suspension or revocation of a surplus lines authority. [PL 1997, c. 592, §59 (AMD).]

3. Upon a ruling by the superintendent suspending or revoking a producer's surplus lines authority the superintendent may suspend or revoke all other licenses or authorities held by the same individual under this Title. [PL 1997, c. 592, §59 (AMD).]
24-A M.R.S. § 4361 — ME Code / Title 24-A / Chapter 57 / Section 4361
24-A §4361. Service of process
Status: in_force

A certified copy of any order to show cause issued under section 4360 , and a copy of the petition upon which the same is made, must be served upon the insurer by delivering the same to its president, vice-president, secretary, treasurer, director or to its managing agent or attorney in fact, if a reciprocal insurer; or if no such officer or functionary can readily be found in this State, then such process may be served upon the insurer by service thereof upon the superintendent pursuant to section 421 . [PL 1997, c. 457, §51 (AMD).]
24-A M.R.S. § 2732 — ME Code / Title 24-A / Chapter 33 / Section 2732
24-A §2732. Requirements of other jurisdictions
Status: in_force

1. Any policy of a foreign or alien insurer, when delivered or issued for delivery to any person in this State, may contain any provision which is not less favorable to the insured or the beneficiary than the provisions of this chapter and which is prescribed or required by the law of the state or country under which the insurer is organized. [PL 1969, c. 132, §1 (NEW).]

2. Any policy of a domestic insurer may, when issued for delivery in any other state or country, contain any provision permitted or required by the laws of such other state or country. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 4320-R — ME Code / Title 24-A / Chapter 56-A / Section 4320-R
24-A §4320-R. 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 4233‑B, subsection 1 . [PL 2021, c. 520, §8 (NEW).] B. "Disability" means a physical, mental, intellectual or developmental disability that renders a person incapable of self-sustaining employment. [PL 2021, c. 520, §8 (NEW).] [PL 2021, c. 520, §8 (NEW).]

2. Offer of coverage. A health plan subject to the requirements of the federal Affordable Care Act 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, §8 (NEW).]

3. Proof of disability. A parent shall furnish proof of a dependent child's disability to the carrier within 31 days of the dependent child's attainment of the limiting age established in section 4320‑B and subsequently as may be required by the carrier, but the carrier 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, §8 (NEW).]

Revisor's Note: §4320-R. Implementation of federal mental health parity laws (As enacted by PL 2021, c. 638, §4 is REALLOCATED TO TITLE 24-A, SECTION 4320-T)
24-A M.R.S. § 6713 — ME Code / Title 24-A / Chapter 83 / Section 6713
24-A §6713. Exemption from compulsory associations
Status: in_force

A captive insurance company may not join or contribute financially to any plan, pool, association or guaranty or insolvency fund in this State, and a captive insurance company and its insureds, its parent or any affiliated company or member organization of its association may not receive any benefit from the plan, pool, association or guaranty or insolvency fund for claims arising out of the operations of the captive insurance company. [PL 1997, c. 435, §1 (NEW).]
24-A M.R.S. § 4366 — ME Code / Title 24-A / Chapter 57 / Section 4366
24-A §4366. Claims of nonresidents against domestic insurers
Status: in_force

1. In a delinquency proceeding begun in this State against a domestic insurer, claimants residing in reciprocal states may file claims either with the ancillary receivers, if any, in their respective states, or with the domiciliary receiver, but claimants residing in foreign countries or in states not reciprocal states must file claims in this State. All such claims must be filed on or before the last date fixed for the filing of claims in the domiciliary delinquency proceedings. [PL 1991, c. 828, §29 (AMD).]

2. Controverted claims belonging to claimants residing in reciprocal states may either: A. Be proved in this State, or [PL 1969, c. 132, §1 (NEW).] B. If ancillary proceedings have been commenced in such reciprocal states, may be proved in those proceedings. In the event a claimant elects to prove the claimant's claim in ancillary proceedings, if notice of the claim and opportunity to appear and be heard is afforded the domiciliary receiver of this State, as provided in section 4367 with respect to ancillary proceedings in this State, the final allowance of such claim by the courts in the ancillary state must be accepted in this State as conclusive as to its amount and must also be accepted as conclusive as to its priority, if any, against special deposits or other security located within the ancillary state. [RR 2021, c. 1, Pt. B, §363 (COR).] [RR 2021, c. 1, Pt. B, §363 (COR).]
24-A M.R.S. § 4305 — ME Code / Title 24-A / Chapter 56-A / Section 4305
24-A §4305. Quality of care
Status: in_force

A carrier offering or renewing a health plan that subjects payment of benefits for otherwise covered services to review for clinical necessity, appropriateness, efficacy or efficiency must meet the following requirements relating to quality of care. [PL 2007, c. 199, Pt. B, §14 (AMD).]

1. Internal quality assurance program. A health plan must have an ongoing quality assurance program for the health care services provided or reimbursed by the health plan. [PL 1995, c. 673, §1 (NEW); PL 1995, c. 673, §2 (AFF).]

2. Written standards. The standards of quality of care must be described in a written document, which must be available for examination by the superintendent or by the Department of Health and Human Services. [PL 1995, c. 673, §1 (NEW); PL 1995, c. 673, §2 (AFF); PL 2003, c. 689, Pt. B, §6 (REV).]

3. Coverage decisions. Following a determination that a particular service is covered, a carrier may not deny payment for that service based on the enrollee's age, nature of disability or degree of medical dependency. [PL 1995, c. 673, §1 (NEW); PL 1995, c. 673, §2 (AFF).]
24-A M.R.S. § 2837-G — ME Code / Title 24-A / Chapter 35 / Section 2837-G
24-A §2837-G. Off-label use of prescription drugs for HIV or AIDS
Status: in_force

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Off-label use" means the prescription and use of drugs for indications other than those stated in the labeling approved by the federal Food and Drug Administration. [PL 1997, c. 701, §3 (NEW).] B. "Peer-reviewed medical literature" means scientific studies published in at least 2 articles from major peer-reviewed medical journals that present data that supports the proposed off-label use as generally safe and effective. [PL 1997, c. 701, §3 (NEW).] C. "Standard reference compendia" means: (1) The United States Pharmacopeia Drug Information or information published by its successor organization; or (2) The American Hospital Formulary Service Drug Information or information published by its successor organization. [PL 1997, c. 701, §3 (NEW).] [PL 1997, c. 701, §3 (NEW).]

2. Required coverage for off-label use. All group insurance policies and contracts that provide coverage for prescription drugs must provide coverage for off-label use in accordance with the following. A. Group insurance policies and contracts that provide coverage for prescription drugs may not exclude coverage of any such drug used for the treatment of HIV or AIDS on the grounds that the drug has not been approved by the federal Food and Drug Administration for that indication, as long as that drug is recognized for the treatment of that indication in one of the standard reference compendia or in peer-reviewed medical literature. [PL 1997, c. 701, §3 (NEW).] B. Coverage of a drug required by this subsection also includes medically necessary services associated with the administration of the drug. [PL 1997, c. 701, §3 (NEW).] C. This subsection may not be construed to require coverage for a drug when the federal Food and Drug Administration has determined its use to be contraindicated for treatment of the current indication. [PL 1997, c. 701, §3 (NEW).] D. A drug use that is covered pursuant to paragraph A may not be denied coverage based on a "medical necessity" requirement except for a reason that is unrelated to the legal status of the drug use. [PL 1997, c. 701, §3 (NEW).] E. A contract that provides coverage of a drug as required by this subsection may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the same extent that these provisions are applicable to coverage of all prescription drugs and are not inconsistent with the requirements of this subsection. [PL 1997, c. 701, §3 (NEW).] [PL 1997, c. 701, §3 (NEW).]

3. Application. The requirements of this section apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 1999. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 1997, c. 701, §3 (NEW).]
24-A M.R.S. § 4314-A — ME Code / Title 24-A / Chapter 56-A / Section 4314-A
24-A §4314-A. Coverage for early refills of prescription eye drops
Status: in_force

1. Required coverage. A carrier offering a health plan in this State shall provide coverage for one early refill of a prescription for eye drops if the following criteria are met: A. The enrollee requests the refill no earlier than the date on which 70% of the days of use authorized by the prescribing health care provider have elapsed; [PL 2015, c. 91, §1 (NEW); PL 2015, c. 91, §2 (AFF).] B. The prescribing health care provider indicated on the original prescription that a specific number of refills are authorized; [PL 2015, c. 91, §1 (NEW); PL 2015, c. 91, §2 (AFF).] C. The refill requested by the enrollee does not exceed the number of refills indicated on the original prescription; [PL 2015, c. 91, §1 (NEW); PL 2015, c. 91, §2 (AFF).] D. The prescription has not been refilled more than once during the period authorized by the prescribing health care provider prior to the request for an early refill; and [PL 2015, c. 91, §1 (NEW); PL 2015, c. 91, §2 (AFF).] E. The prescription eye drops are a covered benefit under the enrollee's health plan. [PL 2015, c. 91, §1 (NEW); PL 2015, c. 91, §2 (AFF).] [PL 2015, c. 91, §1 (NEW); PL 2015, c. 91, §2 (AFF).]

2. Cost sharing. A carrier may impose a deductible, copayment or coinsurance requirement for an early refill under this section as permitted under the health plan. [PL 2015, c. 91, §1 (NEW); PL 2015, c. 91, §2 (AFF).]
24-A M.R.S. § 7102 — ME Code / Title 24-A / Chapter 91 / Section 7102
24-A §7102. Definitions
Status: in_force

As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).]

1. Administrator. "Administrator" means the person who is responsible for the administration of a service contract program or who is responsible for any submission required by this chapter. [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).]

2. Consumer. "Consumer" means an individual who buys other than for purposes of resale any tangible personal property that is distributed in commerce and that is normally used for personal, family or household purposes and not for business or research purposes. [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).]

3. Maintenance agreement. "Maintenance agreement" means a contract of limited duration that provides for scheduled maintenance only and does not include repair or replacement. [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).]

4. Motor vehicle manufacturer. "Motor vehicle manufacturer" means a person that: A. Manufactures or produces motor vehicles and sells motor vehicles under its own name or label; [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).] B. Is a wholly owned subsidiary of a person that manufactures or produces motor vehicles; [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).] C. Is a corporation that owns 100% of a person that manufactures or produces motor vehicles; [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).] D. Sells motor vehicles under the trade name or label of another person that manufactures or produces motor vehicles; or [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).] E. Does not manufacture or produce motor vehicles but, pursuant to a written contract, licenses the use of its trade name or label to another person that manufactures or produces motor vehicles and that sells motor vehicles under the licensor's trade name or label. [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).] [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).]

5. Nonoriginal manufacturer's parts. "Nonoriginal manufacturer's parts" means replacement parts not made for or by the original manufacturer of the property, commonly referred to as "aftermarket parts." [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).]

6. Person. "Person" means an individual, partnership, corporation, incorporated or unincorporated association, joint stock company, reciprocal, syndicate or any similar entity or combination of entities acting in concert. [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).]

7. Premium. "Premium" means the consideration paid to an insurer for a reimbursement insurance policy. [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).]

8. Provider. "Provider" means a person who is contractually obligated to a service contract holder under the terms of a service contract. [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).]

9. Provider fee. "Provider fee" means the consideration paid for a service contract. [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).]

10. Reimbursement insurance policy. "Reimbursement insurance policy" means a policy of insurance, issued to a provider, that provides reimbursement to the provider under the terms of the insured service contracts issued or sold by the provider or, in the event of the provider's nonperformance, pays to service contract holders on behalf of the provider all covered contractual obligations incurred by the provider under the terms of the insured service contracts issued or sold by the provider. [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).]

11. Service contract. "Service contract" means a contract or agreement for a separately stated consideration for a specific duration to perform the repair, replacement or maintenance of property or to indemnify for the repair, replacement or maintenance for an operational or structural failure of any motor vehicle or other property due to a defect in materials or workmanship or normal wear and tear, with or without additional provisions for incidental payment of indemnity under limited circumstances, including, but not limited to, towing, rental and emergency road service and road hazard protection. Coverage issued by an authorized insurance company pursuant to a personal automobile insurance policy for payment of towing, rental, emergency road service or automobile mechanical breakdown is not a service contract. Service contracts may provide for the repair, replacement or maintenance of property for damage resulting from power surges or interruption. "Service contract" includes a contract or agreement sold for a separately stated consideration for a specific duration that provides for any of the following: A. The repair or replacement or indemnification for the repair or replacement of a motor vehicle for the operational or structural failure of one or more parts or systems of the motor vehicle brought about by the failure of an additive product to perform as represented; [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).] B. The repair or replacement of tires or wheels on a motor vehicle damaged as a result of coming into contact with road hazards, including, but not limited to, potholes, rocks, wood debris, metal parts, glass, plastic, curbs or composite scraps; [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).] C. The removal of dents, dings or creases on a motor vehicle that can be repaired using the process of paintless dent removal without affecting the existing paint finish and without replacing vehicle body panels, sanding, bonding or painting; [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).] D. The repair of small motor vehicle windshield chips or cracks but not the replacement of the entire windshield; [PL 2021, c. 128, §1 (AMD).] E. The repair of damage to the interior components of a motor vehicle caused by wear and tear but that expressly excludes the replacement of any part or component of a motor vehicle's interior; [PL 2021, c. 128, §2 (AMD).] F. The replacement of a motor vehicle key or key fob in the event the key or key fob becomes inoperable or is lost or stolen; or [PL 2021, c. 128, §3 (NEW).] G. In conjunction with a motor vehicle lease, the repair, replacement or maintenance of the motor vehicle, or indemnification for repair, replacement or maintenance, due to excess wear and use; due to damage for items such as tires, paint cracks or chips, interior stains, rips or scratches, exterior dents or scratches, windshield cracks or chips or missing interior or exterior parts; or due to excess mileage that results in a lease-end charge or any other charge for damage that is determined to be excess wear and use by a lessor under a motor vehicle lease, as long as any such payment does not exceed the purchase price of the motor vehicle. [PL 2021, c. 128, §4 (NEW).] Notwithstanding any other provision of law, service contracts are not insurance in this State and may not be regulated as insurance except for a contract or agreement providing indemnification for a loss caused by misplacement, theft, collision, fire or other peril typically covered in the comprehensive section of an automobile insurance policy or by a homeowner's policy or a marine or inland marine policy. [PL 2021, c. 128, §§1-4 (AMD).]

12. Service contract holder. "Service contract holder" means a person who is the purchaser or holder of a service contract. [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).]

13. Superintendent. "Superintendent" means the Superintendent of Insurance. [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).]

14. Tangible net worth. "Tangible net worth" means equity less assets that have no physical existence and depend on expected future benefits for their ascribed value. [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).]

15. Warranty. "Warranty" means a warranty made solely by the manufacturer, importer or seller of property or services without consideration that is not negotiated or separated from the sale of the product and is incidental to the sale of the product and that guarantees indemnity for defective parts, mechanical or electrical breakdown, labor or other remedial measures, such as repair or replacement of the property or repetition of services. [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).]
24-A M.R.S. § 4253 — ME Code / Title 24-A / Chapter 56 / Section 4253
24-A §4253. Enrollment for individuals or families establishing eligibility for MaineCare
Status: in_force

When an individual or family is eligible for MaineCare and is also eligible for health maintenance organization coverage provided by an employer through a health maintenance organization, the health maintenance organization must permit the individual or family to enroll in the health maintenance organization coverage without regard to any enrollment season restrictions. [PL 2007, c. 448, §12 (NEW).] Revisor's Note: §4253. Coverage for hearing aids (As enacted by PL 2007, c. 452, §4 is REALLOCATED TO TITLE 24-A, SECTION 4255)
24-A M.R.S. § 3307 — ME Code / Title 24-A / Chapter 47 / Section 3307
24-A §3307. Articles of incorporation, approval and filing
Status: in_force

1. The incorporators of a proposed insurer shall deliver the triplicate originals of the articles of incorporation to the superintendent. The superintendent shall deliver one set of such originals to the Attorney General of this State, and the Attorney General shall examine the same. If the Attorney General finds that the articles of incorporation comply with law, the Attorney General shall so certify in writing and return the original of the articles of incorporation, so certified, to the superintendent. [PL 2013, c. 299, §3 (AMD).]

2. When the articles of incorporation have been approved and returned by the Attorney General pursuant to subsection 1 , the superintendent shall also endorse the superintendent's approval upon each set of the articles of incorporation and return the triplicate originals of the articles of incorporation to the incorporators. The incorporators shall then file one of the sets with the Secretary of State and one set with the superintendent bearing the certification of the Secretary of State and shall retain the remaining set in the corporate records. [PL 2013, c. 299, §3 (AMD).]

3. For filing the articles of incorporation of a mutual insurer, the Secretary of State shall charge and collect a filing fee of $25; except that if it is a mutual insurance corporation with provision for guaranty capital shares, the Secretary of State shall charge and collect for the filing of the articles of incorporation the same amount as would be payable by a stock insurance corporation having a like amount of authorized capital stock. [PL 2013, c. 299, §3 (AMD).]

4. If the Attorney General finds that the proposed articles of incorporation do not comply with law, the Attorney General shall refuse to approve the same and shall return the set of the articles of incorporation to the superintendent, together with a written statement of the respects in which the Attorney General finds that the articles do not comply. The superintendent shall return all sets of the proposed articles of incorporation to the proposed incorporators together with the Attorney General's written statement. [PL 2013, c. 299, §3 (AMD).]

5. The Secretary of State may not permit the filing in the Secretary of State's office of any articles of incorporation unless the articles bear the superintendent's approval as provided in this section. [PL 2013, c. 299, §3 (AMD).]

6. The approval of the Attorney General or superintendent, as provided for in this section, is considered to relate only to the form and contents of the articles, and does not constitute approval or commitment as to any other aspect or operation of the proposed insurer or relative to its entitlement, if any, to a certificate of authority. [PL 2013, c. 299, §3 (AMD).]

7. The superintendent and Attorney General shall perform all duties required of them under this section within a reasonable time after the articles of incorporation have been submitted to the superintendent as provided in subsection 1 . [PL 2013, c. 299, §3 (AMD).]
24-A M.R.S. § 2443 — ME Code / Title 24-A / Chapter 27 / Section 2443
24-A §2443. Powers of the superintendent
Status: in_force

The superintendent may authorize a lower score than the Flesch reading ease score required in section 2441, subsection 1, paragraph A , whenever, in the superintendent's sole discretion, the superintendent finds that a lower score will provide a more accurate reflection of the readability of a policy form, or is warranted by the nature of a particular policy form or type or class of policy forms, or is caused by certain policy language that is drafted to conform to the requirements of any state law, regulation or agency interpretation. [RR 2021, c. 1, Pt. B, §224 (COR).]
24-A M.R.S. § 4126 — ME Code / Title 24-A / Chapter 55 / Section 4126
24-A §4126. Injunction -- liquidation -- receivership of domestic society
Status: in_force

1. When the superintendent upon investigation finds that a domestic society: A. Has exceeded its powers; [PL 1969, c. 132, §1 (NEW).] B. Has failed to comply with any provision of this chapter; [PL 1969, c. 132, §1 (NEW).] C. Is not fulfilling its contracts in good faith; [PL 1969, c. 132, §1 (NEW).] D. Has a membership of less than 400 after an existence of 1 year or more; or [PL 1969, c. 132, §1 (NEW).] E. Is conducting business fraudulently or in a manner hazardous to its members, creditors, the public or the business; [PL 1969, c. 132, §1 (NEW).] the superintendent shall notify the society of such deficiency or deficiencies and state in writing the reasons for the superintendent's dissatisfaction. The superintendent shall at once issue a written notice to the society requiring that the deficiency or deficiencies that exist are corrected. After such notice the society has a 30-day period in which to comply with the superintendent's request for correction, and if the society fails to comply, the superintendent shall notify the society of the superintendent's findings of noncompliance and require the society to show cause on a date named why it should not be enjoined from carrying on any business until the violation complained of has been corrected, or why an action in quo warranto should not be commenced against the society. If on such date the society does not present good and sufficient reasons why it should not be so enjoined or why such action should not be commenced, the superintendent may present the facts relating thereto to the Attorney General who shall, if the Attorney General considers the circumstances warrant, commence an action to enjoin the society from transacting business or in quo warranto. The court shall thereupon notify the officers of the society of a hearing. If after a full hearing it appears that the society should be so enjoined or liquidated or a receiver appointed, the court shall enter the necessary order. [RR 2021, c. 1, Pt. B, §331 (COR).]

2. No society so enjoined shall have the authority to do business until: A. The superintendent finds that the violation complained of has been corrected; [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).] B. The cost of such action shall have been paid by the society if the court finds that the society was in default as charged; [PL 1969, c. 132, §1 (NEW).] C. The court has dissolved its injunction; and [PL 1969, c. 132, §1 (NEW).] D. The society's certificate of authority has been reinstated. [PL 1977, c. 694, §431 (RPR).] [PL 1977, c. 694, §431 (AMD).]

3. If the court orders the society liquidated, it shall be enjoined from carrying on any further business, whereupon the receiver of the society shall proceed at once to take possession of the books, papers, money and other assets of the society and, under the direction of the court, proceed forthwith to close the affairs of the society and to distribute its funds to those entitled thereto. [PL 1969, c. 132, §1 (NEW).]

4. No action under this section shall be recognized in any court of this State unless brought by the Attorney General upon request of the superintendent. Whenever a receiver is to be appointed for a domestic society, the court shall appoint the superintendent as such receiver. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

5. The provisions of this section relating to hearing by the superintendent, action by the Attorney General at the request of the superintendent, hearing by the court, injunction and receivership shall be applicable to a society which shall voluntarily determine to discontinue business. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

6. 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 2009, c. 13, §3 (NEW).]
24-A M.R.S. § 6310 — ME Code / Title 24-A / Chapter 75 / Section 6310
24-A §6310. Appeals
Status: in_force

1. Assessments. Physicians, hospitals and physicians' employers aggrieved by an insurer's application of the assessment provided for in this chapter may request a hearing before the superintendent. The hearing must be held in accordance with chapter 3 , the Maine Administrative Procedure Act and procedural rules of the bureau. [PL 1989, c. 931, §5 (NEW).]

2. Eligibility. Physicians aggrieved by an eligibility determination by the Department of Health and Human Services under section 6307 may request a hearing under the Maine Administrative Procedure Act. [PL 1989, c. 931, §5 (NEW); PL 2003, c. 689, Pt. B, §6 (REV).]
24-A M.R.S. § 2847-I — ME Code / Title 24-A / Chapter 35 / Section 2847-I
24-A §2847-I. Coverage for services provided by registered nurse first assistants (REALLOCATED FROM TITLE 24-A, SECTION 2847-G)
Status: in_force

(REALLOCATED FROM TITLE 24-A, SECTION 2847-G)

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Perioperative nursing" means a practice of nursing in which the nurse provides preoperative, intraoperative and postoperative nursing care to surgical patients. [RR 1999, c. 1, §35 (RAL).] B. "Recognized program" means a program that addresses all content of the core curriculum for registered nurse first assistants as established by the Association of Operating Room Nurses or its successor organization. [RR 1999, c. 1, §35 (RAL).] C. "Registered nurse first assistant," or "RNFA," means a person who: (1) Is licensed as a registered nurse under Title 32, chapter 31 ; (2) Is experienced in perioperative nursing; and (3) Has successfully completed a recognized program. [RR 1999, c. 1, §35 (RAL).] [RR 1999, c. 1, §35 (RAL).]

2. Institutional powers. Each health care institution, as defined in Title 22, chapter 405 , may establish specific procedures for the appointment and reappointment of registered nurse first assistants and for granting, renewing and revising their clinical privileges. [RR 1999, c. 1, §35 (RAL).]

3. Required coverage for services. Notwithstanding any other provisions of this chapter, an insurer that issues group health insurance policies and contracts that provide coverage for surgical first assisting benefits or services shall provide coverage and payment under those contracts to a registered nurse first assistant who performs services that are within the scope of a registered nurse first assistant's qualifications. The provisions of this subsection apply only if reimbursement for an assisting physician would be covered and a registered nurse first assistant who performed those services is used as a substitute. This section does not apply to policies or contracts that cover only specified diseases. [RR 1999, c. 1, §35 (RAL).]

4. Limits; coinsurance; deductibles. Any contract that provides coverage for the services required by this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section. [RR 1999, c. 1, §35 (RAL).]

5. 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, §20 (NEW).]
24-A M.R.S. § 2001 — ME Code / Title 24-A / Chapter 19 / Section 2001
24-A §2001. Short title
Status: in_force

This chapter constitutes and may be cited as the "Surplus Lines Law." [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2167-A — ME Code / Title 24-A / Chapter 23 / Section 2167-A
24-A §2167-A. Notice to domiciliary supervisory official
Status: in_force

Whenever the superintendent has reason to believe that a foreign or alien insurer or licensed insurance professional is acting in violation of this chapter or chapter 21 , the superintendent shall notify the insurance supervisory official of that person's domiciliary jurisdiction. [PL 1991, c. 298, §15 (NEW).]
24-A M.R.S. § 4317-D — ME Code / Title 24-A / Chapter 56-A / Section 4317-D
24-A §4317-D. Coverage of HIV prevention drugs
Status: in_force

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "CDC guidelines" means guidelines related to the nonoccupational exposure to potential HIV infection, or any subsequent guidelines, published by the federal Department of Health and Human Services, Centers for Disease Control and Prevention. [PL 2021, c. 265, §4 (NEW); PL 2021, c. 265, §8 (AFF).] B. "HIV prevention drug" means a preexposure prophylaxis drug, post-exposure prophylaxis drug or other drug approved for the prevention of HIV infection by the federal Food and Drug Administration. [PL 2021, c. 265, §4 (NEW); PL 2021, c. 265, §8 (AFF).] C. "Post-exposure prophylaxis drug" means a drug or drug combination that meets the clinical eligibility recommendations provided in CDC guidelines following potential exposure to HIV infection. [PL 2021, c. 265, §4 (NEW); PL 2021, c. 265, §8 (AFF).] D. "Preexposure prophylaxis drug" means a drug or drug combination that meets the clinical eligibility recommendations provided in CDC guidelines to prevent HIV infection. [PL 2021, c. 265, §4 (NEW); PL 2021, c. 265, §8 (AFF).] [PL 2021, c. 265, §4 (NEW); PL 2021, c. 265, §8 (AFF).]

2. Coverage required. A carrier offering a health plan in this State shall provide coverage for an HIV prevention drug that has been prescribed by a provider or that has been prescribed, dispensed and administered by a pharmacist under Title 32, section 13786‑E . Coverage under this section is subject to the following. A. If the federal Food and Drug Administration has approved one or more HIV prevention drugs that use the same method of administration, a carrier is not required to cover all approved drugs as long as the carrier covers at least one approved drug for each method of administration with no out-of-pocket cost. Notwithstanding this paragraph, a carrier shall provide coverage with no out-of-pocket cost for HIV prevention drugs for the prevention of the acquisition of HIV infection in accordance with a rating of A or B in the recommendations of the United States Preventive Services Task Force or equivalent rating from a successor organization and guidelines issued by the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services. [PL 2025, c. 483, §2 (AMD).] B. A carrier is not required to cover any preexposure prophylaxis drug or post-exposure prophylaxis drug dispensed or administered by an out-of-network pharmacy provider unless the enrollee's health plan provides an out-of-network pharmacy benefit. [PL 2021, c. 265, §4 (NEW); PL 2021, c. 265, §8 (AFF).] C. A carrier may not prohibit, or permit a pharmacy benefits manager to prohibit, a pharmacy provider from prescribing, dispensing or administering any HIV prevention drugs. [PL 2025, c. 483, §2 (AMD).] D. A carrier shall authorize a pharmacist to bill the carrier and receive direct payment for a service that the pharmacist provides to an enrollee pursuant to this section and shall identify the pharmacist as the provider in the billing and claims process for payment for the service. A carrier may not impose on a pharmacist, in order for the pharmacist to receive payment for a service provided pursuant to this section, a practice, education or collaboration requirement that is inconsistent with or more restrictive than a requirement of state law or agency or board rules. [PL 2025, c. 483, §2 (NEW).] [PL 2025, c. 483, §2 (AMD).]

3. Limits on prior authorization and step therapy requirements. Notwithstanding any requirements in section 4304 or 4320‑N to the contrary, a carrier may not subject any HIV prevention drug to any prior authorization or step therapy requirement except as provided in this subsection. If the federal Food and Drug Administration has approved one or more methods of administering HIV prevention drugs, a carrier is not required to cover all of the approved drugs without prior authorization or step therapy requirements as long as the carrier covers at least one approved drug for each method of administration without prior authorization or step therapy requirements. Notwithstanding this subsection, a carrier shall provide coverage without prior authorization or step therapy requirements for HIV prevention drugs for the prevention of the acquisition of HIV infection in accordance with a rating of A or B in the recommendations of the United States Preventive Services Task Force or equivalent rating from a successor organization and guidelines issued by the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services. If prior authorization or step therapy requirements are met for a particular enrollee with regard to a particular HIV prevention drug, the carrier is required to cover that drug with no out-of-pocket cost to the enrollee. [PL 2025, c. 483, §3 (AMD).]

4. Coverage for laboratory testing related to HIV prevention drugs. A carrier offering a health plan in this State shall provide coverage with no out-of-pocket cost for laboratory testing recommended by a provider related to the ongoing monitoring of an enrollee who is taking an HIV prevention drug covered by this section. [PL 2021, c. 265, §4 (NEW); PL 2021, c. 265, §8 (AFF).]
24-A M.R.S. § 747 — ME Code / Title 24-A / Chapter 9 / Section 747
24-A §747. Required contract provisions; reinsurance intermediary-managers
Status: in_force

Transactions between a reinsurance intermediary-manager and the reinsurer it represents in such capacity may be entered into only pursuant to a written contract, specifying the responsibilities of each party, that must be approved by the reinsurer's board of directors. At least 30 days before the reinsurer assumes or cedes business through the reinsurance intermediary-manager, a true copy of the approved contract must be filed with the superintendent for approval. The contract must, at a minimum, contain the following terms and conditions. [PL 1991, c. 828, §20 (NEW).]

1. Termination. The reinsurer may terminate the contract for cause upon 5 days' written notice to the reinsurance intermediary-manager. The reinsurer may immediately suspend the authority of the reinsurance intermediary-manager to assume or cede business during the pendency of any dispute regarding the cause for termination. [PL 1991, c. 828, §20 (NEW).]

2. Accounting. The reinsurance intermediary-manager shall render accounts to the reinsurer accurately detailing all material transactions, including information necessary to support all commissions, charges and other fees received by or owed, to the reinsurance intermediary-manager and remit all funds due under the contract to the reinsurer on not less than a monthly basis. [PL 1991, c. 828, §20 (NEW).]

3. Bank as fiduciary. All funds collected for the reinsurer's account must be held in trust by the reinsurance intermediary-manager in a fiduciary capacity in a bank that is a qualified United States financial institution. The reinsurance intermediary-manager may retain no more than 3 months' estimated claims payments and allocated loss adjustment expenses. The reinsurance intermediary-manager shall maintain a separate bank account for each reinsurer that it represents. [PL 1991, c. 828, §20 (NEW).]

4. Compliance with law. The reinsurance intermediary-manager shall comply with section 748 . [PL 1991, c. 828, §20 (NEW).]

5. Access. The reinsurer must have access to and may copy all accounts and records maintained by the reinsurance intermediary-manager related to its business in a form usable by the reinsurer. [PL 1991, c. 828, §20 (NEW).]

6. Nonassignable. The contract may not be assigned in whole or in part by the reinsurance intermediary-manager. [PL 1991, c. 828, §20 (NEW).]

7. Compliance with standards. The reinsurance intermediary-manager shall comply with the written underwriting and rating standards established by the insurer for the acceptance, rejection or cession of all risks. [PL 1991, c. 828, §20 (NEW).]

8. Commissions; fees. The contract must set forth the rates, terms and purposes of commissions, charges and other fees that the reinsurance intermediary-manager may levy against the reinsurer. [PL 1991, c. 828, §20 (NEW).]

9. Settlement. If the contract permits the reinsurance intermediary-manager to settle claims on behalf of the reinsurer: A. All claims must be reported to the reinsurer in a timely manner; [PL 1991, c. 828, §20 (NEW).] B. A copy of each claim file must be sent to the reinsurer at its request or as soon as it becomes known that the claim: (1) Has the potential to exceed the lesser of an amount determined by the superintendent or the limit set by the reinsurer; (2) Involves a coverage dispute; (3) May exceed the reinsurance intermediary-manager's claims settlement authority; (4) Is open for more than 6 months; or (5) Is closed by payment of the lesser of an amount set by a court of competent jurisdiction or an amount agreed by the reinsurer; [PL 1991, c. 828, §20 (NEW).] C. All claim files must be the joint property of the reinsurer and the reinsurance intermediary-manager; except that, upon an order of liquidation of the reinsurer, the files become the sole property of the reinsurer or its estate. The reinsurance intermediary-manager must have reasonable access to and may copy the files on a timely basis; and [PL 1991, c. 828, §20 (NEW).] D. Any settlement authority granted to the reinsurance intermediary-manager may be terminated for cause upon the reinsurer's notice to the reinsurance intermediary-manager or upon the termination of the contract. The reinsurer may suspend the settlement authority during the pendency of the dispute regarding the cause of termination. [PL 1991, c. 828, §20 (NEW).] [PL 1991, c. 828, §20 (NEW).]

10. Interim profits. If the contract provides for a sharing of interim profits by the reinsurance intermediary-manager, interim profits may not be paid until one year after the end of each underwriting period for property business and 5 years after the end of each underwriting period for casualty business or other period set by the superintendent for other specified kinds of insurance and not until the adequacy of reserves on remaining claims has been verified pursuant to section 750, subsection 3 . [PL 1991, c. 828, §20 (NEW).]

11. Financial statements. The reinsurance intermediary-manager shall annually provide the reinsurer with a statement of current origin of its financial condition prepared by an independent certified accountant. These statements must be certified reports or review statements prepared by a certified public accountant. [PL 1991, c. 828, §20 (NEW).]

12. On-site review. The reinsurer shall periodically and no less than semiannually conduct an on-site review of the underwriting and claims processing operations of the reinsurance intermediary-manager. [PL 1991, c. 828, §20 (NEW).]

13. Disclosure. The reinsurance intermediary-manager shall disclose to the reinsurer any relationship the reinsurer has with any insurer prior to ceding or assuming any business with the insurer pursuant to this contract. [PL 1991, c. 828, §20 (NEW).]

14. Scope of authority. Within the scope of its actual or apparent authority the acts of the reinsurance intermediary-manager are deemed to be the acts of the reinsurer on whose behalf it is acting. [PL 1991, c. 828, §20 (NEW).]
24-A M.R.S. § 6309 — ME Code / Title 24-A / Chapter 75 / Section 6309
24-A §6309. Intercorporate transfers
Status: in_force

The superintendent may order intercorporate transfers of funds to balance assessments and program payments on an equitable basis among insurers and to provide for payments to eligible self-insureds. [PL 1991, c. 734, §5 (AMD).]
24-A M.R.S. § 2837 — ME Code / Title 24-A / Chapter 35 / Section 2837
24-A §2837. Home health care coverage
Status: in_force

Every insurer which issues or issues for delivery in this State group or blanket health insurance policies or plans, which provide coverage on an expense incurred basis for inpatient hospital care, shall make available that coverage for home health care services by a home health care provider. [PL 1977, c. 696, §202 (RPR).]

The policy 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 policy. Each visit by an individual member of a home health care provider shall be considered as one home care visit. [PL 1977, c. 470, §3 (NEW).]

1. Home health care services. "Home health care services" means those health care services rendered in a covered person's 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, §3 (NEW).] B. The plan covering the home health services is established as prescribed in writing by a physician. [PL 1977, c. 470, §3 (NEW).] There may not be a requirement that hospitalization be an antecedent to coverage under the policy. [RR 2021, c. 1, Pt. B, §249 (COR).]

2. Home health care 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, §3 (NEW).] B. A physician's home or office visits or both; [PL 1977, c. 470, §3 (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, §3 (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, §3 (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, §3 (NEW).] [PL 1977, c. 470, §3 (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, §3 (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, §3 (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, §3 (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, §3 (NEW).] E. Has under contract the services of a physician-advisor licensed by the State or a physician; [PL 1977, c. 470, §3 (NEW).] F. Conducts periodic case conferences for the purpose of individualized patient care planning and utilization review; and [PL 1977, c. 470, §3 (NEW).] G. Maintains a complete medical record on each patient. [PL 1977, c. 470, §3 (NEW).] [PL 1977, c. 470, §3 (NEW).]

4. Exclusions. A. No policy shall require home health care coverage to persons eligible for medicare; and [PL 1977, c. 470, §3 (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, §3 (NEW).] [PL 1977, c. 470, §3 (NEW).]
24-A M.R.S. § 2809 — ME Code / Title 24-A / Chapter 35 / Section 2809
24-A §2809. Coverage of family, dependents; continuation of coverage
Status: in_force

1. Any policy of group health insurance issued pursuant to sections 2804 (employee groups), 2805 (labor union groups), 2805‑A (association groups), 2806 (trustee groups), 2807‑A (credit union groups) or 2808 (other groups) may include coverage for members of the family or dependents of individuals otherwise insured in such groups. [PL 1981, c. 147, §9 (AMD).]

1-A. Any such policy of group health insurance that provides coverage for family members or dependents of individuals in the insured group may not define the terms "family" or "dependent" to exclude from coverage those minor children of any covered individual who do not reside with that individual. Insurers must comply with 42 United States Code, Section 1396g‑1. [PL 1995, c. 418, Pt. C, §3 (AMD).]

2. Any group health insurance policy which contains provisions for the payment by the insurer of benefits for expenses incurred on account of hospital, nursing, medical or surgical services for members of the family or dependents of an individual in the insured group may provide for the continuation of such benefit provisions, or any part or parts thereof, after the death of such individual. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 1103 — ME Code / Title 24-A / Chapter 13 / Section 1103
24-A §1103. General qualifications
Status: in_force

1. No security or investment, other than real and personal property acquired under section 1125 (real estate), shall be eligible for acquisition unless it is interest bearing or interest accruing or entitled to dividends, if declared, or is otherwise income-entitled, is not then in default in any respect, and the insurer is entitled to receive for its exclusive account and benefit the interest or income accruing thereon. Notwithstanding this subsection, nothing in this chapter may be deemed to prohibit an insurer from effecting or maintaining bona fide hedging transactions in foreign currency in connection with the purchase and sale of securities eligible for investment under this chapter or in contracts for future delivery of options, calls and other rights to purchase and puts and other rights to require another person to purchase, securities eligible for investment under this chapter, provided that those contracts, options, calls, puts and rights are traded on a national securities exchange or board of trade regulated under the laws of the United States and provided that the aggregate amount of those investments, as valued for all purposes in accordance with generally accepted accounting principles, shall not exceed 1% of the insurer's assets. For purposes of this subsection, a "bona fide hedging transaction" means a purchase or sale of foreign currency or of a contract, option, call, put or right, as the case may be, entered into for the purchase of offsetting changes in foreign currency exchange rates or in the market value of a security held or proposed to be acquired by the insurer. [PL 1983, c. 442, §1 (AMD).]

2. No provision of this chapter shall prohibit the acquisition by an insurer of other or additional securities or property if received as a dividend or as a lawful distribution of assets, or upon a debt or judgment, or under a lawful and bona fide agreement of bulk reinsurance, merger or consolidation. Any security or property so acquired which is not otherwise an eligible investment under this chapter shall be disposed of pursuant to section 1133 if real estate, or pursuant to section 1134 if personal property or securities. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2211 — ME Code / Title 24-A / Chapter 24 / Section 2211
24-A §2211. Correction, amendment or deletion of recorded personal information
Status: in_force

1. Action by regulated insurance entity. Within 30 days after receiving a written request from an insurance consumer to correct, amend or delete any recorded personal information within its possession about the consumer, a regulated insurance entity or insurance support organization shall: A. In the case of recorded personal information contained within a consumer report, provide the consumer with the name and address of the consumer reporting agency that furnished the report and notify the consumer of the rights under 15 United States Code, Section 1681i governing the correction of inaccurate personal information contained in a consumer report; or [PL 2013, c. 588, Pt. D, §5 (AMD).] B. In the case of other recorded personal information, either: (1) Correct, amend or delete the portion of the recorded personal information in dispute; or (2) Notify the consumer of its refusal to make the requested correction, amendment or deletion; the reasons for the refusal; and the consumer's right to file a statement as provided in subsection 3 . [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] [PL 2013, c. 588, Pt. D, §5 (AMD).]

2. Notice to others. If the regulated insurance entity or insurance support organization corrects, amends or deletes recorded personal information in accordance with subsection 1, paragraph B , the regulated insurance entity or insurance support organization shall notify the consumer in writing and furnish the correction, amendment or fact of deletion to: A. Any person specifically designated by the consumer who may have, within the preceding 2 years, received that recorded personal information; [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] B. Any insurance support organization whose primary source of personal information is insurance carriers, if the insurance support organization has systematically received recorded personal information from the carrier within the preceding 7 years. However, the correction, amendment or fact of deletion need not be furnished if the insurance support organization no longer maintains recorded personal information about the consumer; and [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] C. Any insurance support organization that furnished the personal information that has been corrected, amended or deleted. [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]

3. Consumer statement. When a consumer disagrees with a regulated insurance entity's or insurance support organization's refusal to correct, amend or delete recorded personal information, or when the regulated insurance entity or insurance support organization has not made all relevant recorded personal information available for verification by the consumer, the consumer must be permitted to file with the regulated insurance entity or insurance support organization: A. A concise statement setting forth what the consumer thinks is the correct, relevant or fair information; and [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] B. A concise statement of the reasons why the consumer disagrees with the regulated insurance entity's or insurance support organization's refusal to correct, amend or delete recorded personal information. [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]

4. Filing of statement. In the event a consumer files a statement as described in subsection 3 , the regulated insurance entity or insurance support organization shall: A. File the statement with the disputed personal information and provide a means by which anyone reviewing the disputed personal information will be made aware of the consumer's statement and have access to it; [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] B. In any subsequent disclosure by the regulated insurance entity or insurance support organization of the recorded personal information that is the subject of disagreement, clearly identify the matter or matters in dispute and provide the consumer's statement along with the recorded personal information being disclosed; and [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] C. Furnish the statement to the persons and in the manner specified in subsection 2 . [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]

5. Applicability. This section does not apply to a consumer reporting agency except to the extent that this section imposes more stringent requirements on a consumer reporting agency than other state or federal law. [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]
24-A M.R.S. § 417 — ME Code / Title 24-A / Chapter 5 / Section 417
24-A §417. Suspension or revocation of certificate of authority; discretionary and special grounds
Status: in_force

1. Notwithstanding Title 4, chapter 5 and Title 5, section 10051 , the superintendent may refuse to continue or may suspend or revoke an insurer's certificate of authority if the superintendent finds, after a hearing thereon or upon waiver of hearing by the insurer, that the insurer has violated or failed to comply with any lawful order of the superintendent, or has willfully violated or willfully failed to comply with any lawful rule of the superintendent, or has violated any provision of this Title other than those for violation of which suspension or revocation is mandatory. [PL 1999, c. 547, Pt. B, §45 (AMD); PL 1999, c. 547, Pt. B, §80 (AFF).]

2. The superintendent shall suspend or revoke an insurer's certificate of authority on any of the following grounds, if the superintendent finds after a hearing held in conformity with Title 5, chapter 375, subchapter 4 that the insurer: A. Is in unsound condition, or is being fraudulently conducted, or is in such condition or using such methods and practices in the conduct of its business as to render its further transaction of insurance in this State currently or prospectively hazardous or injurious to policyholders or to the public; [PL 1983, c. 419, §2 (AMD).] B. With such frequency as to indicate its general business practice in this State, has without just cause failed to pay, or delayed payment of, claims arising under its policies, whether the claim is in favor of an insured or is in favor of a 3rd person; or, with like frequency, without just cause compels insureds or claimants to accept less than the amount due them or to employ attorneys or to bring suit against the insurer or an insured to secure full payment or settlement of such claims; [RR 2021, c. 1, Pt. B, §181 (COR).] C. Refuses to be examined, or if its directors, officers, employees or representatives refuse to submit to examination relative to its affairs, or to produce its accounts, records and files for examination by the superintendent when required, or refuse to perform any legal obligation relative to the examination; or [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).] D. Has failed to pay any final judgment rendered against it in this State upon any policy, bond, recognizance or undertaking as issued or guaranteed by it, within 30 days after the judgment became final or within 30 days after dismissal of an appeal before final determination, whichever date is the later. [PL 1969, c. 132, §1 (NEW).] [RR 2021, c. 1, Pt. B, §181 (COR).]

3. Notwithstanding Title 4, chapter 5 and Title 5, section 10051 , the superintendent may, without notice or a hearing thereon, immediately suspend the certificate of authority of any insurer as to which proceedings for receivership, conservatorship, rehabilitation or other delinquency proceedings have been commenced against the insurer in any state by the public official charged with supervising the insurance industry in that state. Upon suspending a certificate of authority under this subsection, the superintendent shall promptly schedule a hearing on the matter, to be held within 30 days of the suspension. The superintendent shall make a determination within 30 days after the conclusion of that hearing. [PL 1999, c. 547, Pt. B, §45 (AMD); PL 1999, c. 547, Pt. B, §80 (AFF).]
24-A M.R.S. § 4101 — ME Code / Title 24-A / Chapter 55 / Section 4101
24-A §4101. Fraternal benefit societies defined
Status: in_force

1. Any incorporated society, order or supreme lodge, without capital stock, including one exempted under section 4142 , whether incorporated or not, conducted solely for the benefit of its members and their beneficiaries and not for profit, operated on a lodge system with ritualistic form of work, having a representative form of government, and which makes provision for the payment of benefits in accordance with this chapter, is hereby declared to be a fraternal benefit society. [PL 1969, c. 132, §1 (NEW).]

2. When used in this chapter the word "society," unless otherwise indicated, shall mean fraternal benefit society. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 4105 — ME Code / Title 24-A / Chapter 55 / Section 4105
24-A §4105. Corporate powers retained
Status: in_force

Any incorporated society authorized to transact business in this State at the time this chapter becomes effective may thereafter exercise all the rights, powers and privileges prescribed in this chapter and in its charter or articles of incorporation as far as consistent with this chapter. A domestic society shall not be required to reincorporate. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 744 — ME Code / Title 24-A / Chapter 9 / Section 744
24-A §744. Required contract provisions; reinsurance intermediary-broker
Status: in_force

Transactions between a reinsurance intermediary-broker and the insurer it represents in such a capacity may be entered into only pursuant to a written authorization specifying the responsibilities of each party. The authorization must, at a minimum, provide that: [PL 1991, c. 828, §20 (NEW).]

1. Termination. The insurer may terminate the reinsurance intermediary-broker's authority at any time upon 5 days' written notice to the reinsurance intermediary-broker; [PL 1991, c. 828, §20 (NEW).]

2. Accounting. The reinsurance intermediary-broker shall render timely accounts to the insurer accurately detailing all material transactions, including information necessary to support all commissions, charges and other fees received by or owed, to the reinsurance intermediary-broker and remit all funds due to the insurer within 30 days of receipt; [PL 1991, c. 828, §20 (NEW).]

3. Bank as fiduciary. All funds collected for the insurer's account must be held by the reinsurance intermediary-broker in a fiduciary capacity in a bank that is a qualified United States financial institution; [PL 1991, c. 828, §20 (NEW).]

4. Compliance with law. The reinsurance intermediary-broker shall comply with section 745 ; [PL 1991, c. 828, §20 (NEW).]

5. Compliance with standards. The reinsurance intermediary-broker shall comply with the written standards established by the insurer for the cession or retrocession of all risks; and [PL 1991, c. 828, §20 (NEW).]

6. Disclosure. The reinsurance intermediary-broker shall disclose to the insurer any relationship with any reinsurer or insurer to which business will be ceded or retroceded. [PL 1991, c. 828, §20 (NEW).]
24-A M.R.S. § 3863 — ME Code / Title 24-A / Chapter 53 / Section 3863
24-A §3863. Service of process; judgment
Status: in_force

1. Legal process must be served upon a domestic reciprocal insurer by serving the insurer's attorney at that attorney's principal offices. [PL 1997, c. 457, §47 (AMD).]

2. Any judgment based upon legal process so served shall be binding upon each of the insurer's subscribers as their respective interests may appear, but in an amount not exceeding their respective contingent liabilities, if any, the same as though personal service of process was had upon each such subscriber. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 4402 — ME Code / Title 24-A / Chapter 57 / Section 4402
24-A §4402. -- appeal from superintendent's order
Status: in_force

If the superintendent has issued a summary order before hearing as provided in section 4401, subsection 2 , any person upon whom such order is served may waive the superintendent hearing and apply for any immediate judicial relief available under law and without first exhausting administrative remedies. Section 236 (appeal from superintendent) shall apply as to appeals from the superintendent's order made after hearing. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 2511 — ME Code / Title 24-A / Chapter 29 / Section 2511
24-A §2511. Table of installments
Status: in_force

In case the policy provides that the proceeds may be payable in installments which are determinable at issue of the policy, there shall be a table showing the amounts of the guaranteed installments. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2672 — ME Code / Title 24-A / Chapter 32 / Section 2672
24-A §2672. Selective contracting authorized
Status: in_force

Carriers or administrators may enter into preferred provider arrangements with providers of their choice. In selecting preferred providers, carriers or administrators may consider, among other factors, price differences between or among providers, geographic accessibility, specialization and projected utilization by enrollees. Selective contracting does not constitute unreasonable discrimination against or among providers. [PL 1999, c. 609, §6 (AMD).]
24-A M.R.S. § 3702 — ME Code / Title 24-A / Chapter 52 / Section 3702
24-A §3702. Definitions
Status: in_force

As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 1991, c. 615, Pt. D, §1 (NEW).]

1. Board. "Board" means the Board of Directors of the Maine Employers' Mutual Insurance Company. [PL 1991, c. 615, Pt. D, §1 (NEW).]

2. Company. "Company" means the Maine Employers' Mutual Insurance Company created in section 3703 . [PL 1991, c. 615, Pt. D, §1 (NEW).]

3. Division. [PL 2001, c. 350, §2 (RP).]

3-A. Maine-based employer. "Maine-based employer" means an employer with a principal place of business located in this State. [PL 1995, c. 551, §3 (NEW).]

4. Superintendent. "Superintendent" means the Superintendent of Insurance. [PL 1991, c. 885, Pt. C, §2 (NEW).]

5. Voluntary market. "Voluntary market" means the workers' compensation insurance market in which insurance companies voluntarily offer coverage to applicants who meet the insurers' underwriting standards or guidelines. [PL 1991, c. 885, Pt. C, §2 (NEW).]

6. Workers' compensation residual market mechanism. "Workers' compensation residual market mechanism" means the instrument to provide coverage to employers not able to obtain coverage in the voluntary market that immediately preceded the Maine Employers' Mutual Insurance Company. [PL 2001, c. 350, §3 (AMD).]
24-A M.R.S. § 6725 — ME Code / Title 24-A / Chapter 83 / Section 6725
24-A §6725. Branch captive insurance companies
Status: in_force

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Alien captive insurance company" means an insurance company formed to write insurance business for its parents and affiliates and licensed pursuant to the laws of an alien jurisdiction that imposes statutory or regulatory standards in a form acceptable to the superintendent on companies transacting the business of insurance in the alien jurisdiction. [PL 2009, c. 335, §24 (NEW).] B. "Branch business" means any insurance business transacted by a branch captive insurance company in this State. [PL 2009, c. 335, §24 (NEW).] C. "Branch captive insurance company" means any alien captive insurance company licensed by the superintendent to transact the business of insurance in this State through a business unit with a principal place of business in this State. [PL 2009, c. 335, §24 (NEW).] D. "Branch operations" means any business operations of a branch captive insurance company in this State. [PL 2009, c. 335, §24 (NEW).] [PL 2009, c. 335, §24 (NEW).]

2. Establishment of a branch captive insurance company. A branch captive insurance company may be established in this State in accordance with the provisions of this chapter to write in this State only insurance or reinsurance of the employee benefit business of its parent and affiliated companies that is subject to the provisions of the federal Employee Retirement Income Security Act of 1974, as amended. In addition to the general provisions of this chapter, the provisions of this section apply to branch captive insurance companies. A branch captive insurance company may not do any insurance business in this State unless it maintains the principal place of business for its branch operations in this State. [PL 2009, c. 335, §24 (NEW).]

3. Security required. In the case of a branch captive insurance company, as security for the payment of liabilities attributable to the branch operations, the superintendent shall require that either a trust fund funded by assets acceptable to the superintendent or an irrevocable letter of credit be established and maintained in the United States for the benefit of United States policyholders and United States ceding insurers under insurance policies issued or reinsurance contracts issued or assumed by the branch captive insurance company through its branch operations. The amount of the security may be no less than the amount set forth in section 6704, subsection 1, paragraph A and the reserves on the insurance policies or reinsurance contracts, including reserves for losses, allocated loss adjustment expenses, incurred but not reported losses and unearned premiums with regard to business written through the branch operation, except that the superintendent may permit a branch captive insurance company that is required to post security for loss reserves on branch business by its reinsurer to reduce the funds in the trust account or the amount payable under the irrevocable letter of credit required by this subsection by the same amount as long as the security remains posted with the reinsurer. If the form of security selected is a letter of credit, the letter of credit must be established by, or issued or confirmed by, a bank chartered in this State or a member bank of the Federal Reserve System. [PL 2009, c. 335, §24 (NEW).]

4. Certificate of general good. In the case of a captive insurance company licensed as a branch captive insurance company, the alien captive insurance company shall petition the superintendent to issue a certificate setting forth the superintendent's finding that, after considering the character, reputation, financial responsibility, insurance experience and business qualifications of the officers and directors of the alien captive insurance company, the licensing and maintenance of the branch operations will promote the general good of the State. The alien captive insurance company may register to do business in this State after the superintendent's certificate is issued. [PL 2009, c. 335, §24 (NEW).]

5. Reports. Prior to March 1st of each year, or with the approval of the superintendent within 60 days after its fiscal year-end, a branch captive insurance company shall file with the superintendent a copy of all reports and statements required to be filed under the laws of the jurisdiction in which the alien captive insurance company is formed, verified by oath of 2 of its executive officers. If the superintendent is satisfied that the annual report filed by the alien captive insurance company in its domiciliary jurisdiction provides adequate information concerning the financial condition of the alien captive insurance company, the superintendent may waive the requirement for completion of the captive annual statement for business written in the alien jurisdiction. [PL 2009, c. 335, §24 (NEW).]

6. Examination of branch captive insurance companies. The examination of a branch captive insurance company pursuant to section 6708 must be of the branch business and branch operations only, as long as the branch captive insurance company provides annually to the superintendent a certificate of compliance, or its equivalent, issued by or filed with the licensing authority of the jurisdiction in which the branch captive insurance company is formed and demonstrates to the superintendent's satisfaction that it is operating in sound financial condition in accordance with all applicable laws and regulations of that jurisdiction. As a condition of licensure, the alien captive insurance company must grant authority to the superintendent for examination of the affairs of the alien captive insurance company in the jurisdiction in which the alien captive insurance company is formed. [PL 2009, c. 335, §24 (NEW).]
24-A M.R.S. § 2419 — ME Code / Title 24-A / Chapter 27 / Section 2419
24-A §2419. Delivery of policy as to motor vehicle insurance
Status: in_force

In event the original policy is delivered or is so required to be delivered to or for deposit with any vendor, mortgagee, or pledgee of any motor vehicle, and in which policy any interest of the vendee, mortgagor, or pledgor in or with reference to such vehicle is insured, a duplicate of such policy setting forth the name and address of the insurer, insurance classification of vehicle, type of coverage, limits of liability, premiums for the respective coverages, and duration of the policy, or memorandum thereof containing the same such information, shall be delivered by the vendor, mortgagee, or pledgee to each such vendee, mortgagor, or pledgor named in the policy or coming within the group of persons designated in the policy to be so included. If the policy does not provide coverage of legal liability for injury to persons or damage to the property of third parties, a statement of such fact shall be printed, written, or stamped conspicuously on the face of such duplicate policy or memorandum. This section does not apply to inland marine floater policies. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 731-C — ME Code / Title 24-A / Chapter 9 / Section 731-C
24-A §731-C. Bulk reinsurance
Status: in_force

The cession of bulk reinsurance by a domestic insurer is subject to section 3483 . [PL 1989, c. 846, Pt. E, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]
24-A M.R.S. § 1420-H — ME Code / Title 24-A / Chapter 16 / Section 1420-H
24-A §1420-H. Exemption from examination
Status: in_force

1. Exemption. An individual who applies for an insurance producer license in this State who was previously licensed for the same lines of authority in another state is not required to complete any examination pursuant to section 1410 . This exemption is only available if the person is currently licensed in that state or if the application is received within 90 days of the cancellation of the applicant's previous license and if the prior state issues a certification that, at the time of cancellation, the applicant was in good standing in that state, or the state's producer database records, maintained by the National Association of Insurance Commissioners, its affiliates or subsidiaries or any successor organization, indicate that the producer is or was licensed in good standing for the line of authority requested. [PL 2007, c. 51, §4 (AMD).]

2. Application. A person licensed as an insurance producer in another state who moves to this State shall make application within 90 days of establishing legal residence to become a resident licensee pursuant to section 1420‑E . An examination pursuant to section 1410 is not required of that person to obtain any line of authority previously held in the prior state except when the superintendent determines otherwise by rule. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2007, c. 51, §4 (AMD).]

3. Additional exemptions. An examination is also not required of: A. An applicant for a license covering the same kind or kinds of insurance for which the applicant was licensed under a similar license in this State within the past 2 years, other than a temporary license issued pursuant to section 1420‑J . This exemption applies only to persons who have met the applicable continuing education requirements during the 2-year period, who voluntarily terminated their previous license and who continue to be fully qualified for the license. A person whose previous license was revoked or suspended may not become relicensed pursuant to this paragraph; [PL 2001, c. 259, §24 (NEW).] B. An applicant for a license as a limited insurance producer who solicits or sells travel insurance; [PL 2015, c. 133, §3 (AMD).] C. An applicant for a license as a resident title insurance producer who is an attorney at law duly licensed to practice law in this State; [PL 2001, c. 259, §24 (NEW).] D. An applicant for a license as a limited insurance producer who solicits or sells mechanical breakdown insurance; [PL 2015, c. 77, §5 (AMD).] E. An applicant for a license as a limited insurance producer employed by a motor vehicle rental company who solicits or sells insurance in connection with and incidental to the rental of a motor vehicle for a period not to exceed 60 days in accordance with section 1420‑F, subsection 1, paragraph L ; or [PL 2015, c. 77, §6 (AMD).] F. An applicant for a license as a limited insurance producer employed by an equipment rental company who solicits or sells insurance in connection with and incidental to the rental of covered rental equipment in accordance with section 1420‑F, subsection 1, paragraph M . [PL 2015, c. 77, §7 (NEW).] [PL 2015, c. 77, §§5-7 (AMD); PL 2015, c. 133, §3 (AMD).]
24-A M.R.S. § 3154 — ME Code / Title 24-A / Chapter 44 / Section 3154
24-A §3154. Policy definitions and exclusions
Status: in_force

1. Use of defined terms. If an insurer uses any of the terms that are defined in section 3153 in a pet insurance policy, the insurer shall use the definition of each of those terms as set forth in section 3153 and include the definition of those terms in the policy. The insurer shall also make the definition available through a clear and conspicuous link on the main page of the insurer's or insurer's program administrator's publicly accessible website. [PL 2021, c. 562, §1 (NEW).]

2. Exclusions. This chapter does not limit or prohibit the types of exclusions an insurer may use in a pet insurance policy or require an insurer to include any of the limitations or exclusions described in section 3155 . [PL 2021, c. 562, §1 (NEW).]
24-A M.R.S. § 2321-A — ME Code / Title 24-A / Chapter 25 / Section 2321-A
24-A §2321-A. Licensing advisory organizations
Status: in_force

1. No advisory organization may provide any service relating to the rates of any insurance subject to this chapter, and no insurer may utilize the services of that organization for those purposes unless the organization has obtained a license under subsection 3, paragraph C . [PL 1989, c. 797, §23 (NEW); PL 1989, c. 797, §§37, 38 (AFF).]

2. No advisory organization may refuse to supply any services for which it is licensed in this State to any insurer authorized to do business in this State and offering to pay the fair and usual compensation for the services. [PL 1989, c. 797, §23 (NEW); PL 1989, c. 797, §§37, 38 (AFF).]

3. The licensing of advisory organizations is governed by the following. A. An advisory organization's application for a license must include: (1) A copy of its constitution, charter, articles of organization, agreement, association or incorporation, and a copy of its bylaws, plan of operation and any other rules or regulations governing the conduct of its business; (2) A list of its members and subscribers; (3) The name and address of one or more residents of this State upon whom notices, process affecting it, or orders of the superintendent may be served; (4) A statement showing its technical qualifications for acting in the capacity for which it seeks a license; (5) A biography of the ownership and management of the organization; and (6) Any other relevant information and documents that the superintendent may require. [PL 1989, c. 797, §23 (NEW); PL 1989, c. 797, §§37, 38 (AFF).] B. Every organization which has applied for a license must notify the superintendent of every material change in the facts or in the documents on which its application was based. Any amendment to a document filed under this section must be filed at least 30 days before it becomes effective. [PL 1989, c. 797, §23 (NEW); PL 1989, c. 797, §§37, 38 (AFF).] C. If the superintendent finds that the applicant and the natural persons through whom it acts are competent, trustworthy and technically qualified to provide the services proposed, and that all requirements of the law are met, the superintendent shall issue a license specifying the authorized activity of the applicant. The superintendent may not issue a license if the proposed activity would tend to create a monopoly or to lessen substantially the competition in any market. [PL 1989, c. 797, §23 (NEW); PL 1989, c. 797, §§37, 38 (AFF).] D. The superintendent may at any time, after hearing, revoke or suspend the license of an advisory organization that does not comply with the requirements and standards of this section. [PL 1989, c. 797, §23 (NEW); PL 1989, c. 797, §§37, 38 (AFF).] [PL 1989, c. 797, §23 (NEW); PL 1989, c. 797, §§37, 38 (AFF).]
24-A M.R.S. § 3053 — ME Code / Title 24-A / Chapter 41 / Section 3053
24-A §3053. 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. 239 (NEW).]
24-A M.R.S. § 3056 — ME Code / Title 24-A / Chapter 41 / Section 3056
24-A §3056. Nonliability for certain statements
Status: in_force

1. Notices. Except as provided in Title 10, chapter 209‑B , no insurer or licensed agent or employee of the insurer may be held liable in any civil action for statements made in a notice of cancellation or intent not to renew under this chapter if: A. The statements were made in good faith; [PL 1979, c. 112, §2 (NEW).] B. The statements are reasonably related to the reason for cancellation or intent not to renew; and [PL 1979, c. 112, §2 (NEW).] C. In the case of a notice of cancellation, the reason for cancellation is a reason permitted under section 3049 . [PL 1979, c. 112, §2 (NEW).] [PL 2013, c. 588, Pt. C, §15 (AMD).]

2. Hearings. Except as provided in Title 10, chapter 209‑B , no person may be held liable in any civil action for statements made or information given at a hearing held under this chapter if: A. The statements were made or the information was given in good faith; [PL 1979, c. 112, §2 (NEW).] B. The statements or the information are reasonably related to the reason for cancellation or intent not to renew; and [PL 1979, c. 112, §2 (NEW).] C. In the case of a hearing held on a notice of cancellation, the reason for cancellation is a reason permitted under section 3049 . [PL 1979, c. 112, §2 (NEW).] [PL 2013, c. 588, Pt. C, §15 (AMD).]
24-A M.R.S. § 237 — ME Code / Title 24-A / Chapter 3 / Section 237
24-A §237. Assessment for expense of maintaining the Bureau of Insurance
Status: in_force

The expense of maintaining the Bureau of Insurance must be assessed annually by the Superintendent of Insurance against all insurers and health maintenance organizations licensed to do business in this State in proportion to their respective direct gross premium written on business in this State during the year ending December 31st immediately preceding the fiscal year for which assessment is made. The annual assessment upon all insurers must be applied to the budget of the bureau for the fiscal year commencing July 1st. For any biennial period, total assessment must be in an amount not exceeding .002 of total direct premiums written. When the superintendent calculates the amount of the annual assessment, the superintendent must consider, among other factors, the staffing level required to administer the responsibilities of the bureau. [PL 1997, c. 79, §2 (AMD).]

1. Expense of examination. The expense of examination of an insurer or of any person regulated by section 222 continues to be borne by the person examined. The expense of examination consistent with section 228 may not be considered when determining the assessment for maintaining the Bureau of Insurance. [PL 1997, c. 79, §2 (AMD).]

2. Direct gross premium. Based on the annual statement filed by each insurer pursuant to section 423 or health maintenance organization pursuant to section 4208 , the superintendent shall ascertain the amount of direct gross premium it received in that year. For the purpose of this section only, "direct gross premiums" means and includes policy, membership, annuity considerations and other fees, policy dividends applied in payment for insurance and other considerations for insurance received by insurers or health maintenance organizations, on account of policies or contracts covering subjects of insurance, or risks located, resident or to be performed in this State, after deducting return premiums or dividends actually returned or credited to policyholders. [PL 1997, c. 79, §2 (AMD).]

3. Minimum assessment. In any year in which an insurer or health maintenance organization has no direct gross premium writings in this State, or in which direct gross premium written is not sufficient to produce at the rate prescribed an amount equal to or in excess of $100, the minimum assessment payable by any insurer or health maintenance organization is $100. [PL 1997, c. 79, §2 (AMD).]

4. Notification of assessment. On or before July 1st of each year, the superintendent shall forward to each insurer or health maintenance organization an itemized bill of the amount due for the annual assessment, the amount due for filing of the annual statement pursuant to sections 423 and 601 and the amount due for the certificate of authority annual continuation fee pursuant to section 601 . When an extension of the time of filing an annual statement is granted for good cause by the superintendent pursuant to section 423, subsection 1 , or section 4208 , the insurer or health maintenance organization must be assessed a provisional amount of $100. Upon receipt of the insurer's or health maintenance organization's annual statement, the provisional assessment must be adjusted to effect a final assessment for the fiscal year at the same rate utilized by the superintendent and levied upon all insurers by the general assessment of July 1st. [PL 1997, c. 79, §2 (AMD).]

5. Time of payment. Time of payment for the annual assessment, the annual statement filing fee and the annual continuation fee must be made on or before August 10th. [PL 1995, c. 544, §1 (AMD).]

6. Revocation or suspension. If the annual assessment, annual statement filing fee or annual continuation fee is not paid to the superintendent on or before the prescribed date, the license or certificate of authority of an insurer or health maintenance organization to transact business in this State may be revoked or suspended by the superintendent after a hearing or upon waiver of hearing by the insurer or health maintenance organization until the annual assessment, annual statement filing fee and annual continuation fee is paid. A reinstatement of certificate of authority may not be made prior to payment of the balance of the annual assessment, annual statement filing fee or continuation fee. [PL 1997, c. 79, §2 (AMD).]

7. Recalculation of assessment. Immediately following the close of the fiscal year ending June 30, 1987, and at the close of each 2nd succeeding fiscal year, the superintendent shall recalculate the assessment made against each party assessed after giving recognition to actual expenditures of the bureau during the preceding biennial period. On or before October 1st, the superintendent shall render to each party assessed a statement showing the difference between their respective recalculated assessment and the amount they had paid with respect to the preceding biennium. Any overpayment of annual assessment resulting from complying with the requirements of this section must be refunded or, at the option of the assessed party, applied as a credit against the assessment for the succeeding fiscal year. Any overpayment of $100 or less must be applied as a credit against the assessment for the succeeding fiscal year. [PL 1997, c. 79, §2 (AMD).]

8. Deposit with Treasurer of State. The superintendent shall deposit all payments made pursuant to this section with the Treasurer of State. The money must be used for the sole purpose of paying the expenses of the Bureau of Insurance. [PL 1997, c. 79, §2 (AMD).]

9. Exclusions. This section does not apply to fraternal benefit societies, as defined in section 4101 ; assessment mutual insurance companies, as defined in section 3603 ; and joint underwriting associations, subject to section 2322‑A . [RR 2021, c. 2, Pt. A, §67 (COR).]

10. Applicability. This section applies with respect to insurers for fiscal years commencing on or after July 1, 1986 and to health maintenance organizations for fiscal years commencing on or after July 1, 1997. [PL 1997, c. 79, §2 (AMD).]
24-A M.R.S. § 4306 — ME Code / Title 24-A / Chapter 56-A / Section 4306
24-A §4306. Enrollee choice of primary care provider
Status: in_force

A carrier offering or renewing a managed care plan shall allow enrollees to choose their own primary care providers, as allowed under the managed care plan's rules, from among the panel of participating providers made available to enrollees under the managed care plan's rules. A carrier shall allow physicians, including, but not limited to, pediatricians and physicians who specialize in obstetrics and gynecology, and physician associates licensed pursuant to Title 32, section 2594‑E or section 3270‑E and certified nurse practitioners who have been approved by the State Board of Nursing to practice advanced practice registered nursing without the supervision of a physician pursuant to Title 32, section 2102, subsection 2‑A to serve as primary care providers for managed care plans. A carrier is not required to contract with certified nurse practitioners, physician associates or physicians as primary care providers in any manner that exceeds the access and provider network standards required in this chapter or chapter 56 , or any rules adopted pursuant to those chapters. A carrier shall allow enrollees in a managed care plan to change primary care providers without good cause at least once annually and to change with good cause as necessary. When an enrollee fails to choose a primary care provider, the carrier may assign the enrollee a primary care provider located in the same geographic area in which the enrollee resides. [PL 2019, c. 627, Pt. A, §1 (AMD); PL 2019, c. 627, Pt. A, §3 (AFF); PL 2025, c. 316, §3 (REV).]
24-A M.R.S. § 421 — ME Code / Title 24-A / Chapter 5 / Section 421
24-A §421. Superintendent process agent for insurers
Status: in_force

1. Before the superintendent authorizes it to transact insurance in this State, each insurer shall appoint an agent to receive service of legal process issued against the insurer in this State. The insurer shall file with the superintendent a copy of the appointment. The notice to the superintendent must be accompanied by a copy of a resolution of the board of directors or like governing body of the insurer, if an incorporated insurer, showing that those officers who executed the appointment were duly authorized to do so on behalf of the insurer. The registered agent must consent to the appointment. [PL 1997, c. 592, §12 (AMD).]

1-A. [PL 1997, c. 457, §1 (NEW); MRSA T. 24-A §421, sub-§1-A (RP).]

2. [PL 1997, c. 457, §12 (RP).]

3. Service of process against a foreign or alien insurer may be made only by service thereof upon the attorney appointed by the insurer. [PL 1997, c. 457, §13 (AMD).]

4. Service of such process against a domestic insurer may be made as provided hereunder, or in any other manner provided by law. [PL 1969, c. 132, §1 (NEW).]

5. At the time of application for a certificate of authority the insurer shall file the appointment with the superintendent, together with designation of the person to whom process against it served upon the appointed agent is to be forwarded. The insurer may change such designation by a new filing. [PL 1997, c. 592, §13 (AMD).]

6. A copy of such appointment, certified by the superintendent, shall be received in evidence in all courts of this State. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

7. Any person or entity required by Title 24 or this Title to appoint an agent for service of process who does not have a valid appointment on file with the superintendent or required by applicable law to appoint the superintendent as agent for service of process is deemed to have appointed the superintendent as agent for service of process, and process may be served within this State in the same manner as provided in section 2105 . This subsection does not relieve that person or entity from any requirement to appoint an agent for service of process or from the applicable penalties for failure to comply with that requirement. [PL 2013, c. 238, Pt. E, §1 (AMD).]
24-A M.R.S. § 3477 — ME Code / Title 24-A / Chapter 47 / Section 3477
24-A §3477. Conversion of mutual to stock insurer
Status: in_force

1. A mutual insurer may amend its charter pursuant to this section to become a stock insurer, or a combination stock and mutual insurer, under such reasonable plan and procedure as may be approved by the superintendent after a hearing thereon of which notice was given to the insurer, its directors or trustees, its officers, employees and its policyholders, all of whom shall have the right to appear and be heard at the hearing. [PL 1985, c. 399, §3 (AMD).]

2. The superintendent shall not approve any such plan or procedure unless: A. Its terms and conditions are fair and equitable; [PL 1969, c. 132, §1 (NEW).] B. It is subject to approval by vote of not less than 2/3 of the insurer's policyholders voting thereon in person, by proxy, or by mail at a meeting of policyholders called for the purpose pursuant to such reasonable notice and procedure as may be approved by the superintendent and each such policyholder shall be entitled to one vote, provided that only persons who were policyholders both at least one year prior to the submission of the insurer's plan to the superintendent and on a subsequent date, found reasonable by the superintendent, prior to the vote shall be entitled to vote; provided that as to life insurers chartered by special Act prior to January 1, 1970, the persons entitled to vote shall be further limited to owners of life insurance policies and contracts, and those persons shall be entitled to one vote and to an additional vote for each $1,000 of insurance above 1,000, except that in the case of any policy or contract of group life insurance or any group annuity contract providing life insurance, the employer or other person, firm, corporation or association, to whom or in whose name the master policy or contract shall have been issued or held, shall be deemed to be the owner within the meaning of this paragraph and shall be entitled to one vote for each such policy or contract of group life insurance or each such group annuity contract irrespective of the number of lives insured under that policy or contract; [PL 1985, c. 399, §4 (RPR).] C. The equity of each member in the insurer is determinable under a fair and reasonable formula approved by the superintendent, which such equity shall be based upon the insurer's entire surplus as shown by the insurer's financial statement filed with the superintendent, including all voluntary reserves but excluding contingently repayable funds and outstanding guaranty capital shares at the redemption value thereof, and without taking into account the value of nonadmitted assets or of insurance business in force; [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).] D. The plan gives to each member of the insurer as specified in paragraph E , a preemptive right to acquire the member's proportionate part of all of the proposed capital stock of the insurer, or all of the stock of a proposed parent corporation of the insurer, within a designated reasonable period, as such part is determinable under the plan of conversion, and to apply upon the purchase thereof the amount of the member's equity in the insurer as determined under paragraph C , except that the plan may provide, subject to the approval of the superintendent, that such preemptive right will not apply to members who reside in jurisdictions in which the issuance of stock is impossible, would involve unreasonable delay or would require the insurer to bear unreasonable costs, as long as any such member receives 100% of the member's equity share in the insurer in the form of a cash payment; [RR 2021, c. 1, Pt. B, §286 (COR).] E. The members entitled to participate in the purchase of stock or distribution of assets shall include not less than all policyholders of the insurer as of the date the plan was submitted to the superintendent and each existing person who had been a policyholder of the insurer within 3 years prior to such date; [PL 1985, c. 399, §6 (AMD).] F. Shares are to be offered to members at a price not greater than to be thereafter offered under the plan to others; [PL 1969, c. 132, §1 (NEW).] G. The plan provides for payment to each member of the member's entire equity share in the insurer, with that payment to be made in cash or to be applied for or upon the purchase of stock to which the member is preemptively entitled, or both, except that with respect to each member who is not given the option of receiving the member's entire equity share in cash, the plan must provide that that member has the option to receive a reasonable portion of the member's equity share, as provided in the plan, but not in excess of 50% of the member's entire equity, in the form of a cash payment, which payment together with the amount applied to the purchase of stock constitutes full payment and discharge of the member's equity or property interest in that mutual insurer; and except that the superintendent may permit an insurer to forego the option of making a cash payment to members if the superintendent determines that it would be reasonable not to provide for the cash election, after taking into account all the facts and circumstances, including whether there is expected to be an active market for the stock to be received in the conversion; [RR 2021, c. 1, Pt. B, §287 (COR).] H. The plan, when completed, would provide for the converted insurer paid-in capital stock in an amount not less than the minimum paid-in capital stock required of a new domestic stock insurer upon initial authorization to transact like kinds of insurance, together with expendable surplus funds in amount not less than 1/2 of such required capital stock; and [PL 1969, c. 132, §1 (NEW).] I. The superintendent finds that the insurer's management has not, through reduction in volume of new business written, or cancellation or through any other means sought to reduce, limit, or affect the number or identity of the insurer's members to be entitled to participate in such plan, or to secure for the individuals comprising management any unfair advantage through such plan. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).] [RR 2021, c. 1, Pt. B, §§286, 287 (COR).]

3. Any such combination stock and mutual insurer referred to in subsection 1 must have and maintain separate paid-in capital stock and basic surplus in respective amounts as would be required under this Title of separate domestic stock and mutual insurers transacting the same kind or kinds of insurance. [PL 1969, c. 132, §1 (NEW).]

4. Subsection 2 shall not be deemed to prohibit the inclusion in the conversion plan of provisions under which the individuals comprising the insurer's management and employee group shall be entitled to purchase for cash at the same price as offered to the insurer's members, shares of stock not taken by members on the preemptive offering to members, in accordance with such reasonable classification of such individuals as may be included in the plan and approved by the superintendent. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

5. No director, officer, agent or employee of the insurer, or any other person, shall receive any fee, commission or other valuable consideration whatsoever, other than their usual regular salaries and compensation, for in any manner aiding, promoting or assisting in such conversion except as set forth in the plan approved by the superintendent. This provision shall not be deemed to prohibit the payment of reasonable fees and compensation to attorneys at law, accountants and actuaries for services performed in the independent practice of their professions, even though also directors of the insurer. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

6. Costs. For the purpose of determining whether a conversion plan meets the requirements of this section and any other relevant provisions of this Title, the superintendent may employ staff personnel and outside consultants. All reasonable costs related to the review of a plan of conversion, including those costs attributable to the use of staff personnel, shall be borne by the insurer or insurers making the filing. [PL 1985, c. 399, §8 (NEW).]
24-A M.R.S. § 2606-A — ME Code / Title 24-A / Chapter 31 / Section 2606-A
24-A §2606-A. Trustee groups
Status: in_force

The lives of a group of individuals may be insured under a policy issued to a trust or to the trustee or trustees of a fund established or adopted by 2 or more employers, or by one or more labor unions or similar employee organizations, or by one or more employers and one or more labor unions or similar employee organizations, which trust or trustees are considered the policyholder, to insure employees of the employers or members of the unions or organizations for the benefit of persons other than the employers or the unions or organizations, subject to the following requirements. [PL 2011, c. 163, §2 (AMD).]

1. The persons eligible for insurance are all of the employees of the employers or all of the members of the unions or organizations, or all of any class or classes thereof. The policy may provide that the term "employees" includes retired employees, the individual proprietor or partners if an employer is an individual proprietorship or a partnership, and directors of a corporate employer. The policy may provide that the term "employees" includes the trustees or their employees, or both, if their duties are principally connected with that trusteeship. [PL 1981, c. 150, §7 (NEW).]

2. The premium for the policy shall be paid from funds contributed by the employer or employers of the insured persons or by the union or unions or similar employee organizations, or by both, or from funds contributed by the insured persons or from both the insured persons and the employer or union or similar employee organization. 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 persons specifically for their insurance must insure all eligible persons, except those who reject that coverage in writing. [PL 1981, c. 150, §7 (NEW).]

3. An insurer may exclude or limit the coverage on any person as to whom evidence of individual insurability is not satisfactory to the insurer. [PL 1981, c. 150, §7 (NEW).]
24-A M.R.S. § 235 — ME Code / Title 24-A / Chapter 3 / Section 235
24-A §235. Order on hearing
Status: in_force

1. In the conduct of hearings under this Title and making the superintendent's order thereon, the superintendent shall act in a quasi-judicial capacity. [RR 2021, c. 1, Pt. B, §175 (COR).]

2. Within 30 days after termination of a hearing, or of any rehearing thereof or reargument thereon, or within such other period as may be specified in this Title as to particular proceedings, or within such further reasonable period as the superintendent for good cause may require, the superintendent shall make the superintendent's order on hearing covering matters involved in such hearing, and give a copy of the order to each party to the hearing in the same manner as notice of the hearing was given to such party; except that as to hearings held with respect to merger, consolidation, bulk reinsurance, conversion, affiliation or change of control of a domestic insurer as provided in chapter 47 when notice of the hearing was given to all stockholders and policyholders of an insurer involved, the superintendent is required to give a copy of the order on hearing to the corporation and insurer parties, to intervening parties, to a reasonable number of such stockholders or policyholders as representative of the class, and to other parties only upon written request of such parties. [RR 2021, c. 2, Pt. A, §66 (COR).]

3. The order must contain: A. A concise statement of facts found by the superintendent upon the evidence adduced at the hearing; [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).] B. A concise statement of the superintendent's conclusions from the facts so found; [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).] C. The superintendent's order, and the effective date of the order; [RR 2009, c. 2, §64 (COR).] D. Citation of the provisions of this Title upon which the order is based; but failure to so designate a particular provision does not deprive the superintendent of the right thereafter to rely thereon; and [RR 2009, c. 2, §64 (COR).] E. Notice of the party's right to appeal or review of the order, of the action required for appeal and of the time within which the action must be taken in order to exercise the right. [RR 2009, c. 2, §64 (COR).] [RR 2009, c. 2, §64 (COR).]

4. The order may affirm, modify or rescind action theretofore taken or may constitute taking of new action within the scope of the notice of the hearing. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2849-C — ME Code / Title 24-A / Chapter 36 / Section 2849-C
24-A §2849-C. Certifications of coverage
Status: in_force

1. Application. This section applies to: A. Individual health plans subject to section 2736‑C ; and [PL 2001, c. 258, Pt. C, §1 (NEW).] B. Group and blanket health insurance contracts subject to chapter 35 , except: (1) Medicare supplement policies subject to chapter 67 ; and (2) Contracts designed to cover specific diseases, hospital indemnity or accidental injury only. [PL 2001, c. 258, Pt. C, §1 (NEW).] [PL 2001, c. 258, Pt. C, §1 (NEW).]

2. Requirement for certification of period of creditable coverage. The requirement for a certification of the period of creditable coverage is as follows. A. A carrier, as defined in section 4301‑A, subsection 3 , must provide the certification described in paragraph B with respect to health plans subject to this section: (1) At the time an individual ceases to be covered under the plan or otherwise becomes covered under a COBRA continuation provision; (2) In the case of an individual becoming covered under a COBRA continuation provision, at the time the individual ceases to be covered under that provision; and (3) On the request on behalf of an individual made not later than 24 months after the date of cessation of the coverage described in subparagraph (1) or (2), whichever is later. The certification under subparagraph (1) may be provided, to the extent practicable, at a time consistent with notices required under any applicable COBRA continuation provision. [PL 2001, c. 258, Pt. C, §1 (NEW).] B. The certification described in this paragraph is a written certification of: (1) The period of federally creditable coverage of the individual under the plan and the coverage, if any, under the COBRA continuation provision; (2) The waiting period, if any, imposed with respect to the individual for any coverage under the plan; and (3) An educational statement regarding the federal Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, consistent with federal law. [PL 2007, c. 199, Pt. A, §6 (AMD).] [PL 2007, c. 199, Pt. A, §6 (AMD).]

3. Alternative evidence of prior coverage. A carrier may not deny continuity rights as required by section 2849‑B solely because the individual does not provide a certification described in subsection 2 . The carrier must accept alternative evidence of prior coverage provided by the individual. If the individual asserts the existence of prior coverage but is unable to provide evidence, the carrier must make reasonable efforts to verify the existence of the prior coverage. The carrier may deny continuity rights if the individual refuses to cooperate in the carrier's efforts to verify prior coverage, such as if the individual refuses to provide needed authorization for the release of information to the carrier when requested by the carrier. [PL 2001, c. 258, Pt. C, §1 (NEW).]

4. Notice. A carrier may not impose a preexisting condition exclusion before providing the individual with notice consistent with federal law of the individual's continuity rights and giving the individual an opportunity to provide a certification as described in subsection 2 or alternative evidence of prior coverage as described in subsection 3 . [PL 2007, c. 199, Pt. A, §7 (AMD).]

5. Rules. The superintendent may issue rules specifying the contents of certifications or other requirements consistent with this section. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter II‑A . [PL 2001, c. 258, Pt. C, §1 (NEW).]
24-A M.R.S. § 2401 — ME Code / Title 24-A / Chapter 27 / Section 2401
24-A §2401. Scope of chapter
Status: in_force

This chapter applies as to all insurance contracts and annuity contracts, other than: [PL 1969, c. 132, §1 (NEW).]

1. Reinsurance. [PL 1969, c. 132, §1 (NEW).]

2. Unless otherwise specifically indicated, policies or contracts not issued for delivery in this State nor delivered in this State; and [PL 1993, c. 171, Pt. C, §1 (AMD).]

3. Wet marine and transportation insurance. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 414 — ME Code / Title 24-A / Chapter 5 / Section 414
24-A §414. Issuance, refusal of authority, ownership of certificate
Status: in_force

1. If upon completion of its application, the superintendent finds that the insurer has met the requirements therefor under this Title, and that the insurer has furnished evidence satisfactory to the superintendent that its methods of operation are not such as would render its proposed operation hazardous to the public or its policyholders in this State, the superintendent shall issue to the insurer a proper certificate of authority; otherwise, the superintendent shall issue an order refusing such certificate. [RR 2021, c. 1, Pt. B, §179 (COR).]

2. The certificate of authority, if issued, shall state the insurer's name, home office address, state or country of organization, and the kinds of insurance the insurer is authorized to transact throughout this State. At the insurer's request, the superintendent may issue a certificate of authority limited to particular types of insurance or coverages within a kind of insurance as defined in chapter 9 . [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

3. Although issued and delivered to the insurer, the certificate of authority at all times shall be the property of the State of Maine. Upon any expiration, suspension or termination thereof, the insurer shall promptly deliver the certificate to the superintendent. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

4. Insurers required to file an annual statement must, as a condition to the issuance or continuance of a certificate of authority, provide the National Association of Insurance Commissioners with all information required for participation in the Insurance Regulatory Information System. This filing must contain the insurer's current annual statement convention blank and, if requested by the superintendent or the National Association of Insurance Commissioners, publicly available financial reports of any affiliated insurers or other entities necessary for analyzing any insurer licensed in this State. Each statement furnished by an insurer must be executed by those persons who are required by section 423 to verify an annual statement utilizing the prescribed jurat following the practices and procedures prescribed by the National Association of Insurance Commissioners. Any amendments and addendums to the annual statement subsequently filed with the superintendent must also be filed with the National Association of Insurance Commissioners. Insurers shall provide written certification to the superintendent that they have complied with this subsection when they file their annual statements. This subsection does not apply to any insurer doing business under chapter 51 . In the absence of bad faith, fraud or intentional act, an officer or an employee of the National Association of Insurance Commissioners may not be subject to civil liability for libel, slander or any other cause of action in tort as a result of processing data or other information filed by insurers under this subsection or distribution of reports prepared on the basis of that information to insurance regulatory officials of any state that has subscribed to and used the Insurance Regulatory Information System through the National Association of Insurance Commissioners. Information provided to the superintendent that is held confidential by the National Association of Insurance Commissioners must be held confidential by the superintendent unless that information is relevant to any hearing conducted by the superintendent pursuant to section 229 or an order requiring disclosure is issued by the Superior Court. [PL 2025, c. 348, §7 (AMD).]

5. The superintendent may require insurers subject to this section to make available any accountant's work papers created during an audit. A. The superintendent may review the accountant's work papers upon timely notice to the insurer. The superintendent may photocopy or otherwise record the contents of work papers during the review. [PL 1989, c. 846, Pt. C, §3 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] B. Any work papers or copies of work papers under the superintendent's custody or control are confidential and are not subject to public inspection. [PL 1989, c. 846, Pt. C, §3 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] C. The work papers of an insurer's subsidiaries, parent or other corporate affiliates are deemed to be the insurer's work papers to the extent that the work papers reference transactions between the insurer and the subsidiary, parent or corporate affiliate and affect the insurer's final equity determination. [PL 1989, c. 846, Pt. C, §3 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] D. The insurer shall, as a condition of the accountant's engagement, require accountants: (1) To retain any work papers prepared in connection with an audit of the insurer for at least 6 years after the close of a reporting period; and (2) To provide the work papers, or a copy, to the insurer at the insurer's request. [PL 1989, c. 846, Pt. C, §3 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] E. For purposes of this subsection, the term "work papers" includes, but is not limited to, schedules, analyses, reconciliations, abstracts, memoranda, narratives, flow charts, copies of company records or other documents prepared or obtained by the accountant and the accountant's employees in conducting the examination of the insurer. [PL 1989, c. 846, Pt. C, §3 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] [PL 1989, c. 846, Pt. C, §3 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]
24-A M.R.S. § 4607 — ME Code / Title 24-A / Chapter 62 / Section 4607
24-A §4607. Board of directors
Status: in_force

1. Membership. The board of directors of the association must consist of not less than 7 nor more than 11 members representing member insurers serving terms as established in the plan of operation pursuant to section 4610 . The members of the board are selected by member insurers subject to the approval of the superintendent. Vacancies on the board must be filled for the remaining period of the term in the manner described in the plan of operation. To select the initial board of directors and initially organize the association, the superintendent shall give notice to all member insurers of the time and place of the organizational meeting. In determining voting rights at the organizational meeting each member insurer is entitled to one vote in person or by proxy. If the board of directors is not selected within 60 days after notice of the organizational meeting, the superintendent may appoint the initial members. [PL 2017, c. 382, §15 (AMD).]

2. Appointments; representation of member insurers. In approving selections or in appointing members to the board, the superintendent shall consider, among other things, whether all member insurers are fairly represented. [PL 1983, c. 846 (NEW).]

3. Reimbursement. 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, but members of the board may not otherwise be compensated by the association for their services. [PL 2005, c. 346, §6 (AMD); PL 2005, c. 346, §16 (AFF).]
24-A M.R.S. § 2742-C — ME Code / Title 24-A / Chapter 33 / Section 2742-C
24-A §2742-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 2742‑B, subsection 1 . [PL 2021, c. 520, §2 (NEW).] B. "Disability" means a physical, mental, intellectual or developmental disability that renders a person incapable of self-sustaining employment. [PL 2021, c. 520, §2 (NEW).] [PL 2021, c. 520, §2 (NEW).]

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

3. Proof of disability. A policyholder 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 2742‑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, §2 (NEW).]
24-A M.R.S. § 6225 — ME Code / Title 24-A / Chapter 73 / Section 6225
24-A §6225. Rehabilitation, liquidation or conservation of providers
Status: in_force

Any rehabilitation, liquidation or conservation of a provider shall be deemed to be the rehabilitation, liquidation or conservation of an insurance company and shall be conducted under the supervision of the superintendent pursuant to the laws governing the rehabilitation, liquidation or conservation of insurance companies. The superintendent may institute summary proceedings in the same manner as provided in the laws governing delinquent insurers and he may apply for an order directing him to rehabilitate, liquidate or conserve a provider when, in his opinion, the continued operation of the provider will be hazardous either to the enrollees or to the people of this State. [PL 1987, c. 482, §1 (NEW).]
24-A M.R.S. § 2174-A — ME Code / Title 24-A / Chapter 23 / Section 2174-A
24-A §2174-A. Public works employees' insurance rates
Status: in_force

1. Definitions. For the purposes of this section, "public works employee" means a government employee, as defined by Title 14, section 8102, subsection 1 , whose employment involves the care, maintenance or construction of municipally or state-owned buildings, open space, parks, parking facilities, waste water treatment systems, sewers or other property, roads, highways or other public ways. For purposes of this section, "public works employee" also includes an individual who is an independent contractor or employee of an independent contractor, under contract to the governmental entity and whose employment involves the functions listed in this subsection. [PL 1989, c. 362 (NEW).]

2. Public works employees. No insurer may increase the premium for a personal insurance policy providing motor vehicle liability or collision insurance to a public works employee on the basis of one or more accidents involving a motor vehicle operated by that employee if: A. The accident occurred while the employee was operating a motor vehicle in the course and scope of employment; and [PL 1989, c. 362 (NEW).] B. There is a policy of insurance other than the personal insurance policy providing motor vehicle liability or collision coverage for the accident or accidents. [PL 1989, c. 362 (NEW); PL 1989, c. 737, §1 (AMD).] [PL 1989, c. 362 (NEW); PL 1989, c. 737, §1 (AMD).]

3. Governmental entity. This section in no way restricts the premium an insurer may charge a governmental entity, as defined in Title 14, section 8102, subsection 2 , for an insurance policy providing motor vehicle liability or collision insurance covering public works employees. [PL 1989, c. 362 (NEW).]
24-A M.R.S. § 960 — ME Code / Title 24-A / Chapter 11 / Section 960
24-A §960. Requirements for principle-based reserves
Status: in_force

1. Scope. This section applies to all policies and contracts for which principle-based reserving is required by the valuation manual, unless exempted by the superintendent in accordance with the following standards: A. An exemption under this subsection may not be granted unless the insurer is licensed and doing business exclusively in this State; [PL 2013, c. 238, Pt. C, §9 (NEW).] B. The exemption must be in writing; [PL 2013, c. 238, Pt. C, §9 (NEW).] C. The superintendent may rescind or modify the exemption in writing at any time, with reasonable notice to the insurer; [PL 2013, c. 238, Pt. C, §9 (NEW).] D. The exemption may apply to all business written by the insurer or to specific policy or contract forms or product lines; and [PL 2013, c. 238, Pt. C, §9 (NEW).] E. An insurer granted an exemption under this subsection shall value its reserves using the assumptions and methods used before the operative date of the valuation manual, in addition to any requirements established by the superintendent by rule or by the terms of the order granting the exemption. [PL 2013, c. 238, Pt. C, §9 (NEW).] [PL 2013, c. 238, Pt. C, §9 (NEW).]

2. Standards. An insurer shall establish reserves for policies and contracts subject to this section using a valuation methodology that meets all applicable requirements of the valuation manual and that: A. Quantifies the benefits and guarantees, and the funding, associated with the policies and contracts and their risks at a level of conservatism that reflects conditions that include unfavorable events that have a reasonable probability of occurring during the lifetime of the policies and contracts. For polices and contracts with significant tail risk, the methodology must reflect conditions appropriately adverse to quantify the tail risk; [PL 2013, c. 238, Pt. C, §9 (NEW).] B. Incorporates assumptions, risk analysis methods and financial models and management techniques that are consistent with, but not necessarily identical to, those used within the insurer's overall risk assessment process, while recognizing potential differences in financial reporting structures and any prescribed assumptions or methods; [PL 2013, c. 238, Pt. C, §9 (NEW).] C. Incorporates assumptions that are derived in one of the following manners: (1) The assumption is prescribed in the valuation manual; or (2) For assumptions that are not prescribed in the valuation manual, the assumptions are: (a) Established using the insurer's available experience, to the extent that it is relevant and statistically credible; or (b) To the extent that insurer-specific data is not available, relevant or statistically credible, established using other relevant, statistically credible experience; and [PL 2013, c. 238, Pt. C, §9 (NEW).] D. Provides margins for uncertainty including adverse deviation and estimation error, such that the greater the uncertainty the larger the margin and resulting reserve. [PL 2013, c. 238, Pt. C, §9 (NEW).] [PL 2013, c. 238, Pt. C, §9 (NEW).]

3. Oversight and controls. An insurer using a principle-based valuation for one or more policies or contracts subject to this section as specified in the valuation manual shall: A. Establish procedures for corporate governance and oversight of the actuarial valuation function consistent with those described in the valuation manual; [PL 2013, c. 238, Pt. C, §9 (NEW).] B. Provide to the superintendent and the insurer's board of directors an annual certification of the effectiveness of the internal controls with respect to the principle-based valuation. Such controls must be designed to ensure that all material risks inherent in the liabilities and associated assets subject to principle-based valuation are included in the valuation and that valuations are made in accordance with the valuation manual. The certification must be based on the controls in place as of the end of the preceding calendar year; and [PL 2013, c. 238, Pt. C, §9 (NEW).] C. Develop, and file with the superintendent upon request, a principle-based valuation report that complies with standards prescribed in the valuation manual. [PL 2013, c. 238, Pt. C, §9 (NEW).] [PL 2013, c. 238, Pt. C, §9 (NEW).]

4. Formulaic components. A principle-based valuation may include a formulaic reserve component and must do so when prescribed by the valuation manual or required by the superintendent. [PL 2013, c. 238, Pt. C, §9 (NEW).]

5. Applicability of rules. Rules adopted by the superintendent pursuant to this subchapter before January 1, 2014 do not apply to policies, contracts or actuarial opinions issued on or after the operative date of the valuation manual unless expressly made applicable by rule or order of the superintendent. [PL 2013, c. 238, Pt. C, §9 (NEW).]
24-A M.R.S. § 2158 — ME Code / Title 24-A / Chapter 23 / Section 2158
24-A §2158. Boycott, coercion and intimidation
Status: in_force

No person shall: [PL 1969, c. 132, §1 (NEW).]

1. Enter into any agreement to commit, or by any concerted action commit, any act of boycott, coercion or intimidation resulting in or tending to result in unreasonable restraint of or monopoly in the business of insurance. [PL 1969, c. 132, §1 (NEW).]

2. Enter into any agreement to commit any act of boycott, coercion or intimidation, or in pursuance thereof monopolize or attempt to monopolize any part of the business of insurance. [PL 1969, c. 132, §1 (NEW).]