24 M.R.S. § 2332-G — ME Code / Title 24 / Chapter 19 / Section 2332-G
24 §2332-G. Gynecological and obstetrical services (REALLOCATED FROM TITLE 24, SECTION 2332-F)
Status: in_force

(REALLOCATED FROM TITLE 24, SECTION 2332-F)

1. Coverage in managed care plans. With respect to managed care plans that require subscribers to select primary care physicians, a nonprofit hospital and medical service organization that issues group contracts and certificates must meet the following requirements. A. The organization must permit a physician who specializes in obstetrics and gynecology to serve as a primary care physician if the physician qualifies under the organization's credentialling policy. [RR 1995, c. 2, §49 (RAL); RR 1995, c. 2, §50 (AFF).] B. All group plan contracts must provide coverage for an annual gynecological examination, including routine pelvic and clinical breast examinations, performed by a physician, certified nurse practitioner or certified nurse midwife participating in the plan, without requiring the prior approval of the primary care physician. [RR 1995, c. 2, §49 (RAL); RR 1995, c. 2, §50 (AFF).] C. If the examination specified in paragraph B reveals a gynecological condition for which another visit to the physician participating in the plan is medically required and appropriate, or for any gynecological care beyond the annual examination, the carrier may require the patient or the examining physician, certified nurse practitioner or certified nurse midwife to secure from the patient's primary care physician a referral to the participating physician, certified nurse practitioner or certified nurse midwife from whom such care may be obtained. [RR 1995, c. 2, §49 (RAL); RR 1995, c. 2, §50 (AFF).] [PL 2003, c. 517, Pt. A, §4 (AMD); PL 2003, c. 517, Pt. A, §13 (AFF).]

2. Application. This section applies to all contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 2003, c. 517, Pt. A, §4 (AMD); PL 2003, c. 517, Pt. A, §13 (AFF).]

This section does not prohibit a carrier from requiring a physician, certified nurse practitioner or certified nurse midwife participating in the plan to inform a woman's primary care physician prior to each treatment pursuant to this section. [RR 1995, c. 2, §49 (RAL); RR 1995, c. 2, §50 (AFF).]
24 M.R.S. § 2325-C — ME Code / Title 24 / Chapter 19 / Section 2325-C
24 §2325-C. Coverage for prostate cancer screening
Status: in_force

1. Definition. As used in this section, "services for the early detection of prostate cancer" means the following procedures provided to a man for the purpose of early detection of prostate cancer: A. A digital rectal examination; and [PL 1997, c. 754, §1 (NEW).] B. A prostate-specific antigen test. [PL 1997, c. 754, §1 (NEW).] [PL 1997, c. 754, §1 (NEW).]

2. Required coverage for prostate cancer screening. All individual and group nonprofit hospital and medical services plan contracts must provide coverage for services for the early detection of prostate cancer. The contracts must reimburse for services for the early detection of prostate cancer, if recommended by a physician, at least once a year for men 50 years of age or older until a man reaches the age of 72. [PL 1997, c. 754, §1 (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 September 1, 1998. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 1997, c. 754, §1 (NEW).]
24-A M.R.S. § 3869 — ME Code / Title 24-A / Chapter 53 / Section 3869
24-A §3869. Subscribers' liability on judgment
Status: in_force

1. No action shall lie against any subscriber upon any obligation claimed against the insurer until a final judgment has been obtained against the insurer and remains unsatisfied for 30 days. [PL 1969, c. 132, §1 (NEW).]

2. Any such judgment is binding upon each subscriber only in such proportion as the subscriber's interests may appear and in amount not exceeding the subscriber's contingent liability, if any. [RR 2021, c. 1, Pt. B, §316 (COR).]
24-A M.R.S. § 2801 — ME Code / Title 24-A / Chapter 35 / Section 2801
24-A §2801. Scope of chapter -- short title
Status: in_force

1. This chapter applies only to group health insurance contracts and to blanket health insurance contracts as herein provided. Nothing in this chapter pertains to legal services insurance as described in chapter 38 , except to the extent expressly permitted in that chapter. [PL 1983, c. 801, §10 (AMD).]

2. This chapter may be cited as the "Group or Blanket Health Insurance Law." [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 4337 — ME Code / Title 24-A / Chapter 56-A / Section 4337
24-A §4337. Requirements related to subcontracting arrangements
Status: in_force

1. Physician groups. A carrier that contracts with a downstream entity that places the individual physician members at substantial financial risk for services they do not furnish shall disclose to the superintendent any incentive plan between the downstream entity and the entity's individual physicians that bases compensation to the physician on the use or cost of services furnished to enrollees. The disclosure must include the information specified in section 4336, subsection 1 . [PL 1999, c. 609, §20 (NEW).]

2. Intermediate entities. A carrier that contracts with a downstream entity, other than a physician group, for the provision of services to enrollees shall disclose to the superintendent any risk arrangement between the entity and a physician or physician group that bases compensation to the physician or physician group on the use or cost of services furnished to enrollees. The disclosure must include the information required to be disclosed under section 4336, subsection 1 . [PL 1999, c. 609, §20 (NEW).]

3. Sanctions against the carrier. The superintendent may apply intermediate sanctions if the superintendent determines that a carrier fails to comply with the requirements of this section. [PL 1999, c. 609, §20 (NEW).]
24-A M.R.S. § 4137 — ME Code / Title 24-A / Chapter 55 / Section 4137
24-A §4137. No adverse publications
Status: in_force

Pending, during or after an examination or investigation of a society, either domestic, foreign or alien, the superintendent may not make public any financial statement, report or finding, nor may the superintendent permit to become public any financial statement, report or finding affecting the status, standing or rights of any society, until a copy thereof has been served upon the society at its principal office and the society has been afforded a reasonable opportunity to answer any such financial statement, report or finding and to make such showing in connection therewith as it may desire. [RR 2021, c. 1, Pt. B, §339 (COR).]
24-A M.R.S. § 4246 — ME Code / Title 24-A / Chapter 56 / Section 4246
24-A §4246. Coverage for services provided by registered nurse first assistants
Status: in_force

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. [PL 1999, c. 412, §4 (NEW).] 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. [PL 1999, c. 412, §4 (NEW).] 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. [PL 1999, c. 412, §4 (NEW).] [PL 1999, c. 412, §4 (NEW).]

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. [PL 1999, c. 412, §4 (NEW).]

3. Required coverage for services. Notwithstanding any other provisions of this chapter, a health maintenance organization that issues individual and group health care 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. [PL 1999, c. 412, §4 (NEW).]

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. [PL 1999, c. 412, §4 (NEW).]

5. Application. The requirements of this section apply to all individual and group policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 2003, c. 617, Pt. B, §26 (NEW).]
24-A M.R.S. § 2261 — ME Code / Title 24-A / Chapter 24-B / Section 2261
24-A §2261. Short title
Status: in_force

This chapter may be known and cited as "the Maine Insurance Data Security Act." [PL 2021, c. 24, §1 (NEW).]
24 M.R.S. § 2314 — ME Code / Title 24 / Chapter 19 / Section 2314
24 §2314. Suspension or revocation of certificate of authority
Status: in_force

Notwithstanding Title 4, chapter 5 and Title 5, section 10051 , the superintendent may suspend or revoke a certificate of authority granted under this chapter for cause at any time pursuant to a hearing held in accordance with Title 5, chapter 375, subchapter IV . [PL 1999, c. 547, Pt. B, §43 (AMD); PL 1999, c. 547, Pt. B, §80 (AFF).]
24-A M.R.S. § 2602-A — ME Code / Title 24-A / Chapter 31 / Section 2602-A
24-A §2602-A. Eligible groups
Status: in_force

Except as provided in section 2612‑A , no policy of group life insurance may be delivered in this State unless it conforms to one of the descriptions in sections 2603 to 2610‑A . [PL 1981, c. 150, §2 (NEW).]
24-A M.R.S. § 2743-B — ME Code / Title 24-A / Chapter 33 / Section 2743-B
24-A §2743-B. Maternity and postpartum care
Status: in_force

An insurer that issues individual contracts providing maternity benefits shall provide coverage for 12 months following childbirth for postpartum care services and support necessary to transition a patient to a healthy and stable condition that meets the recommendations of the American College of Obstetricians and Gynecologists outlined in the "Optimizing Postpartum Care" opinion published May 2018. The postpartum care services and support provided in accordance with this section must include coverage for development of a postpartum care plan; contact with the patient within 3 weeks of the end of pregnancy; a comprehensive postpartum visit, including a full assessment of the patient's physical, social and psychological well-being; treatment of complications of pregnancy and childbirth, including pelvic floor disorders and postpartum depression; assessment of risk factors for cardiovascular disease; and care related to pregnancy loss. [PL 2021, c. 691, §1 (NEW); PL 2021, c. 691, §5 (AFF).]
24-A M.R.S. § 1420-G — ME Code / Title 24-A / Chapter 16 / Section 1420-G
24-A §1420-G. Nonresident licensing
Status: in_force

1. Qualifications. Unless denied licensure pursuant to section 1420‑K , a nonresident person must be issued a nonresident producer license if: A. The person is currently licensed as a resident and in good standing in that person's home state; [PL 2001, c. 259, §24 (NEW).] B. The person has submitted the proper request for licensure and has paid any fees required by section 601 ; [PL 2001, c. 259, §24 (NEW).] C. The person has submitted or transmitted to the superintendent the application for licensure submitted to that person's home state, or in lieu of the same, a completed uniform application; and [PL 2001, c. 259, §24 (NEW).] D. The person's home state awards nonresident producer licenses to residents of this State on the same basis. [PL 2001, c. 259, §24 (NEW).] [PL 2001, c. 259, §24 (NEW).]

2. Verification. The superintendent may verify the producer's licensing status through the producer database maintained by the National Association of Insurance Commissioners, its affiliates or subsidiaries or any successor organization. [PL 2001, c. 259, §24 (NEW).]

3. Change of address. A nonresident producer who moves from one state to another state or a resident producer who moves from this State to another state shall file a change of address and provide certification from the new resident state within 30 days of the change of legal residence. A fee or license application is not required. [PL 2001, c. 259, §24 (NEW).]

4. Surplus lines; license in home state. Notwithstanding any other provision of this subchapter, a person licensed as a surplus lines producer in that person's home state must be issued a nonresident surplus lines producer license pursuant to subsection 1 . Except as provided in subsection 1 , nothing in this section otherwise amends or supersedes any other provision of chapter 19 . [PL 2001, c. 259, §24 (NEW).]

5. Limited lines; license in home state. Notwithstanding any other provision of this subchapter, a person licensed as a limited line credit insurance or other type of limited lines producer in that person's home state must be issued a nonresident limited lines producer license, pursuant to subsection 1 , granting the same scope of authority as granted under the license issued by the producer's home state. For the purposes of this section, limited line insurance is any authority granted by the home state that restricts the authority of the license to less than the total authority prescribed in the associated major lines pursuant to section 1420‑F, subsection 1, paragraphs A to F . [PL 2001, c. 259, §24 (NEW).]
24-A M.R.S. § 4380 — ME Code / Title 24-A / Chapter 57 / Section 4380
24-A §4380. Subordination of claims for noncooperation
Status: in_force

If an ancillary receiver, by whatever name called, in another state or foreign country fails to transfer to the domiciliary liquidator in this State any assets within the ancillary receiver's control other than special deposits, diminished only by the expenses, if any, of the ancillary receivership, the claims filed in the ancillary receivership, other than special deposit claims or secured claims, must be placed in the class of claims under section 4379, subsection 8 . [RR 2021, c. 1, Pt. B, §374 (COR).]
24-A M.R.S. § 2382-A — ME Code / Title 24-A / Chapter 25 / Section 2382-A
24-A §2382-A. Payment of dividends
Status: in_force

Nothing in this Act prohibits or regulates the payment of dividends, savings or unabsorbed premium deposits allowed or returned by insurers to their policyholders, members or subscribers, but in the payment of such dividends there may be no unfair discrimination between policyholders. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

A plan for the payment of dividends, savings or unabsorbed premium deposits allowed or returned by insurers to their policyholders, members or subscribers is not a rating plan or system. [PL 1991, c. 885, Pt. A, §12 (NEW); PL 1991, c. 885, Pt. A, §13 (AFF).]
24-A M.R.S. § 4371 — ME Code / Title 24-A / Chapter 57 / Section 4371
24-A §4371. Deposit of money
Status: in_force

The money collected by the superintendent in a proceeding under this chapter must be from time to time deposited in one or more state or national banks, savings banks or trust companies, and in the case of the insolvency or voluntary or involuntary liquidation of any such depositary that is an institution organized and supervised under the laws of this State, such deposits are entitled to priority of payment on an equality with any other priority given by the banking laws of this State. The superintendent may in the superintendent's discretion deposit such money or any part thereof in a national bank or trust company as a trust fund. [RR 2021, c. 1, Pt. B, §367 (COR).]
24-A M.R.S. § 5016 — ME Code / Title 24-A / Chapter 67 / Section 5016
24-A §5016. Notification prior to cancellation; restrictions on lapse or termination due to cognitive impairment or functional incapacity
Status: in_force

1. Notice of cancellation. An insurer that issues Medicare supplement policies shall provide notification to the insured person and another person, if designated by the insured, prior to cancellation of a Medicare supplement policy for nonpayment of premiums. [PL 2011, c. 123, §4 (NEW); PL 2011, c. 123, §5 (AFF).]

2. Right to reinstatement. Within 90 days after cancellation, termination or lapse of coverage due to nonpayment of premium, a policyholder, a person authorized to act on behalf of the policyholder or a dependent of the policyholder covered under the policy may request reinstatement of the policy on the basis that the loss of coverage was a result of the policyholder's cognitive impairment or functional incapacity. An insurer may require a medical demonstration that the policyholder suffered from cognitive impairment or functional incapacity at the time of cancellation, termination or lapse. If the medical demonstration is waived or substantiates the existence of a cognitive impairment or functional incapacity at the time of policy cancellation to the satisfaction of the insurer, the policy must be reinstated. The medical demonstration may be at the expense of the policyholder. A policy reinstated pursuant to this subsection must cover any loss or claim occurring from the date of the termination, cancellation or lapse and must be issued without any evidence of insurability. Within 15 days after request from an insurer, a policyholder of a policy reinstated pursuant to this subsection shall pay any unpaid premium from the date of the last premium payment at the rate that would have been in effect had the policy remained in force. If the premium is not paid as required, the policy may not be reinstated and the insurer is not responsible for claims incurred after the initial date of cancellation. If an insurer denies a request for reinstatement, the insurer shall notify the policyholder that the policyholder may request a hearing before the superintendent. [PL 2011, c. 123, §4 (NEW); PL 2011, c. 123, §5 (AFF).]

3. Rules. The superintendent may adopt rules to implement the requirements of this section. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . The requirements of this section apply to all policies and certificates executed, delivered, issued for delivery, continued or renewed in this State. [PL 2011, c. 123, §4 (NEW); PL 2011, c. 123, §5 (AFF).]
24-A M.R.S. § 2722 — ME Code / Title 24-A / Chapter 33 / Section 2722
24-A §2722. Insurance with other insurers, provision of service or expense incurred basis
Status: in_force

1. There may be a provision as follows: Insurance with other insurers: If there be other valid coverage, not with this insurer, providing benefits for the same loss on a provision of service basis or on an expense incurred basis and of which this insurer has not been given written notice prior to the occurrence or commencement of loss, the only liability under any expense incurred coverage of this policy shall be for such proportion of the loss as the amount which would otherwise have been payable hereunder plus the total of the like amounts under all such other valid coverages for the same loss of which this insurer had notice bears to the total like amounts under all valid coverages for such loss, and for the return of such portion of the premiums paid as shall exceed the pro rata portion for the amount so determined. For the purpose of applying this provision when other coverage is on a provision of service basis, the "like amount" of such other coverage shall be taken as the amount which the services rendered would have cost in the absence of such coverage. [PL 1969, c. 132, §1 (NEW).]

2. If the foregoing policy provision is included in a policy which also contains the policy provision set out in section 2723 there shall be added to the caption of the foregoing provision the phrase "-- expense incurred benefits." The insurer may, at its option, include in this provision a definition of "other valid coverage," approved as to form by the superintendent, which definition shall be limited in subject matter to coverage provided by organizations subject to regulation by insurance law or by insurance authorities of this or any other state of the United States or any province of Canada, and by hospital or medical service organizations, and to any other coverage the inclusion of which may be approved by the superintendent. In the absence of such definition such term shall not include group insurance, automobile medical payments insurance, or coverage provided by hospital or medical service organization or by union welfare plans or employer or employee benefit organizations. For the purpose of applying the foregoing policy provision with respect to any insured, any amount of benefit provided for such insured pursuant to any compulsory benefit statute, including any workers' compensation or employer's liability statute, whether provided by a governmental agency or otherwise shall in all cases be deemed to be "other valid coverage" of which the insurer has had notice. In applying the foregoing policy provision no third party liability coverage shall be included as "other valid coverage." [PL 1989, c. 502, Pt. A, §95 (AMD).]
24-A M.R.S. § 2802 — ME Code / Title 24-A / Chapter 35 / Section 2802
24-A §2802. Group insurance defined
Status: in_force

1. Any policy or contract of insurance against death or injury resulting from accident or from accidental means which covers more than one person, except blanket accident policies as defined in section 2813 and family accident and sickness policies conforming to section 2703 , shall be deemed a group accident insurance policy. [PL 1969, c. 177, §48 (AMD).]

2. Any policy or contract which insures against disablement, disease or sickness of the insured, excluding disablement which results from accident or from accidental means, and which covers more than one person, except blanket sickness insurance policies as defined in section 2813 and family accident and sickness policies conforming to section 2703 , shall be deemed a group sickness insurance policy or contract. [PL 1969, c. 132, §1 (NEW).]

3. Any policy or contract of insurance which combines the coverage of group accident insurance and of group sickness insurance shall be deemed a group accident and sickness insurance policy. [PL 1969, c. 132, §1 (NEW).]

4. Any reference hereinafter to group health insurance shall mean group accident, group sickness and group accident and sickness insurance as herein defined. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 3311 — ME Code / Title 24-A / Chapter 47 / Section 3311
24-A §3311. Insurance business exclusive; exceptions
Status: in_force

1. No domestic insurer heretofore or hereafter formed shall engage in any business other than the insurance business and in business activities reasonably and necessarily incidental to such insurance business. [PL 1969, c. 132, §1 (NEW).]

2. Except that: A. A title insurer may also engage in business as an escrow agent; [PL 1969, c. 132, §1 (NEW).] B. Any insurer may also engage in business activities reasonably related to the management, supervision, servicing of, and protection of its interests as to its lawful investments; [PL 1969, c. 132, §1 (NEW).] C. An insurer may own subsidiaries or subsidiaries owning other subsidiaries which may engage in such businesses all as provided for in section 1115 (stocks of subsidiaries) or in section 1157 (investment in subsidiaries); [PL 1987, c. 399, §17 (AMD).] D. An insurer may utilize its facilities to perform administrative services for any governmental body, unit or agency; and [PL 1987, c. 399, §17 (AMD).] E. An insurer transacting business of a type described in section 702 , life insurance; section 703 , annuity; or section 704 , health insurance; or any combination of those types of business, may engage in any other business in which it is otherwise qualified to engage to the extent and in the manner approved by the superintendent. [PL 1987, c. 399, §18 (NEW).] [PL 1987, c. 399, §§17, 18 (AMD).]
24-A M.R.S. § 2864 — ME Code / Title 24-A / Chapter 37 / Section 2864
24-A §2864. Enforcement
Status: in_force

Whenever the superintendent finds that there has been a violation of this chapter or any regulations issued pursuant thereto, and after written notice thereof and hearing given to the insurer or other person authorized or licensed by the superintendent, such hearing to conform to the provisions of Title 5, chapter 375, subchapter 4 , the superintendent shall set forth the details of the superintendent's findings together with an order for compliance by a specified date. Such order is binding on the insurer and other person authorized or licensed by the superintendent on the date specified unless sooner withdrawn by the superintendent. [RR 2021, c. 1, Pt. B, §253 (COR).]
24-A M.R.S. § 2707-A — ME Code / Title 24-A / Chapter 33 / Section 2707-A
24-A §2707-A. Notification prior to cancellation; restrictions on lapse or termination due to cognitive impairment or functional incapacity
Status: in_force

An insurer shall provide for notification of the insured person and another person, if designated by the insured, prior to cancellation of a health insurance policy for nonpayment of premium. [PL 2011, c. 123, §2 (AMD); PL 2011, c. 123, §5 (AFF).]

Within 90 days after cancellation due to nonpayment of premium, a policyholder, a person authorized to act on behalf of the policyholder or a dependent of the policyholder covered under a health insurance policy or certificate may request reinstatement on the basis that the loss of coverage was the result of the policyholder's cognitive impairment or functional incapacity. An insurer may require a medical demonstration that the policyholder suffered from cognitive impairment or functional incapacity at the time of cancellation. If the medical demonstration is waived or substantiates the existence of a cognitive impairment or functional incapacity at the time of policy cancellation to the satisfaction of the insurer, the policy must be reinstated. The medical demonstration may be at the expense of the policyholder. [PL 2011, c. 123, §2 (NEW); PL 2011, c. 123, §5 (AFF).]

A policy reinstated pursuant to this section must cover any loss or claim occurring from the date of the cancellation. Within 15 days after request from an insurer, a policyholder of a policy reinstated pursuant to this section shall pay any unpaid premium from the date of the last premium payment at the rate that would have been in effect had the policy remained in force. If the premium is not paid as required, the policy may not be reinstated and the insurer is not responsible for claims incurred after the initial date of cancellation. If an insurer denies a request for reinstatement, the insurer shall notify the policyholder that the policyholder may request a hearing before the superintendent. [PL 2011, c. 123, §2 (NEW); PL 2011, c. 123, §5 (AFF).]

The superintendent may adopt rules to implement the requirements of this section. The rules may include, but are not limited to, definitions, minimum disclosure requirements, notice provisions and the right of reinstatement. Rules adopted pursuant to this section are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2011, c. 123, §2 (AMD); PL 2011, c. 123, §5 (AFF).]
24-A M.R.S. § 2429 — ME Code / Title 24-A / Chapter 27 / Section 2429
24-A §2429. Exemption of proceeds, health insurance
Status: in_force

Except as may otherwise be expressly provided by the policy or contract, the proceeds or avails of all contracts of health insurance and of provisions providing benefits on account of the insured's disability that are supplemental to life insurance or annuity contracts heretofore or hereafter effected are exempt from all liability for any debt of the insured, and from any debt of the beneficiary existing at the time the proceeds are made available for the beneficiary's use. [RR 2021, c. 1, Pt. B, §219 (COR).]
24-A M.R.S. § 2009 — ME Code / Title 24-A / Chapter 19 / Section 2009
24-A §2009. Identification and notice on contract and application
Status: in_force

The surplus lines licensee shall give a consumer notice to every person applying for insurance with a nonadmitted insurer. The notice must be printed in 16-point type on a separate document affixed to the application. The applicant shall sign and date a copy of the notice to acknowledge receiving it. The surplus lines licensee shall maintain the signed notice in its file for a period of 5 years from expiration of the policy. The surplus lines licensee shall send a copy of the signed notice to the insured at the time of delivery of each policy the licensee transacts with a nonadmitted insurer. The copy must be a separate document affixed to the policy. The notice must read as follows: [PL 2025, c. 348, §22 (NEW).]

" Notice: A nonadmitted or surplus lines insurer is issuing the insurance policy that you have applied to purchase. These insurers do not participate in insurance guaranty funds. The guaranty funds will not pay your claims or protect your assets if the insurer becomes insolvent and is unable to make payments as promised. For additional information about the above matters and about the insurer, you should ask questions of your insurance agent, broker or surplus lines broker. You may also contact your insurance department consumer helpline." [PL 2025, c. 348, §22 (NEW).]

An insurance contract procured and delivered as a surplus lines coverage under this chapter must contain or be accompanied by a notice in a form acceptable to the superintendent, a copy of which must be maintained by the licensee or the surplus lines producer with the records of the contract and available for possible examination, that includes a statement that: [PL 2025, c. 348, §22 (NEW).]

1. The insurer with which the licensee places the insurance is not licensed by this State and is not subject to its supervision; and [PL 2025, c. 348, §22 (NEW).]

2. In the event of the insolvency of the surplus lines insurer, losses will not be paid by any state insurance guaranty association. [PL 2025, c. 348, §22 (NEW).]
24-A M.R.S. § 219 — ME Code / Title 24-A / Chapter 3 / Section 219
24-A §219. Interstate cooperation
Status: in_force

The superintendent may communicate on request of the insurance supervisory official of any state, province or country any information that it is the superintendent's duty by law to ascertain respecting authorized insurers. [RR 2021, c. 1, Pt. B, §164 (COR).]
24-A M.R.S. § 2742-B — ME Code / Title 24-A / Chapter 33 / Section 2742-B
24-A §2742-B. Mandatory offer to extend coverage for dependent children up to 26 years of age
Status: in_force

1. Dependent child; definition. As used in this section, "dependent child" means the child of a person covered under an individual health insurance policy. A. [PL 2019, c. 5, Pt. A, §8 (RP).] B. [PL 2019, c. 5, Pt. A, §8 (RP).] C. [PL 2019, c. 5, Pt. A, §8 (RP).] D. [PL 2007, c. 514, §3 (RP).] [PL 2019, c. 5, Pt. A, §8 (AMD).]

2. Offer of coverage. Notwithstanding section 2703, subsection 3 , an individual health insurance policy that offers coverage for a dependent child must offer such coverage, at the option of the policyholder, until the dependent child attains 26 years of age. If the dependent child has a disability, the policy must offer coverage in accordance with section 2742‑C . [PL 2021, c. 520, §1 (AMD).]

3. Notice. [PL 2007, c. 514, §5 (NEW); MRSA T. 24-A §2742-B, sub-§3 (RP).]
24-A M.R.S. § 2272 — ME Code / Title 24-A / Chapter 24-B / Section 2272
24-A §2272. Effective date; implementation
Status: in_force

This chapter takes effect January 1, 2022. A licensee must comply with section 2264 no later than January 1, 2022, except that a licensee must comply with section 2264, subsection 6 no later than January 1, 2023. [PL 2021, c. 24, §1 (NEW).]
24-A M.R.S. § 2862 — ME Code / Title 24-A / Chapter 37 / Section 2862
24-A §2862. Claims
Status: in_force

1. Claims reported. All claims shall be promptly reported to the insurer or its designated claim representative, and the insurer shall maintain adequate claim files. All claims shall be settled as soon as possible and in accordance with the terms of the insurance contract. [PL 1969, c. 132, §1 (NEW).]

2. Claims paid. All claims shall be paid either by draft drawn upon the insurer or by check of the insurer to the order of the claimant to whom payment of the claim is due pursuant to the policy provisions, or upon direction of such claimant to one specified. [PL 1969, c. 132, §1 (NEW).]

3. Creditor may not adjust claims. No plan or arrangement shall be used whereby any person other than the insurer or its designated claim representative shall be authorized to settle or adjust claims. The creditor shall not be designated as claim representative for the insurer in adjusting claims; except that a group policyholder may, by arrangement with the group insurer, draw drafts or checks in payment of claims due to the group policyholder subject to audit and review by the insurer. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 6218 — ME Code / Title 24-A / Chapter 73 / Section 6218
24-A §6218. Financial and organizational disclosure statements
Status: in_force

Every provider shall provide to its subscribers within 120 days following the close of its first fiscal year of operation: [PL 1987, c. 482, §1 (NEW).]

1. Statement of financial condition. The most recent certified annual statement of financial condition, including a balance sheet and summary of receipts and disbursements, including notes of that statement; [PL 1987, c. 482, §1 (NEW).]

2. Description of structure and operation. A description of the organizational structure and operation of the provider, including the kind and extent of subscriber participation and a summary of any material changes since the issuance of the last report; [PL 1987, c. 482, §1 (NEW).]

3. Description of services. A description of services and information as to where and how to secure them; and [PL 1987, c. 482, §1 (NEW).]

4. Method of subscriber complaints. A clear and understandable description of the provider's method for resolving subscriber complaints. [PL 1987, c. 482, §1 (NEW).]

On an annual basis, material changes in the information required to be provided pursuant to this section shall be furnished to all subscribers. [PL 1987, c. 482, §1 (NEW).]
24-A M.R.S. § 2508 — ME Code / Title 24-A / Chapter 29 / Section 2508
24-A §2508. Misstatement of age
Status: in_force

There shall be a provision that if the age of the insured or of any other person whose age is considered in determining the premium or benefit has been misstated, any amount payable or benefit accruing under the policy shall be such as the premium would have purchased at the correct age or ages. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2770-A — ME Code / Title 24-A / Chapter 33 / Section 2770-A
24-A §2770-A. Fees for covered dental services
Status: in_force

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Covered dental service" means a dental service for which reimbursement is available under an insurance policy or contract or for which reimbursement would be available but for the application of contractual limitations such as a deductible, copayment, coinsurance, waiting period, annual or lifetime maximum, frequency limitation, alternative benefit payment or any other similar limitation. [PL 2025, c. 298, §2 (NEW).] B. "Dental provider" means a person licensed under Title 32, chapter 143, subchapter 3 . [PL 2025, c. 298, §2 (NEW).] [PL 2025, c. 298, §2 (NEW).]

2. Prohibition of required fees for dental services not covered. An insurer that issues individual dental insurance or that issues health insurance that covers dental services may not require, directly or indirectly, that a participating dental provider provide dental services at a fee set by, or subject to the approval of, the insurer for a service that is not a covered dental service. [PL 2025, c. 298, §2 (NEW).]

3. Fees for covered dental services. A fee for a covered dental service must be set by the insurer in good faith and may not be nominal. [PL 2025, c. 298, §2 (NEW).]
24-A M.R.S. § 4376 — ME Code / Title 24-A / Chapter 57 / Section 4376
24-A §4376. Date rights fixed on liquidation
Status: in_force

The rights and liabilities of the insurer and of its creditors, policyholders, stockholders, members, subscribers and all other persons interested in its estate shall, unless otherwise directed by the court, be fixed as of the date on which the order directing the liquidation of the insurer is filed in the office of the clerk of the court which made the order, subject to this chapter with respect to the rights of claimants holding contingent claims. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 3423 — ME Code / Title 24-A / Chapter 47 / Section 3423
24-A §3423. Impairment of capital funds
Status: in_force

1. If a domestic stock insurer's paid-in capital stock, as represented by the aggregate par value of its outstanding capital stock, becomes impaired, or the assets of a domestic mutual insurer are less than its liabilities and the minimum amount of basic surplus required to be maintained by it under this Title for authority to transact the kinds of insurance being transacted, the superintendent shall at once determine the amount of deficiency and serve notice upon the insurer to cure the deficiency and file proof thereof with the superintendent within the period specified in the notice, which period may not be less than 30 nor more than 90 days from the date of the notice. Such notice may be so served by delivery to the insurer, or by mailing to the insurer addressed to its registered office in this State. [PL 2023, c. 405, Pt. A, §91 (AMD).]

2. The deficiency may be made good in cash or in assets eligible under chapter 13 (investments) for the investment of the insurer's funds or by amendment of the insurer's certificate of authority to cover only such kind or kinds of insurance thereafter for which the insurer has sufficient paid-in capital stock, if a stock insurer, or surplus, if a mutual insurer, under this Title; or, if a stock insurer, by reduction of the number of shares of the insurer's authorized capital stock or the par value of the capital stock through amendment of its certificate of organization or articles of incorporation, to an amount of authorized and unimpaired paid-in capital stock not below the minimum required for the kinds of insurance thereafter to be transacted. [PL 2013, c. 299, §14 (AMD).]

3. If the deficiency is not made good and proof thereof filed with the superintendent within the period required by the notice as specified in subsection 1 , the insurer shall be deemed insolvent and the superintendent shall institute delinquency proceedings against it under chapter 57 . [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 3624 — ME Code / Title 24-A / Chapter 51 / Section 3624
24-A §3624. Unearned premium reserve
Status: in_force

An insurer which collects a cash premium or advance assessment shall maintain an unearned premium reserve equal to 50% of the cash premium or advance assessment on its policies in force. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2212 — ME Code / Title 24-A / Chapter 24 / Section 2212
24-A §2212. Reasons for adverse underwriting decisions
Status: in_force

1. Notice to consumer. In the event of an adverse underwriting decision, the carrier or producer responsible for the decision shall: A. Comply with the federal Fair Credit Reporting Act, 15 United States Code, Section 1681m if the decision is based in whole or in part on any information contained in a consumer report; [PL 2013, c. 588, Pt. D, §6 (AMD).] B. Either provide the consumer with the specific reason or reasons for the adverse underwriting decision in writing or advise the consumer that upon written request the consumer may receive the specific reason or reasons in writing; and [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] C. Provide the consumer with a summary of the rights established under subsection 2 and sections 2210 and 2211 . [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] [PL 2013, c. 588, Pt. D, §6 (AMD).]

2. Request for explanation. If a consumer makes a written request for explanation of an adverse underwriting decision within 90 days after receiving written notice of the decision, the carrier or producer shall furnish to the consumer within 21 days after receiving the request: A. The specific reason or reasons for the adverse underwriting decision, in writing, if such information was not initially furnished in writing pursuant to subsection 1, paragraph A or B ; [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] B. The specific items of personal information that support those reasons, except that: (1) The carrier or producer is not required to furnish confidential investigative information if it has a reasonable suspicion, based upon specific information available for review by the superintendent, that the consumer has engaged in criminal activity, fraud, material misrepresentation or material nondisclosure; and (2) In lieu of disclosure directly to the consumer, the carrier or producer may elect to disclose health care information to a person designated by the consumer who is licensed to provide health care with respect to the condition to which the information relates; and [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] C. The names and addresses of the institutional sources that supplied the specific items of information pursuant to paragraph B , except that the carrier may elect to disclose the identity of any health care provider to the consumer's designated health care practitioner. [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. Satisfaction by other carrier, producer or administrator. The obligations imposed by this section upon a carrier or producer may be satisfied by another carrier, producer or administrator authorized to act on its behalf. [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]
24-A M.R.S. § 4621 — ME Code / Title 24-A / Chapter 62 / Section 4621
24-A §4621. Credits for assessments paid; tax offsets
Status: in_force

1. Credit allowed. A member insurer may offset against its premium tax liability to this State an assessment described in section 4609, subsection 2‑A, paragraph B and for which a certificate under section 4609, subsection 9 is issued, to the extent of 20% of the amount of the assessment for each of the 5 calendar years following the year in which the assessment was paid. In the event a member insurer ceases doing business, all uncredited assessments may be credited against its premium tax liability for the year it ceases doing business. [PL 2005, c. 346, §14 (NEW); PL 2005, c. 346, §16 (AFF).]

2. Refunds. Any sums that are acquired by refund, pursuant to section 4609, subsection 6 , from the association by member insurers, and that have been offset against premium taxes as provided in subsection 1 , must be recaptured in such manner as required by the State Tax Assessor under Title 36 . The association shall notify the superintendent and the State Tax Assessor that refunds have been made. The association also shall provide the State Tax Assessor with a list of all members who were issued refunds and the dates and amounts of such refunds. [PL 2005, c. 346, §14 (NEW); PL 2005, c. 346, §16 (AFF).]

2-A. Insurers not subject to premium tax. A member insurer that is not subject to premium taxation may take the credit allowed under subsection 1 against its income tax liability to this State. A member insurer that is exempt from both premium taxation and income taxation in this State may recoup its assessments by a surcharge on its premiums in an amount reasonably calculated to recoup the assessments over a reasonable period of time, as approved by the superintendent. Amounts recouped are not considered premiums for any other purpose, including medical loss ratio calculations and premium-based assessments. If a member insurer collects excess surcharges, the insurer shall remit the excess amount to the association, and the excess amount must be applied to reduce future assessments in the appropriate account. [PL 2017, c. 382, §30 (NEW).]

3. Application. This section applies to assessments paid to the association by a member insurer on or after January 1, 2005. [PL 2005, c. 346, §14 (NEW); PL 2005, c. 346, §16 (AFF).]
24-A M.R.S. § 4372 — ME Code / Title 24-A / Chapter 57 / Section 4372
24-A §4372. Exemption from fees
Status: in_force

The superintendent may not be required to pay any fee to any public officer in this State for service of process, filing, recording, issuing a transcript or certificate or authenticating any paper or instrument pertaining to the exercise by the superintendent of any of the powers or duties conferred upon the superintendent under this chapter, whether or not such paper or instrument be executed by the superintendent or the superintendent's deputies, employees or attorneys of record and whether or not it is connected with the commencement of any action or proceeding by or against the superintendent, or with the subsequent conduct of such action or proceeding. [RR 2021, c. 1, Pt. B, §368 (COR).]
24-A M.R.S. § 4320-D — ME Code / Title 24-A / Chapter 56-A / Section 4320-D
24-A §4320-D. Comprehensive health coverage
Status: in_force

Notwithstanding any other requirements of this Title, a carrier offering a health plan in this State shall, at a minimum, provide coverage that incorporates an essential health benefits package consistent with the requirements of this section. [PL 2019, c. 5, Pt. B, §1 (AMD).]

1. Essential health benefits package; definition. As used in this section, "essential health benefits package" means, with respect to any health plan, coverage that: A. Provides for the essential health benefits in accordance with subsection 2 ; [PL 2019, c. 5, Pt. B, §1 (NEW).] B. Limits cost sharing for coverage in accordance with subsection 3 ; and [PL 2019, c. 5, Pt. B, §1 (NEW).] C. Provides for levels of coverage in accordance with subsection 4 . [PL 2019, c. 5, Pt. B, §1 (NEW).] [PL 2019, c. 5, Pt. B, §1 (NEW).]

2. Substantially similar to federal Affordable Care Act; required categories. With respect to any individual or small group health plan offered on or after January 1, 2020, a carrier shall provide essential health benefits that are substantially similar to that of the essential health benefits required in this State for a health plan subject to the federal Affordable Care Act as of January 1, 2019. Essential health benefits required for a health plan must include at least the following general categories and the items and services covered within the categories: A. Ambulatory patient services; [PL 2019, c. 5, Pt. B, §1 (NEW).] B. Emergency services; [PL 2019, c. 5, Pt. B, §1 (NEW).] C. Hospitalization; [PL 2019, c. 5, Pt. B, §1 (NEW).] D. Maternity and newborn care; [PL 2019, c. 5, Pt. B, §1 (NEW).] E. Mental health and substance use disorder services, including behavioral health treatment; [PL 2019, c. 5, Pt. B, §1 (NEW).] F. Prescription drugs; [PL 2019, c. 5, Pt. B, §1 (NEW).] G. Rehabilitative and habilitative services and devices; [PL 2019, c. 5, Pt. B, §1 (NEW).] H. Laboratory services; [PL 2019, c. 5, Pt. B, §1 (NEW).] I. Preventive and wellness services and chronic disease management; and [PL 2019, c. 5, Pt. B, §1 (NEW).] J. Pediatric services, including oral and vision care, to the extent required by the federal Affordable Care Act as of January 1, 2019. [PL 2019, c. 5, Pt. B, §1 (NEW).] [PL 2019, c. 5, Pt. B, §1 (NEW).]

3. Cost-sharing limitations. With respect to any health plan offered on or after the effective date of this subsection, a carrier shall limit cost sharing on an annual basis in a manner that is consistent with the annual limits established for a health plan subject to the federal Affordable Care Act as of January 1, 2019 and as adjusted by the United States Department of Health and Human Services, Centers for Medicare and Medicaid Services, or, if the Centers for Medicare and Medicaid Services does not establish annual limits on cost sharing, the superintendent shall adopt rules establishing annual limits on cost sharing under this subsection that are calculated in substantially the same manner as the Centers for Medicare and Medicaid Services calculated the annual limit in the most recent year it calculated the annual limit. [PL 2019, c. 5, Pt. B, §1 (NEW).]

4. Levels of coverage. Carriers shall offer coverage at levels that are substantially similar to the levels of coverage required for health plans subject to the federal Affordable Care Act as of January 1, 2019. The superintendent may adopt rules defining such levels of coverage. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2019, c. 5, Pt. B, §1 (NEW).]

5. Rule of construction. This section may not be construed to prohibit a health plan from providing benefits in excess of the essential health benefits described in this section. [PL 2019, c. 5, Pt. B, §1 (NEW).]
24 M.R.S. § 2320-D — ME Code / Title 24 / Chapter 19 / Section 2320-D
24 §2320-D. Medical food coverage for inborn error of metabolism
Status: in_force

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

2. Required coverage. All individual and group nonprofit medical services plan policies and contracts and all nonprofit health care plan policies and contracts must provide coverage for metabolic formula and special modified low-protein food products that have been prescribed by a licensed physician for a person with an inborn error of metabolism. The policies and contracts must reimburse: A. For metabolic formula; and [PL 1995, c. 369, §1 (NEW).] B. Up to $3,000 per year for special modified low-protein food products. [PL 1995, c. 369, §1 (NEW).] [PL 1995, c. 369, §1 (NEW).]

3. Application. The requirements of this section apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 1996. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 1995, c. 369, §1 (NEW).]
24-A M.R.S. § 1483 — ME Code / Title 24-A / Chapter 16 / Section 1483
24-A §1483. Application for approval of program
Status: in_force

1. Application. Each application for approval of a continuing education program must be submitted according to the guidelines prescribed by the superintendent accompanied by the appropriate fee in section 601 . The fee is nonrefundable. A fee is required only for original course submissions. Subsequent or renewal filings of approved courses are considered original if modified in any manner. [PL 1997, c. 592, §46 (AMD).]

2. Review. Courses and programs must be approved or disapproved by the superintendent, subject to prior review and nonbinding recommendations of the Continuing Education Advisory Committee or another 3rd-party selected by the superintendent. After review and approval or disapproval, the submissions need not be maintained by the superintendent and may be destroyed. The superintendent may, by rule, establish criteria for the review and approval of courses and for the determination of the number of continuing education hours to be credited for completion of each course or program. Rules adopted pursuant to this subchapter are routine technical rules as defined in Title 5, chapter 375, subchapter II‑A . [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).]
24-A M.R.S. § 2394 — ME Code / Title 24-A / Chapter 26 / Section 2394
24-A §2394. Funding subsequent cash deficiencies
Status: in_force

If the insurers have made payments to the pool totalling $65,000,000 valued as of January 1, 1996 pursuant to section 2393, subsection 1 and the employers have paid surcharges totalling $110,000,000 calculated on a net present value basis using January 1, 1995 as a valuation date and a discount rate of 5%, pursuant to section 2393, subsection 2 , on each July 1st following the full payment date, or more often if the board considers it necessary: [PL 1995, c. 289, §11 (NEW).]

1. Determine cash requirements. The board shall determine the amount of cash receipts that will be required over the ensuing 24 months, in addition to all other funds reasonably anticipated by the board to be available on a cash basis over that period, to produce an amount not less than the pool's projected cash requirements to meet its obligations over that period. In making this determination, the board shall employ and may rely upon professional and consulting services, including such services as may be available through its internal staff, as the board considers necessary. If cash requirements determinations under this subsection commence, any cash requirements determinations and initial surcharge percentage adjustments under section 2393, subsection 2, paragraph E cease. In projecting the pool's anticipated cash requirements, the board shall maintain a reserve equal to 25% of the cash expenditures of the pool over the immediately preceding 12 months; and [PL 1995, c. 289, §11 (NEW).]

2. Establish supplemental surcharges and assessments. The pool shall establish, bill and collect supplemental surcharges from employers and assessments from insurers in an aggregate amount determined by the board to be sufficient to satisfy the pool's cash requirements, determined under subsection 1 , in accordance with the following provisions. A. Liability for funding cash requirements determined under subsection 1 is allocated 70% to employers and 30% to insurers. [PL 1995, c. 289, §11 (NEW).] B. The pool shall establish a surcharge on employers, reflected as a percentage of surchargeable premium, that the board reasonably expects will be sufficient to generate cash receipts over the ensuing 24-month period equal to 70% of the pool's cash requirements for such period as determined pursuant to subsection 1 . The resulting employer surcharges are billed and collected in the same manner as provided in section 2393, subsection 2, paragraph D . [PL 1995, c. 289, §11 (NEW).] C. The pool shall establish, bill and collect from insurers assessments equal to the remaining 30% of the pool's cash requirements. Major insurers are responsible for 90% and minor insurers are responsible for 10% of these assessments. (1) Assessments under this paragraph must be determined and billed quarterly by the pool in an amount equal to 42.9% of the cash receipts actually received by the pool from employer supplemental surcharges during the immediately preceding calendar quarter and must be allocated among existing insurers in the same category in direct proportion to amounts paid by or otherwise collected from those insurers by or on behalf of the pool under section 2393, subsection 1 . Assessments billed by the pool must be paid within 30 days of the billing date. (2) The enforcement provisions established by section 2393, subsection 1, paragraph C apply to assessments on insurers under this paragraph. [PL 1995, c. 289, §11 (NEW).] D. For purposes of establishing the surcharge upon employers, the pool's cash requirements may not include any amounts necessary to compensate the pool for any failure by insurers to pay the full amount of the assessments charged to insurers under this subsection. [PL 1995, c. 289, §11 (NEW).] [PL 1995, c. 289, §11 (NEW).]

For the purposes of this section, "full payment date" means the date on which insurers have paid the entire amount required pursuant to section 2393, subsection 1 and on which employers have paid the entire amount required pursuant to section 2393, subsection 2 . [PL 1995, c. 289, §11 (NEW).]
24-A M.R.S. § 3049-A — ME Code / Title 24-A / Chapter 41 / Section 3049-A
24-A §3049-A. Transfer on death deed; provision and cancellation of property insurance
Status: in_force

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Designated beneficiary" has the same meaning as in Title 18‑C, section 6‑402, subsection 2 . [PL 2021, c. 497, §1 (NEW).] B. "Insurable interest" has the same meaning as in section 2406, subsection 2 . [PL 2021, c. 497, §1 (NEW).] C. "Policy" means an insurance contract subject to this subchapter. [PL 2021, c. 497, §1 (NEW).] D. "Transfer on death deed" has the same meaning as in Title 18‑C, section 6‑402, subsection 6 . [PL 2021, c. 497, §1 (NEW).] E. "Transferor" has the same meaning as in Title 18‑C, section 6‑402, subsection 7 . [PL 2021, c. 497, §1 (NEW).] [PL 2021, c. 497, §1 (NEW).]

2. Policy to include designated beneficiary. Notwithstanding any provision of law to the contrary, when an insured property passes to a designated beneficiary under a transfer on death deed, any policy covering the insured property must extend to the designated beneficiary, except as provided in this section. [PL 2021, c. 497, §1 (NEW).]

3. Cancellation. Upon receiving a notice of death affidavit under Title 18‑C, section 6‑414 , the insurer may cancel a policy extended pursuant to this section as if the policy had been in effect for less than 90 days, as provided in section 3049 . If the insurer does not receive a notice of death affidavit within 30 days after the transferor's death, the policy is deemed to have been cancelled as of the transferor's death without any further action by the insurer. [PL 2021, c. 497, §1 (NEW).]

4. Coverage extended. The coverage extension under this section applies only with respect to the premises and property of the transferor. [PL 2021, c. 497, §1 (NEW).]

5. Proof demanded; policy conditions. Before making any claim payments to a party claiming rights under this section as a designated beneficiary, the insurer may ask for proof that the party is a designated beneficiary under a properly recorded transfer on death deed and that the party has filed a notice of death affidavit under Title 18‑C, section 6‑414 . The designated beneficiary shall comply with the conditions of the policy. [PL 2021, c. 497, §1 (NEW).]

6. Insurable interest; multiple beneficiaries. A designated beneficiary is not entitled to recover under a policy extended as provided in this section in an amount that would exceed the designated beneficiary's insurable interest at the time of loss or damage. If the transfer on death deed has designated multiple beneficiaries, nothing in this section requires the insurer to pay an amount for loss or damage to the premises and property that exceeds the amount that would be owed to the transferor if the transferor were living at the time of loss or damage. [PL 2021, c. 497, §1 (NEW).]
24-A M.R.S. § 2847-V — ME Code / Title 24-A / Chapter 35 / Section 2847-V
24-A §2847-V. Absolute discretion clauses
Status: in_force

A group health insurance policy, contract or certificate, including, but not limited to, a group disability income insurance policy, contract or certificate, may not contain a provision purporting to reserve sole or absolute discretion to the insurer to interpret the terms of the contract, to provide standards of interpretation or review, to determine eligibility for benefits, to determine the amount of benefits or to resolve factual disputes. An insurer may not enforce a provision in a policy, contract or certificate that was offered, executed, delivered or issued for delivery in this State and has been continued or renewed by a group policy holder in this State that purports to reserve sole or absolute discretion to the insurer to interpret the terms of the contract, to provide standards of interpretation or review, to determine eligibility for benefits, to determine the amount of benefits or to resolve factual disputes. [PL 2019, c. 179, §2 (NEW).]
24-A M.R.S. § 4384 — ME Code / Title 24-A / Chapter 57 / Section 4384
24-A §4384. Assessment prima facie correct; notice; payment; proceedings to collect
Status: in_force

1. Any assessment of a subscriber or member of an insurer made by the superintendent pursuant to the order of court fixing the aggregate amount of the assessment against all members or subscribers and approving the classification and formula made by the superintendent under section 4383, subsection 1 shall be prima facie correct. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

2. Each member or subscriber must be notified of the amount of assessment to be paid by the member or subscriber by written notice mailed to the address of the member or subscriber last of record with the insurer. Failure of the member or subscriber to receive the notice so mailed, within the time specified therein or at all, is not a defense in any proceeding to collect the assessment. [RR 2021, c. 1, Pt. B, §378 (COR).]

3. If any such member or subscriber fails to pay the assessment within the period specified in the notice, which period shall not be less than 20 days after mailing, the superintendent may obtain an order in the delinquency proceedings requiring the member or subscriber to show cause at a time and place fixed by the court why judgment should not be entered against such member or subscriber for the amount of the assessment together with all costs, and a copy of the order and a copy of the petition therefor shall be served upon the member or subscriber within the time and in the manner designated in the order. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

4. If the subscriber or member after due service of a copy of the order and petition referred to in subsection 3 is made upon the subscriber or member: A. Fails to appear at the time and place specified in the order, judgment must be entered against the subscriber or member as prayed for in the petition; or [RR 2021, c. 1, Pt. B, §379 (COR).] B. Appears in the manner and form required by law in response to the order, the court shall hear and determine the matter and enter a judgment in accordance with its decision. [PL 1969, c. 132, §1 (NEW).] [RR 2021, c. 1, Pt. B, §379 (COR).]

5. The superintendent may collect any such assessment through any other lawful means. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 702 — ME Code / Title 24-A / Chapter 9 / Section 702
24-A §702. "Life insurance" defined
Status: in_force

Life insurance is insurance on human lives. The transaction of life insurance includes also the granting endowment benefits, additional benefits in event of death or dismemberment by accident or accidental means, additional benefits in event of the insured's disability, and optional modes of settlement of proceeds of life insurance. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2749-B — ME Code / Title 24-A / Chapter 33 / Section 2749-B
24-A §2749-B. Penalty for noncompliance with utilization review programs
Status: in_force

A health insurance policy issued or renewed in this State after April 8, 1994 may not contain a provision that permits, upon retroactive review and confirmation of medical necessity, the imposition of a penalty of more than $500 for failure to provide notification under a utilization review program. This section does not limit the right of insurers to deny a claim when appropriate prospective or retroactive review concludes that services or treatment rendered were not medically necessary. [PL 1995, c. 332, Pt. M, §4 (AMD).]
24-A M.R.S. § 2170 — ME Code / Title 24-A / Chapter 23 / Section 2170
24-A §2170. Certain fees for handling insurance transactions in connection with loans prohibited
Status: in_force

1. No person who makes a loan on real or personal property shall in connection with such a transaction make any separate charge to or require any fee from or require the payment of any money for handling insurance papers for an insurer, insurance agency, borrower, mortgagor or purchaser, other than the insurance premium on insurance written as additional security for the loan. This prohibition includes any separate charge or fee or payment of any money for the substitution by a borrower or a mortgagor or a purchaser of one insurance policy on the property for an existing policy on the property when the existing or substituted policy is provided through an insurer or insurance agent or broker licensed to do business in the State. [PL 1969, c. 132, §1 (NEW).]

2. This section does not prohibit fees paid to a lender for handling or processing credit accident and health or credit life insurance not exceeding 10% of prima facie premiums as set forth by rules adopted by the superintendent. [PL 1993, c. 208, §2 (AMD).]

3. Nothing in this section prevents the payment of the interest which may be charged on premium loans or premium advances in accordance with the security agreement, or the payment of dividends to group policyholders provided that the payment of dividends to group credit life and group credit health policyholders shall be subject to such rules and regulations as shall be promulgated by the superintendent. [PL 1969, c. 177, §34 (AMD); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 2480 — ME Code / Title 24-A / Chapter 28 / Section 2480
24-A §2480. Dispute resolution -- Article 9
Status: in_force

The commission shall attempt, upon the request of a member, to resolve any disputes or other issues that are subject to this compact and that may arise between 2 or more compacting states, or between compacting states and noncompacting states, and the commission shall promulgate an operating procedure providing for resolution of such disputes. [PL 2003, c. 680, §1 (NEW).]
24-A M.R.S. § 6905 — ME Code / Title 24-A / Chapter 87 / Section 6905
24-A §6905. Limitation on liability
Status: in_force

1. Indemnification of Dirigo Health employees. An employee of Dirigo Health is not subject to any personal liability for having acted within the course and scope of membership or employment to carry out any power or duty under this chapter. Dirigo Health shall indemnify any member of the board and any employee of Dirigo Health against expenses actually and necessarily incurred by that member or employee in connection with the defense of any action or proceeding in which that member or employee is made a party by reason of past or present authority with Dirigo Health. [PL 2007, c. 447, §5 (NEW).]

2. Limitation on liability of board members. The personal liability of a member of the board is governed by Title 18‑B, section 1010 . [PL 2007, c. 447, §5 (NEW).]
24-A M.R.S. § 7402 — ME Code / Title 24-A / Chapter 95 / Section 7402
24-A §7402. Definitions
Status: in_force

As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 2019, c. 367, §1 (NEW).]

1. Car sharing delivery period. "Car sharing delivery period" means the period of time during which a shared vehicle is being delivered to the location of the car sharing start time, if applicable, as documented by the governing car sharing program agreement. [PL 2019, c. 367, §1 (NEW).]

2. Car sharing period. "Car sharing period" means the time period that commences with the car sharing delivery period or, if there is no delivery period, that commences with the car sharing start time and in either case ends at the car sharing termination time. [PL 2019, c. 367, §1 (NEW).]

3. Car sharing program agreement. "Car sharing program agreement" means an agreement describing the terms and conditions applicable to a shared vehicle owner and a shared vehicle driver that govern the use of a shared vehicle through a program. [PL 2019, c. 367, §1 (NEW).]

4. Car sharing start time. "Car sharing start time" means the time when a shared vehicle becomes subject to the control of a shared vehicle driver, which must be at or after the time the reservation of the shared vehicle is scheduled to begin as documented in the records of a program. [PL 2019, c. 367, §1 (NEW).]

5. Car sharing termination time. "Car sharing termination time" means the time of the earliest of the following events: A. The expiration of the agreed-upon period of time established for the use of a shared vehicle according to the terms of the car sharing program agreement if the shared vehicle is delivered to the location agreed upon in the car sharing program agreement; [PL 2019, c. 367, §1 (NEW).] B. When the shared vehicle is returned to a location as alternatively agreed upon by the shared vehicle owner and shared vehicle driver as communicated through a program, as long as the alternatively agreed location is incorporated into the car sharing program agreement; and [PL 2021, c. 352, §1 (AMD).] C. When the shared vehicle owner or the shared vehicle owner's authorized designee takes possession and control of the shared vehicle. [PL 2019, c. 367, §1 (NEW).] [PL 2021, c. 352, §1 (AMD).]

6. Insurer. "Insurer" means an insurer authorized to transact business in this State or an insurer that is authorized as a surplus lines insurer. [PL 2019, c. 367, §1 (NEW).]

7. Motor vehicle. "Motor vehicle" has the same meaning as in Title 29‑A, section 101, subsection 42 . [PL 2019, c. 367, §1 (NEW).]

8. Peer-to-peer car sharing. "Peer-to-peer car sharing" means the authorized use of a motor vehicle by an individual other than the registered owner through a program. "Peer-to-peer car sharing" does not include the business of renting motor vehicles within the meaning of Title 29‑A, section 254 . [PL 2021, c. 352, §2 (AMD).]

9. Peer-to-peer car sharing program; program. "Peer-to-peer car sharing program" or "program" means a business, including a business platform, that, digitally or otherwise, connects registered owners of motor vehicles with individuals to enable the sharing of motor vehicles for financial consideration. "Peer-to-peer car sharing program" does not include the business of renting motor vehicles within the meaning of Title 29‑A, section 254 . [PL 2021, c. 352, §3 (AMD).]

10. Provider. "Provider" means a person that facilitates peer-to-peer car sharing through the ownership and operation of a peer-to-peer car sharing program. [PL 2019, c. 367, §1 (NEW).]

11. Shared vehicle. "Shared vehicle" means a motor vehicle that is available for sharing through a peer-to-peer car sharing program. A. [PL 2021, c. 352, §4 (RP).] B. [PL 2021, c. 352, §4 (RP).] C. [PL 2021, c. 352, §4 (RP).] [PL 2021, c. 352, §4 (AMD).]

12. Shared vehicle driver. "Shared vehicle driver" means an individual authorized to use a shared vehicle by the shared vehicle owner under a car sharing program agreement. [PL 2021, c. 352, §5 (AMD).]

13. Shared vehicle owner. "Shared vehicle owner" means the registered owner of a shared vehicle, or a person or entity designated by the registered owner of a vehicle made available for sharing to shared vehicle drivers through a peer-to-peer car sharing program. "Shared vehicle owner" does not include a person engaged in the business of renting motor vehicles within the meaning of Title 29‑A, section 254 . [PL 2021, c. 352, §6 (AMD).]
24-A M.R.S. § 2506 — ME Code / Title 24-A / Chapter 29 / Section 2506
24-A §2506. Entire contract
Status: in_force

There shall be a provision that except as otherwise expressly provided by law, the policy and the application therefor, if a copy of such application is endorsed upon or attached to the policy when issued, shall constitute the entire contract between the parties, and that all statements contained in the application shall, in the absence of fraud, be deemed representations and not warranties. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 6451-A — ME Code / Title 24-A / Chapter 79 / Section 6451-A
24-A §6451-A. Applicability to other regulated entities
Status: in_force

This chapter applies to fraternal benefit societies authorized to do business in this State pursuant to section 4124 , to health maintenance organizations authorized to do business in this State pursuant to section 4204 and to nonprofit hospital or medical service organizations authorized to do business in this State pursuant to Title 24, section 2305 . [PL 2009, c. 511, Pt. E, §1 (RPR).]

1. Fraternal benefit societies providing life or annuity benefits. Fraternal benefit societies providing life or annuity benefits are subject to the provisions of this chapter applicable to life or health insurers. [PL 2009, c. 511, Pt. E, §1 (NEW).]

2. Fraternal benefit societies providing health benefits. Fraternal benefit societies providing health benefits are considered health organizations for purposes of this chapter. [PL 2009, c. 511, Pt. E, §1 (NEW).]

3. Other licensees. Health maintenance organizations and nonprofit hospital or medical service organizations are considered health organizations for purposes of this chapter. [PL 2009, c. 511, Pt. E, §1 (NEW).]

3-A. Qualified nonprofit health insurance issuers. Qualified nonprofit health insurance issuers as defined in Section 1322 of the federal Affordable Care Act are considered health organizations for purposes of this chapter. [PL 2011, c. 364, §35 (NEW).]

4. Provisions applicable to health organizations. Except as otherwise expressly provided in this chapter, health organizations are subject to the provisions of this chapter applicable to property and casualty insurers. [PL 2009, c. 511, Pt. E, §1 (NEW).]
24-A M.R.S. § 2830 — ME Code / Title 24-A / Chapter 35 / Section 2830
24-A §2830. Omissions, modifications: superintendent may approve
Status: in_force

The superintendent may approve any form of group or blanket health insurance policy, or any form of certificate or printed information to be issued under such policy, that omits or modifies any of the provisions hereinbefore required, if the superintendent considers such omission or modification suitable for the character of such insurance and not unjust to the persons insured thereunder. [RR 2021, c. 1, Pt. B, §246 (COR).]
24-A M.R.S. § 4108 — ME Code / Title 24-A / Chapter 55 / Section 4108
24-A §4108. Consolidations and mergers
Status: in_force

A domestic society may consolidate or merge with any other society by complying with the provisions of this section. [PL 1969, c. 132, §1 (NEW).]

It shall file with the superintendent: [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

1. A certified copy of the written contract containing in full the terms and conditions of the consolidation or merger; [PL 1969, c. 132, §1 (NEW).]

2. A sworn statement by the president and secretary or corresponding officers of each society showing the financial condition thereof on a date fixed by the superintendent but not earlier than December 31, next preceding the date of the contract; [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

3. A certificate of such officers, duly verified by their respective oaths, that the consolidation or merger has been approved by a 2/3 vote of the supreme legislative or governing body of each society; and [PL 1969, c. 132, §1 (NEW).]

4. Evidence that at least 60 days prior to the action of the supreme legislative or governing body of each society, the text of the contract has been furnished to all members of each society either by mail or by publication in full in the official organ of each society. [PL 1969, c. 132, §1 (NEW).]

If the superintendent finds that the contract is in conformity with the provisions of this section, that the financial statements are correct and that the consolidation or merger is just and equitable to the members of each society, the superintendent shall approve the contract and issue the superintendent's certificate to such effect. Upon such approval, the contract is in full force and effect unless any society that is a party to the contract is incorporated under the laws of any other state or territory. In such event the consolidation or merger does not become effective unless and until it has been approved as provided by the laws of such state or territory and a certificate of such approval filed with the superintendent or, if the laws of such state or territory contain no such provision, then the consolidation or merger does not become effective unless and until it has been approved by the superintendent of such state or territory and a certificate of such approval filed with the superintendent of this State. [RR 2021, c. 1, Pt. B, §325 (COR).]

Upon the consolidation or merger becoming effective as herein provided, all the rights, franchises and interests of the consolidated or merged societies in and to every species of property, real, personal or mixed, and things in action thereunto belonging shall be vested in the society resulting from or remaining after the consolidation or merger without any other instrument, except that conveyances of real property may be evidenced by proper deeds, and the title to any real estate or interest therein, vested under the laws of this State in any of the societies consolidated or merged, shall not revert or be in any way impaired by reason of the consolidation or merger, but shall vest absolutely in the society resulting from or remaining after such consolidation or merger. [PL 1969, c. 132, §1 (NEW).]

The affidavit of any officer of the society or of anyone authorized by it to mail any notice or document, stating that such notice or document has been duly addressed and mailed, shall be prima facie evidence that such notice or document has been furnished the addressees. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 6403 — ME Code / Title 24-A / Chapter 77 / Section 6403
24-A §6403. Applicability
Status: in_force

This chapter applies to licensed property or casualty insurers, either domiciled in this State or domiciled in a state that is not an accredited state with a substantially similar law in effect. Section 222 , to the extent not modified by this chapter, continues to apply to all parties within holding company systems subject to this chapter. [PL 2017, c. 169, Pt. E, §8 (AMD).]
24-A M.R.S. § 6226 — ME Code / Title 24-A / Chapter 73 / Section 6226
24-A §6226. Continuing Care Retirement Community - Certificate of Need Demonstration Project
Status: in_force

The following provisions apply to applicants seeking to obtain a Certificate of Need from the department for the first Continuing Care Retirement Community Demonstration Project, pursuant to Title 22, chapter 103 , and the Demonstration Project Rules as adopted by the department on April 16, 1987. [PL 1987, c. 563, §7 (NEW).]

1. Initial deposits. After the disclosure statement, the escrow agreement, the receipt and the continuing care agreement have been reviewed on a preliminary basis by the department's Certificate of Need staff, the department shall forward the documents with recommendations, if any, to the superintendent. All provisions of section 6203 , including approval of the receipt and the escrow agreement by the superintendent, remain applicable. Thereafter the limit on deposits that may be collected may not exceed an amount equal to 10% of the entrance fee. Following issuance by the department of a Certificate of Need, any unsuccessful applicant for the first demonstration project shall refund amounts collected from subscribers with interest earned thereon pursuant to this chapter. The refunds must be made no later than 10 days after notification by the department to the unsuccessful applicant unless the unsuccessful applicant appeals the decision of the department as provided by former Title 22, chapter 103. If the applicant appeals and the appeal is denied, then refunds must be made no later than 10 days after notification of the denial. [PL 2003, c. 510, Pt. A, §23 (AMD).]

2. Exception. Except as specifically addressed in this section, all other requirements of this chapter shall apply. [PL 1987, c. 563, §7 (NEW).]
24-A M.R.S. § 2207 — ME Code / Title 24-A / Chapter 24 / Section 2207
24-A §2207. Marketing and research surveys
Status: in_force

A regulated insurance entity that asks questions in connection with an insurance transaction shall clearly identify any questions that are designed to obtain information solely for marketing or research purposes and shall inform consumers that answering the questions is voluntary. [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]
24-A M.R.S. § 1498 — ME Code / Title 24-A / Chapter 16 / Section 1498
24-A §1498. Rules
Status: in_force

The superintendent may adopt reasonable rules for the implementation and administration of this subchapter. Rules adopted pursuant to this subchapter are routine technical rules as defined in Title 5, chapter 375, subchapter II‑A . [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]
24-A M.R.S. § 2847-W — ME Code / Title 24-A / Chapter 35 / Section 2847-W
24-A §2847-W. Dental benefit waiting period
Status: in_force

1. Enrollee defined. For the purposes of this section, unless the context otherwise indicates, "enrollee" means a person who is covered under a group policy or contract provided by an insurer. [PL 2019, c. 605, §6 (NEW); PL 2019, c. 605, §8 (AFF).]

2. No waiting period for enrollee under 19 years of age. An insurer that issues group dental insurance or health insurance that includes coverage for dental services may not impose a waiting period, as defined in section 2848, subsection 5 , for any dental or oral health service or treatment, except for orthodontic treatment, for an enrollee if the enrollee is under 19 years of age. [PL 2019, c. 605, §6 (NEW); PL 2019, c. 605, §8 (AFF).]
24-A M.R.S. § 2528 — ME Code / Title 24-A / Chapter 29 / Section 2528
24-A §2528. Short title
Status: in_force

Sections 2528 to 2534 shall be known as the "Standard Nonforfeiture Law for Life Insurance." [PL 1979, c. 442, §1 (AMD).]
24-A M.R.S. § 2009-A — ME Code / Title 24-A / Chapter 19 / Section 2009-A
24-A §2009-A. Cancellation or nonrenewal of surplus lines coverage
Status: in_force

1. Notice. Cancellation or nonrenewal by an insurer of surplus lines coverage subject to this chapter is not effective unless received by the named insured on or before the date specified in this subsection. A postal service certificate of mailing to the named insured at the insured's last known address is conclusive proof of receipt on the 5th calendar day after mailing. The notice must be received: A. No later than the 30th day before policy expiration for any nonrenewal; [PL 2025, c. 348, §23 (NEW).] B. No later than the 10th day before the effective date of cancellation if the cancellation is for nonpayment of premium; or [PL 2025, c. 348, §23 (NEW).] C. No later than the 14th day before the effective date of any cancellation other than a cancellation for nonpayment of premium, or no later than the 20th day if required by section 3050 . [PL 2025, c. 348, §23 (NEW).] [PL 2025, c. 348, §23 (AMD).]

2. Exemption. Cancellation or nonrenewal by an insurer of surplus lines coverage subject to this chapter is not subject to sections 2908 and 3007 . Cancellation or nonrenewal by an insurer of surplus lines coverage for risks identified in section 3048 is subject to chapter 41, subchapter 5 , except those provisions of chapter 41, subchapter 5 that, by their terms, apply to authorized insurers or the admitted market. [PL 2025, c. 348, §23 (AMD).]
24-A M.R.S. § 2316 — ME Code / Title 24-A / Chapter 25 / Section 2316
24-A §2316. Adherence to filings
Status: in_force

No insurer shall make or issue a contract or policy, except in accordance with the filings which are in effect for the insurer as provided in this chapter or in accordance with sections 2305 (exemption from filing) or 2308 (excess rates). This section shall not apply to contracts or policies for inland marine risks as to which filings are not required. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 785 — ME Code / Title 24-A / Chapter 9 / Section 785
24-A §785. Powers
Status: in_force

1. Powers. A special purpose reinsurance vehicle authorized under this subchapter has the powers to enter into contracts and to conduct other commercial activities necessary to fulfill the purposes of this subchapter. These activities may include, but are not limited to, entering into contracts, issuing securities of the special purpose reinsurance vehicle and complying with the terms of the contracts, entering into trust agreements, swap agreements and any other agreements necessary to effectuate an insurance securitization in compliance with the limitations and pursuant to the authorities granted to the reinsurance vehicle under this subchapter or the plan of operation approved by the superintendent. [PL 2003, c. 249, §2 (NEW).]

2. Bylaws. A special purpose reinsurance vehicle organized or doing business under this subchapter is capable of suing or being sued and may make or enforce contracts in relation to the business of the reinsurance vehicle; may have and use a common seal and in the name of the reinsurance vehicle or by a trustee chosen by the board of directors is capable of taking, purchasing, holding and disposing of real and personal property for carrying into effect the purposes of its organization; and may by its board of directors, trustees, officers or managers make bylaws and amendments to the bylaws not inconsistent with the laws or the constitution of this State or of the United States. The bylaws must define the manner of electing directors, trustees or managers and officers of the reinsurance vehicle, together with their qualifications, duties and term of office. [PL 2003, c. 249, §2 (NEW).]
24-A M.R.S. § 2503 — ME Code / Title 24-A / Chapter 29 / Section 2503
24-A §2503. Standard provisions required
Status: in_force

1. No policy of life insurance other than pure endowments with or without return of premiums or of premiums and interest, shall be delivered or issued for delivery in this State unless it contains in substance all of the applicable provisions required by sections 2504 to 2515 . This section shall not apply to annuity contracts nor to any provision of a life insurance policy, or contract supplemental thereto, relating to disability benefits or to additional benefits in the event of death by accident or accidental means. [PL 1969, c. 132, §1 (NEW).]

2. Any of such provisions or portions thereof not applicable to single premium or nonparticipating or term policies or insurance granted in exchange for lapsed or surrendered policies shall to that extent not be incorporated therein. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2837-F — ME Code / Title 24-A / Chapter 35 / Section 2837-F
24-A §2837-F. Off-label use of prescription drugs for cancer
Status: in_force

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Medically accepted indication" includes any use of a drug that has been approved by the federal Food and Drug Administration and includes another use of the drug if that use is supported by one or more citations in the standard reference compendia or if the insurer involved, based upon guidance provided by the federal Department of Health and Human Services Medicare program pursuant to 42 United States Code, Section 1395x(t), determines that that use is medically accepted based on supportive clinical evidence in peer-reviewed medical literature. [PL 1997, c. 701, §3 (NEW).] B. "Off-label use" means the prescription and use of drugs for medically accepted indications other than those stated in the labeling approved by the federal Food and Drug Administration. [PL 1997, c. 701, §3 (NEW).] C. "Peer-reviewed medical literature" means scientific studies published in at least 2 articles from major peer-reviewed medical journals that present data that supports the proposed off-label use as generally safe and effective. [PL 1997, c. 701, §3 (NEW).] D. "Standard reference compendia" means: (1) The United States Pharmacopeia Drug Information or information published by its successor organization; or (2) The American Hospital Formulary Service Drug Information or information published by its successor organization. [PL 1997, c. 701, §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 cancer for a medically accepted indication on the grounds that the drug has not been approved by the federal Food and Drug Administration for that indication, as long as that use of that drug is a medically accepted indication for the treatment of cancer. [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).] Revisor's Note: §2837-F. Coverage for prostate cancer screening (As enacted by PL 1997, c. 754, §3 is REALLOCATED TO TITLE 24-A, SECTION 2837-H)
24-A M.R.S. § 2836 — ME Code / Title 24-A / Chapter 35 / Section 2836
24-A §2836. Limits on priority liens
Status: in_force

No group or blanket policy shall provide for priority over the insured member of payment for any hospital, nursing, medical or surgical services, or of any expenses paid or reimbursed under the policy, in the event the insured member is entitled to receive payment reimbursement from any other person as a result of legal action or claim, except as provided in this section. [PL 1975, c. 770, §108 (NEW).]

A policy may contain a provision that allows such payments, if that provision is approved by the superintendent, and if that provision requires the prior written approval of the insured member and allows such payments only on a just and equitable basis, and not on the basis of a priority lien. A just and equitable basis shall mean that any factors that diminish the potential value of the insured member's claim shall likewise reduce the share in the claim for those claiming payment for services or reimbursement. Such factors shall include, but are not limited to: [PL 1975, c. 770, §108 (NEW).]

1. Legal defenses. Questions of liability and comparative negligence or other legal defenses; [PL 1975, c. 770, §108 (NEW).]

2. Exigencies of trial. Exigencies of trial that reduce a settlement or award in order to resolve the claim; and [PL 1975, c. 770, §108 (NEW).]

3. Limits of coverage. Limits on the amount of applicable insurance coverage that reduce the claim to an amount recoverable by the insured member. [PL 1975, c. 770, §108 (NEW).]

In the event of a dispute as to the application of any such provision or the amount available for payment to those claiming payment for services or reimbursement, the dispute shall be determined if the action is pending, before the court in which it is pending; or if no action is pending, by filing an action in any court for determination of the dispute. [PL 1975, c. 770, §108 (NEW).]
24-A M.R.S. § 991 — ME Code / Title 24-A / Chapter 11 / Section 991
24-A §991. Short title
Status: in_force

This Act may be known and cited as "the Property and Casualty Actuarial Opinion Act." [PL 2007, c. 281, §2 (NEW); PL 2007, c. 281, §3 (AFF).]
24-A M.R.S. § 1107 — ME Code / Title 24-A / Chapter 13 / Section 1107
24-A §1107. Public obligations
Status: in_force

An insurer may invest in bonds or other evidences of indebtedness, not in default as to principal or interest, which are valid and legally authorized obligations issued, assumed or guaranteed by the United States or by any state thereof, or by Canada or any of the provinces thereof, or by any county, city, town, village, municipality or district therein or by any political subdivision thereof or by a public instrumentality of one or more of the foregoing, if, by statutory or other legal requirements applicable thereto, such obligations are payable, as to both principal and interest, from: [PL 1969, c. 132, §1 (NEW).]

1. Taxes levied or by law required to be levied upon all taxable property or all taxable income within the jurisdiction of such governmental unit, or from [PL 1969, c. 132, §1 (NEW).]

2. Adequate special revenues pledged or otherwise appropriated or by law required to be provided for the purpose of such payment; but not including any obligation payable solely out of special assessments on properties benefited by local improvements unless adequate security is evidenced by the ratio of assessment to the value of the property or the obligation is additionally secured by an adequate guaranty fund required by law. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 6615 — ME Code / Title 24-A / Chapter 81 / Section 6615
24-A §6615. Delinquency proceedings
Status: in_force

The rehabilitation, liquidation, conservation or dissolution of a multiple-employer welfare arrangement must be conducted under the supervision of the superintendent, who has all power with regard to the rehabilitation, liquidation, conservation or dissolution of a multiple-employer welfare arrangement granted to the superintendent under the laws governing the rehabilitation, liquidation, conservation or dissolution of insurers. [PL 1993, c. 688, §1 (NEW).]
24-A M.R.S. § 1955 — ME Code / Title 24-A / Chapter 18-A / Section 1955
24-A §1955. Restrictions
Status: in_force

1. Restricted activities. An alliance may not purchase health care services, assume risk for the cost or provision of health care services or otherwise contract with health care providers for the provision of health care services to enrollees without the prior approval of the superintendent. [PL 1997, c. 616, §3 (AMD).]

2. Licensing. A person who solicits applications for insurance, negotiates insurance contracts or takes applications for insurance from enrollees on behalf of an alliance or on behalf of insurance carriers or health maintenance organizations that have contracted with the alliance must be licensed with the bureau in compliance with chapter 16 . [PL 1997, c. 457, §32 (AMD); PL 1997, c. 457, §55 (AFF).]

3. Conflict of interest. A person may not be a board member, officer or employee of an alliance if that person is employed as or by, is a member of the board of directors of, is an officer of, or has a material direct or indirect ownership interest in a carrier or health care provider. A person may not be a board member or officer of an alliance if a member of that person's household is a member of the board of directors of, is an officer of or has a material direct or indirect ownership interest in a carrier or health care provider. An employee of an alliance who is licensed as an agent, broker or consultant may act under that license only on behalf of the alliance and only within the scope of that person's duties as an employee. [PL 1997, c. 616, §3 (AMD).]

4. Commissions. All commissions or other payments to the alliance from or on behalf of carriers must inure to the benefit of the alliance and alliance members. An employee of an alliance may not receive compensation that is contingent upon the amount of coverage sold or upon the health carrier that is chosen. This subsection does not prohibit an alliance from arranging coverage through an unaffiliated agent or broker who is paid on a commission basis in the ordinary course of business. [PL 1995, c. 673, Pt. A, §3 (NEW).]

5. Rulemaking. The superintendent may specify further restrictions by rule. [PL 1995, c. 673, Pt. A, §3 (NEW).]
24-A M.R.S. § 4138-A — ME Code / Title 24-A / Chapter 55 / Section 4138-A
24-A §4138-A. Enforcement; unfair methods of competition and unfair and deceptive acts and practices
Status: in_force

A society authorized to do business in this State is subject to the provisions of section 12‑A and chapter 23 . Nothing in such provisions may be construed as applying to or affecting the right of any society to determine its eligibility requirements for membership or as applying to or affecting the offering of benefits exclusively to members or persons eligible for membership in the society by a subsidiary corporation or affiliated organization of the society or the offering of benefits only to its members. [PL 2009, c. 13, §7 (NEW).]
24-A M.R.S. § 2614 — ME Code / Title 24-A / Chapter 31 / Section 2614
24-A §2614. Grace period
Status: in_force

The group life insurance policy shall contain a provision that the policyholder is entitled to a grace period of 31 days for the payment of any premium due except the first, during which grace period the death benefit coverage shall continue in force, unless the policyholder shall have given the insurer written notice of discontinuance in advance of the date of discontinuance and in accordance with the terms of the policy. The policy may provide that the policyholder shall be liable to the insurer for the payment of a pro rata premium for the time the policy was in force during such grace period. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 606 — ME Code / Title 24-A / Chapter 7 / Section 606
24-A §606. Annual transfer
Status: in_force

Annually, beginning with the 2027-28 fiscal year, within 90 days following the end of the immediately prior fiscal year, and upon verification by the superintendent that sufficient surplus funds exist, the State Controller shall transfer $1,755,000 from available balances in the bureau's Other Special Revenue Funds account to the State Resilience Fund established in Title 5, section 3212 . [PL 2025, c. 33, Pt. C, §6 (NEW).]
24-A M.R.S. § 6453 — ME Code / Title 24-A / Chapter 79 / Section 6453
24-A §6453. Company action level event
Status: in_force

1. Company action level event; defined. "Company action level event" means any of the following events: A. The filing of a risk-based capital report by an insurer that indicates that: (1) The insurer's total adjusted capital is greater than or equal to its regulatory action level risk-based capital but less than its company action level risk-based capital; or (2) The insurer has total adjusted capital that is greater than or equal to its company action level risk-based capital but has a negative trend, if its total adjusted capital is less than the product of its authorized control level risk-based capital and 3.0. [PL 2013, c. 238, Pt. D, §2 (AMD).] B. Provided the insurer does not challenge the adjusted risk-based capital report under section 6457 , the notification by the superintendent to the insurer of an adjusted risk-based capital report that indicates the event in paragraph A ; or [PL 1993, c. 634, Pt. A, §1 (NEW).] C. If the insurer, under section 6457 , challenges the adjusted risk-based capital report that indicates the event in paragraph A , the notification by the superintendent to the insurer that the superintendent has, after a hearing, rejected the insurer's challenge. [PL 1993, c. 634, Pt. A, §1 (NEW).] [PL 2013, c. 238, Pt. D, §2 (AMD).]

2. Contents of risk-based capital plan. When a company action level event occurs, the insurer shall submit to the superintendent a risk-based capital plan that must: A. Identify the conditions in the insurer's business that contribute to the company action level event; [PL 1993, c. 634, Pt. A, §1 (NEW).] B. Contain proposals of corrective actions that the insurer intends to take and that are expected to result in the elimination of the company action level event; [PL 1993, c. 634, Pt. A, §1 (NEW).] C. Provide projections of the insurer's financial results in the current year and at least the 4 succeeding years, with consideration given to the effect of implementing and not implementing the proposed corrective actions, including projections of statutory operating income, net income, capital and surplus. The projections for new and renewal business may include separate projections for each major line of business and separately identify each significant income, expense and benefit component; [PL 1993, c. 634, Pt. A, §1 (NEW).] D. Identify the key assumptions impacting the insurer's projections and the sensitivity of the projections to the assumptions; and [PL 1993, c. 634, Pt. A, §1 (NEW).] E. Identify the quality of, and the problems associated with, the insurer's business, including but not limited to its assets, anticipated business growth and associated surplus strain, extraordinary exposure to risk, mix of business and use of reinsurance in each case, if any. [PL 1993, c. 634, Pt. A, §1 (NEW).] [PL 1993, c. 634, Pt. A, §1 (NEW).]

3. Submission of risk-based capital plan. The risk-based capital plan must be submitted: A. Within 45 days after the company action level event; or [PL 1999, c. 113, §26 (AMD).] B. If the insurer challenges an adjusted risk-based capital report under section 6457 , within 45 days after notification to the insurer that the superintendent has, after a hearing, rejected the insurer's challenge. [PL 1993, c. 634, Pt. A, §1 (NEW).] [PL 1999, c. 113, §26 (AMD).]

4. Review by superintendent. Within 60 days after the submission by an insurer of a risk-based capital plan to the superintendent pursuant to this section, the superintendent shall notify the insurer whether the risk-based capital plan may be implemented or is, in the judgment of the superintendent, unsatisfactory. If the superintendent determines the risk-based capital plan is unsatisfactory, the notification to the insurer must set forth the reasons for the determination and may set forth proposed revisions that will render the risk-based capital plan satisfactory, in the judgment of the superintendent. Upon notification from the superintendent, the insurer shall prepare a revised risk-based capital plan, which may incorporate by reference any revisions proposed by the superintendent, and shall submit the revised risk-based capital plan to the superintendent: A. Within 45 days after the notification from the superintendent; or [PL 1993, c. 634, Pt. A, §1 (NEW).] B. If the insurer challenges the notification from the superintendent under section 6457 , within 45 days after a notification to the insurer that the superintendent has, after a hearing, rejected the insurer's challenge. [PL 1993, c. 634, Pt. A, §1 (NEW).] [PL 1993, c. 634, Pt. A, §1 (NEW).]

5. Notification that plan is unsatisfactory. In the event of a notification by the superintendent to an insurer that the insurer's risk-based capital plan or revised risk-based capital plan is unsatisfactory, the superintendent may at the superintendent's discretion, subject to the insurer's right to a hearing under section 6457 , specify in the notification that the notification constitutes a regulatory action level event. [PL 1993, c. 634, Pt. A, §1 (NEW).]

6. Duty to file copies of plan with other states. A domestic insurer that files a risk-based capital plan or revised risk-based capital plan with the superintendent pursuant to this section shall file a copy of the risk-based capital plan or revised risk-based capital plan with the insurance regulator in any state in which the insurer is authorized to do business if: A. That state has a risk-based capital provision substantially similar to that required by this chapter; and [PL 1993, c. 634, Pt. A, §1 (NEW).] B. The insurance regulator of that state has notified the insurer of its request for the filing in writing, in which case the insurer shall file a copy of the risk-based capital plan or revised risk-based capital plan in that state no later than the later of: (1) Fifteen days after the receipt of notice to file a copy of its risk-based capital plan or revised risk-based capital plan with the state; or (2) The date on which the risk-based capital plan or revised risk-based capital plan is filed with the superintendent. [PL 1999, c. 113, §27 (AMD).] [PL 1999, c. 113, §27 (AMD).]
24-A M.R.S. § 5056 — ME Code / Title 24-A / Chapter 68 / Section 5056
24-A §5056. Standards for marketing
Status: in_force

Every insurer, health care service plan or other entity marketing nursing home care, home health care or long-term care insurance coverage in this State, directly or through its producers, shall: [PL 1997, c. 604, Pt. D, §7 (AMD).]

1. Policy comparison. Establish marketing procedures to ensure that any comparison of policies by its agents or other producers is fair and accurate; [PL 1991, c. 200, Pt. C, §3 (NEW).]

2. Excessive insurance. Establish marketing procedures to ensure that excessive insurance is not sold or issued. The procedures must include a specific standard for persons covered by Medicaid; [PL 1991, c. 200, Pt. C, §3 (NEW).]

3. Replacement policy. Establish marketing procedures that set forth a mechanism or formula for determining whether a replacement policy or certificate contains benefits clearly and substantially greater than the benefits under the replaced policy; and [PL 1991, c. 200, Pt. C, §3 (NEW).]

4. Compliance procedures. Establish auditable procedures for verifying compliance with the standards set out in this section. [PL 1991, c. 200, Pt. C, §3 (NEW).]
24-A M.R.S. § 2611-A — ME Code / Title 24-A / Chapter 31 / Section 2611-A
24-A §2611-A. Dependent's coverage
Status: in_force

Except for a policy issued under section 2604‑A , a group life insurance policy may insure the lives of spouses and dependent children of employees or members against loss due to death without also insuring employees or members against loss due to the death of their spouses and dependent children, or any class or classes thereof, subject to the following. [PL 1993, c. 132, §1 (AMD).]

1. The premium for the insurance must be paid either from funds contributed by the employer, union, association or other person to whom the policy has been issued or from funds contributed by employees or members, or from both. Except as provided in subsection 2 , a policy on which no part of the premium for the spouse's and dependent child's coverage is to be derived from funds contributed by employees or members, spouses or dependent children must insure all eligible employees or members with respect to their spouses and dependent children, or all eligible spouses and dependent children, or any class or classes thereof. [PL 1993, c. 132, §1 (AMD).]

2. An insurer may exclude or limit the coverage on any spouse or dependent child as to whom evidence of individual insurability is not satisfactory to the insurer. [PL 1981, c. 150, §15 (NEW).]

3. [PL 1993, c. 132, §1 (RP).]
24-A M.R.S. § 423-A — ME Code / Title 24-A / Chapter 5 / Section 423-A
24-A §423-A. Interim financial reporting requirements
Status: in_force

1. Quarterly statement. No later than the 15th day of the 2nd month following the close of any calendar quarter, except the 4th quarter, an authorized insurer that is subject to the requirements of section 423 shall file a quarterly statement of financial condition with the superintendent. [PL 2017, c. 169, Pt. A, §4 (AMD).]

2. Form and content. The quarterly statement must be in the form prescribed by the National Association of Insurance Commissioners and must be prepared in accordance with the association's quarterly statement instructions. [PL 2017, c. 169, Pt. A, §4 (AMD).]

3. Verification. The report must be verified by the oath of the insurer's president or vice-president, and the secretary or actuary as applicable, or in the absence of the foregoing, by 2 other principal officers; or if a reciprocal insurer, by the oath of the attorney-in-fact or its like officers if a corporation. [PL 2017, c. 169, Pt. A, §4 (AMD).]

4. Supplemental reporting. Upon the superintendent's request, the insurer shall file periodic reports of financial condition on a monthly basis, or at other intervals prescribed by the superintendent, in such form and containing such information as the superintendent prescribes. [PL 2017, c. 169, Pt. A, §4 (NEW).]
24-A M.R.S. § 2724 — ME Code / Title 24-A / Chapter 33 / Section 2724
24-A §2724. Relation of earnings to insurance
Status: in_force

There may be a provision as follows: If the total monthly amount of loss of time benefits promised for the same loss under all valid loss of time coverage upon the insured, whether payable on a weekly or monthly basis, shall exceed the monthly earnings of the insured at the time disability commenced or the average monthly earnings for the period of 2 years immediately preceding a disability for which claim is made, whichever is the greater, the insurer will be liable only for such proportionate amount of such benefits under this policy as the amount of such monthly earnings or such average monthly earnings of the insured bears to the total amount of monthly benefits for the same loss under all such coverage upon the insured at the time such disability commences and for the return of such part of the premiums paid during such 2 years as shall exceed the pro rata amount of the premiums for the benefits actually paid hereunder; but this shall not operate to reduce the total monthly amount of benefits payable under all such coverage upon the insured below the sum of $200 or the sum of the monthly benefits specified in such coverages, whichever is the lesser, nor shall it operate to reduce benefits other than those payable for loss of time. The foregoing policy provision may be inserted only in a policy which the insured has the right to continue in force subject to its terms by the timely payment of premiums (A.) until at least age 50 or, (B.) in the case of a policy issued after age 44, for at least 5 years from its date of issue. The insurer may, at its option, include in this provision a definition of "valid loss of time coverage", approved as to form by the superintendent, which definition shall be limited in subject matter to coverage provided by governmental agencies or by organizations subject to regulation by insurance law or by insurance authorities of this or any other state of the United States or any province of Canada, or to any other coverage the inclusion of which may be approved by the superintendent or any combination of such coverages. In the absence of such definition such term shall not include any coverage provided for such insured pursuant to any compulsory benefit statute, including any workers' compensation or employer's liability statute, or benefits provided by union welfare plans or by employer or employee benefit organizations. [PL 1989, c. 502, Pt. A, §97 (AMD).]
24-A M.R.S. § 1129 — ME Code / Title 24-A / Chapter 13 / Section 1129
24-A §1129. Special investments of title insurers
Status: in_force

1. A title insurer may also have invested funds in an amount not exceeding 50% of its paid-in capital stock and its surplus, in its abstract plant and equipment and in stocks of abstract companies. [PL 1969, c. 132, §1 (NEW).]

2. Investments authorized under subsection 1 shall not be credited against required reserves. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 4320-G — ME Code / Title 24-A / Chapter 56-A / Section 4320-G
24-A §4320-G. Applicability to health plans grandfathered under the Affordable Care Act
Status: in_force

A health plan that is exempt from certain requirements of the federal Affordable Care Act because it has grandfathered status is also exempt, to the same extent, from substantially similar provisions in this Title and Title 24 enacted after January 1, 2011, except to the extent that those provisions state that they apply to grandfathered health plans. [PL 2011, c. 364, §34 (NEW).]
24-A M.R.S. § 2730 — ME Code / Title 24-A / Chapter 33 / Section 2730
24-A §2730. Order of certain provisions
Status: in_force

The provisions which are the subject of sections 2704 to 2716 , and 2718 to 2728 , or any corresponding provisions which are used in lieu thereof in accordance with such sections shall be printed in the consecutive order of the provisions in such sections or, at the option of the insurer, any such provision may appear as a unit in any part of the policy, with other provisions to which it may be logically related, provided that the resulting policy shall not be in whole or in part unintelligible, uncertain, ambiguous, abstruse or likely to mislead a person to whom the policy is offered, delivered or issued. [PL 1969, c. 177, §47 (AMD).]
24-A M.R.S. § 2304-C — ME Code / Title 24-A / Chapter 25 / Section 2304-C
24-A §2304-C. Physicians and surgeons liability insurance rates
Status: in_force

Physicians and surgeons liability insurance rate filings are first subject to this section, but any other provisions of this chapter not inconsistent with this section also apply. Notwithstanding this section, filings made by advisory organizations are subject to this section only to the extent permitted by law, and laws prohibiting activities or the filing of certain information by advisory organizations supersede the provisions of this section. [PL 1991, c. 377, §11 (NEW).]

1. Contents of filing. Every filing subject to this section must include the data, statistics, schedules or information necessary for the superintendent to determine whether the filing complies with this chapter. The superintendent may waive any noncompliance with this subsection if the superintendent determines that the noncompliance is immaterial. The required information includes, but is not limited to: A. Rates: (1) Current rates by rating class at basic limits and larger optional limits of coverage; and (2) Proposed rates by rating class at basic limits and larger optional limits of coverage; [PL 1991, c. 377, §11 (NEW).] B. Historical experience: (1) Maine total limits premium, paid claims, paid allocated loss adjustment expenses, incurred claims, incurred allocated loss adjustment expenses, and incurred loss ratio for not less than the 5 most recent years available; (2) Maine basic limits written or earned premium or exposure, paid claims, paid allocated loss adjustment expenses, incurred claims, incurred allocated loss adjustment expenses, and incurred loss ratio or pure premium for not less than the 5 most recent years available; and (3) Any other experience used to support the proposed changes; [PL 1991, c. 377, §11 (NEW).] C. Adjustment factors: (1) Premiums or exposure at basic limit adjusted to current rate level or exposure, and a description of the method used to adjust historical earned premium or exposure to current level; (2) Loss development exhibits showing the change in paid and incurred losses and allocated loss adjustment expenses from period to period, evaluated at least annually, and an explanation of the loss development method used to project the ultimate value of claims and allocated loss adjustment expenses; (3) Trend factor calculations and application, including the following: (a) An explanation of the trending procedure and assumptions; (b) Trend based on experience in this State as well as other actuarially sound sources of trend information; and (c) Frequency and severity trend factor calculations, shown separately; and (4) Credibility weighting of alternative sources of data, including a description of the methodology used and the appropriateness of the method to its use in the filing; [PL 1991, c. 377, §11 (NEW).] D. Classification exposure, premium and loss experience in the State for not less than the 5 most recent years available, and other experience determined to be credible in selecting the proposed classification relativities. Classification experience must be provided in any filing in which the filer has proposed changes to the classification relativities, but not less frequently than every 3 years; [PL 1991, c. 377, §11 (NEW).] E. Expense provisions used in developing the proposed rates, an explanation of the procedure used to develop these provisions, and the actual historical expenses for each of the 3 most recent years available in the following categories: commissions; other acquisition expenses; general expenses; taxes, licenses and fees; unallocated loss adjustment expenses; and other expenses; [PL 1991, c. 377, §11 (NEW).] F. An evaluation of any law changes that will become effective during the period in which rates will be in effect or any law changes in effect but not evaluated in a prior filing and not reflected in the reported experience; [PL 1991, c. 377, §11 (NEW).] G. An estimate of the investment income that will be earned on loss and loss adjustment expense reserves and unearned premium reserves during the period the rates are to be in effect and claims remain unpaid, and evidence that the filing gives full consideration to that estimated income. The filing must include the expected expense and claim payout pattern and an explanation of the derivation of the payout pattern; and [PL 1991, c. 377, §11 (NEW).] H. Information regarding cost or expense control programs, procedures or practices implemented by the filer to improve efficiency of the company or to control or limit premium charges to insureds. [PL 1991, c. 377, §11 (NEW).] [PL 1991, c. 377, §11 (NEW).]

2. Additional information. The superintendent may require, at any time, any additional information the superintendent determines necessary. [PL 1991, c. 377, §11 (NEW).]

3. Assertion of confidential status. Any insurer, rating organization or advisory organization that asserts that any portion of a filing is entitled to confidential status for purposes of subsection 5 , shall identify that portion of the filing at the time of filing and shall state the basis for the assertion. [PL 1991, c. 377, §11 (NEW).]

4. Notice of filing. The superintendent shall maintain a list of all persons who request notice of physicians and surgeons liability insurance rate filings. Within 10 days of receipt of such a rate filing, the superintendent shall notify each person on that list. [PL 1991, c. 377, §11 (NEW).]

5. Interested persons. Immediately after receiving a filing under this section, the superintendent shall grant access to the entire filing, including confidential information, to any interested person who pays premiums for physicians and surgeons liability coverage to the company that made the filing, and to any person or organization representing a group of such persons. Any person who has access to confidential information under this section shall maintain the confidentiality of that information by means of a confidentiality agreement or pursuant to a protective order of the superintendent. [PL 1991, c. 377, §11 (NEW).]

6. Public hearing. The superintendent may hold a public hearing on any filing, as provided in sections 229 to 235 . At the request of any person described in subsection 5 , the superintendent shall, as required by section 229 , hold a public hearing on the filing. [PL 1991, c. 377, §11 (NEW).]

7. Procedures; rules. The superintendent may adopt rules under Title 5, chapter 375 , establishing procedures for the administration of this section. [PL 1991, c. 377, §11 (NEW).]
24-A M.R.S. § 745 — ME Code / Title 24-A / Chapter 9 / Section 745
24-A §745. Books and records; reinsurance intermediary-brokers
Status: in_force

1. Records required. For at least 10 years after expiration of each contract of reinsurance transacted by the reinsurance intermediary-broker, the reinsurance intermediary-broker shall keep a complete record for each transaction showing: A. The type of contract, limits, underwriting restrictions, classes of risks and territory; [PL 1991, c. 828, §20 (NEW).] B. Period of coverage, including effective and expiration dates, cancellation provisions and notice required of cancellation; [PL 1991, c. 828, §20 (NEW).] C. Reporting and settlement requirements of balances; [PL 1991, c. 828, §20 (NEW).] D. Rate used to compute the reinsurance premium; [PL 1991, c. 828, §20 (NEW).] E. Names and addresses of assuming reinsurers; [PL 1991, c. 828, §20 (NEW).] F. Rates of all reinsurance commissions, including the commissions on any retrocessions handled by the reinsurance intermediary-broker; [PL 1991, c. 828, §20 (NEW).] G. Related correspondence and memoranda; [PL 1991, c. 828, §20 (NEW).] H. Proof of placement; [PL 1991, c. 828, §20 (NEW).] I. Details regarding retrocessions handled by the reinsurance intermediary-broker, including the identity of retrocessionaires and percentage of each contract assumed or ceded; [PL 1991, c. 828, §20 (NEW).] J. Financial records, including, but not limited to, premium and loss accounts; and [PL 1991, c. 828, §20 (NEW).] K. When the reinsurance intermediary-broker procures a reinsurance contract on behalf of a licensed ceding insurer: (1) Directly from any assuming reinsurer, written evidence that the assuming reinsurer has agreed to assume the risk; or (2) Placed through a representative of the assuming reinsurer that is not an employee, written evidence that the reinsurer has delegated binding authority to the representative. [PL 1991, c. 828, §20 (NEW).] [PL 1991, c. 828, §20 (NEW).]

2. Access. The insurer must have access and may copy and audit all accounts and records maintained by the reinsurance intermediary-broker related to its business in a form usable by the insurer. [PL 1991, c. 828, §20 (NEW).]
24-A M.R.S. § 7104 — ME Code / Title 24-A / Chapter 91 / Section 7104
24-A §7104. Reimbursement insurance policy
Status: in_force

1. Scope of policy. A reimbursement insurance policy insuring service contracts issued, sold or offered for sale in this State must unconditionally obligate the insurer that issued the reimbursement insurance policy to reimburse or pay on behalf of the provider any sums, including the refund of unearned provider fees, the provider is legally obligated to pay directly to the service contract holder or, in the event of the provider's nonperformance, to provide the service that the provider is legally obligated to perform according to the provider's contractual obligations under the service contracts issued or sold by the provider. [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).]

2. Application to insurer. A reimbursement insurance policy must provide that if a covered service is not provided by the provider within 60 days of proof of loss by a service contract holder, or unearned provider fees are not returned within 60 days of a valid refund request, the service contract holder may apply directly to the reimbursement insurance company for reimbursement or performance. [PL 2011, c. 345, §4 (NEW); PL 2011, c. 345, §7 (AFF).]
24-A M.R.S. § 2103 — ME Code / Title 24-A / Chapter 21 / Section 2103
24-A §2103. Unauthorized Insurers Process Act; title; interpretation
Status: in_force

1. Sections 2102 to 2108 constitute and may be cited as the Unauthorized Insurers Process Act. [PL 1969, c. 177, §31 (AMD).]

2. The Act shall be so interpreted as to effectuate its general purpose to make uniform the laws of those states which enact it. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 1471 — ME Code / Title 24-A / Chapter 16 / Section 1471
24-A §1471. Scope of this subchapter
Status: in_force

This subchapter applies only to insurance adjusters as defined in section 1402 . [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).]
24-A M.R.S. § 4315 — ME Code / Title 24-A / Chapter 56-A / Section 4315
24-A §4315. Coverage of prosthetic devices
Status: in_force

1. Definition. As used in this section, "prosthetic device" means an artificial device to replace, in whole or in part, an arm or a leg. [PL 2003, c. 459, §1 (NEW); PL 2003, c. 459, §2 (AFF).]

2. Required coverage. A carrier shall provide coverage for prosthetic devices in all health plans that, at a minimum, equals, except as provided in subsection 8, the coverage and payment for prosthetic devices provided under federal laws and regulations for the aged and disabled pursuant to 42 United States Code, Sections 1395k, 1395l and 1395m and 42 Code of Federal Regulations, Sections 414.202, 414.210, 414.228 and 410.100. Covered benefits must be provided for: A. A prosthetic device determined by the enrollee's provider, in accordance with section 4301‑A, subsection 10‑A , to be the most appropriate model that adequately meets the medical needs of the enrollee; and [PL 2021, c. 741, §1 (NEW); PL 2021, c. 741, §5 (AFF).] B. With respect to an enrollee under 18 years of age, in addition to coverage of a prosthetic device required by paragraph A, a prosthetic device determined by the enrollee's provider, in accordance with section 4301‑A, subsection 10‑A , to be the most appropriate model that meets the medical needs of the enrollee for recreational purposes, as applicable, to maximize the enrollee’s ability to ambulate, run, bike and swim and to maximize upper limb function. [PL 2021, c. 741, §1 (NEW); PL 2021, c. 741, §5 (AFF).] [PL 2021, c. 741, §1 (AMD); PL 2021, c. 741, §5 (AFF).]

3. Prior authorization. A carrier may require prior authorization for prosthetic devices in the same manner as prior authorization is required for any other covered benefit. [PL 2003, c. 459, §1 (NEW); PL 2003, c. 459, §2 (AFF).]

4. Repair or replacement. Coverage under this section must also be provided for repair or replacement of a prosthetic device if repair or replacement is determined appropriate by the enrollee's provider. [PL 2003, c. 459, §1 (NEW); PL 2003, c. 459, §2 (AFF).]

5. Coverage under managed care plan. If coverage under this section is provided through a managed care plan, a carrier may require that prosthetic services be rendered by a provider who contracts with the carrier and that a prosthetic device be provided by a vendor designated by the carrier. [PL 2003, c. 459, §1 (NEW); PL 2003, c. 459, §2 (AFF).]

6. Exclusions. Except as provided in subsection 2, paragraph B for an enrollee under 18 years of age, coverage is not required pursuant to this section for a prosthetic device that is designed exclusively for an athletic purpose. [PL 2021, c. 741, §2 (AMD); PL 2021, c. 741, §5 (AFF).]

7. Application. The requirements of this section apply to all individual and group policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 2003, c. 517, Pt. B, §34 (NEW).]

8. Health savings accounts. Benefits for prosthetic devices under health plans issued for use in connection with health savings accounts as authorized under Title XII of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 may be subject to the same deductibles and out-of-pocket limits that apply to overall benefits under the contract. [PL 2003, c. 688, Pt. I, §2 (NEW).]

9. Report. No later than June 30, 2028, each carrier that issues a health plan subject to this section shall report to the superintendent on its experience pursuant to this section for plan years 2024, 2025, 2026 and 2027. The report must be in a form prescribed by the superintendent and must include the number of claims and the total amount of claims paid in this State for the services required by this section. The superintendent shall aggregate this data by plan year in a report and submit the report to the joint standing committee of the Legislature having jurisdiction over health coverage and insurance matters no later than November 1, 2028. [PL 2021, c. 741, §3 (NEW); PL 2021, c. 741, §5 (AFF).]
24-A M.R.S. § 2302-A — ME Code / Title 24-A / Chapter 25 / Section 2302-A
24-A §2302-A. Definitions
Status: in_force

As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 1989, c. 797, §2 (NEW); PL 1989, c. 797, §§37, 38 (AFF).]

1. "Commercial lines" means any line of insurance that is not a personal line. [PL 1989, c. 797, §2 (NEW); PL 1989, c. 797, §§37, 38 (AFF).]

2. "Developed losses" means losses, including loss adjustment expenses, adjusted, using standard actuarial techniques, to eliminate the effect of differences between current payment or reserve estimates and those needed to provide actual ultimate loss and loss adjustment expense payments. [PL 1989, c. 797, §2 (NEW); PL 1989, c. 797, §§37, 38 (AFF).]

3. "Expense" means that portion of a rate attributable to acquisition, field supervision and collection expenses; general expenses; and taxes, licenses and fees. [PL 1989, c. 797, §2 (NEW); PL 1989, c. 797, §§37, 38 (AFF).]

4. "Loss trending" means any procedure for projecting developed losses to the average date of loss for the period during which the policies are to be effective. [PL 1989, c. 797, §2 (NEW); PL 1989, c. 797, §§37, 38 (AFF).]

5. "Personal lines" means homeowners, tenants, private passenger nonfleet automobiles, mobile homes and other property and casualty insurance for personal, family or household needs. [PL 1989, c. 797, §2 (NEW); PL 1989, c. 797, §§37, 38 (AFF).]

6. "Prospective loss costs" means that portion of a rate that does not include provisions for expenses, other than loss adjustment expenses, or profit, and is based on historical aggregate losses and loss adjustment expenses adjusted through development to their ultimate value and projected through trending to a future point in time. [PL 1989, c. 797, §2 (NEW); PL 1989, c. 797, §§37, 38 (AFF).]

7. "Rate" means the cost of insurance per exposure unit, whether expressed as a single number or as a prospective loss cost with an adjustment to account for the treatment of expenses, profit, and individual insurer variation in loss experience, prior to any application of individual risk variation based on loss or expense considerations, and not including minimum premium. [PL 1989, c. 797, §2 (NEW); PL 1989, c. 797, §§37, 38 (AFF).]

8. "Supplementary rating information" means any manual or plan of rates, classification rating schedule, minimum premium, policy fee, rating rule, underwriting rule, statistical plan and any other similar information needed to determine the applicable rate in effect or to be in effect. [PL 1989, c. 797, §2 (NEW); PL 1989, c. 797, §§37, 38 (AFF).]

9. "Supporting information" means: A. The experience and judgment of the filer and the experience or data of other insurers or advisory organizations relied upon by the filer; [PL 1989, c. 797, §2 (NEW); PL 1989, c. 797, §§37, 38 (AFF).] B. The interpretation of any other data relied upon by the filer; and [PL 1989, c. 797, §2 (NEW); PL 1989, c. 797, §§37, 38 (AFF).] C. Descriptions of methods used in making rates, and any other information required by the superintendent to be filed. [PL 1989, c. 797, §2 (NEW); PL 1989, c. 797, §§37, 38 (AFF).] [PL 1989, c. 797, §2 (NEW); PL 1989, c. 797, §§37, 38 (AFF).]
24-A M.R.S. § 1463 — ME Code / Title 24-A / Chapter 16 / Section 1463
24-A §1463. Qualifications for license
Status: in_force

A license may not be issued pursuant to this subchapter unless the applicant has satisfactorily passed a written examination administered by the superintendent and has filed a bond as required by section 1464 . [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).]
24-A M.R.S. § 992 — ME Code / Title 24-A / Chapter 11 / Section 992
24-A §992. Definitions
Status: in_force

As used in this subchapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 2007, c. 281, §2 (NEW); PL 2007, c. 281, §3 (AFF).]

1. Covered kinds of insurance. "Covered kinds of insurance" means property insurance as defined in section 705 and casualty insurance as defined in section 707 and does not include health insurance as defined in section 704 , unless required by the applicable NAIC annual statement instructions to be included in the property and casualty actuarial opinion of a casualty insurer or multiple lines insurer, or property insurance written by domestic mutual assessment insurers pursuant to chapter 51 . A. [PL 2013, c. 238, Pt. C, §10 (RP).] B. [PL 2013, c. 238, Pt. C, §10 (RP).] [PL 2013, c. 238, Pt. C, §10 (RPR).]

2. NAIC. [PL 2021, c. 521, §27 (RP).]

3. Qualified actuary. "Qualified actuary" means a person who is a member of the American Academy of Actuaries who has obtained a designation either as a fellow or an associate in the Casualty Actuarial Society and, if an associate, has at least 5 years' experience in actuarial practice obtained in the covered kinds of insurance. [PL 2007, c. 281, §2 (NEW); PL 2007, c. 281, §3 (AFF).]
24-A M.R.S. § 2805 — ME Code / Title 24-A / Chapter 35 / Section 2805
24-A §2805. Labor union groups
Status: in_force

A group of individuals may be insured under a policy issued to a labor union or similar employee organization, which shall be deemed to be the policyholder, to insure members of that union or organization for the benefit of persons other than the union or organization or any of its officials, representatives or agents, subject to the following requirements. [PL 1981, c. 147, §3 (RPR).]

1. The members eligible for insurance under the policy shall be all of the members of the union or organization or all of any class or classes thereof. [PL 1981, c. 147, §3 (RPR).]

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

3. Except as provided in section 2736‑C , section 2808‑B and chapter 36 , an insurer may exclude or limit the coverage on any person as to whom evidence of individual insurability is not satisfactory to the insurer. [PL 1999, c. 256, Pt. G, §2 (AMD).]

4. [PL 1981, c. 147, §3 (RP).]
24-A M.R.S. § 3871 — ME Code / Title 24-A / Chapter 53 / Section 3871
24-A §3871. Time limit for assessments
Status: in_force

Every subscriber of a domestic reciprocal insurer having contingent liability is liable for, and shall pay the subscriber's share of any assessment, as computed and limited in accordance with this chapter, if: [RR 2021, c. 1, Pt. B, §319 (COR).]

1. While the subscriber's policy is in force or within one year after its termination, the subscriber is notified by either the attorney or the superintendent of the superintendent's intentions to levy such assessment; or [RR 2021, c. 1, Pt. B, §319 (COR).]

2. An order to show cause why a receiver, conservator, rehabilitator or liquidator of the insurer should not be appointed is issued while the subscriber's policy is in force or within one year after its termination. [PL 2023, c. 405, Pt. A, §92 (AMD).]
24-A M.R.S. § 1445 — ME Code / Title 24-A / Chapter 16 / Section 1445
24-A §1445. Responsibility of insurer, health maintenance organization, fraternal benefit society, or nonprofit hospital or medical service organization; prohibited activities
Status: in_force

1. Responsibilities for training and supervision. In addition to any other applicable provisions of law, the insurer, health maintenance organization, fraternal benefit society or nonprofit hospital or medical service organization: A. Shall ensure adequate training for its appointed producers; [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] B. Shall provide supervision of its appointed producers who sell insurance on its behalf; [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] C. Is responsible for injuries to consumers resulting from the actions of its appointed producers to the extent of restitution, reimbursement of money or payment of interest to the consumer; and [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] D. Is accountable and may be penalized by the superintendent, as provided for in this Title, for the actions of its producers. [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).]

2. Prohibited activities. A licensed insurance producer in this State may not: A. Use knowledge gained as a result of the producer's insurance relationship with the insurance consumer for the producer's own personal gain, other than the receipt of fees or commissions allowed under section 1450 , or use knowledge gained as a result of the relationship for the purpose of investing the insurance consumer's money in property or assets in which the insurance producer or the producer's relatives have or will have a personal ownership interest unless that activity is otherwise authorized under insurance, banking or securities laws or rules; or [PL 1999, c. 225, §4 (AMD).] B. Receive a fee for rendering advice on financial or estate planning or for selling trust packages, if the producer also recommends the purchase of an insurance policy upon which the producer will receive commissions, unless the producer is licensed as a consultant acting in compliance with consultant licensing laws or provides the required documentation in accordance with section 1466, subsection 2 . [PL 1999, c. 225, §4 (AMD).] [PL 1999, c. 225, §4 (AMD).]

3. Common law principles. Nothing in this chapter abrogates the common law principles of apparent or implied authority as available remedies or defenses. [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).]
24-A M.R.S. § 1473 — ME Code / Title 24-A / Chapter 16 / Section 1473
24-A §1473. Adoption of rules
Status: in_force

The superintendent may adopt rules to establish the standards for performance of the duties of the adjuster. In addition to the causes set forth in section 1417 , the superintendent may suspend, revoke or refuse a license of an adjuster for failure to perform the duties of the adjuster in accordance with the standards in this subchapter and in accordance with the standards adopted by rules. Rules adopted pursuant to this subchapter are routine technical rules as defined in Title 5, chapter 375, subchapter II‑A . [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).]
24-A M.R.S. § 2886 — ME Code / Title 24-A / Chapter 38 / Section 2886
24-A §2886. Freedom of selection of attorney
Status: in_force

Beneficiaries of legal services insurance shall not be required to select an attorney other than one of the beneficiary's own choosing to provide covered legal services, except for basic legal advice rendered by telephone or mail, as described in this chapter. [PL 1983, c. 801, §11 (NEW).]
24-A M.R.S. § 2548 — ME Code / Title 24-A / Chapter 29 / Section 2548
24-A §2548. Maturity date
Status: in_force

For the purpose of determining the benefits calculated under section 2546 and 2547 , in the case of annuity contracts under which an election may be made to have annuity payments commence at optional maturity dates, the maturity date shall be deemed to be the latest date for which election shall be permitted by the contract, but shall not be deemed to be later than the anniversary of the contract next following the annuitant's 70th birthday or the 10th anniversary of the contract, whichever is later. [PL 1979, c. 442, §4 (NEW).]
24-A M.R.S. § 4617 — ME Code / Title 24-A / Chapter 62 / Section 4617
24-A §4617. Immunity
Status: in_force

There is no liability on the part of and no cause of action of any nature may arise against any member insurer or its agents or employees, the association or its agents or employees, the board of directors or any member of the board or the superintendent or the superintendent's representatives, for any act or omission by them in the performance of their powers and duties under this chapter. Immunity extends to the participation in any organization of one or more other state associations of similar purposes and to any such organization and its agents or employees. [PL 2005, c. 346, §12 (AMD); PL 2005, c. 346, §16 (AFF).]
24-A M.R.S. § 2824 — ME Code / Title 24-A / Chapter 35 / Section 2824
24-A §2824. Proof of loss
Status: in_force

There shall be a provision that in the case of claim for loss of time for disability, written proof of such loss must be furnished to the insurer within 30 days after the commencement of the period for which the insurer is liable, and that subsequent written proofs of the continuance of such disability must be furnished to the insurer at such intervals as the insurer may reasonably require, and that in the case of claim for any other loss, written proof of such loss must be furnished to the insurer within 90 days after the date of such loss. Failure to furnish such proof within such time shall not invalidate nor reduce any claim, if it shall be shown not to have been reasonably possible to furnish such proof and that such proof was furnished as soon as was reasonably possible. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2745-C — ME Code / Title 24-A / Chapter 33 / Section 2745-C
24-A §2745-C. Coverage for breast cancer treatment
Status: in_force

1. Inpatient care. All individual health policies providing coverage for medical and surgical benefits, except accidental injury, specified disease, hospital indemnity, Medicare supplement, long-term care and other limited benefit health insurance policies and contracts, must ensure that inpatient coverage with respect to the treatment of breast cancer is provided for a period of time determined by the attending physician, after providing notice to the patient regarding the coverage required by this subsection and in consultation with the patient, to be medically appropriate following a mastectomy, a lumpectomy or a lymph node dissection for the treatment of breast cancer. Nothing in this subsection may be construed to require the provision of inpatient coverage if the attending physician and patient determine that a shorter period of hospital stay is appropriate. In implementing the requirements of this subsection, an individual health policy may not modify the terms and conditions of coverage based on the determination by any enrollee to request less than the minimum coverage required under this subsection. All individual health policies must provide written notice to each enrollee under the contract regarding the coverage required by this subsection. The notice must be prominently positioned in any literature or correspondence made available or distributed by the plan and must be transmitted in the next mailing made by the plan to the enrollee or as part of any yearly information packet sent to the enrollee, whichever is earlier. The notice must also be made available to any physician participating in the insurer's provider network. [PL 2015, c. 227, §2 (AMD); PL 2015, c. 227, §5 (AFF).]

2. Reconstruction. All individual health policies providing coverage for mastectomy surgery must provide coverage for reconstruction of the breast on which surgery has been performed and surgery and reconstruction of the other breast to produce a symmetrical appearance if the patient elects reconstruction and in the manner chosen by the patient and the physician. [PL 1997, c. 408, §4 (NEW); PL 1997, c. 408, §8 (AFF).]
24-A M.R.S. § 3854 — ME Code / Title 24-A / Chapter 53 / Section 3854
24-A §3854. Name; suits
Status: in_force

A reciprocal insurer shall: [PL 1969, c. 132, §1 (NEW).]

1. Have and use a business name. The name shall include the word "reciprocal," or "interinsurer," or "interinsurance," or "exchange," or "underwriters," or "underwriting" or "association." [PL 1969, c. 132, §1 (NEW).]

2. Sue and be sued in its own name. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 1120 — ME Code / Title 24-A / Chapter 13 / Section 1120
24-A §1120. Common trust funds, mutual funds
Status: in_force

An insurer may invest in: [PL 1969, c. 132, §1 (NEW).]

1. A bank's common trust fund as defined in section 584 of the United States Internal Revenue Code of 1954; and [PL 1969, c. 132, §1 (NEW).]

2. The securities of any open-end management type investment company or investment trust registered with the federal Securities and Exchange Commission under the Investment Company Act of 1940 as from time to time amended, if such investment company or trust, other than one of which a subsidiary of the insurer is investment adviser or principal underwriter, has a net asset value of not less than $25,000,000 as at the date of investment by the insurer. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2720 — ME Code / Title 24-A / Chapter 33 / Section 2720
24-A §2720. Misstatement of age
Status: in_force

There may be a provision as follows: Misstatement of age: If the age of the insured has been misstated, all amounts payable under this policy shall be such as the premium paid would have purchased at the correct age. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2678 — ME Code / Title 24-A / Chapter 32 / Section 2678
24-A §2678. Annual experience report
Status: in_force

On or before April 1st of each year, an administrator or carrier who issues or administers a program, policy or contract in this State that includes incentives for the enrollee to use the services of a provider who has entered into an agreement with the carrier or administrator shall file a report of its activities for the preceding year with the superintendent. The report must be in the form prescribed by the superintendent and at a minimum must contain the following: [PL 1999, c. 609, §15 (AMD).]

1. A provider directory that includes the name, address and scope of license of each preferred provider; and [PL 1999, c. 609, §15 (AMD).]

2. [PL 1999, c. 609, §15 (RP).]

3. Annual information specified in chapter 56‑A or rules adopted under that chapter. Annual information reported to the superintendent pursuant to chapter 56‑A under another license must be referenced in the report and not reported in a duplicate manner. [PL 1999, c. 609, §15 (NEW).]
24-A M.R.S. § 4303-A — ME Code / Title 24-A / Chapter 56-A / Section 4303-A
24-A §4303-A. Provider profiling programs
Status: in_force

1. Disclosure. At least 60 days prior to using or publicly disclosing the results of the provider profiling program, a carrier with a provider profiling program shall disclose to providers the methodologies, criteria, data and analysis used to evaluate provider quality, performance and cost, including but not limited to unit cost, price and cost-efficiency ratings. For the purposes of this subsection, the disclosure of data is satisfied by the provision by a carrier of a description of the data used in the evaluation, the source of the data, the time period subject to evaluation and, if applicable, the types of claims used in the evaluation including any adjustments to the data and exclusion from the data. [PL 2013, c. 383, §5 (NEW).]

2. Provider profile. A carrier shall create and share with providers their provider profile at least 60 days prior to using or publicly disclosing the results of the provider profiling program. [PL 2013, c. 383, §5 (NEW).]

3. Request for data. A provider may request a copy of its data within 30 days of the carrier's disclosure to a provider as required by subsection 2 , and, upon request from a provider, a carrier shall provide to that provider the data associated with the requesting provider and all adjustments to the data used to evaluate that provider as part of the carrier's provider profiling program. The bureau shall adopt rules to establish requirements for the disclosure of data by a carrier to a provider in accordance with this subsection. The bureau shall provide in the rules for a time and manner of disclosure consistent with a carrier's ability to adopt, revise and develop an effective provider profiling program. [PL 2013, c. 383, §5 (NEW).]

4. Appeals. A carrier shall establish a process that affords a provider the opportunity to review and dispute its provider profiling result within 30 days of being provided with its provider profile pursuant to subsection 2 . The appeal process must: A. Afford the provider the opportunity to correct material errors, submit additional information for consideration and seek review of data and performance ratings; [PL 2013, c. 383, §5 (NEW).] B. Afford the provider the opportunity to review any information or evaluation prepared by a 3rd party and used by the carrier as part of its provider profiling program; however, if the 3rd party provides the right to review and correct that data, any appeal pursuant to this paragraph is limited to whether the carrier accurately portrayed the information and not to the underlying determination made by the 3rd party; and [PL 2013, c. 383, §5 (NEW).] C. Allow the provider to request reconsideration of its provider profiling result and submit supplemental information, including information demonstrating any computational or data errors. [PL 2013, c. 383, §5 (NEW).] [PL 2013, c. 383, §5 (NEW).]

5. Out-of-network providers. If a carrier has a provider profiling program that includes out-of-network providers, a carrier must meet the requirements of this section with regard to an out-of-network provider as well as for a provider in a carrier's network. [PL 2013, c. 383, §5 (NEW).]

6. Rules. The bureau shall adopt rules 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 2013, c. 383, §5 (NEW).]
24-A M.R.S. § 2916-B — ME Code / Title 24-A / Chapter 39 / Section 2916-B
24-A §2916-B. Exclusion of covered persons under personal automobile policy
Status: in_force

In order to avoid cancellation or nonrenewal of an automobile insurance policy, and to allow an insurer to provide or to continue to provide coverage without an unreasonable risk, an insurer and the named insured may agree, by an endorsement to the policy signed by the interested parties, to exclude from coverage as operators of the insured vehicle or vehicles any covered person or persons who commit an act or acts for which the policy could be cancelled under section 2914, subsection 4 , or for which the insurer could refuse to renew under section 2916‑A, subsections 1 and 2 . Every endorsement under this section must contain the following notice in conspicuous print: "NOTICE TO POLICYHOLDER IF THE PERSON EXCLUDED FROM COVERAGE BY THIS ENDORSEMENT IS UNDER THE AGE OF 18 YEARS, YOU CAN BE HELD LIABLE UNDER STATE LAW FOR THE PERSON'S NEGLIGENCE WHEN THE PERSON OPERATES YOUR VEHICLE WITH YOUR PERMISSION. YOUR POLICY DOES NOT INSURE YOU AGAINST THIS LIABILITY." [RR 2021, c. 1, Pt. B, §256 (COR).]
24-A M.R.S. § 2847-S — ME Code / Title 24-A / Chapter 35 / Section 2847-S
24-A §2847-S. Coverage for children's early intervention services (REALLOCATED FROM TITLE 24-A, SECTION 2847-R)
Status: in_force

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

1. Definition. For purposes of this section, "children's early intervention services" means services provided by licensed occupational therapists, physical therapists, speech-language pathologists or clinical social workers working with children from birth to 36 months of age with an identified developmental disability or delay as described in the federal Individuals with Disabilities Education Act, Part C, 20 United States Code, Section 1411, et seq. [PL 2011, c. 420, Pt. A, §25 (RAL).]

2. Required coverage. All group health insurance policies, contracts and certificates must provide coverage for children's early intervention services in accordance with this subsection. A. A referral from the child's primary care provider is required. [PL 2011, c. 420, Pt. A, §25 (RAL).] B. The policy, contract or certificate may limit coverage to $3,200 per year for each child not to exceed $9,600 by the child's 3rd birthday. [PL 2011, c. 420, Pt. A, §25 (RAL).] C. The policy, contract or certificate may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section. [PL 2011, c. 420, Pt. A, §25 (RAL).] [PL 2011, c. 420, Pt. A, §25 (RAL).]
24-A M.R.S. § 2917 — ME Code / Title 24-A / Chapter 39 / Section 2917
24-A §2917. Notice of intent
Status: in_force

An insurer may not fail to renew a policy except by notice to the insured as provided in this subchapter. A notice of intention not to renew is not effective unless received by the named insured at least 30 days prior to the expiration date of the policy. In the event the policy provides automobile physical damage coverage, like notice of intention not to renew must be given to any party named in the loss payable clause. A post office department certificate of mailing to the named insured at the insured's last known address is conclusive proof of receipt on the 3rd calendar day after mailing. [PL 2007, c. 188, Pt. C, §7 (AMD).]

The reason or reasons for the intended nonrenewal action must accompany the notice of intent not to renew and the reason or reasons must be explicit. Explanations such as "underwriting reasons," "underwriting experience," "loss record," "driving experience," "credit report" and similar insurance terms are not by themselves acceptable explanations of an insurer's intended nonrenewal of an automobile insurance policy. A notice of a right to apply for a hearing before the superintendent within 30 days as provided in this section must accompany the notice of intent not to renew. [PL 2007, c. 188, Pt. C, §7 (AMD).]

This section does not apply: [PL 2007, c. 188, Pt. C, §7 (AMD).]

1. If the insurer has manifested its willingness to renew; [PL 1973, c. 339, §1 (NEW).]

2. If the insured fails to pay any premium due or any advance premium required by the insurer for renewal; or [PL 2007, c. 188, Pt. C, §7 (AMD).]

3. If the insurer has transferred a policy to an affiliate. Prior to the date of renewal of a policy that has been transferred by an insurer to an affiliate, the insured must receive notice of any changes to the terms of the policy that are less favorable to the insured. [PL 2007, c. 188, Pt. C, §7 (NEW).]
24-A M.R.S. § 2382-C — ME Code / Title 24-A / Chapter 25 / Section 2382-C
24-A §2382-C. Filing of rates and other rating information; filing of forms
Status: in_force

1. Prefiling required. Every insurer shall file with the superintendent all rates and supplementary rate information to be used in the State, except as filed by an advisory organization as provided in section 2384‑A . Such rates and supplementary rate information must be filed at least 30 days prior to the stated effective date. An insurer may adopt by reference, with or without deviation, the rates and supplementary rate information filed by another insurer. Upon application by the filer, the superintendent may authorize an earlier effective date. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

2. Form and manner of filing. Rates filed pursuant to this section must be filed in a form prescribed by the superintendent. If a filing is not accompanied by the information the superintendent has required under this section, the superintendent shall notify the insurer as soon as possible and the filing is deemed as not made until the information is provided. A filing required under this section must be made electronically in a format required by the superintendent unless exempted by rule adopted by the superintendent. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2009, c. 14, §2 (AMD).]

3. Public records. All rates, supplementary rate information and any supporting information for risks filed under this Act are, as soon as filed, public records within the meaning of Title 1, chapter 13 . [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

4. Additional period. The period during which the filing may not become effective may be extended by the superintendent for an additional period not to exceed 60 days if the superintendent gives written notice to the insurer or advisory organization that made the filing that the superintendent needs additional time for consideration of the filing. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

5. Advisory organization. Subject to the provisions of this Act, the designated workers' compensation and advisory organization shall file with the superintendent: A. Workers' compensation pure premium rates and rating plans; [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).] B. Workers' compensation policy forms and endorsements to be used by its members; [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).] C. The uniform experience rating plans and rules; [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).] D. The uniform classification plan and rules; [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).] E. A uniform statistical plan and rules; and [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).] F. Any other information that the superintendent requests. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).] [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

6. Approved forms. Every insurance company issuing workers' compensation insurance policies covering the payment of compensation and benefits shall use only policy forms filed and approved pursuant to section 2412 . Filings required by that section may be made on behalf of members and subscribers by an approved advisory organization. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]
24-A M.R.S. § 2437 — ME Code / Title 24-A / Chapter 27 / Section 2437
24-A §2437. Procedures covered by health insurance policies whether performed by physician or dentist
Status: in_force

Whenever the terms "physician" and "doctor" are used in any policy of health or accident insurance issued in this State, these terms include within their meaning those persons licensed under and in accordance with the laws relating to the practice of dentistry, Title 32, chapter 143 , in respect to any care, services, procedures or benefits covered by that policy of insurance that those persons are licensed to perform, any provisions in any such policy of insurance to the contrary notwithstanding. [PL 2017, c. 288, Pt. A, §31 (AMD).]
24-A M.R.S. § 1135 — ME Code / Title 24-A / Chapter 13 / Section 1135
24-A §1135. Failure to dispose of real estate or securities; effect, penalty
Status: in_force

1. Any real estate, personal property or securities lawfully acquired, and held by an insurer after expiration of the period for disposal thereof or any extension of such period granted by the superintendent as provided in sections 1133 and 1134 shall not be allowed as an asset of the insurer. [PL 1973, c. 585, §12 (AMD); PL 1969, c. 132, §1 (NEW).]

2. The insurer shall forthwith dispose of any ineligible investment unlawfully acquired by it, and the superintendent shall suspend or revoke the insurer's certificate of authority if the insurer fails to dispose of the investment within such reasonable time as the superintendent may, by the superintendent's order, specify. [RR 2021, c. 1, Pt. B, §190 (COR).]
24-A M.R.S. § 2673-A — ME Code / Title 24-A / Chapter 32 / Section 2673-A
24-A §2673-A. Preferred provider arrangements
Status: in_force

1. Filing with superintendent; disapproval. A carrier or administrator who proposes to offer a preferred provider arrangement shall file with the superintendent proposed agreements, rates, geographic service areas, provider networks and other materials relevant to the proposed arrangement. The superintendent shall disapprove any preferred provider arrangement if the arrangement contains any unjust, unfair or inequitable provisions; unreasonably restricts access and availability of health care services; or fails to comply with other requirements of this chapter, chapter 56‑A or rules adopted by the superintendent. [PL 1999, c. 609, §8 (NEW).]

2. Considered separate preferred provider arrangements. If health plans offered by the same carrier have different geographic service areas, or if there are preferred providers in one health plan who are nonpreferred providers in another health plan offered by the same carrier or administered by the same administrator or who are in a different preference tier if the plan is a multitier plan, then the plans represent different preferred provider arrangements and must be separately filed and approved. [PL 1999, c. 609, §8 (NEW).]

3. Rules. Preferred provider arrangements offered by carriers that are subject to chapter 56‑A must be in compliance with applicable provisions of that chapter and any rules adopted under that chapter. Employer-sponsored plans that are exempt from this chapter pursuant to federal law and administrators offering preferred provider arrangements to employer-sponsored plans are not subject to the provisions of chapter 56‑A or rules adopted under that chapter, provided either the administrator or any other participating entity, other than the self-insured employer, does not undertake insurance risk. The superintendent may adopt rules establishing procedures for filing and approval of preferred provider arrangements, including the time period within which the superintendent must act on a completed application; specific criteria for determining when a term or condition is unjust, unfair or inequitable or has the effect of unreasonably restricting access and availability to health care services; and standards consistent with this chapter and chapter 56‑A for the ongoing operation and oversight of approved provider arrangements. The rules may prohibit the carrier from applying a benefit level differential to enrollees who must travel an unreasonable distance to obtain the service. Rules adopted pursuant to this subsection are routine technical rules pursuant to Title 5, chapter 375, subchapter II‑A . [PL 1999, c. 609, §8 (NEW).]
24-A M.R.S. § 1907 — ME Code / Title 24-A / Chapter 18 / Section 1907
24-A §1907. License suspension, revocation or denial
Status: in_force

Any license issued under this chapter may be suspended or revoked after notice to the licensee and an opportunity for hearing and any application for license may be denied after notice and opportunity for hearing: [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]

1. For any of the grounds for suspension or revocation of a license set forth in section 1417 ; or [PL 1997, c. 457, §31 (AMD); PL 1997, c. 457, §55 (AFF).]

2. If the licensee or applicant: A. Is using any method or practice in conducting business that renders further transaction of business in this State hazardous or injurious to covered individuals or the public; [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] B. Is affiliated with and is under the same general management as another administrator that transacts business in this State without being licensed under this chapter; or [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] C. Has failed to report a conviction as required by section 1908 . [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]
24-A M.R.S. § 6455 — ME Code / Title 24-A / Chapter 79 / Section 6455
24-A §6455. Authorized control level event
Status: in_force

1. Authorized control level event; defined. "Authorized control level event" means any of the following events: A. The filing of a risk-based capital report by the insurer that indicates that the insurer's total adjusted capital is greater than or equal to its mandatory control level risk-based capital but less than its authorized control level risk-based capital; [PL 1993, c. 634, Pt. A, §1 (NEW).] B. Provided the insurer does not challenge the adjusted risk-based capital report under section 6457 , the notification by the superintendent to the insurer of an adjusted risk-based capital report that indicates the event in paragraph A ; [PL 1993, c. 634, Pt. A, §1 (NEW).] C. If the insurer, under section 6457 , challenges an adjusted risk-based capital report that indicates the event in paragraph A , the notification by the superintendent to the insurer that the superintendent has, after a hearing, rejected the insurer's challenge; [PL 1993, c. 634, Pt. A, §1 (NEW).] D. Provided the insurer has not challenged the corrective order under section 6457 , the failure of the insurer to respond, in a manner satisfactory to the superintendent, to a corrective order; or [PL 1993, c. 634, Pt. A, §1 (NEW).] E. If the insurer has challenged a corrective order under section 6457 and the superintendent has, after a hearing, rejected the challenge or modified the corrective order, the failure of the insurer to respond, in a manner satisfactory to the superintendent, to the corrective order subsequent to rejection or modification by the superintendent. [PL 1993, c. 634, Pt. A, §1 (NEW).] [PL 1993, c. 634, Pt. A, §1 (NEW).]

2. Superintendent duties; authorized control level event. When an authorized control level event occurs, the superintendent shall: A. Take those actions that are required under section 6454 regarding an insurer with respect to which a regulatory action level event has occurred; or [PL 1993, c. 634, Pt. A, §1 (NEW).] B. If the superintendent considers it to be in the best interests of the policyholders and creditors of the insurer and of the public, take those actions that are necessary to cause the insurer to be placed under regulatory control under chapter 57 . If the commissioner takes those actions, the authorized control level event is deemed sufficient grounds for the superintendent to take action under chapter 57 , and the superintendent has the rights, powers and duties with respect to the insurer as are set forth in chapter 57 . If the superintendent takes actions under this paragraph pursuant to an adjusted risk-based capital report, the insurer is entitled to those protections that are afforded to insurers under the provisions of chapter 57, subchapter II pertaining to summary proceedings. [PL 1993, c. 634, Pt. A, §1 (NEW).] [PL 1993, c. 634, Pt. A, §1 (NEW).]
24-A M.R.S. § 205 — ME Code / Title 24-A / Chapter 3 / Section 205
24-A §205. Bureau organization
Status: in_force

With the approval of the Commissioner of Professional and Financial Regulation, the superintendent shall organize the bureau in a manner the superintendent determines necessary for the discharge of the superintendent's duties. [PL 1995, c. 502, Pt. H, §15 (RPR).]
24-A M.R.S. § 2544 — ME Code / Title 24-A / Chapter 29 / Section 2544
24-A §2544. Minimum values
Status: in_force

The minimum values as specified in sections 2545 to 2548 and section 2550 of any paid-up annuity, cash surrender or death benefits available under an annuity contract must be based upon minimum nonforfeiture amounts as defined in this section. [PL 2003, c. 307, §1 (AMD).]

1. The minimum nonforfeiture amount at any time at or prior to the commencement of any annuity payments must be equal to an accumulation up to that time at a rate of interest as permitted under subsection 1‑A of the net considerations, as hereinafter defined, paid prior to that time, decreased by the sum of: A. Any prior withdrawals from or partial surrenders of the contract accumulated at a rate of interest as permitted under subsection 1‑A ; [PL 2003, c. 307, §1 (AMD).] B. The amount of any indebtedness to the insurer on the contract, including interest due and accrued; [PL 2003, c. 307, §1 (AMD).] C. An annual contract charge of $50, accumulated at a rate of interest as permitted under subsection 1‑A ; and [PL 2003, c. 307, §1 (NEW).] D. Any premium tax paid by the insurer for the contract, accumulated at a rate of interest as permitted under subsection 1‑A . [PL 2003, c. 307, §1 (NEW).] The net considerations for a given contract year used to define the minimum nonforfeiture amount must be an amount equal to 87 1/2% of the gross considerations credited to the contract during that contract year. [PL 2003, c. 307, §1 (AMD).]

1-A. The rate of interest used in determining minimum nonforfeiture amounts must be determined in accordance with the following requirements and specified in any contract providing for recalculation of the rate of interest permitted under this subsection. A. The rate of interest must be an annual rate of interest determined as the lesser of 3% per annum and the 5-year Constant Maturity Treasury Rate reported by the Federal Reserve rounded to the nearest 1/20th of 1% as of a date, or average over a period, specified in the contract that is no later than 15 months prior to the contract issue date or the redetermination date decreased by 125 basis points as long as the resulting rate of interest is not less than 1%. [PL 2003, c. 307, §1 (NEW).] B. The rate of interest applies for an initial period and may be redetermined for additional periods. The redetermination date, basis and period, if any, must be stated in the contract. The basis is the date or average over a specified period that produces the value of the 5-year Constant Maturity Treasury Rate to be used at each redetermination date. [PL 2003, c. 307, §1 (NEW).] C. During the period or term that a contract provides substantive participation in an equity indexed benefit, the contract may increase the reduction described in paragraph A by up to an additional 100 basis points to reflect the value of the equity indexed benefit. The present value at the contract issue date, and at each redetermination date thereafter, of the additional reduction may not exceed the market value of the benefit. The superintendent may require a demonstration that the present value of the additional reduction does not exceed the market value of the benefit and may disallow or limit the reduction if such a demonstration is not accepted. [PL 2003, c. 307, §1 (NEW).] D. The superintendent may adopt rules to implement this subsection and to provide for further adjustments to the minimum nonforfeiture amounts for contracts providing for substantive participation in an equity indexed benefit and for contracts for which the superintendent determines adjustments are appropriate. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2003, c. 307, §1 (NEW).] [PL 2003, c. 307, §1 (NEW).]

2. [PL 2003, c. 307, §1 (RP).]

3. [PL 2003, c. 307, §1 (RP).]

4. [PL 2003, c. 307, §1 (NEW); MRSA T. 24-A §2544, sub-§4 (RP).]
24-A M.R.S. § 4614 — ME Code / Title 24-A / Chapter 62 / Section 4614
24-A §4614. Miscellaneous provisions
Status: in_force

1. Liability for unpaid assessments of insureds of an impaired insurer. Nothing in this chapter may be construed to reduce the liability for unpaid assessments of the insureds of an impaired insurer operating under a plan with assessment liability. [PL 1983, c. 846 (NEW).]

2. Records. Records must be kept of all negotiations and meetings in which the association or its representatives are involved to discuss the activities of the association in carrying out its powers and duties under section 4608 . Records of the negotiations or meetings may be made public only upon the termination of a liquidation, rehabilitation or conservation proceeding involving the impaired or insolvent insurer, upon the termination of the impairment of the insurer, or upon the order of a court of competent jurisdiction. Nothing in this subsection limits the duty of the association to render a report of its activities under section 4615 . [PL 2005, c. 346, §12 (AMD); PL 2005, c. 346, §16 (AFF).]

3. Association deemed to be creditor of impaired or insolvent insurer. For the purpose of carrying out its obligations under this chapter, the association is deemed to be a creditor of the impaired insurer to the extent of assets attributable to covered policies reduced by any amounts to which the association is entitled as subrogee pursuant to section 4608, subsection 9 . All assets of the impaired insurer attributable to covered policies must be used to continue all covered policies and pay all contractual obligations of the impaired insurer as required by this chapter. Assets attributable to covered policies, as used in this subsection, are to be construed as that proportion of the assets that the reserves that should have been established for these policies bear to the reserve that should have been established for all policies of insurance written by the impaired insurer. As creditors of the impaired or insolvent insurer, the association and other similar associations are entitled to receive a disbursement of assets out of the marshaled assets, from time to time as the assets become available to reimburse it, as a credit against contractual obligations under this chapter. If the liquidator has not, within 120 days of a final determination of insolvency of an insurer by the receivership court, made an application to the court for the approval of a proposal to disburse assets out of marshaled assets to guaranty associations having obligations because of the insolvency, then the association is entitled to make application to the receivership court for approval of its own proposal to disburse these assets. [PL 2005, c. 346, §12 (AMD); PL 2005, c. 346, §16 (AFF).]

4. Factors considered in distributing assets. In distributing assets, the following factors must be considered. A. Prior to the termination of any liquidation, rehabilitation or conservation proceeding, the court may take into consideration the contributions of the respective parties, including the association, the shareholders, policy owners, contract owners, certificate holders and enrollees of the impaired or insolvent insurer and any other party with a bona fide interest, in making an equitable distribution of the ownership rights of the impaired or insolvent insurer. In such a determination, consideration must be given to the welfare of the policy owners, contract owners, certificate holders and enrollees of the continuing or successor insurer. [PL 2017, c. 382, §28 (AMD).] B. No distribution to stockholders, if any, of an impaired or insolvent insurer may be made until and unless the total amount of assessments levied by the association with respect to the insurer have been fully recovered by the association. [PL 2005, c. 346, §12 (AMD); PL 2005, c. 346, §16 (AFF).] [PL 2017, c. 382, §28 (AMD).]

5. Unfair trade practice. [PL 2005, c. 346, §12 (RP); PL 2005, c. 346, §16 (AFF).]

6. Recovery procedure; provisions. The recovery procedure must provide that: A. If an order for liquidation or rehabilitation of an insurer domiciled in this State has been entered, the receiver appointed under that order has a right to recover on behalf of the insurer, from any affiliate that controlled it, the amount of distributions, other than stock dividends paid by the insurer on its capital stock, made at any time during the 5 years preceding the petition for liquidation or rehabilitation subject to the limitations of paragraphs B to D ; [PL 2005, c. 346, §12 (AMD); PL 2005, c. 346, §16 (AFF).] B. No distribution may be recoverable if the insurer shows that when paid the distribution was lawful and reasonable and that the insurer did not know and could not reasonably have known that the distribution might adversely affect the ability of the insurer to fulfill its contractual obligations; [PL 2005, c. 346, §12 (AMD); PL 2005, c. 346, §16 (AFF).] C. Any person who was an affiliate that controlled the insurer at the time the distributions were paid is liable up to the amount of distributions the person received. Any person who was an affiliate that controlled the insurer at the time the distributions were declared is liable up to the amount of distributions the person would have received if they had been paid immediately. If 2 or more persons are liable with respect to the same distributions they are jointly and severally liable; [PL 2005, c. 346, §12 (AMD); PL 2005, c. 346, §16 (AFF).] D. The maximum amount recoverable under this section is the amount needed in excess of all other available assets of the impaired or insolvent insurer to pay the contractual obligations of the impaired or insolvent insurer on a fair and equitable basis; and [PL 2005, c. 346, §12 (AMD); PL 2005, c. 346, §16 (AFF).] E. If any person liable under paragraph C is insolvent, all its affiliates that controlled it at the time the distribution was paid are jointly and severally liable for any resulting deficiency in the amount recovered from the insolvent affiliate. [PL 2005, c. 346, §12 (AMD); PL 2005, c. 346, §16 (AFF).] [PL 2005, c. 346, §12 (AMD); PL 2005, c. 346, §16 (AFF).]
24-A M.R.S. § 765 — ME Code / Title 24-A / Chapter 9 / Section 765
24-A §765. Effect of consent by the policyholder
Status: in_force

If a policyholder consents to the transfer pursuant to section 764 or if the transfer is effected under section 766 , there is a novation of the contract of insurance subject to the assumption reinsurance agreement with the result that the transferring insurer is relieved of all insurance obligations or risks transferred under the assumption reinsurance agreement and the assuming insurer is directly and solely liable to the policyholder for those insurance obligations or risks. [PL 1993, c. 603 (NEW).]
24-A M.R.S. § 1261 — ME Code / Title 24-A / Chapter 15 / Section 1261
24-A §1261. Levy upon deposit
Status: in_force

No judgment creditor or other claimant of an insurer shall have the right to levy upon any of the assets held in this State as a deposit for the protection of the insurer's policyholders or policyholders and creditors. As to deposits made pursuant to the retaliatory provision, section 428 , levy thereupon shall be permitted if so provided in the superintendent's order under which the deposit is required. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 2610-A — ME Code / Title 24-A / Chapter 31 / Section 2610-A
24-A §2610-A. Credit union groups
Status: in_force

The lives of a group of individuals may be insured under a policy issued to a credit union or to a trustee or trustees or agent designated by 2 or more credit unions, which credit union, trustee, trustees or agent is considered the policyholder, to insure members of the credit union or credit unions for the benefit of persons other than the credit union or credit unions, trustee or trustees or agent or any of their officials, subject to the following requirements. [PL 1981, c. 150, §13 (NEW).]

1. The members eligible for insurance are all of the members of the credit union or credit unions or all of any class or classes thereof. [PL 1981, c. 150, §13 (NEW).]

2. The premium for the policy shall be paid by the policyholder from the credit union's funds and, except as provided in subsection 3 , must insure all eligible members. [PL 1981, c. 150, §13 (NEW).]

3. An insurer may exclude or limit the coverage on any member as to whom evidence of individual insurability is not satisfactory to the insurer. [PL 1981, c. 150, §13 (NEW).]
24-A M.R.S. § 2322-A — ME Code / Title 24-A / Chapter 25 / Section 2322-A
24-A §2322-A. Joint underwriting, joint reinsurance pool and residual market activities
Status: in_force

1. Notwithstanding section 2321‑B, subsection 2 and consistent with sections 2325 , 2325‑A , 2325‑B and 2366, insurers, rating organizations and advisory organizations participating in joint underwriting, joint reinsurance pools or residual market mechanisms may, in connection with such activity, act in cooperation with each other in the making of rates, rating systems, policy forms, underwriting rules, surveys, inspections and investigations, the furnishing of loss and expense statistics or other information, or conducting research. Joint underwriting, joint reinsurance pools and residual market mechanisms are not considered to be advisory organizations. [PL 2003, c. 671, Pt. B, §1 (AMD).]

2. Insurers, joint underwriters, joint reinsurance pools and residual market activities are regulated as follows. A. Except to the extent modified by this section, insurers, joint underwriting, joint insurance pool and residual market mechanism activities are subject to the other provisions of chapters 23 and 25 . [PL 1989, c. 797, §25 (NEW); PL 1989, c. 797, §§37, 38 (AFF).] B. If, after hearing, the superintendent finds that any activity or practice of an insurer participating in joint underwriting or a pool is unfair, is unreasonable, will tend to lessen competition in any market or is otherwise inconsistent with the provisions or purposes of this chapter, the superintendent may issue a written order and require the discontinuance of such activity or practice. [PL 1989, c. 797, §25 (NEW); PL 1989, c. 797, §§37, 38 (AFF).] [PL 1989, c. 797, §25 (NEW); PL 1989, c. 797, §§37, 38 (AFF).]
24-A M.R.S. § 4 — ME Code / Title 24-A / Chapter 1 / Section 4
24-A §4. "Insurer" defined
Status: in_force

"Insurer" includes every person engaged as principal and as indemnitor, surety or contractor in the business of entering into contracts of insurance. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2244 — ME Code / Title 24-A / Chapter 24-A / Section 2244
24-A §2244. Jurisdiction; filing
Status: in_force

1. Jurisdiction. The Superior Court has nonexclusive jurisdiction over any application for authorization under this chapter of a transfer of structured settlement payment rights. [PL 1999, c. 268, §2 (NEW).]

2. Filing. Not less than 30 days prior to the scheduled hearing on any application for authorization of a transfer of structured settlement payment rights under this chapter, the transferee shall file with the court or responsible administrative authority and serve on any other government authority that previously approved the structured settlement, all interested parties, the structured settlement obligor and annuity issuer a notice of the proposed transfer and the application of its authorization, including in that notice: A. A copy of the transferee's application; [PL 1999, c. 268, §2 (NEW).] B. A copy of the transfer agreement; [PL 1999, c. 268, §2 (NEW).] C. A copy of the disclosure statement required under section 2243, subsection 2, paragraph B ; [PL 1999, c. 268, §2 (NEW).] D. Notification that any interested party, structured settlement obligor or annuity issuer is entitled to support, oppose or otherwise respond to the transferee's application, either in person or by counsel, by submitting written comments to the court or responsible administrative authority or by participating in the hearing; and [PL 1999, c. 268, §2 (NEW).] E. Notification of the time and place of the hearing and notification of the manner in which and the time by which written responses to the application must be filed, which may be not less than 30 days after service of the transferee's notice, in order to be considered by the court or responsible administrative authority. [PL 1999, c. 268, §2 (NEW).] [PL 1999, c. 268, §2 (NEW).]
24-A M.R.S. § 3054 — ME Code / Title 24-A / Chapter 41 / Section 3054
24-A §3054. Hearing before Superintendent of Insurance
Status: in_force

A named insured who has received a statement of reason for cancellation, or of reason for an insurer's intent not to renew a policy, may, within 30 days of the receipt of a statement of reason, request a hearing before the Superintendent of Insurance. The purpose of this hearing is limited to establishing the existence of the proof or evidence used by the insurer in its reason for cancellation or intent not to renew. The burden of proof of the reason for cancellation or intent not to renew is on the insurer. If an insurer's reason for nonrenewal is not based on a ground for cancellation permitted under section 3049 , the insurer must provide proof or evidence that the reason for nonrenewal is a good faith reason and related to the insurability of the property. A statement from the insurer that the risk does not meet the insurer's underwriting guidelines alone is not considered sufficient proof or evidence. The superintendent shall adopt rules for carrying out this section. The superintendent may order the policy to continue in effect both pending and, if the superintendent finds in favor of the insured, subsequent to a hearing. If the superintendent finds in favor of the insurer at a hearing, the superintendent may order the policy to remain in force for 14 days to allow the insured to obtain other coverage. [PL 2003, c. 671, Pt. A, §9 (AMD).]
24-A M.R.S. § 2940 — ME Code / Title 24-A / Chapter 40 / Section 2940
24-A §2940. Applicability
Status: in_force

This chapter shall be applicable only to insurance policies issued or renewed in this State after November 1, 1973 and is in addition to, and not in substitution for, other applicable requirements of the Maine Insurance Code and bureau regulations. [PL 1973, c. 585, §12 (AMD); PL 1973, c. 625, §146 (NEW).]
24-A M.R.S. § 3357 — ME Code / Title 24-A / Chapter 47 / Section 3357
24-A §3357. Authority to transact additional kinds of insurance
Status: in_force

After being authorized to transact one kind or combination of kinds of insurance as provided in section 3352 , a mutual insurer may be authorized by the superintendent to transact such additional kinds of insurance as are permitted under section 409 (combinations of insuring powers), while otherwise in compliance with this Title and while maintaining unimpaired surplus and guaranty capital funds in an amount not less than the amount of paid-in capital stock required to be maintained by a like domestic stock insurer transacting the same kinds of insurance. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 4125 — ME Code / Title 24-A / Chapter 55 / Section 4125
24-A §4125. Foreign or alien society -- admission
Status: in_force

No foreign or alien society shall transact business in this State without a license issued by the superintendent. Any such society may be licensed to transact business in this State upon filing with the superintendent: [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

1. A duly certified copy of its charter or articles of incorporation; [PL 1969, c. 132, §1 (NEW).]

2. A copy of its constitution and laws, certified by its secretary or corresponding officer; [PL 1969, c. 132, §1 (NEW).]

3. A power of attorney to the superintendent as prescribed in section 4129 ; [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

4. A statement of its business under oath of its president and secretary or corresponding officers in a form prescribed by the superintendent, duly verified by an examination made by the supervising insurance official of its home state or other state, territory, province or country, satisfactory to the superintendent of this State; [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

5. A certificate from the proper official of its home state, territory, province or country that the society is legally incorporated and licensed to transact business therein; [PL 1969, c. 132, §1 (NEW).]

6. Copies of its certificate forms; and [PL 1969, c. 132, §1 (NEW).]

7. Such other information as the superintendent considers necessary; and upon a showing that its assets are invested in accordance with the provisions of this chapter. [RR 2021, c. 1, Pt. B, §330 (COR).]

Any foreign or alien society desiring admission to this State shall have the qualifications required of domestic societies organized under this chapter. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 225 — ME Code / Title 24-A / Chapter 3 / Section 225
24-A §225. Examination report; contents; prima facie evidence in certain proceedings
Status: in_force

1. Upon completion of an examination, the examiner in charge shall make a true report thereof which shall comprise only facts appearing upon the books, records or other documents of the person examined, or from an appraisal of assets, or as ascertained from the sworn testimony of its officers or agents or other individuals examined concerning its affairs, and such conclusions and recommendations as may reasonably be warranted from such facts. The report of examination shall be verified by the oath of the examiner in charge thereof. [PL 1969, c. 132, §1 (NEW).]

2. Such a report of examination of an insurer so verified shall be prima facie evidence in any delinquency proceeding against the insurer, its officers, employees or agents upon the facts stated therein, and whether or not the report has then been filed in the bureau as provided in section 226 . [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

3. All working papers, recorded information, documents and copies of any of these media produced by, obtained by or disclosed to the superintendent or any other person in the course of an examination made under this chapter are confidential, are not subject to subpoena and may not be made public by the superintendent or any other person, except to the extent provided in sections 226 and 227 . Access may be granted to the National Association of Insurance Commissioners. Any parties granted access must agree in writing prior to receiving the information to provide the information with the same confidential treatment as required by this section unless prior written consent of the insurer to which the information pertains has been obtained. [PL 2011, c. 320, Pt. A, §3 (AMD).]
24-A M.R.S. § 200 — ME Code / Title 24-A / Chapter 3 / Section 200
24-A §200. Department continued
Status: in_force

There is continued a department of State Government known as the Insurance Bureau. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 2615 — ME Code / Title 24-A / Chapter 31 / Section 2615
24-A §2615. Incontestability
Status: in_force

1. The group life insurance policy must contain a provision that the validity of the policy may not be contested, except for nonpayment of premium, after it has been in force for 2 years from its date of issue; and that no statement made by any person insured under the policy relating to the person's insurability may be used in contesting the validity of the insurance with respect to which such statement was made after such insurance has been in force prior to the contest for a period of 2 years during such person's lifetime nor unless it is contained in a written instrument signed by the person; except that any such provision may not preclude the assertion at any time of defenses based upon provisions in the policy that relate to eligibility for coverage. [RR 2021, c. 1, Pt. B, §227 (COR).]

2. [PL 1981, c. 150, §19 (RP).]
24-A M.R.S. § 2381-B — ME Code / Title 24-A / Chapter 25 / Section 2381-B
24-A §2381-B. Scope of application
Status: in_force

This Act applies to workers' compensation insurance and employers' liability insurance written in connection with workers' compensation insurance. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]
24-A M.R.S. § 2526-A — ME Code / Title 24-A / Chapter 29 / Section 2526-A
24-A §2526-A. Acquired Immune Deficiency Syndrome
Status: in_force

No individual policy of life insurance delivered or issued for delivery in this State may provide more restrictive coverage for death resulting from Acquired Immune Deficiency Syndrome (AIDS), AIDS Related Complex (ARC) or HIV related diseases than for death resulting from any other disease or sickness or exclude coverage for death resulting from AIDS, ARC or HIV related diseases. This section shall not apply to death by accident or accidental means. [PL 1989, c. 176, §3 (NEW).]
24-A M.R.S. § 4234-C — ME Code / Title 24-A / Chapter 56 / Section 4234-C
24-A §4234-C. Newborn children coverage
Status: in_force

All individual and group health maintenance organization contracts must provide that benefits are payable with respect to a newly born child from the moment of birth. [PL 1997, c. 604, Pt. C, §4 (NEW).]

The coverage for newly born children must consist of coverage of injury, sickness or other benefits provided by the contract, including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities. [PL 1997, c. 604, Pt. C, §4 (NEW).]

If payment of a specific premium or subscription fee is required to provide coverage for a child, the contract may require that notification of birth of a newly born child and payment of the required fees must be furnished to the nonprofit hospital or medical service organization within 31 days after the date of birth in order to have the coverage continue beyond that 31-day period. The payment may be required to be retroactive to the date of birth. Benefits required by section 4234‑B must be paid regardless of whether coverage under this section is elected. [PL 1997, c. 604, Pt. C, §4 (NEW).]

The requirements of this section apply to all contracts delivered or issued for delivery in this State on or after the effective date of this Act. [PL 1997, c. 604, Pt. C, §4 (NEW).]
24-A M.R.S. § 4341 — ME Code / Title 24-A / Chapter 56-A / Section 4341
24-A §4341. Limitations on premium transfer
Status: in_force

The superintendent may deny a request for waiver based on any of the following characteristics: [PL 1999, c. 609, §20 (NEW).]

1. Transfer of 30% of annual aggregate premium. A contract by which 30% or more of the carrier's annual aggregate premium with respect to a contract, plan or product is transferred to a single downstream entity. This transfer is the sum of capitated payments plus the sum of amounts returnable to the carrier through incentive payments or other risk adjustments; or [PL 1999, c. 609, §20 (NEW).]

2. Transfer of 75% of annual aggregate premium. Multiple contracts by which 75% or more of the carrier's annual aggregate premium with respect to a contract, plan or product is transferred to one or more downstream entities. This transfer is the sum of capitated payments plus the sum of amounts returnable to the carrier through incentive payments or other risk adjustments. [PL 1999, c. 609, §20 (NEW).]
24-A M.R.S. § 415-A — ME Code / Title 24-A / Chapter 5 / Section 415-A
24-A §415-A. Termination of certificate of authority
Status: in_force

An authorized insurer which elects to terminate its license authority in this State, in whole or in part, shall submit a withdrawal plan designed to protect policyholders and claimants which is subject to approval by the superintendent. The insurer shall submit its plan at least 60 days prior to its proposed date of withdrawal. The plan shall include, but not be limited to, requirements and procedures for meeting the insurer's existing contractual obligations, providing security in the event of a subsequent insolvency and meeting any applicable statutory obligations. The plan shall also comply with any further terms and conditions which are prescribed by rules adopted by the superintendent. In order to protect the interest of the people of this State, the superintendent may require the insurer to make a deposit of securities of a nature and type eligible under section 1253 , to be held in trust by the treasurer in the name of the superintendent. [PL 1985, c. 330, §5 (NEW).]

If an insurer's license authority is revoked, suspended or otherwise terminated in a manner other than by its election, the superintendent shall issue an order which prescribes terms and conditions related to the license termination which shall, to the extent practicable, conform to the requirements governing withdrawal plans as prescribed by this section and rules promulgated under this section. In the event that an insurer attempts to terminate its license authority in this State without filing a withdrawal plan acceptable to the superintendent, the superintendent shall issue an order prescribing the terms and conditions of the termination. Any order issued pursuant to this section, including an order directing an insurer to produce relevant information, may be enforced as provided by section 214 . [PL 1985, c. 330, §5 (NEW).]