24-A M.R.S. § 2729-A — ME Code / Title 24-A / Chapter 33 / Section 2729-A
24-A §2729-A. Limits on priority liens
Status: in_force

No policy for health insurance shall provide for priority over the insured 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 is entitled to receive payment reimbursement from any other person as a result of legal action or claim, except as provided herein. [PL 1975, c. 471, §1 (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 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'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. 471, §1 (NEW).]

1. Legal defenses. Questions of liability and comparative negligence or other legal defenses; [PL 1975, c. 471, §1 (NEW).]

2. Exigencies of trial. Exigencies of trial that reduce a settlement or award in order to resolve the claim; and [PL 1975, c. 471, §1 (NEW).]

3. Limits of coverage. Limits on the amount of applicable insurance coverage that reduce the claim to an amount recoverable by the insured. [PL 1975, c. 471, §1 (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. 471, §1 (NEW).]
24-A M.R.S. § 472 — ME Code / Title 24-A / Chapter 5 / Section 472
24-A §472. Rules and regulations
Status: in_force

During the period of any insurance emergency described in section 471 , the superintendent has power to make, amend or rescind such rules and regulations governing the business of any insurers as the superintendent considers expedient in order to adopt and maintain sound methods of protecting the interests of insurer, insureds, beneficiaries or the public. [RR 2021, c. 1, Pt. B, §182 (COR).]
24-A M.R.S. § 1492 — ME Code / Title 24-A / Chapter 16 / Section 1492
24-A §1492. Definitions
Status: in_force

As used in this subchapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]

1. Actuary. "Actuary" means a person who is a member in good standing of the American Academy of Actuaries. [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]

2. Insurer. "Insurer" means a person engaged as principal and as indemnitor, surety or contractor in the business of entering into contracts of insurance who holds an existing certificate of authority to transact insurance in this State pursuant to section 404 . [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]

3. Managing general agent or MGA. "Managing general agent" or "MGA" means a person who negotiates and binds ceding reinsurance contracts on behalf of an insurer or manages all or part of the insurance business of an insurer, including the management of a separate division, department or underwriting office, and acts as a producer for the insurer, whether known as a managing general agent, manager or other similar term; and who, with or without the authority, either separately or together with affiliates, directly or indirectly, produces and underwrites an amount of gross direct written premium equal to or more than 5% of the policyholder surplus as reported in the last annual statement of the insurer in any one quarter of the year following the last annual statement and adjusts or pays claims in excess of an amount determined by the superintendent or negotiates reinsurance on behalf of the insurer, or both. The term does not include: A. An employee of the insurer; [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] B. A manager of a branch of an alien insurer that is located in the United States; [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] C. An underwriting manager who, pursuant to contract, manages all or part of the insurance operations of the insurer, is under common control with the insurer, subject to section 222 and whose compensation is not based on the volume of premiums written; and [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] D. The attorney-in-fact authorized by and acting for the subscribers of a reciprocal insurer or interinsurance exchange under powers of attorney. [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]

4. Underwrite. "Underwrite" means the authority to accept or reject risk on behalf of the insurer. [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]
24-A M.R.S. § 6916 — ME Code / Title 24-A / Chapter 87 / Section 6916
24-A §6916. Marketing and sale of Dirigo Health Program;  qualifications of insurance producers
Status: in_force

1. Qualifications of insurance producers. An insurance producer licensed pursuant to chapter 16 may solicit, negotiate and sell insurance products offered by or through the Dirigo Health Program if the following conditions are met prior to any such solicitation, negotiation or sale: A. The producer is authorized by the superintendent to solicit, negotiate and sell insurance products for the health line of business; [PL 2007, c. 447, §10 (NEW).] B. The producer has successfully completed all training offered and required by the Dirigo Health Program for the solicitation, negotiation and sale of Dirigo Health Program insurance products, including any continuing training offered and required by the Dirigo Health Program; [PL 2007, c. 447, §10 (NEW).] C. The producer provides the carrier or carriers with which the Dirigo Health Program has contracted to underwrite and provide Dirigo Health Program coverage a current certificate from the Dirigo Health Program certifying the successful completion of all training offered and required by the Dirigo Health Program; and [PL 2007, c. 447, §10 (NEW).] D. The producer successfully completes all training specific to the sale of Dirigo Health Program insurance products offered and required by the carrier or carriers contracting with the Dirigo Health Program to underwrite and provide Dirigo Health Program coverage, including any continuing training offered and required by such carrier or carriers. [PL 2007, c. 447, §10 (NEW).] [PL 2007, c. 447, §10 (NEW).]

2. Annual certification required. Training pursuant to subsection 1 must be completed annually, and any certificate establishing successful completion of training is valid for one year from the date of issuance. If a producer fails to obtain certification following the expiration of the prior year's certification, the producer may not continue to solicit, negotiate and sell insurance products offered by or through the Dirigo Health Program. [PL 2007, c. 447, §10 (NEW).]

3. Carrier appointment not required. Notwithstanding any other provision of law, an insurance producer licensed pursuant to chapter 16 who complies with this section may solicit, negotiate and sell insurance products offered by or through the Dirigo Health Program without being appointed by the carrier or carriers contracting with the Dirigo Health Program to underwrite and provide Dirigo Health Program coverage. A producer may not solicit, negotiate or sell insurance products offered by or through the Dirigo Health Program if the producer is not in compliance with this subsection. Notwithstanding section 1445 , the carrier or carriers contracting with the Dirigo Health Program to underwrite and provide Dirigo Health Program coverage are not liable for the actions of an insurance producer who has not been appointed to solicit, negotiate and sell insurance products offered by or through the Dirigo Health Program. [PL 2007, c. 447, §10 (NEW).]
24-A M.R.S. § 3104 — ME Code / Title 24-A / Chapter 43 / Section 3104
24-A §3104. Notice of authorization to registers of probate
Status: in_force

Whenever any surety insurer is authorized to transact business in this State, the superintendent shall maintain the name of such insurer and the names of all agents of such insurer who have been licensed by the superintendent, their places of residence and the dates when their licenses will expire. [PL 1993, c. 637, §34 (AMD).]
24-A M.R.S. § 4320-B — ME Code / Title 24-A / Chapter 56-A / Section 4320-B
24-A §4320-B. Extension of dependent coverage
Status: in_force

A carrier offering a health plan subject to the requirements of the federal Affordable Care Act that provides dependent coverage of children shall continue to make such coverage available for an adult child until the child turns 26 years of age, consistent with the federal Affordable Care Act, and offer coverage for a dependent child with a disability in accordance with section 4320‑R . [PL 2021, c. 520, §7 (AMD).]
24-A M.R.S. § 2327 — ME Code / Title 24-A / Chapter 25 / Section 2327
24-A §2327. Fleet rates
Status: in_force

1. Two or more insurers, who, by virtue of their business associations in the United States, represent themselves to be or are customarily known as a "group" or similar insurance trade designation, may make the same filings or use the same rates for each such insurer, subject to the provisions of section 2303 ; and nothing contained in this chapter shall be construed to prohibit an agreement to make the same filings or use the same rates and concerted action in connection with such filings or rates by such insurers. This section shall not apply to 2 or more insurers who are not under the same common executive or general management or control and who act in concert in underwriting groups or pools. [PL 1969, c. 132, §1 (NEW).]

2. This section does not prohibit or restrict any agreement or action otherwise lawful under section 2322‑A . [RR 2021, c. 2, Pt. A, §72 (COR).]
24-A M.R.S. § 4310 — ME Code / Title 24-A / Chapter 56-A / Section 4310
24-A §4310. Access to clinical trials
Status: in_force

1. Qualified enrollee. An enrollee is eligible for coverage for participation in an approved clinical trial if the enrollee meets the following conditions: A. The enrollee has a life-threatening illness for which no standard treatment is effective; [PL 1999, c. 742, §19 (NEW); PL 1999, c. 742, §21 (AFF).] B. The enrollee is eligible to participate according to the clinical trial protocol with respect to treatment of such illness; [PL 1999, c. 742, §19 (NEW); PL 1999, c. 742, §21 (AFF).] C. The enrollee's participation in the trial offers meaningful potential for significant clinical benefit to the enrollee; and [PL 1999, c. 742, §19 (NEW); PL 1999, c. 742, §21 (AFF).] D. The enrollee's referring physician has concluded that the enrollee's participation in such a trial would be appropriate based upon the satisfaction of the conditions in paragraphs A , B and C . [PL 1999, c. 742, §19 (NEW); PL 1999, c. 742, §21 (AFF).] [PL 1999, c. 742, §19 (NEW); PL 1999, c. 742, §21 (AFF).]

2. Coverage. A carrier may not deny a qualified enrollee participation in an approved clinical trial or deny, limit or impose additional conditions on the coverage of routine patient costs for items and services furnished in connection with participation in the clinical trial. For the purposes of this section, "routine patient costs" does not include the costs of the tests or measurements conducted primarily for the purpose of the clinical trial involved. [PL 1999, c. 742, §19 (NEW); PL 1999, c. 742, §21 (AFF).]

3. Payment. A carrier shall provide payment for routine patient costs but is not required to pay for costs of items and services that are reasonably expected to be paid for by the sponsors of an approved clinical trial. In the case of covered items and services, the carrier shall pay participating providers at the agreed upon rate and pay nonparticipating providers at the same rate the carrier would pay for comparable services performed by participating providers. [PL 1999, c. 742, §19 (NEW); PL 1999, c. 742, §21 (AFF).]

4. Approved clinical trial. For the purposes of this section, "approved clinical trial" means a clinical research study or clinical investigation approved and funded by the federal Department of Health and Human Services, National Institutes of Health or a cooperative group or center of the National Institutes of Health. [PL 1999, c. 742, §19 (NEW); PL 1999, c. 742, §21 (AFF).]

5. Application. The requirements of this section apply to all individual and group policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 2003, c. 517, Pt. B, §31 (NEW).]
24-A M.R.S. § 3362 — ME Code / Title 24-A / Chapter 47 / Section 3362
24-A §3362. Special meetings of members
Status: in_force

1. A special meeting of the members of a mutual insurer may be held for any lawful purpose. The meeting shall be called by the corporate secretary pursuant to request of the insurer's president or of its board of directors, or upon request in writing signed by not less than 1/10 of the insurer's members. The meeting shall be held at such time as the secretary may fix, but not less than 10 nor more than 30 days after receipt of the request. If the secretary fails to issue such call, the president, directors or members making the request may do so. [PL 1969, c. 132, §1 (NEW).]

2. Not less than 10 days' written notice of the meeting shall be given. Notice addressed to the insurer's members at their respective post-office addresses last of record with the insurer and deposited, postage prepaid, in a letter depository of the United States post office, shall be deemed to have been given when so mailed. In lieu of mailed notice, the insurer may publish the notice in such publication or publications as shall afford a majority of its members a reasonable opportunity to have actual advance notice of the meeting. The notice shall state the purposes of the meeting, and no business shall be transacted at the meeting of which notice was not so given. [RR 2015, c. 2, §15 (COR).]
24-A M.R.S. § 2010 — ME Code / Title 24-A / Chapter 19 / Section 2010
24-A §2010. Surplus lines insurance valid
Status: in_force

Insurance contracts procured as surplus line coverage from nonadmitted insurers in accordance with this chapter are fully valid and enforceable as to all parties, and must be given recognition in all matters and respects to the same effect as like contracts issued by authorized insurers. [PL 2025, c. 348, §24 (AMD).]
24-A M.R.S. § 2607-A — ME Code / Title 24-A / Chapter 31 / Section 2607-A
24-A §2607-A. Association groups
Status: in_force

The lives of a group of individuals may be insured under a policy issued to an association or to a trust or to the trustee or trustees of a fund established, created or maintained for the benefit of members of one or more associations. The association or associations shall have at the outset a minimum of 50 persons; shall have been organized and maintained in good faith for purposes other than that of obtaining insurance; shall have been in active existence for at least 2 years; and shall have a constitution and bylaws which provides that: The association or associations hold regular meetings not less than annually to further purposes of the members; except for credit unions, the association or associations collect dues or solicit contributions from members; and the members have voting privileges and representation on the governing board and committees. The policy is subject to the following requirements. [PL 1981, c. 150, §9 (NEW).]

1. The policy may insure members of the association or associations, employees thereof or employees of members, or one or more of the preceding or all of any class or classes thereof for the benefit of persons other than the employees' employer. [PL 1981, c. 150, §9 (NEW).]

2. The premium for the policy shall be paid from funds contributed by the association or associations or by employer members, or by both, or from funds contributed by the covered persons or from both the covered persons and the association, associations or employer members. [PL 1981, c. 150, §9 (NEW).]

3. Except as provided in subsection 4 , a policy on which no part of the premium is to be derived from funds contributed by the covered persons specifically for their insurance must insure all eligible persons, except those who reject that coverage in writing. [PL 1981, c. 150, §9 (NEW).]

4. An insurer may exclude or limit the coverage on any person as to whom evidence of individual insurability is not satisfactory to the insurer. [PL 1981, c. 150, §9 (NEW).]
24-A M.R.S. § 2819 — ME Code / Title 24-A / Chapter 35 / Section 2819
24-A §2819. New employees, members
Status: in_force

There shall be a provision that all new employees or new members, as the case may be, in the groups or classes eligible for such insurance must be added to such groups or classes for which they are respectively eligible. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 7056 — ME Code / Title 24-A / Chapter 90 / Section 7056
24-A §7056. Policy; responsibilities; enforcement; standards
Status: in_force

1. Policy. Notwithstanding any provision of this Title to the contrary, travel insurance rates and forms must be filed with and approved by the superintendent. For purposes of such filings, travel insurance must be classified and filed for purposes of rates and forms as inland marine insurance, except that travel insurance that provides coverage for sickness, accident, disability or death occurring during travel, either exclusively or in conjunction with related coverages of emergency evacuation or repatriation of remains, or incidental limited property and casualty benefits such as lost baggage or trip cancellation, may, subject to the superintendent's discretion, be filed as either health insurance or inland marine insurance. Travel insurance may be provided under an individual policy or under a group or blanket travel insurance policy. [PL 2021, c. 354, §13 (AMD).]

2. Responsibility. As the insurer's designee, a supervising travel insurance producer is responsible for the acts of a travel retailer offering and disseminating travel insurance under the supervising travel insurance producer's authority and shall use reasonable means to ensure compliance by the travel retailer with this chapter. [PL 2021, c. 354, §13 (AMD).]

3. Enforcement. A supervising travel insurance producer and any travel retailer offering and disseminating travel insurance are subject to chapters 16 and 23 . [PL 2015, c. 133, §4 (NEW).]

4. Eligibility and underwriting standards. Eligibility and underwriting standards for travel insurance may be developed and provided based on travel protection plans designed for individual or identified marketing or distribution channels, as long as those standards also meet the State's underwriting standards for inland marine insurance. [PL 2021, c. 354, §13 (NEW).]
24-A M.R.S. § 2863 — ME Code / Title 24-A / Chapter 37 / Section 2863
24-A §2863. Existing insurance; choice of insurer
Status: in_force

When credit life insurance or credit health insurance is required as additional security for any indebtedness, the debtor shall, upon request to the creditor, have the option of furnishing the required amount of insurance through existing policies of insurance owned or controlled by the debtor or of procuring and furnishing the required coverage through any insurer authorized to transact such insurance within this State. [RR 2021, c. 1, Pt. B, §252 (COR).]
24-A M.R.S. § 2805-A — ME Code / Title 24-A / Chapter 35 / Section 2805-A
24-A §2805-A. Association groups
Status: in_force

A group of individuals may be insured under a policy issued to an association or to a trust or to the trustees of a fund established, created or maintained for the benefit of members of one or more associations. The association or associations shall have at the outset a minimum of 50 persons; shall have been organized and maintained in good faith for purposes other than that of obtaining insurance; shall have been in active existence for at least 2 years; and shall have a constitution and bylaws which provides that: The association or associations hold regular meetings not less than annually to further purposes of the members; except for credit unions, the association or associations collect dues or solicit contributions from members; and the members have voting privileges and representation on the governing board and committees. The policy is subject to the following requirements. [PL 1981, c. 147, §4 (NEW).]

1. The policy may insure members of the association or associations, employees thereof or employees of members or one or more of the preceding or all of any class or classes thereof for the benefit of persons other than the employees' employer. [PL 1981, c. 147, §4 (NEW).]

2. The premium for the policy shall be paid from funds contributed by the association or associations or by employer members, or by both, or from funds contributed by the covered persons or from both the covered persons and the association, associations or employer members. [PL 1981, c. 147, §4 (NEW).]

3. Except as provided in subsection 4 , a policy on which no part of the premium is to be derived from funds contributed by the covered persons specifically for their insurance must insure all eligible persons, except those who reject that coverage in writing. [PL 1981, c. 147, §4 (NEW).]

4. Except as provided in section 2736‑C , section 2808‑B and chapter 36 , an insurer may exclude or limit the coverage on any person as to whom evidence of individual insurability is not satisfactory to the insurer. [PL 1999, c. 256, Pt. G, §3 (AMD).]
24-A M.R.S. § 5002-B — ME Code / Title 24-A / Chapter 67 / Section 5002-B
24-A §5002-B. Continuity of coverage
Status: in_force

1. Persons provided continuity of coverage. This section provides continuity of coverage for a person who has a Medicare supplement policy and seeks coverage under a new Medicare supplement policy with the same or lesser benefits if: A. That person, including a person entitled to Medicare benefits due to disability, has been covered under a policy that supplemented benefits under Medicare or has been covered under a Medicare Advantage plan with no gap in coverage greater than 90 days beginning with the person's open enrollment period. A policy supplementing benefits payable under Medicare may include an individual health policy, a group health plan, a Medicare supplement policy or other coverage issued by the same or a different carrier. [PL 2009, c. 244, Pt. A, §1 (AMD).] B. [PL 2003, c. 157, §1 (RP).] C. [PL 2003, c. 157, §1 (RP).] [PL 2009, c. 244, Pt. A, §1 (AMD).]

2. Prohibition against discontinuity. The insurer shall, for any person described in subsection 1 , waive any medical underwriting or preexisting conditions exclusion to the extent that benefits would have been payable under the prior Medicare supplement policy and any earlier Medicare supplement policy if those policies were still in effect. This subsection does not require the succeeding insurer to pay any benefits that are not within the terms of coverage of the succeeding policy solely because they would have been paid by the prior policy. [PL 2003, c. 157, §1 (AMD).]

2-A. Low-cost drugs for the elderly or disabled program. [PL 2013, c. 94, §1 (RP).]

3. Determination of benefits. When a determination of benefits under the prior policy is required, the issuer of the prior policy shall, at the request of the issuer of the succeeding policy, furnish a statement of benefits available or pertinent information sufficient to permit verification of the benefit determination or the determination itself by the issuer of the succeeding policy. For purposes of this section, benefits of the prior policy are determined in accordance with the definitions, conditions and covered expense provisions of that policy rather than those of the succeeding policy. The benefit determination must be made as if coverage had not been replaced. [PL 1999, c. 36, §4 (NEW).]

4. Rulemaking. The superintendent shall adopt rules concerning guaranteed issuance and continuity of Medicare supplement policies for certain eligible persons. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter II‑A . [PL 1999, c. 36, §4 (NEW).]
24-A M.R.S. § 4611 — ME Code / Title 24-A / Chapter 62 / Section 4611
24-A §4611. Duties and powers of the superintendent
Status: in_force

In addition to the duties and powers enumerated elsewhere in this chapter: [PL 1983, c. 846 (NEW).]

1. Powers and duties. The superintendent shall: A. Notify the board of directors of the existence of an impaired insurer not later than 3 days after a determination of impairment or insolvency is made or the superintendent has received the notice of impairment or insolvency; [PL 2005, c. 346, §8 (AMD); PL 2005, c. 346, §16 (AFF).] B. Upon request of the board of directors, provide the association with a statement of the premiums in the appropriate states for each member insurer; [PL 1983, c. 846 (NEW).] C. When an impairment is determined, as defined in section 4605‑A, subsection 10 , and the amount of the impairment is determined, serve a demand upon the impaired insurer to make good the impairment within a reasonable time. Notice to the impaired insurer constitutes notice to its shareholders, if any. The failure of the insurer to promptly comply with the demand does not excuse the association from the performance of its powers and duties under this chapter; and [PL 2005, c. 346, §8 (AMD); PL 2005, c. 346, §16 (AFF).] D. In any liquidation or rehabilitation proceeding involving a domestic insurer, the superintendent shall be appointed as the liquidator or rehabilitator, pursuant to chapter 57 . If a foreign or alien member insurer is subject to a liquidation proceeding in its domiciliary jurisdiction or state of entry other than this State, the superintendent may be appointed conservator or an ancillary receiver. [PL 1983, c. 846 (NEW).] [PL 2005, c. 346, §8 (AMD); PL 2005, c. 346, §16 (AFF).]

2. Suspension or revocation of certificate of authority. The superintendent may suspend or revoke, after notice and hearing, the certificate of authority to transact business in this State of any member insurer that fails to pay an assessment when due or fails to comply with the plan of operation. In lieu of such suspension or revocation, any member insurer that fails to pay an assessment when due or fails to comply with the plan of operation may be punished by a fine not to exceed the greater of 5% of the unpaid assessment per month or $100 per month. [PL 2017, c. 382, §26 (AMD).]

3. Appeal of actions of board of directors or association. Any final action of the board of directors or the association may be appealed to the superintendent by any member insurer if such appeal is taken within 30 days of the action being appealed. Any final action or order of the superintendent is subject to judicial review pursuant to chapter 3 . [PL 2005, c. 346, §9 (AMD); PL 2005, c. 346, §16 (AFF).]

4. Notification of interested persons. The liquidator, rehabilitator or conservator of any impaired insurer may notify all interested persons of the effect of this chapter. [PL 1983, c. 846 (NEW).]
24-A M.R.S. § 3622 — ME Code / Title 24-A / Chapter 51 / Section 3622
24-A §3622. Nonassessable policies; assessable, nonassessable liability
Status: in_force

1. A mutual insurer heretofore formed and transacting insurance under this chapter may issue nonassessable advance cash premium policies in this State upon compliance with either of the following requirements: A. Surplus. The insurer shall have and maintain a surplus to policyholders, as determined by its last annual statement filed with the superintendent, of not less than $100,000, or [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).] B. Surplus and unearned premium reserve. The insurer shall have and maintain a surplus to policyholders, as determined by its latest annual statement filed with the superintendent, of not less than $75,000, provided its unearned premium reserve is at all times less than its surplus to policyholders. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).] [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

2. If such an insurer, after qualifying to issue a nonassessable cash premium policy, fails to maintain one of the above requirements it shall cease to issue a nonassessable policy until it has again met and maintained the requirements for a period of one year. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 6213 — ME Code / Title 24-A / Chapter 73 / Section 6213
24-A §6213. Actions for damages or equitable relief
Status: in_force

1. Action for damages. Any subscriber injured by a violation of this chapter may bring an action for the recovery of damages in any court of competent jurisdiction. In those cases, the court may award reasonable attorneys fees to a subscriber in whose favor a judgment is rendered. [PL 1987, c. 482, §1 (NEW).]

2. Equitable relief. Any subscriber injured by a violation of this chapter may institute an action for an appropriate temporary restraining order or injunction. [PL 1987, c. 482, §1 (NEW).]
24-A M.R.S. § 1914 — ME Code / Title 24-A / Chapter 18 / Section 1914
24-A §1914. Plan sponsor access to claims data; right to audit
Status: in_force

1. High-cost claims data. Upon request of a plan sponsor that has certified its compliance with the use and disclosure requirements of 45 Code of Federal Regulations, Section 164.504(f), an administrator shall provide data on a high-cost claim so that a plan sponsor may perform an audit to ensure compliance with the plan sponsor's contract prior to payment of the high-cost claim. The data must include any itemized billing statements and medical records associated with the claim in the possession of the administrator or the administrator's agents. The plan sponsor or the plan sponsor's designee shall make a request for data on a high-cost claim within 2 business days of receipt of the claim and the administrator must provide the requested information within 30 business days of the request. For the purposes of this subsection, "high-cost claim" means any claim related to an individual provided health coverage by a plan sponsor that exceeds $100,000. [PL 2025, c. 487, §1 (NEW).]

2. Claims data; right to audit. An administrator that contracts with a plan sponsor to provide health coverage shall permit a plan sponsor to perform a post-payment audit of all claims paid to ensure compliance with the contract at least once in a calendar year as long as the request is not earlier than 6 months following a previously requested audit. Upon request of a plan sponsor as part of an audit, an administrator shall disclose within 30 business days to a plan sponsor that has certified its compliance with the use and disclosure requirements of 45 Code of Federal Regulations, Section 164.504(f) or, to the extent permitted by law and if requested by the plan sponsor, to the plan sponsor's designated business associate the following information specific to the plan sponsor: A. Claims data received by the administrator via electronic claims transactions on any current standardized claim form approved by the Federal Government for professional services or institutional services. The form or transaction may be modified only as necessary to comply with the federal Health Insurance Portability and Accountability Act of 1996, Public Law 104-191; [PL 2025, c. 487, §1 (NEW).] B. Claims payments, electronic funds transfers or remittance advice notices provided by the administrator as electronic files compliant with the federal Health Insurance Portability and Accountability Act of 1996, Public Law 104-191, including, but not limited to, electronic claims transactions for both the billed amount and the paid amount for professional services and both the billed amount and the paid amount for institutional services. The files may be modified only as necessary to comply with the federal Health Insurance Portability and Accountability Act of 1996, Public Law 104‑191, and the federal Health Information Technology for Economic and Clinical Health Act of 2009, Title XIII, Subtitle D, Public Law 111-5, and any regulations promulgated under those laws; [PL 2025, c. 487, §1 (NEW).] C. Any fees charged to the plan sponsor related to plan administration and claims processing, including renegotiation fees, access fees, repricing fees or enhanced review fees; and [PL 2025, c. 487, §1 (NEW).] D. Any out-of-network fees or out-of-network negotiated discounts, aligned incentive program fees, pay-for-performance payments and recoveries, cost-containment program fees, overpayment recovery program fees, subrogation fees and any other special program fees and discounts. [PL 2025, c. 487, §1 (NEW).] [PL 2025, c. 487, §1 (NEW).]

3. No conditions or fees on audit. An administrator may not impose on a plan sponsor: A. Any fees relating to an audit request under this section that exceed the direct expenses properly and actually incurred by the administrator to provide the data; or [PL 2025, c. 487, §1 (NEW).] B. Any conditions that would restrict a plan sponsor's right to conduct an audit under this section, including, but not limited to, restrictions on: (1) The time period covered by the audit, except that a request pursuant to this section must be made within 24 months of the end of each plan year to be audited; (2) The number of claims analyzed; (3) The type of analysis conducted; (4) The data elements used in the analysis; (5) The means by which an auditor is compensated by a plan sponsor; or (6) The plan sponsor's choice of auditor as long as the plan sponsor certifies that the auditor has adequate conflict of interest protection provisions to prevent conflicts of interest from adversely affecting the outcome of the audit. [PL 2025, c. 487, §1 (NEW).] [PL 2025, c. 487, §1 (NEW).]

4. Nondisclosure and data use agreement. An administrator may require that the plan sponsor and the plan sponsor's designated business associate execute a nondisclosure and data use agreement that reasonably restricts the auditor's use of data provided by the administrator to the sole purpose of conducting an audit on behalf of a plan sponsor. The coverage limits of any cybersecurity insurance or liability insurance policy required under the nondisclosure and data use agreement may not exceed the administrator's limit of liability under the services agreement between the plan sponsor and the administrator, if such limit applies. In addition, an administrator is not required to provide data to an auditor selected by a plan sponsor if the auditor has previously breached a nondisclosure and data use agreement with that administrator or refuses to execute a nondisclosure and data use agreement. [PL 2025, c. 487, §1 (NEW).]

5. Compliance with federal law. Information provided by an administrator to a plan sponsor in accordance with this section must comply with any applicable requirements of the federal Health Insurance Portability and Accountability Act of 1996, Public Law 104‑191, and the federal Health Information Technology for Economic and Clinical Health Act of 2009, Title XIII, Subtitle D, Public Law 111-5, and any regulations promulgated under those laws. [PL 2025, c. 487, §1 (NEW).]

6. Application. An administrator may not enter into, issue, amend or renew any contract or network services agreement with a plan sponsor on or after January 1, 2026 that contains any provision that violates this section. [PL 2025, c. 487, §1 (NEW).]

7. Exclusive enforcement; violation. Notwithstanding section 12‑A , a violation of this section is subject to exclusive enforcement under the Maine Unfair Trade Practices Act, including any of the remedies provided for in the Act. A violation is committed each time a prohibited act under this section occurs. Investigations of violations by administrators may include a 3rd party that may possess evidence supporting such investigation. [PL 2025, c. 487, §1 (NEW).]
24-A M.R.S. § 2413 — ME Code / Title 24-A / Chapter 27 / Section 2413
24-A §2413. Grounds for disapproval
Status: in_force

1. The superintendent shall disapprove any form filed under section 2412 , or withdraw any previous approval thereof, only on one or more of the following grounds: A. If it is in any respect in violation of or does not comply with this Title; [PL 1969, c. 132, §1 (NEW).] B. If it contains or incorporates by reference, where such incorporation is otherwise permissible, any inconsistent, ambiguous or misleading clauses, or exceptions and conditions which deceptively affect the risk purported to be assumed in the general coverage of the contract; [PL 1969, c. 132, §1 (NEW).] C. If it has any title, heading or other indication of its provisions which is misleading; [PL 1969, c. 132, §1 (NEW).] D. As to an individual health insurance policy, if the benefits provided therein are unreasonable in relation to the premium charged; or, as to any health insurance contract, if it contains any unjust, unfair or inequitable provision or provisions; [PL 1969, c. 132, §1 (NEW).] E. As to a life insurance or health insurance policy, if it contains a provision or provisions such as to encourage misrepresentation; [PL 1991, c. 211, §1 (AMD).] F. As to Medicare supplement policies or contracts, as defined in chapter 67 , if the policy cannot be anticipated, as estimated for the entire period for which rates are to be computed to provide coverage, on the basis of incurred claims experience and earned premiums for that period and in accordance with accepted actuarial principles and practices, to return to policyholders in the form of aggregate benefits provided under the policy at least 65% of the aggregate amount of premiums collected in the case of individual policies and at least 75% of the aggregate amount of premiums collected in the case of group policies; or [PL 1991, c. 211, §2 (AMD).] G. As to an individual health insurance policy, contract or rider, if it insures against a specific disease and does not meet the minimum loss ratio standards specified in subparagraph (2). (1) As used in this paragraph, unless the context otherwise indicates, the following terms have the following meanings. (a) "Conditionally renewable" means renewal may be declined by the insurer by class, geographic area or for stated reasons other than health. (b) "Guaranteed renewable" means renewal may be declined by the insurer only for nonpayment of premium but rates may be revised on a class basis. (c) "Noncancelable" means renewal may not be declined by the insurer and rates may not be revised. (d) "Optionally renewable" means renewal is at the option of the insurer. (2) The loss ratio standards for each type of renewal clause are: (a) Optionally renewable insurance, 60%; (b) Conditionally renewable insurance, 55%; and (c) Guaranteed renewable and noncancelable insurance, 50%. [PL 1991, c. 211, §3 (NEW).] [PL 1991, c. 211, §§1-3 (AMD).]

2. The insurer shall not use in this State any such form after disapproval or withdrawal of approval. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2504 — ME Code / Title 24-A / Chapter 29 / Section 2504
24-A §2504. Payment of premiums
Status: in_force

There shall be a provision relating to the time and place of payment of premiums. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 1420-F — ME Code / Title 24-A / Chapter 16 / Section 1420-F
24-A §1420-F. License
Status: in_force

1. Issuance; lines of authority. Unless denied licensure pursuant to section 1420‑K , a person who has met the requirements of sections 1420‑D and 1420‑E must be issued an insurance producer license. An insurance producer may receive qualification for a license in one or more of the following lines of authority, as designated in this subsection for the purposes of this subchapter: A. Life, which is insurance coverage on human lives, including benefits of endowment and annuities, and may include benefits in the event of death or dismemberment by accident and benefits for disability income; [PL 2001, c. 259, §24 (NEW).] B. Accident and health or sickness, which is insurance coverage for sickness, bodily injury or accidental death and may include benefits for disability income; [PL 2001, c. 259, §24 (NEW).] C. Property, which is insurance coverage for the direct or consequential loss of or damage to property of every kind; [PL 2001, c. 259, §24 (NEW).] D. Casualty, which is insurance coverage against legal liability, including coverage for death, injury or disability or damage to real or personal property; [PL 2001, c. 259, §24 (NEW).] E. Variable life and variable annuity products, which is insurance coverage provided under variable life insurance contracts and variable annuities; [PL 2001, c. 259, §24 (NEW).] F. Personal lines, which is property and casualty insurance coverage sold to individuals and families for primarily noncommercial purposes; [PL 2001, c. 259, §24 (NEW).] G. Credit, which is limited line credit insurance; [PL 2001, c. 259, §24 (NEW).] H. Travel insurance, which is a limited line and which means insurance coverage for personal risks incident to planned travel, including but not limited to: (1) Interruption or cancellation of a trip or event; (2) Loss of baggage or personal effects; (3) Damages to accommodations or rental vehicles; (4) Sickness, accident, disability or death occurring during travel; (5) Emergency evacuation; (6) Repatriation of remains; or (7) Any other contractual obligations to indemnify or pay a specified amount to a traveler upon determinable contingencies related to travel as approved by the superintendent. Travel insurance does not include a major medical plan that provides comprehensive medical protection for travelers on trips lasting longer than 6 months, including travelers working or residing overseas as expatriates, or any other product that requires a specific insurance producer license; [PL 2021, c. 354, §3 (AMD).] I. Title insurance contracts, which are a limited line; [PL 2001, c. 259, §24 (NEW).] J. [PL 2005, c. 43, §2 (RP).] K. Automobile mechanical breakdown contracts, which are a limited line; [PL 2015, c. 77, §2 (AMD).] L. Insurance offered, sold or solicited in connection with and incidental to the rental of rental cars for a period of no more than 60 days, whether at the rental office or by preselection of coverage in master, corporate, group or individual agreements, that is nontransferable, applies only to the rental car that is the subject of the rental agreement and is limited to the following kinds of insurance: (1) Personal accident insurance for renters and other rental car occupants for accidental death or dismemberment and for medical expenses resulting from an accident that occurs with the rental car during the rental period; (2) Liability insurance that provides protection to the renters and other authorized drivers of a rental car for liability arising from the operation or use of the rental car during the rental period; (3) Personal effects insurance that provides coverage to renters and other vehicle occupants for loss of, or damage to, personal effects in the rental car during the rental period; (4) Roadside assistance and emergency sickness protection insurance; and (5) Any other coverage designated by the superintendent; and [PL 2015, c. 77, §3 (AMD).] M. Insurance offered, sold or solicited in connection with and incidental to the rental of covered rental equipment, as defined in section 3043 , insuring against the loss of or damage to that equipment. [PL 2015, c. 77, §4 (NEW).] [PL 2021, c. 354, §3 (AMD).]

2. Duration. An insurance producer license remains in effect, unless revoked or suspended, as long as any applicable fee set forth in section 601 is paid and education requirements pursuant to subchapter VII for resident individual producers are met by the due date. [PL 2001, c. 259, §24 (NEW).]

3. Lapse. An individual insurance producer whose license lapses may, within 12 months, reinstate the same license without the necessity of passing a written examination. [PL 2001, c. 259, §24 (NEW).]

4. Waiver. A licensed insurance producer who is unable to comply with license continuation procedures due to military service or some other extenuating circumstance, such as a long-term medical disability, may request a waiver of those procedures. The producer may also request a waiver of any examination requirement or any other fine or sanction imposed for failure to comply with continuation procedures. [PL 2001, c. 259, §24 (NEW).]

5. Contents. The license must contain the licensee's name, address, personal identification number, the date of issuance, the lines of authority and any other information required by the superintendent. [PL 2001, c. 259, §24 (NEW).]

6. Change of name or address. A licensee shall inform the superintendent by any means acceptable to the superintendent of a change of address within 30 days of the change. Failure to timely inform the superintendent of a change in legal name or address results in a penalty pursuant to section 601 . [PL 2001, c. 259, §24 (NEW).]

7. Contract with other entities. In order to assist in the performance of the superintendent's duties, the superintendent may contract with nongovernmental entities, including the National Association of Insurance Commissioners, its affiliates or subsidiaries or its successor organization, to perform any ministerial functions, including the collection of fees, related to producer licensing that the superintendent and the nongovernmental entity determine appropriate. [PL 2001, c. 259, §24 (NEW).]
24-A M.R.S. § 4357 — ME Code / Title 24-A / Chapter 57 / Section 4357
24-A §4357. Grounds for liquidation of domestic insurer or domiciled alien insurer
Status: in_force

The superintendent may apply to the court for an order appointing the superintendent as receiver, if the superintendent's appointment as receiver is not then in effect, and directing the superintendent to liquidate the business of a domestic insurer or of the United States branch of an alien insurer having trusteed assets in this State, whether or not there has been a prior order directing the superintendent to rehabilitate the insurer, upon any one or more of the following grounds: [RR 2021, c. 1, Pt. B, §353 (COR).]

1. That the insurer has failed to cure an impairment of surplus or capital or assets within the time allowed therefor by any lawful order of the superintendent; [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

2. That the insurer is insolvent, or has commenced voluntary liquidation or dissolution, or attempts to commence or prosecute or is the object, in this State or elsewhere, of any action of proceeding to liquidate its business or affairs or to dissolve its corporate charter or to procure the appointment of a receiver, trustee, custodian or sequestrator under any law except this Title. This provision shall not apply as to the conversion of a stock insurer to an ordinary business corporation as authorized under section 3473 or to voluntary dissolution of the insurer pursuant to section 3484 ; [PL 1969, c. 132, §1 (NEW).]

3. That the insurer has ceased for a period of one year to transact insurance business; [PL 1969, c. 132, §1 (NEW).]

4. If a proposed insurer has not completed its organization and obtained a certificate of authority as an insurer within the time allowed therefor under any applicable law; [PL 1969, c. 132, §1 (NEW).]

5. That efforts to rehabilitate the insurer and remove the causes or adverse effects thereof for which rehabilitation was instituted have failed despite all reasonable efforts by the superintendent, or cannot be continued without material increase of risk of loss to the insurer's creditors or policyholders; or [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

6. If the insurer has requested or consented to liquidation by vote or written authorization of a majority of its directors or stockholders, or members if a mutual insurer. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2622 — ME Code / Title 24-A / Chapter 31 / Section 2622
24-A §2622. Conversion on termination of policy
Status: in_force

The group life insurance policy must contain a provision that if the group policy terminates or is amended so as to terminate the insurance of any class of insured persons, every person insured thereunder at the date of such termination whose insurance terminates, including the insured dependent of a covered person, and who has been so insured for at least 5 years prior to such termination date is entitled to have issued to the person by the insurer an individual policy of life insurance, subject to the same conditions and limitations as are provided by section 2621 , except that the group policy may provide that the amount of such individual policy may not exceed the smaller of: [RR 2021, c. 1, Pt. B, §234 (COR).]

1. The amount of the person's life insurance protection ceasing because of the termination or amendment of the group policy, less the amount of any life insurance for which the person is or becomes eligible under a group policy issued or reinstated by the same or another insurer within 31 days after such termination; and [RR 2021, c. 1, Pt. B, §233 (COR).]

2. $10,000. [PL 1981, c. 150, §26 (AMD).]
24-A M.R.S. § 2760 — ME Code / Title 24-A / Chapter 33 / Section 2760
24-A §2760. Coverage for general anesthesia for dentistry (REALLOCATED FROM TITLE 24-A, SECTION 2759)
Status: in_force

(REALLOCATED FROM TITLE 24-A, SECTION 2759)

1. Enrollee defined. For the purposes of this section, unless the context otherwise indicates, "enrollee" means a person who is covered under an individual health insurance contract provided by an insurer. [RR 2001, c. 1, §31 (RAL).]

2. General anesthesia and associated facility charges. An insurer that issues individual health insurance contracts shall provide coverage for general anesthesia and associated facility charges for dental procedures rendered in a hospital when the clinical status or underlying medical condition of an enrollee requires dental procedures that ordinarily would not require general anesthesia to be rendered in a hospital. The insurer may require prior authorization of general anesthesia and associated charges required for dental care procedures in the same manner that prior authorization is required for other covered diseases or conditions. [RR 2001, c. 1, §31 (RAL).]

3. Limitations on coverage. This section applies only to general anesthesia and associated facility charges for only the following enrollees if the enrollees meet the criteria in subsection 2 : A. Enrollees, including infants, exhibiting physical, intellectual or medically compromising conditions for which dental treatment under local anesthesia, with or without additional adjunctive techniques and modalities, can not be expected to provide a successful result and for which dental treatment under general anesthesia can be expected to produce a superior result; [RR 2001, c. 1, §31 (RAL).] B. Enrollees demonstrating dental treatment needs for which local anesthesia is ineffective because of acute infection, anatomic variation or allergy; [RR 2001, c. 1, §31 (RAL).] C. Extremely uncooperative, fearful, anxious or uncommunicative children or adolescents with dental needs of such magnitude that treatment should not be postponed or deferred and for whom lack of treatment can be expected to result in dental or oral pain or infection, loss of teeth or other increased oral or dental morbidity; and [RR 2001, c. 1, §31 (RAL).] D. Enrollees who have sustained extensive oral-facial or dental trauma for which treatment under local anesthesia would be ineffective or compromised. [RR 2001, c. 1, §31 (RAL).] [RR 2001, c. 1, §31 (RAL).]

4. Dental procedures and dentist's fee not covered. This section does not require an insurer that issues individual contracts to cover any charges for the dental procedure itself, including, but not limited to, the professional fee of the dentist. Coverage for anesthesia and associated facility charges pursuant to this section is subject to all other terms and conditions of the individual contract that apply generally to other benefits. [RR 2001, c. 1, §31 (RAL).]

5. Coordination of benefits with dental insurance. If an enrollee eligible for coverage under this section is also eligible for coverage for general anesthesia and associated facility charges under a dental insurance policy or contract, the nonprofit health care service organization or insurer providing dental insurance is the primary payer responsible for those charges and the insurer providing individual health insurance is the secondary payer. [RR 2001, c. 1, §31 (RAL).]
24-A M.R.S. § 7003 — ME Code / Title 24-A / Chapter 89 / Section 7003
24-A §7003. Requirements for sale of portable electronic device insurance
Status: in_force

1. Brochures. At every location where portable electronic device insurance is offered to customers, brochures or other written materials must be made available to a prospective customer that: A. Disclose that portable electronic device insurance may provide a duplication of coverage already provided by a customer's homeowner's insurance policy, renter's insurance policy or other source of coverage; [PL 2011, c. 297, §5 (NEW).] B. State that the enrollment by the customer in a portable electronic device insurance policy is not required in order to purchase or lease a portable electronic device or service; [PL 2011, c. 297, §5 (NEW).] C. Summarize the material terms of the insurance coverage, including: (1) The identity of the insurer; (2) The identity of the supervising entity; (3) The amount of any applicable deductible and how it is to be paid; (4) Benefits of the coverage; and (5) Key terms and conditions of coverage such as whether the portable electronic device may be replaced with a similar make and model or repaired using reconditioned or nonoriginal manufacturer parts or equipment; [PL 2011, c. 297, §5 (NEW).] D. Summarize the process for filing a claim, including a description of any requirements to return the portable electronic device and the maximum fee applicable if the customer fails to comply with any equipment return requirements; and [PL 2011, c. 297, §5 (NEW).] E. State that the customer may cancel enrollment for coverage under a portable electronic device insurance policy at any time and the person paying the premium must receive a refund of any applicable unearned premium. [PL 2011, c. 297, §5 (NEW).] [PL 2011, c. 297, §5 (NEW).]

2. Periodic basis of coverage. Portable electronic device insurance may be offered on a month-to-month or other periodic basis as a group or master commercial inland marine policy issued to a vendor under which individual customers may elect to enroll for coverage. [PL 2011, c. 297, §5 (NEW).]

3. Eligibility and underwriting standards. Eligibility and underwriting standards for customers electing to enroll in coverage must be established by an insurer for each portable electronic device insurance program. [PL 2011, c. 297, §5 (NEW).]
24-A M.R.S. § 4236 — ME Code / Title 24-A / Chapter 56 / Section 4236
24-A §4236. Chiropractors in health maintenance organizations
Status: in_force

Every health maintenance organization shall include in every plan for health care services chiropractic services delivered by qualified chiropractic providers in accordance with this section. [PL 1993, c. 669, §6 (NEW).]

1. Qualifications of chiropractic providers. The health maintenance organization shall determine the qualifications of chiropractic providers using reasonable standards that are similar to and consistent with the standards applied to other providers. [PL 1993, c. 669, §6 (NEW).]

2. Benefits; discrimination. The health maintenance organization shall provide benefits covering care by chiropractic providers at least equal to and consistent with the benefits paid to other health care providers treating similar neuro-musculoskeletal conditions. A health maintenance organization may not refuse to reimburse a chiropractic provider who participates in the health maintenance organization's provider network for providing a health care service or procedure covered by the health maintenance organization as long as the chiropractic provider is acting within the lawful scope of that provider's license in the delivery of the covered service or procedure. Consistent with reasonable medical management techniques specified under the health maintenance organization's contract with respect to the method, treatment or setting for a covered service or procedure, the health maintenance organization may not discriminate based on the chiropractic provider's license. This subsection does not require a health maintenance organization to accept all chiropractic providers into a network or govern the reimbursement paid to a chiropractic provider. [PL 2015, c. 111, §3 (AMD); PL 2015, c. 111, §4 (AFF).]

3. Self-referrals for chiropractic care. A health maintenance organization must provide benefits to an enrollee who utilizes the services of a chiropractic provider by self-referral under the following conditions. A. An enrollee may utilize the services of a participating chiropractic provider within the enrollee's health maintenance organization for 3 weeks or a maximum of 12 visits, whichever occurs first, of acute care treatment without the prior approval of a primary care provider of the health maintenance organization. For purposes of this subsection, "acute care treatment" means treatment for accidental bodily injury or sudden, severe pain that affects the ability of the enrollee to engage in the normal activities, duties or responsibilities of daily living. [PL 1995, c. 350, §1 (NEW).] B. Within 3 working days of the first consultation, the participating chiropractic provider shall send to the primary care provider a report containing the enrollee's complaint, related history, examination, initial diagnosis and treatment plan. If the chiropractic provider fails to send a report to the primary care provider within 3 working days, the health maintenance organization is not obligated to provide benefits for chiropractic care and the enrollee is not liable to the chiropractic provider for any unpaid fees. [PL 1995, c. 350, §1 (NEW).] C. If the enrollee and the participating chiropractic provider determine that the condition of the enrollee has not improved after 3 weeks of treatment or a maximum of 12 visits the participating chiropractic provider shall discontinue treatment and refer the enrollee to the primary care provider. [PL 1995, c. 350, §1 (NEW).] D. If the chiropractic provider recommends treatment beyond 3 weeks or a maximum of 12 visits, the participating chiropractic provider shall send to the primary care provider a report containing information on the enrollee's progress and outlining a treatment plan for extended chiropractic care of up to 5 more weeks or a maximum of 12 more visits, whichever occurs first. [PL 1995, c. 350, §1 (NEW).] E. Without the approval of the primary care provider, an enrollee may not receive benefits for more than 36 visits to a participating chiropractic provider in a 12-month period. After a maximum of 36 visits, an enrollee's continuing chiropractic treatment must be authorized by the primary care provider. [PL 1995, c. 350, §1 (NEW).] In the provision of chiropractic services under this subsection, a participating chiropractic provider is liable for a professional diagnosis of a mental or physical condition that has resulted or may result in the chiropractic provider performing duties in a manner that endangers the health or safety of an enrollee. The provisions of this subsection apply to all health maintenance organization contracts, except a contract between a health maintenance organization and the State Employee Health Insurance Program. This subsection takes effect January 1, 1996. [PL 1997, c. 99, §1 (AMD).]
24-A M.R.S. § 1442 — ME Code / Title 24-A / Chapter 16 / Section 1442
24-A §1442. Authority of insurance producer
Status: in_force

1. Licensed insurance producer. A licensed insurance producer in this State may: A. Engage in insurance producer activities throughout this State within the authority granted the insurance producer by the insurer, health maintenance organization, fraternal benefit society, or nonprofit hospital or medical service organization and the scope of the producer's license; [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] B. Adjust the losses of the insurer or fraternal benefit society within the authority granted the insurance producer by the insurer or fraternal benefit society; [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] C. Not place or seek to place insurance coverage, other than with an insurer, health maintenance organization, fraternal benefit society or nonprofit hospital association for which the insurance producer holds an appointment, except as provided under section 1450, subsection 2 . A licensed resident or a nonresident insurance producer may not place or seek to place insurance coverage other than in an authorized insurer, health maintenance organization, fraternal benefit society or nonprofit hospital or medical service organization, except as provided in chapter 19 ; and [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] D. Enter into a contract or arrangement with a financial institution for the purpose of participating in a finance program with the financial institution. In this case, the financial institution need not be licensed as a producer, as long as the purpose of the arrangement is to authorize an insurance producer to facilitate, direct or refer insureds, prospective insureds or other customers to the financial institution for loans or for the purpose of authorizing an insurance producer to facilitate arrangements for leases, loans or credit applications with the financial institution. [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).] [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).]
24-A M.R.S. § 2382-D — ME Code / Title 24-A / Chapter 25 / Section 2382-D
24-A §2382-D. Uniform experience rating plan; merit rating plan
Status: in_force

1. Required contents. The experience rating plan required under section 2382‑C must contain: A. Reasonable eligibility standards; [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).] B. Incentives for loss prevention; [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).] C. Sufficient premium differentials to encourage safety; and [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).] D. Provisions for reasonable and equitable limitations on the ability of policyholders to avoid the impact of past adverse claims experience through change of ownership, control, management or operation. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).] [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

2. Experience rating. The uniform experience rating plan must be the exclusive means for providing premium adjustments based on the past claim experience of an insured employer. The experience rating plan must provide that the claims experience for the 3 most recent years for which data is available be considered on the following bases. A. The claims and exposure for the most recent year for which data is available must be given 40% weight. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).] B. The claims and exposure for the 2nd most recent year for which data is available must be given 35% weight. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).] C. The claims and exposure for the 3rd most recent year for which data is available must be given 25% weight. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).] If data is available for only 2 years of experience, the weighting must be 60% for the most recent year and 40% for the 2nd most recent year. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

3. Merit rating. If an insured is not eligible for the experience rating plan, a merit rating plan must be applied using the following guidelines. A. A plan must provide for the following credits or debits to be applied to the otherwise applicable manual premium, based on the number of lost-time claims of the insured during the most recent 3-year period for which statistics are available: (1) No claims or a loss ratio of less than 1.0, an 8% credit; (2) One claim resulting in a loss ratio greater than 1.0, no credit or debit; and (3) Two or more claims resulting in a loss ratio greater than 1.0, an 8% debit. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).] B. The insurer shall notify the insured of the premium adjustment and the reason for the adjustment. [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).]

4. Prior lost-time work-related injury. The experience rating or merit rating plan may not permit, in the calculation of experience modification factors, consideration of those lost-time claims attributable to work-related injuries that are aggravations of, or combine with, any prior lost-time work-related injury to produce incapacity. The superintendent shall adopt rules to protect employers from the impact of these subsequent injury claims and to equitably compensate insurers that provide coverage to these employers. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

5. Retrospective rating. Nothing in this section prevents an insurer or an advisory organization from filing rating plans that provide for retrospective premium adjustments based on the insured's experience during the policy period. Except as provided in section 2386, subsection 8 , in the voluntary market and the residual market retrospective rating plans must be voluntary and may not be used without the prior consent of the insured. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

6. Dividend plan. Nothing in this section prohibits an insurer from developing and operating a dividend plan based on the loss experience of the insured. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]
24-A M.R.S. § 4240 — ME Code / Title 24-A / Chapter 56 / Section 4240
24-A §4240. Coverage for diabetes supplies
Status: in_force

All health maintenance organization individual and group health contracts and certificates must provide coverage for the medically appropriate and necessary equipment, limited to insulin, oral hypoglycemic agents, monitors, test strips, syringes and lancets, and the out-patient self-management training and educational services used to treat diabetes, if: [PL 2003, c. 517, Pt. A, §10 (AMD); PL 2003, c. 517, Pt. A, §13 (AFF).]

1. Certification of medical necessity. The enrollee's treating physician or a physician who specializes in the treatment of diabetes certifies that the equipment and services are necessary; and [PL 1995, c. 592, §4 (NEW).]

2. Provision of medical services. The diabetes out-patient self-management training and educational services are provided through ambulatory diabetes education facilities authorized by the State's Diabetes Control Project within the Bureau of Health. [PL 1995, c. 592, §4 (NEW).]

The requirements of this section apply to all group policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 2003, c. 517, Pt. A, §10 (NEW); PL 2003, c. 517, Pt. A, §13 (AFF).] Revisor's Note: §4240. Coverage for Pap tests (As enacted by PL 1995, c. 617, §5 is REALLOCATED TO TITLE 24-A, SECTION 4242)
24-A M.R.S. § 6710 — ME Code / Title 24-A / Chapter 83 / Section 6710
24-A §6710. Legal investments
Status: in_force

A pure captive insurance company is not subject to any restrictions on allowable investments including those provided under chapter 13 and chapter 13‑A , except that the superintendent may prohibit or limit any investment that threatens the solvency or liquidity of such insurance company. A pure captive insurance company may not make a loan to or investments in its parent or affiliated companies without the prior written approval of the superintendent. A loan of any minimum capital and surplus funds required by section 6704 is prohibited. Except as otherwise authorized by the superintendent, association captive insurance companies and industrial insured captive insurance companies are subject to the restrictions on allowable investments applicable to admitted insurers transacting the same type of business. With respect to investments of association captive insurance companies, the superintendent may approve the use of alternative methods of valuation and rating. [PL 2009, c. 335, §16 (AMD).]
24-A M.R.S. § 2828 — ME Code / Title 24-A / Chapter 35 / Section 2828
24-A §2828. Time for suits
Status: in_force

There shall be a provision that no action at law or in equity shall be brought to recover on the policy prior to the expiration of 60 days after proof of loss has been filed in accordance with the requirements of the policy and that no such action shall be brought at all, unless brought within 2 years from the expiration of the time within which proof of loss is required by the policy. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2696 — ME Code / Title 24-A / Chapter 32-A / Section 2696
24-A §2696. Preexisting conditions
Status: in_force

1. Exclusion based on preexisting condition limited after 12 months. Notwithstanding the provisions of section 2706, subsection 2 , division (b), if an insurer elects to use a simplified application or enrollment form, with or without a question as to the prospective insured's health at the time of application or enrollment but without any questions concerning the prospective insured's health history or medical treatment history, the policy must cover any loss occurring after the policy has been in force for 12 months from any preexisting condition not specifically excluded from coverage by terms of the policy, and, except for such specific exclusions, the policy or certificate may not include wording that would permit a defense based upon preexisting conditions, other than rescission for affirmative misrepresentations, after it has been in force for 12 months. [PL 2001, c. 410, Pt. C, §1 (NEW).]

2. Exclusion based on preexisting condition limited after 6 months. Notwithstanding the provisions of subsection 1 and section 2706, subsection 2 , division (b), an insurer that issues a specified disease policy or certificate may not deny a claim for any covered loss that begins after the policy or certificate has been in force for at least 6 months, unless that loss results from a preexisting condition that was diagnosed by a physician before the date of application for coverage or that first manifested itself within the 6 months immediately preceding the application date. Other defenses based upon preexisting conditions are not permitted except for rescission for misrepresentation. This subsection applies regardless of whether the policy or certificate is issued on the basis of a detailed application form, a simplified application form or an enrollment form. [PL 2007, c. 199, Pt. G, §1 (AMD).]
24-A M.R.S. § 2849-A — ME Code / Title 24-A / Chapter 36 / Section 2849-A
24-A §2849-A. Extension of benefits for disabled persons
Status: in_force

1. Policies subject to this section. This section applies to group and blanket policies that provide hospital or medical expense coverage or specific indemnity during hospital confinement. This section does not apply to group policies providing coverage only for dental expense or to group long-term care policies as defined in section 5051 or group short-term and long-term disability policies. [PL 1999, c. 256, Pt. L, §5 (AMD).]

2. Requirement. Every group or blanket policy subject to this section must provide a reasonable extension of benefits for a person who is totally disabled on the date the group or blanket policy is discontinued, or on the date coverage for a subgroup in the policy is discontinued. A premium may not be charged during the period of extension. For a policy providing hospital or medical expense coverage, an extension of benefits provision is reasonable if it provides benefits for covered expenses directly relating to the condition causing total disability for at least 6 months following the effective date of discontinuance. For a policy providing specific indemnity during hospital confinement, "extension of benefits" means that discontinuance of the policy during a disability has no effect on benefits payable for that confinement. [PL 2007, c. 199, Pt. D, §2 (AMD).]

3. Description of benefit extension. The extension of benefits provision must be described in all policies and group certificates. The benefits payable during any period of extension are subject to the regular benefit limits under the policy. [PL 1989, c. 867, §8 (NEW); PL 1989, c. 867, §10 (AFF).]

4. Liability after discontinuance. After discontinuance of a policy, the insurer or health maintenance organization remains liable only to the extent of its accrued liabilities and extensions of benefits. [PL 1997, c. 604, Pt. H, §1 (AMD).]

4-A. Coordination of benefits. If replacement coverage is secured by the group or blanket policyholder from an insurer, nonprofit hospital or medical service organization or health maintenance organization and a totally disabled person is covered under the replacement coverage, the replacement coverage must pay as primary coverage and the replaced coverage must pay as secondary coverage for the covered expenses directly relating to the condition causing total disability during the extension of benefits required under this section. [PL 2007, c. 199, Pt. D, §3 (AMD).]

5. Rules. The superintendent shall adopt rules to define the term "total disability" for purposes of this section. The definition must identify persons who are unable, as a result of disability, to obtain comparable alternative coverage through comparable employment or otherwise. [PL 1989, c. 867, §8 (NEW); PL 1989, c. 867, §10 (AFF).]
24-A M.R.S. § 6708 — ME Code / Title 24-A / Chapter 83 / Section 6708
24-A §6708. Examinations and investigations
Status: in_force

1. Powers, authorities and duties of superintendent. The powers, authorities and duties relating to examinations and investigations are vested in and imposed upon the superintendent in order for the superintendent to verify that all captive insurance companies operate in accordance with the provisions of this chapter. [PL 2011, c. 90, Pt. I, §6 (AMD).]

2. Confidentiality of examinations documents. All examination reports, preliminary examination reports or results, working papers, recorded information, documents and copies of any of these produced by, obtained by or disclosed to the superintendent or any other person in the course of an examination made under this section are confidential and are not subject to subpoena and may not be made public by the superintendent or any other person, except to the extent provided in this subsection. The superintendent may grant access to such information to public officers having jurisdiction over the regulation of insurance in any other state or country or to law enforcement officers of this State or any other state or agency of the Federal Government at any time, as long as the officers receiving the information agree in writing to hold it in a manner consistent with this subsection. [PL 1997, c. 435, §1 (NEW).]

3. Examinations. At least once in 3 years, and whenever the superintendent determines it to be prudent, the superintendent shall personally, or by some competent person appointed by the superintendent, visit each captive insurance company and thoroughly inspect and examine its affairs to ascertain its financial condition, its ability to fulfill its obligations and whether it has complied with the provisions of this chapter. The superintendent may enlarge the 3-year period to 5 years, as long as the captive insurance company is subject to a comprehensive annual audit during the period of a scope satisfactory to the superintendent by independent auditors approved by the superintendent. The expenses and charges of the examination must be paid to the State by the company or companies examined. [PL 2009, c. 335, §13 (NEW).]
24-A M.R.S. § 2771 — ME Code / Title 24-A / Chapter 34 / Section 2771
24-A §2771. Review entities
Status: in_force

1. Licensure. A person, partnership or corporation, other than an insurer, nonprofit service organization, health maintenance organization, preferred provider organization or employee of those exempt organizations, that performs medical utilization review services on behalf of commercial insurers, nonprofit service organizations, 3rd-party administrators, health maintenance organizations, preferred provider organizations or employers shall apply for licensure by the Bureau of Insurance and pay an application fee of not more than $400 and an annual license fee of not more than $100; except that programs of review of medical services for occupational claims compensated under Title 39‑A are subject only to the certification requirements of that title and are not subject to licensure under this section. A person, partnership or corporation, other than an insurer or nonprofit service organization, health maintenance organization, preferred provider organization or the employees of exempt organizations, may not perform utilization review services or medical utilization review services unless the person, partnership or corporation has received a license to perform those activities. [PL 1995, c. 332, Pt. M, §5 (AMD).]

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

3. Information required. Each person, partnership or corporation licensed pursuant to this section shall, at the time of initial licensure and on or before April 1st of each succeeding year, provide the Bureau of Insurance with the following information: A. The process by which the entity carries out its utilization review services. The information provided to the bureau must include the categories of health care personnel that perform any activities coming under the definition of utilization review and whether or not these individuals are licensed in the State. The information provided to the bureau also must include copies of any licensure agreements the utilization review entity has in effect with any entity that sells or furnishes the utilization review entity with medical utilization review criteria and the expiration date of any such agreements. If the utilization review entity develops its own medical utilization review criteria, the utilization review entity shall include copies of any policies and procedures or both for the use of the criteria; [PL 1995, c. 332, Pt. M, §6 (AMD).] B. The process used by the entity for addressing beneficiary or provider complaints; [PL 1989, c. 556, Pt. C, §2 (NEW).] C. The types of utilization review programs offered by the entity, such as: (1) Second opinion programs; (2) Prehospital admission certification; (3) Preinpatient service eligibility determination; or (4) Concurrent hospital review to determine appropriate length of stay; and [PL 1989, c. 556, Pt. C, §2 (NEW).] D. The process chosen by the entity to preserve beneficiary confidentiality of medical information. [PL 1989, c. 556, Pt. C, §2 (NEW).] As part of its initial application, the entity shall submit copies of all materials to be used to inform beneficiaries and providers of the requirements of its utilization review plans and their rights and responsibilities under the plan. [PL 1995, c. 332, Pt. M, §6 (AMD).]

4. Transition for existing entities. Notwithstanding subsection 1 , persons, partnerships or corporations performing utilization review services on the effective date of this section shall have 90 days from its effective date to submit an application to the superintendent. The superintendent shall act upon those applications within 6 months of the date of receipt of the application, during which time the review entities may continue to perform medical utilization review services. [PL 1989, c. 556, Pt. C, §2 (NEW).]
24-A M.R.S. § 4358 — ME Code / Title 24-A / Chapter 57 / Section 4358
24-A §4358. Grounds for conservation, foreign and alien insurers
Status: in_force

The superintendent may apply to the court for an order appointing the superintendent as receiver or ancillary receiver and directing the superintendent to conserve the assets within this State of a foreign or alien insurer upon any of the applicable grounds specified in section 4356 or 4357 or upon the ground that the insurer's property has been sequestrated in its domiciliary sovereignty or in any other sovereignty; or, in the case of an alien insurer, that the insurer has failed to make good an impairment of its trusteed funds within the time required therefor by order of the superintendent. [RR 2021, c. 2, Pt. A, §82 (COR).]
24-A M.R.S. § 2850 — ME Code / Title 24-A / Chapter 36 / Section 2850
24-A §2850. Limitations on exclusion and waiting periods
Status: in_force

1. Application. This section applies to individual, group and blanket medical insurance contracts subject to chapters 33 and 35 , except Medicare supplement contracts, converted contracts issued under section 2809‑A and contracts designed to cover specific diseases, hospital indemnity or accidental injury only. [PL 1999, c. 256, Pt. L, §8 (AMD).]

1-A. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Date of enrollment" means the effective date of coverage or, if earlier, the first day of the waiting period for such coverage. [PL 2001, c. 258, Pt. E, §9 (NEW).] B. "Preexisting condition exclusion," with respect to coverage, means a limitation or exclusion of benefits relating to a condition based on the fact or perception that the condition was present, or that the person was at particularized risk of developing the condition, before the date of enrollment for coverage, whether or not any medical advice, diagnosis, care or treatment was recommended or received before that date. [PL 2001, c. 258, Pt. E, §9 (NEW).] [PL 2001, c. 258, Pt. E, §9 (RPR).]

2. Limitation. An individual, group or blanket contract issued by an insurer may not impose a preexisting condition exclusion. This subsection does not limit a carrier's ability to restrict enrollment in an individual contract to open enrollment and special enrollment periods in accordance with section 2736‑C, subsection 11 . A. [PL 2019, c. 5, Pt. A, §16 (RP).] B. [PL 2019, c. 5, Pt. A, §16 (RP).] C. [PL 2019, c. 5, Pt. A, §16 (RP).] D. [PL 2019, c. 5, Pt. A, §16 (RP).] E. [PL 2019, c. 5, Pt. A, §16 (RP).] F. [PL 2019, c. 5, Pt. A, §16 (RP).] [PL 2019, c. 5, Pt. A, §16 (AMD).]
24-A M.R.S. § 4139-A — ME Code / Title 24-A / Chapter 55 / Section 4139-A
24-A §4139-A. Funeral service contracts
Status: in_force

Every society is subject to the provisions of section 2176 . [PL 1989, c. 206, §3 (NEW).]
24-A M.R.S. § 2831 — ME Code / Title 24-A / Chapter 35 / Section 2831
24-A §2831. Hospital, medical benefits; direct payment
Status: in_force

Any such group or blanket policy may include benefits payable on account of hospital or medical or surgical aid for an employee or other member of the group insured by such policy, the employee's or other member's spouse, child or children or other dependents, and may provide that, at the insured's option, any such benefits be paid by the insurer directly to the hospital, physician, surgeon doctor, nurse or other person furnishing services covered by such provisions of the policy. [RR 2021, c. 1, Pt. B, §247 (COR).]
24-A M.R.S. § 1901 — ME Code / Title 24-A / Chapter 18 / Section 1901
24-A §1901. Definitions
Status: in_force

As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]

1. "Administrator" means any person who, on behalf of a plan sponsor, health care service plan, health maintenance organization or insurer, receives or collects charges, contributions or premiums for, or adjusts or settles claims on residents of this State in connection with any type of life, annuity, health, workers' compensation or employee benefit excess insurance benefit provided in or as an alternative to insurance as defined by sections 702 to 704 , former Title 39 or Title 39‑A , other than any of the following: A. An employer on behalf of the employer's employees or the employees of one or more subsidiary or affiliated corporations of the employer; [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] B. A union on behalf of its members; [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] C. A plan sponsor administering its own plan; [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] D. An insurance company that is: (1) Authorized to transact insurance business in this State; or (2) Acting as an insurer with respect to a policy lawfully issued and delivered by that company in and pursuant to the laws of a state in which the insurer was authorized to transact an insurance business; [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] E. A nonprofit hospital, medical or health care services plan, health maintenance organization, professional service plan corporation or person in the business of providing continuing care, possessing a valid certificate of authority issued by the Bureau of Insurance, and the sole representative of that person, plan, organization or corporation, if the activities of the plan, organization, corporation or person are limited to the activities permitted under the certificate of authority; [PL 1993, c. 702, Pt. A, §10 (AMD).] F. An insurance agent or broker licensed in this State, whose activities are limited to the scope of that license; [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] G. An adjuster licensed in this State, whose activities are limited to the adjustment of claims; [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] H. A creditor on behalf of the creditor's debtors with respect to insurance covering a debt between the creditor and its debtors; [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] I. A trust and its trustees, agents, and employees acting pursuant to a trust established in conformity with 29 United States Code, Section 186; [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] J. A trust exempt from taxation under the federal Internal Revenue Code of 1986, Section 501(a), and the trustees and employees acting pursuant to that trust, or a custodian and its agents and employees, including individuals representing the trustees in overseeing the activities of a service company or administrator, acting pursuant to a custodial account that meets the requirements of the federal Internal Revenue Code of 1986, Section 401(f); [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] K. A financial institution or a mortgage lender that collects and remits premiums to licensed insurance agents or authorized insurers concurrently or in connection with mortgage loan payments; [PL 1997, c. 457, §28 (AMD).] L. A credit card issuing company that advances for and collects premiums or charges from its credit card holders who have authorized that collection if the company does not adjust or settle claims; [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).] M. A person who adjusts or settles claims in the normal course of that person's practice or employment as an attorney and who does not collect charges or premiums in connection with life or health insurance coverage; [PL 1995, c. 673, Pt. A, §1 (AMD).] N. A person acting as a trustee, named fiduciary or plan official of an employee benefit plan within the meaning of the federal Employee Retirement Income Security Act of 1974, as amended, 29 United States Code, Section 1001, et seq.; and [PL 1995, c. 673, Pt. A, §1 (AMD).] O. A private purchasing alliance licensed in accordance with chapter 18‑A . [PL 1995, c. 673, Pt. A, §2 (NEW).] Notwithstanding any other provision of this subsection, "administrator" includes any administrator of a preferred provider arrangement required to register under this chapter pursuant to section 2674‑A . [PL 2003, c. 428, Pt. C, §1 (AMD).]

2. "ATF" means an administrator trust fund that is a special fiduciary account, established and maintained by an administrator under section 1909 , in which contributions and premiums are deposited. [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]

3. "CASA" means a claims administration services account that is a special fiduciary account, established and maintained by an administrator under section 1909 , from which claims and claims adjustment expenses are disbursed. [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]

4. "Charges" means any compensation paid by a plan sponsor, health care service plan, health maintenance organization or insurer for services performed by the administrator. [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]

5. "Contributions" means the value of funds that have been provided or are to be applied by a plan sponsor or other entity to fund the self-insured portion of any plan, or premiums charged to a plan sponsor or other entity by an insurer for coverage under contracts of insurance or excess insurance. Contributions include administrative fees charged to a covered individual. "Administrative fee" means any compensation paid by a covered individual for services performed by the administrator. [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]

6. "Covered individual" means any individual eligible for life, annuity, workers' compensation or health benefits under a plan. [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]

7. "Plan" means any plan, fund or program established or maintained by a plan sponsor, health care service plan, health maintenance organization or insurer to the extent that the plan, fund or program was established or is maintained to provide through insurance or alternatives to insurance any type of life, annuity, health or workers' compensation benefit within the scope of sections 702 to 704 , former Title 39 or Title 39‑A . [PL 1991, c. 885, Pt. E, §26 (AMD); PL 1991, c. 885, Pt. E, §47 (AFF).]

8. "Plan sponsor" means any person, other than an insurer, who establishes or maintains a plan covering residents of this State, including, but not limited to, plans established or maintained by 2 or more employers or jointly by one or more employers and one or more employee organizations, the association, committee, joint board of trustees or other similar group of representatives of the parties that establish or maintain the plan. [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]

9. "Premium" means any money charged a covered individual, plan sponsor or other entity to provide life, accident, workers' compensation or health insurance under a plan. The term "premium" includes amounts paid by or charged to a covered individual plan sponsor or other entity for stop loss or excess insurance. [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]

10. "Quasi-resident" means a nonresident licensee who receives or collects 50% or more of calendar year contributions, premium volume or other funds subject to administration from plan sponsors or insureds resident in this State. [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]
24-A M.R.S. § 2902-E — ME Code / Title 24-A / Chapter 39 / Section 2902-E
24-A §2902-E. Limitation on surcharge
Status: in_force

An insurer may not impose a surcharge or otherwise increase the rate for a motor vehicle insurance policy solely on the basis that the named insured, a member of the insured's household or a person who customarily operates the insured's vehicle has had an operator's license suspended pursuant to Title 28‑A, sections 2052 and 2053 . [PL 1993, c. 93, §1 (NEW).]
24-A M.R.S. § 2001-A — ME Code / Title 24-A / Chapter 19 / Section 2001-A
24-A §2001-A. Scope
Status: in_force

Except as provided by section 2002‑A, subsection 1 , this chapter applies exclusively to transactions when this State is the home state of the applicant or insured. Nothing in this chapter applies to the sale, solicitation, negotiation, placement or writing of contracts of insurance for eligible lines of business for any applicant or insured whose home state is in a jurisdiction other than in this State. [PL 2025, c. 348, §11 (AMD).]
24-A M.R.S. § 1161 — ME Code / Title 24-A / Chapter 13-A / Section 1161
24-A §1161. Investments of foreign insurers
Status: in_force

The investment portfolio of a foreign or alien insurer shall be as permitted by the laws of its domicile, if of a quality substantially equal to that required under this chapter for similar funds of like domestic insurers. [PL 1987, c. 399, §14 (NEW).]
24-A M.R.S. § 2263 — ME Code / Title 24-A / Chapter 24-B / Section 2263
24-A §2263. Definitions
Status: in_force

As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 2021, c. 24, §1 (NEW).]

1. Authorized individual. "Authorized individual" means an individual whose access to the nonpublic information held by a licensee and its information systems is authorized and determined by the licensee to be necessary and appropriate. [PL 2021, c. 24, §1 (NEW).]

1-A. Ancillary service provider. "Ancillary service provider" means a person that is not a licensee and that contracts with a 3rd-party service provider or with another ancillary service provider to maintain, process or store nonpublic information obtained from the licensee or is otherwise permitted access to nonpublic information obtained from the licensee through its provision of services to the 3rd-party service provider or other ancillary service provider. [PL 2025, c. 348, §29 (NEW).]

2. Consumer. "Consumer" means an individual, including but not limited to an applicant for insurance, policyholder, insured, beneficiary, claimant or certificate holder, who is a resident of this State and whose nonpublic information is in a licensee's possession, custody or control. [PL 2021, c. 24, §1 (NEW).]

3. Cybersecurity event. "Cybersecurity event" means an event resulting in unauthorized access to, disruption of or misuse of an information system or information stored on an information system. "Cybersecurity event" does not include the unauthorized acquisition of encrypted nonpublic information if the encryption process or key is not also acquired, released or used without authorization. "Cybersecurity event" does not include an event with regard to which the licensee has determined that the nonpublic information accessed by an unauthorized person has not been used or released and has been returned or destroyed. [PL 2021, c. 24, §1 (NEW).]

4. Encrypted. "Encrypted," with respect to data, means that the data has been transformed into a form that results in a low probability of assigning meaning without the use of a protective process or key. [PL 2021, c. 24, §1 (NEW).]

5. Information security program. "Information security program" means the administrative, technical and physical safeguards that a licensee uses to access, collect, distribute, process, protect, store, use, transmit, dispose of or otherwise handle nonpublic information. [PL 2021, c. 24, §1 (NEW).]

6. Information system. "Information system" means a discrete set of electronic information resources organized for the collection, processing, maintenance, use, sharing, dissemination or disposition of electronic information, as well as any specialized system such as an industrial or process control system, a telephone switching and private branch exchange system or an environmental control system. [PL 2021, c. 24, §1 (NEW).]

7. Insurance carrier. "Insurance carrier" has the same meaning as in section 2204, subsection 15 . [PL 2021, c. 24, §1 (NEW).]

8. Licensee. "Licensee" means a person licensed, authorized to operate or registered or required to be licensed, authorized or registered pursuant to the insurance laws of this State. "Licensee" does not include a purchasing group or a risk retention group chartered and licensed in a state other than this State or a licensee that is acting as an assuming insurer and is domiciled in another state or jurisdiction. [PL 2021, c. 24, §1 (NEW).]

9. Multifactor authentication. "Multifactor authentication" means authentication through verification of at least 2 of the following types of authentication factors: A. Knowledge factors, such as a password; [PL 2021, c. 24, §1 (NEW).] B. Possession factors, such as a token or text message on a mobile telephone; and [PL 2021, c. 24, §1 (NEW).] C. Inherence factors, such as a biometric characteristic. [PL 2021, c. 24, §1 (NEW).] [PL 2021, c. 24, §1 (NEW).]

10. Nonpublic information. "Nonpublic information" means information that is not publicly available information and is: A. Business-related information of a licensee the tampering with or unauthorized disclosure of, access to or use of which would materially and adversely affect the business, operations or security of the licensee; [PL 2021, c. 24, §1 (NEW).] B. Information that, because of name, number, personal mark or other identifier, can be used in combination with any one or more of the following data elements to identify a consumer: (1) Social security number; (2) Driver's license number or nondriver identification card number; (3) Financial account number or credit or debit card number; (4) Any security code, access code or password that would permit access to a consumer's financial account; or (5) Biometric records; or [PL 2021, c. 24, §1 (NEW).] C. Information or data, except age or gender, in any form or medium created by or derived from a health care provider or a consumer and that relates to: (1) The past, present or future physical, mental or behavioral health or condition of a consumer or a member of the consumer's family; (2) The provision of health care to a consumer; or (3) Payment for the provision of health care to a consumer. [PL 2021, c. 24, §1 (NEW).] "Nonpublic information" does not include a consumer's personally identifiable information that has been anonymized using a method no less secure than the so-called safe harbor method under the federal Health Insurance Portability and Accountability Act of 1996, Public Law 104-191. [PL 2021, c. 24, §1 (NEW).]

11. Publicly available information. "Publicly available information" means information that a licensee has a reasonable basis to believe is lawfully made available to the general public from: A. Federal, state or local government records; [PL 2021, c. 24, §1 (NEW).] B. Widely distributed media; or [PL 2021, c. 24, §1 (NEW).] C. Disclosures to the general public that are required to be made by federal, state or local law. [PL 2021, c. 24, §1 (NEW).] For the purposes of this definition, a licensee has a reasonable basis to believe that information is lawfully made available to the general public if the licensee has taken steps to determine that the information is of a type that is available to the general public and if a consumer can direct that the information not be made available to the general public and, if so, that the consumer has not done so. [PL 2021, c. 24, §1 (NEW).]

12. Risk assessment. "Risk assessment" means the risk assessment that a licensee is required to conduct under section 2264, subsection 3 . [PL 2021, c. 24, §1 (NEW).]

13. Third-party service provider. "Third-party service provider" means a person that is not a licensee and that contracts with a licensee to maintain, process or store or otherwise is permitted access to nonpublic information through its provision of services to the licensee. [PL 2021, c. 24, §1 (NEW).]
24-A M.R.S. § 2744 — ME Code / Title 24-A / Chapter 33 / Section 2744
24-A §2744. Mental health services
Status: in_force

1. Notwithstanding any provision of a health insurance policy subject to this chapter, whenever the policy provides for payment or reimbursement for services that are within the lawful scope of practice of a professional listed in subsection 2‑A , any person covered by the policy is entitled to reimbursement for these services if the services are performed by a physician or a professional listed in subsection 2‑A . Payment or reimbursement for services rendered by a professional listed in subsection 2‑A, paragraph B , C , D , E or F may not be conditioned upon prior diagnosis or referral by a physician or other health care professional, except when diagnosis of the condition for which the services are rendered is beyond the scope of their licensure. [PL 2005, c. 683, Pt. A, §39 (RPR).]

2. Nothing in subsection 1 may be construed to require a health insurance policy subject to this chapter to provide for reimbursement of services that are within the lawful scope of practice of a professional listed in subsection 2‑A . [PL 2005, c. 683, Pt. A, §39 (RPR).]

2-A. Subsections 1 and 2 apply with respect to the following types of professionals: A. A psychologist licensed to practice in this State; [PL 2005, c. 683, Pt. A, §39 (RPR).] B. A certified social worker licensed for the independent practice of social work in this State; [PL 2005, c. 683, Pt. A, §39 (RPR).] C. A licensed clinical professional counselor licensed for the independent practice of counseling in this State; [PL 2005, c. 683, Pt. A, §39 (RPR).] D. A licensed nurse who is certified by the American Nurses' Association as a clinical specialist in adult psychiatric and mental health nursing or as a clinical specialist in child and adolescent psychiatric and mental health nursing; [PL 2005, c. 683, Pt. A, §39 (RPR).] E. A marriage and family therapist licensed as a marriage and family therapist in this State; and [PL 2005, c. 683, Pt. A, §39 (NEW).] F. A licensed pastoral counselor licensed as a pastoral counselor in this State. [PL 2005, c. 683, Pt. A, §39 (NEW).] [PL 2005, c. 683, Pt. A, §39 (RPR).]

3. Mental health services provided by counseling professionals. Except as provided in subsection 1 with regard to reimbursement of clinical professional counselors, pastoral counselors and marriage and family therapists licensed in this State, an insurer that issues individual health care contracts providing coverage for mental health services shall offer coverage for those services when performed by a counseling professional who is licensed by the State pursuant to Title 32, chapter 119 to assess and treat interpersonal and intrapersonal problems, has at least a master's degree in counseling or a related field from an accredited educational institution and has been employed as a counselor for at least 2 years. Any contract providing coverage for the services of counseling professionals pursuant to this section may be subject to any reasonable limitations, maximum benefits, coinsurance, deductibles or exclusion provisions applicable to overall benefits under the contract. This subsection applies to all contracts executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 1997. For purposes of this subsection, all contracts are deemed renewed no later than the next yearly anniversary of the contract date. [PL 2005, c. 683, Pt. A, §39 (RPR).]
24-A M.R.S. § 4233-B — ME Code / Title 24-A / Chapter 56 / Section 4233-B
24-A §4233-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 or group health maintenance organization contract. A. [PL 2019, c. 5, Pt. A, §18 (RP).] B. [PL 2019, c. 5, Pt. A, §18 (RP).] C. [PL 2019, c. 5, Pt. A, §18 (RP).] D. [PL 2007, c. 514, §13 (RP).] [PL 2019, c. 5, Pt. A, §18 (AMD).]

2. Offer of coverage. An individual or group health maintenance organization contract that offers coverage for a dependent child must offer such coverage, at the option of the parent, until the dependent child attains 26 years of age. If the dependent child has a disability, the contract must offer coverage in accordance with section 4233‑C . [PL 2021, c. 520, §5 (AMD).]

3. Notice. [PL 2007, c. 514, §15 (NEW); MRSA T. 24-A §4233-B, sub-§3 (RP).]
24-A M.R.S. § 2404 — ME Code / Title 24-A / Chapter 27 / Section 2404
24-A §2404. Insurable interest -- personal insurance
Status: in_force

1. Any individual of competent legal capacity may procure or effect an insurance contract upon the individual's own life or body for the benefit of any person. But a person may not procure or cause to be procured any insurance contract upon the life or body of another individual unless the benefits under such contract are payable to the individual insured or the individual insured's personal representatives, or to a person having, at the time when such contract was made, an insurable interest in the individual insured. [RR 2021, c. 1, Pt. B, §207 (COR).]

2. If the beneficiary, assignee, or other payee under any contract made in violation of this section receives from the insurer any benefits thereunder accruing upon the death, disablement or injury of the individual insured, the individual insured or the individual insured's executor or administrator, as the case may be, may maintain an action to recover such benefits from the person so receiving them. [RR 2021, c. 1, Pt. B, §208 (COR).]

3. "Insurable interest" as to such personal insurance means that every individual has an insurable interest in the individual's own life, body, and health, and that a person has an insurable interest in other individuals as follows: A. In the case of individuals related closely by blood or by law, a substantial interest engendered by love and affection; [PL 1969, c. 132, §1 (NEW).] B. In the case of other persons, a lawful and substantial economic interest in having the life, health or bodily safety of the individual insured continue, as distinguished from an interest which would arise only by, or would be enhanced in value by, the death, disablement or injury of the individual insured; [PL 1989, c. 353, §1 (AMD).] C. A party to a contract or option for the purchase or sale, including a redemption, of an interest in a business proprietorship, partnership or firm, or of shares of stock of a corporation or of an interest in these shares, has an insurable interest in the life, body and health of each individual party to that contract or option, and for the purposes of that contract or option only, in addition to any insurable interest that may otherwise exist as to that individual; [PL 1993, c. 320, §1 (AMD); PL 1993, c. 320, §4 (AFF).] D. A corporation has an insurable interest in the lives of its employees, former employees and retirees for the purpose of funding, in the aggregate, all or part of the corporation's cost for preretirement and postretirement medical, death, disability and pension benefits to its employees, former employees, retirees or their beneficiaries, as long as an insurance program used to finance these employee benefits includes former employees, retirees or a broad class of employees selected by objective standards related to age, service, sex or category of employment and that the proceeds created by that insurance program are used for the sole purpose of funding the corporation's preretirement or postretirement benefit programs covering at least a broad class of employees; and [RR 2011, c. 2, §30 (COR).] E. Any revocable or irrevocable trust has an insurable interest, provided any settlor or any beneficiary of the trust has an insurable interest as provided in paragraph A , B , C or D . A partnership has an insurable interest provided any partner has an insurable interest. [PL 2003, c. 173, §1 (AMD).] [RR 2011, c. 2, §30 (COR).]

4. An insurer shall be entitled to rely upon all statements, declarations and representations made by an applicant for insurance relative to the insurable interest of the applicant in the insured; and no insurer shall incur legal liability except as set forth in the policy, by virtue of any untrue statements, declarations or representations so relied upon in good faith by the insurer. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2522 — ME Code / Title 24-A / Chapter 29 / Section 2522
24-A §2522. Dividends -- annuities
Status: in_force

If an annuity or pure endowment contract, other than a reversionary, survivorship, or group annuity, is participating, there shall be a provision that the insurer shall annually ascertain and apportion any divisible surplus accruing on the contract. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 1254 — ME Code / Title 24-A / Chapter 15 / Section 1254
24-A §1254. Depositary; records
Status: in_force

1. Deposits made in this State under this Title shall be made through the superintendent with the Treasurer of State. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

2. The Treasurer of State shall furnish the superintendent, for delivery to the depositing insurer, the Treasurer of State's official certificate identifying the securities deposited, the amount and par value of each, and the Treasurer of State's opinion of their value. [RR 2021, c. 1, Pt. B, §193 (COR).]

3. The superintendent shall keep a record of the securities comprising the deposit of each insurer, showing as far as practical the amount and market value of each item, and all the superintendent's transactions relative thereto. [RR 2021, c. 1, Pt. B, §194 (COR).]
24-A M.R.S. § 2164-E — ME Code / Title 24-A / Chapter 23 / Section 2164-E
24-A §2164-E. Disclosure of coverage limits to claimant; penalty
Status: in_force

Upon written request by a claimant or the claimant's attorney, an insurer doing business in this State shall provide the claimant or the claimant's attorney with the liability coverage limits of that insurer's insured. The insurer must provide the liability coverage limits within 60 days of receipt of the written request. [PL 2009, c. 189, §1 (NEW).]

An insurer who fails to comply with this section is subject to a penalty of $500, plus reasonable attorney's fees and expenses incurred in obtaining the liability coverage limits. [PL 2009, c. 189, §1 (NEW).]
24 M.R.S. § 2302-B — ME Code / Title 24 / Chapter 19 / Section 2302-B
24 §2302-B. Penalty for failure to notify of hospitalization
Status: in_force

A contract issued by a nonprofit hospital or medical services organization may not include a provision permitting the organization to impose a penalty for the failure of any person to notify the organization of a covered person's hospitalization for emergency treatment. For purposes of this section, "emergency treatment" has the same meaning as defined in Title 22, section 1829 . [PL 1995, c. 332, Pt. M, §1 (RPR).]

This section applies to contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State on or after the effective date of this section. 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. 332, Pt. M, §1 (RPR).]
24-A M.R.S. § 4320-I — ME Code / Title 24-A / Chapter 56-A / Section 4320-I
24-A §4320-I. Coverage for the cost of testing for bone marrow donation suitability
Status: in_force

1. Required coverage. A carrier offering a health plan in this State shall provide coverage for laboratory fees up to $150 arising from human leukocyte antigen testing performed to establish bone marrow transplantation suitability in accordance with the following requirements: A. The enrollee covered under the health plan must meet the criteria for testing established by the National Marrow Donor Program, or its successor organization; [PL 2013, c. 603, §1 (NEW); PL 2013, c. 603, §2 (AFF).] B. The testing must be performed in a facility that is accredited by a national accrediting body with requirements that are substantially equivalent to or more stringent than those of the College of American Pathologists and is certified under the federal Clinical Laboratories Improvement Act of 1967, 42 United States Code, Section 263a; [PL 2013, c. 603, §1 (NEW); PL 2013, c. 603, §2 (AFF).] C. At the time of the testing, the enrollee covered under the health plan must complete and sign an informed consent form that authorizes the results of the test to be used for participation in the National Marrow Donor Program, or its successor organization, and acknowledges a willingness to be a bone marrow donor if a suitable match is found; and [PL 2013, c. 603, §1 (NEW); PL 2013, c. 603, §2 (AFF).] D. The carrier may limit each enrollee to one test per lifetime. [PL 2013, c. 603, §1 (NEW); PL 2013, c. 603, §2 (AFF).] [PL 2013, c. 603, §1 (NEW); PL 2013, c. 603, §2 (AFF).]

2. Prohibition on cost-sharing. A carrier may not impose any deductible, copayment, coinsurance or other cost-sharing requirement on an enrollee for the coverage required under this section. [PL 2013, c. 603, §1 (NEW); PL 2013, c. 603, §2 (AFF).]
24-A M.R.S. § 4407 — ME Code / Title 24-A / Chapter 57 / Section 4407
24-A §4407.  Penalty for refusal to deliver property, etc.
Status: in_force

Any person having possession or custody of and refusing to deliver to the superintendent or the superintendent's representative upon request any of the property, books, accounts, documents or other records of an insurer against which a seizure order or a summary order has been issued by the superintendent or by the court, as provided under sections 4401 to 4406 , is upon conviction thereof subject to a fine of not over $10,000 or imprisonment for less than one year, or by both such fine and imprisonment. [RR 2021, c. 1, Pt. B, §386 (COR).]
24-A M.R.S. § 4431 — ME Code / Title 24-A / Chapter 57 / Section 4431
24-A §4431. Short title
Status: in_force

This subchapter shall be known and may be cited as the Maine Insurance Guaranty Association Act. [PL 1969, c. 561 (NEW).]
24-A M.R.S. § 3556 — ME Code / Title 24-A / Chapter 49 / Section 3556
24-A §3556. General provisions
Status: in_force

1. Presumption. In any action or proceeding it shall be presumed that an acute emergency existing within any city or county within this State constitutes an acute emergency affecting every insurance organization doing business within such city or county. [PL 1969, c. 132, §1 (NEW).]

2. Powers of board. During an acute emergency the board of a domestic insurance organization which has adopted emergency bylaws approved by the superintendent shall have all of the powers conferred by such bylaws, and no other or different powers with respect to the subject matter of this chapter, and the board of a domestic insurance organization which has not adopted emergency bylaws approved by the superintendent shall have all of the powers of an emergency board of directors as the same are provided for under this chapter. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 1422 — ME Code / Title 24-A / Chapter 16 / Section 1422
24-A §1422. License to be issued only on compliance
Status: in_force

The superintendent may not issue or permit any license of an applicant who is not in compliance with or who has not established qualifications in accordance with the applicable provisions of this chapter. [PL 2001, c. 259, §26 (AMD).]
24-A M.R.S. § 3868 — ME Code / Title 24-A / Chapter 53 / Section 3868
24-A §3868. Subscribers' liability
Status: in_force

1. The liability of each subscriber, other than as to a nonassessable policy, for the obligations of the reciprocal insurer shall be an individual, several and proportionate liability, and not joint. [PL 1969, c. 132, §1 (NEW).]

2. Except as to a nonassessable policy, each subscriber has a contingent assessment liability, in the amount provided for in the power of attorney or in the subscribers' agreement, for payment of actual losses and expenses incurred while the subscriber's policy was in force. Such contingent liability may be at the rate of not less than one nor more than 10 times the premium or premium deposit stated in the policy, and the maximum aggregate thereof must be computed in the manner set forth in section 3872 . [RR 2021, c. 1, Pt. B, §315 (COR).]

3. Each assessable policy issued by the insurer shall contain a statement of the contingent liability, set in type of the same prominence as the insuring clause. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2617 — ME Code / Title 24-A / Chapter 31 / Section 2617
24-A §2617. Insurability
Status: in_force

The group life insurance policy must contain a provision setting forth the conditions, if any, under which the insurer reserves the right to require a person eligible for insurance to furnish evidence of individual insurability satisfactory to the insurer as a condition to part or all of the individual's coverage. [RR 2021, c. 1, Pt. B, §229 (COR).]
24-A M.R.S. § 4242 — ME Code / Title 24-A / Chapter 56 / Section 4242
24-A §4242. Coverage for Pap tests (REALLOCATED FROM TITLE 24-A, SECTION 4240)
Status: in_force

(REALLOCATED FROM TITLE 24-A, SECTION 4240)

All health maintenance organization plan contracts and certificates must provide coverage for screening Pap tests recommended by a physician. [PL 2003, c. 517, Pt. A, §12 (AMD); PL 2003, c. 517, Pt. A, §13 (AFF).]
24-A M.R.S. § 6604 — ME Code / Title 24-A / Chapter 81 / Section 6604
24-A §6604. Filing requirements
Status: in_force

The sponsoring association shall file with the superintendent an application for authorization of the arrangement upon a form to be furnished by the superintendent. The application must include or have attached the following: [PL 1993, c. 688, §1 (NEW).]

1. Constitution or bylaws. A copy of the constitution or bylaws of the association; [PL 1993, c. 688, §1 (NEW).]

2. Identification of trustees. The names and addresses of the trustees of the arrangement; [PL 1993, c. 688, §1 (NEW).]

3. Document governing operation. A copy of the declaration of trust, trust agreement and any other documents that govern the operation of the arrangement; [PL 1993, c. 688, §1 (NEW).]

4. Evidence of benefits provided. A copy of the employer participation agreement and the certificate, summary plan description or other evidence of the benefits and coverage provided to covered employees; [PL 1993, c. 688, §1 (NEW).]

5. Proof of deposit or surety bond. Proof of deposit or a copy of the surety bond required pursuant to section 6607 ; [PL 1993, c. 688, §1 (NEW).]

6. Excess insurance agreement. A copy of the arrangement's excess insurance agreement; [PL 1993, c. 688, §1 (NEW).]

7. Evidence of sound actuarial principles. Evidence satisfactory to the superintendent showing that the arrangement will be operated in accordance with sound actuarial principles. The superintendent may not approve the arrangement unless the superintendent determines that the plan is designed to provide sufficient revenues to pay current and future liabilities, as determined in accordance with sound actuarial principles; [PL 1995, c. 618, §8 (AMD).]

8. Additional information. Additional information that the superintendent may reasonably require; and [PL 1995, c. 618, §8 (AMD).]

9. Filing fee. The filing fee specified in section 601 . [PL 1995, c. 618, §8 (NEW).]
24-A M.R.S. § 4233 — ME Code / Title 24-A / Chapter 56 / Section 4233
24-A §4233. Registration, regulation and supervision of holding company systems
Status: in_force

1. [PL 1995, c. 332, Pt. O, §11 (RP).]

2. Every domestic health maintenance organization is subject to the requirements of section 221‑A . At the superintendent's request, a domestic health maintenance organization must make available to the superintendent the audit work papers of any accountant who has audited that health maintenance organization. Upon timely notice to a health maintenance organization, the superintendent may review, photocopy or otherwise record the audit work papers generated by any accountant who has audited that health maintenance organization. Health maintenance organization work papers under the superintendent's custody or control are confidential and not subject to public inspection. The work papers of a health maintenance organization's parent, subsidiaries or other corporate affiliates are deemed to be the work papers of that health maintenance organization to the extent the work papers affect the health maintenance organization's final equity determination and reference any transaction between the health maintenance organization and its parent, subsidiaries or corporate affiliates. As a condition of engaging an auditing accountant, the health maintenance organization shall require the accountant to: A. Retain for a period of at least 6 years any work papers prepared in connection with the accountant's audit of that health maintenance organization; and [PL 1993, c. 313, §36 (NEW).] B. Provide, at the request of the health maintenance organization, the original or copies of any work papers created by the accountant in connection with an audit of that health maintenance organization. [PL 1993, c. 313, §36 (NEW).] For purposes of this subsection, the term "work papers" includes, but is not limited to, originals or copies of any schedules, analyses, reconciliations, abstracts, memoranda, narratives, flow charts, company records or other documents prepared or obtained by the accountant and the accountant's employees in the course of conducting an audit of the health maintenance organization. [PL 1993, c. 313, §36 (NEW).]
24-A M.R.S. § 6721 — ME Code / Title 24-A / Chapter 83 / Section 6721
24-A §6721. Rules for controlled unaffiliated business
Status: in_force

The superintendent may adopt rules establishing standards to ensure that a parent or affiliated company is able to exercise control of the risk management function of any controlled unaffiliated business to be insured by a pure captive insurance company. In the absence of any rules, the superintendent may approve the coverage of such risks by a pure captive insurance company upon request. Any rules adopted by the superintendent pursuant to this section are routine technical rules as described in Title 5, chapter 375, subchapter 2‑A . [PL 2009, c. 335, §21 (NEW).]
24-A M.R.S. § 215 — ME Code / Title 24-A / Chapter 3 / Section 215
24-A §215. Violation of rules, regulations, orders; penalty
Status: in_force

Any person who knowingly violates any rule, regulation or order of the superintendent shall be subject to such suspension or revocation of certificate of authority or license as may be applicable under this Title for violation of the provision to which such rule, regulation or order relates. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 2804 — ME Code / Title 24-A / Chapter 35 / Section 2804
24-A §2804. Employee groups
Status: in_force

A group of individuals may be insured under a policy issued to an employer or to the trustees of a fund established by an employer, which employer or trustees shall be deemed the policyholder, to insure employees of the employer for the benefit of persons other than the employer, subject to the following requirements. [PL 1981, c. 147, §2 (RPR).]

1. The employees eligible for insurance under the policy must be all of the employees of the employer, or all of any class or classes thereof. The policy may provide that the term "employees" includes the employees of one or more subsidiary corporations and the employees, individual proprietors, and partners of one or more affiliated corporations, proprietorships or partnerships if the business of the employer and of the affiliated corporations, proprietorships or partnerships is under common control. The policy may provide that the term "employees" includes the individual proprietor or partners if the employer is an individual proprietorship or partnership. The policy may provide that the term "employees" includes retired employees and directors of a corporate employer. A policy issued to insure the employees of a public body may provide that the term "employees" includes elected or appointed officials. If authorized by the school boards of the alternative organizational structure's member school administrative units pursuant to Title 20‑A, section 1001 , an alternative organizational structure established pursuant to Title 20‑A, section 1461‑B may contract for group health insurance that is offered to all eligible employees and retirees of the alternative organizational structure and its member school administrative units and their dependents in one or more employment classifications. [PL 2015, c. 420, §3 (AMD).]

2. The premium for the policy shall be paid either from the employer's funds or from funds contributed by the insured employees, 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 employees must insure all eligible employees, except those who reject such coverage in writing. [PL 1981, c. 147, §2 (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, §1 (AMD).]

4. [PL 1981, c. 147, §2 (RP).]
24-A M.R.S. § 2015 — ME Code / Title 24-A / Chapter 19 / Section 2015
24-A §2015. Record of procured coverages
Status: in_force

1. Each producer shall keep in the producer's office a full and true record of each surplus lines coverage procured by the producer, including a copy of each daily report, if any, a copy of each certificate of insurance issued, books of account in which financial entries are recorded respecting these transactions and such of the following items as may be applicable: A. Amount of the insurance; [PL 1969, c. 132, §1 (NEW).] B. Gross premium charged; [PL 1969, c. 132, §1 (NEW).] C. Return premium paid, if any; [PL 1969, c. 132, §1 (NEW).] D. Rate of premium charged upon the several items of property; [PL 1969, c. 132, §1 (NEW).] E. Effective date of the contract and the terms of the contract; [PL 1997, c. 592, §61 (AMD).] F. Name and address of each insurer on the direct risk and the proportion of the entire risk assumed by such insurer, if less than the entire risk; [PL 1997, c. 592, §61 (AMD).] G. Name and address of the insured; [PL 1969, c. 132, §1 (NEW).] H. Brief general description of the property or risk insured and where located or to be performed; and [PL 1969, c. 132, §1 (NEW).] I. Other information as may be required by the superintendent. [PL 1969, c. 132, §1 (NEW).] [PL 2007, c. 51, §5 (AMD).]

2. The record may not be removed from this State in the case of a resident producer with surplus lines authority and in the case of both resident and nonresident licensees must be made available and open to examination by the superintendent at all times within 5 years after issuance of the coverage to which it relates. For the purpose of investigation or examination by the superintendent, records may be maintained in electronic form. [PL 2007, c. 51, §5 (AMD).]
24-A M.R.S. § 1910 — ME Code / Title 24-A / Chapter 18 / Section 1910
24-A §1910. Unauthorized activities
Status: in_force

Nothing in this chapter may be construed to permit any person or entity to receive or collect charges, contributions or premiums for, or adjust or settle claims in connection with, any type of life or accident or health benefit, unless the person or entity is authorized through the insurance laws of a state or the Employee Retirement Income Security Act of 1974, 29 United States Code, Section 1001, et seq. as amended, to provide those benefits. [PL 1989, c. 846, Pt. D, §2 (NEW); PL 1989, c. 846, Pt. E, §4 (AFF).]
24-A M.R.S. § 2383 — ME Code / Title 24-A / Chapter 25 / Section 2383
24-A §2383. Interchange of data
Status: in_force

1. Exchange of information. To further uniform administration of rate regulatory laws, the superintendent, insurers and the designated advisory organization may exchange information and experience data with insurance regulatory officials, insurers and advisory organizations in other states and may consult with them with respect to the rating plans permitted by this Act. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

2. Cooperation. Cooperation among advisory organizations or among advisory organizations and insurers in rating plans and other matters within the scope of this Act is authorized, but any filings resulting from such cooperation are subject to all provisions of this Act. The superintendent may review any such cooperative activities and practices and if, after hearing, any such activity or practice is found to violate the provisions of this Act, the superintendent may issue an order requiring the discontinuance of the activity or practice and may take any other action as permitted by law. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]
24-A M.R.S. § 2422 — ME Code / Title 24-A / Chapter 27 / Section 2422
24-A §2422. Notice to, knowledge of agent binding on insurer
Status: in_force

1. An agent authorized by an insurer, if the name of such agent is borne on the policy, is the insurer's agent in all matters of insurance. Any notice required to be given by the insured to the insurer or any of its officers may be given in writing to such agent. [PL 1969, c. 132, §1 (NEW).]

2. The authorized agent of an insurer must be regarded as in the place of the insurer in all respects regarding any insurance effected by the agent. The insurer is bound by the agent's knowledge of the risk and all matters connected therewith. Omissions and misdescriptions known to the agent must be regarded as known to the insurer and waived by it as if noted in the policy. [RR 2021, c. 1, Pt. B, §217 (COR).]
24-A M.R.S. § 232 — ME Code / Title 24-A / Chapter 3 / Section 232
24-A §232. Witnesses and documentary evidence
Status: in_force

1. As to the subject of any examination, investigation or hearing being conducted by the superintendent, the superintendent may subpoena witnesses and administer oaths or affirmations and examine any individual under oath, or take depositions; and by subpoena duces tecum may require the production of documentary and other evidence. Any delegation by the superintendent of power of subpoena shall be in writing. The procedures of Title 5, section 9060, subsection 1 , shall also apply to the issuance of subpoenas. [PL 1989, c. 269, §7 (AMD).]

2. Every person subpoenaed to appear at any such hearing, examination or investigation shall obey the subpoena, testify truthfully, behave with decorum and in no way obstruct the proceeding or purpose thereof. [RR 2021, c. 1, Pt. B, §173 (COR).]

3. Witnesses shall be entitled to the same fees and allowances as witnesses in Superior Court; except that no insurer, agent, broker or other person subject to this Title who is a subject of such proceeding, and no officer, director or employee of any of the foregoing, shall be entitled to witness or mileage fees. No person shall be excused from attending and testifying in obedience to a subpoena on the ground that the proper witness fee was not tendered or paid, unless the witness shall have demanded such payment as a condition precedent to attending the hearing, examination or investigation and unless such demand shall not have been complied with. [PL 1969, c. 132, §1 (NEW).]

4. Any individual knowingly testifying falsely under oath or making a false affirmation, as to any matter material to any such examination, investigation or hearing, shall upon conviction thereof be guilty of perjury. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2325 — ME Code / Title 24-A / Chapter 25 / Section 2325
24-A §2325. Assigned risks
Status: in_force

1. Agreements may be made among casualty insurers with respect to the equitable apportionment among them of insurance which may be afforded applicants who are in good faith entitled to but who are unable to procure such insurance through ordinary methods and such insurers may agree among themselves on the use of reasonable rate modifications for such insurance, such agreements and rate modifications to be subject to the approval of the superintendent. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

2. Every insurer undertaking to transact in this State the business of automobile and motor vehicle bodily injury, property damage liability, physical damage and medical payments insurance and every advisory organization that files rates for that insurance shall cooperate in the preparation and submission of a plan for the equitable apportionment among insurers of applicants for insurance who are in good faith entitled to, but who are unable to procure through ordinary methods, such insurance. Administration of the plan is the responsibility of the plan member insurers subject to regulatory oversight by the bureau. The plan must provide: A. Reasonable rules governing the equitable distribution of risks by direct insurance, reinsurance or otherwise and their assignment to insurers; [PL 1989, c. 797, §29 (AMD); PL 1989, c. 797, §§37, 38 (AFF).] B. Rates and rate modifications applicable to such risks, which may not be excessive, inadequate or unfairly discriminatory; [PL 1991, c. 667, §1 (AMD).] C. The limits of liability that the insurer is required to assume, except that the maximum amount of physical damage coverage for commercial type vehicles must be determined by the superintendent based on the current cost of new vehicles but not to exceed a maximum amount of $100,000; and [PL 1991, c. 667, §1 (AMD).] D. A method whereby applicants for insurance, insureds and insurers may have a hearing on grievances and the right of appeal to the superintendent. [PL 1989, c. 797, §29 (AMD); PL 1989, c. 797, §§37, 38 (AFF).] [PL 1991, c. 667, §1 (AMD).]

3. The plan referred to in subsection 2 must be filed in writing with the superintendent. The superintendent shall review the plan as soon as reasonably possible after filing in order to determine whether it meets the requirements set forth in subsection 2, paragraphs A , B , C and D . The plan, unless sooner approved in writing, must be on file for a waiting period of 30 days before it becomes effective. The plan is deemed approved unless disapproved by the superintendent within the waiting period. Subsequent to the waiting period, the superintendent may disapprove the plan on the grounds that it does not meet the requirements set forth in subsection 2, paragraphs A , B , C and D , but only after a hearing held upon not less than 10 days' written notice to every insurer and advisory organization affected, specifying the matters to be considered at the hearing, and only by an order specifying in what respect the superintendent finds that the plan fails to meet the requirements, and stating when within a reasonable period thereafter the plan is deemed no longer effective. That order does not affect any assignment made or policy issued or made prior to the expiration of the period set forth in the order. Amendments to the plan must be prepared, filed and reviewed in the same manner as provided in this subsection with respect to the original plan. The superintendent may, as necessary and in accordance with the Maine Administrative Procedure Act, initiate rulemaking with respect to the plan. [PL 1991, c. 667, §2 (AMD).]

4. When the plan referred to in subsection 2 or amendments thereto have been approved or promulgated, no insurer shall thereafter issue a policy of automobile and motor vehicle bodily injury, property damage liability, physical damage and medical payments insurance or undertake to transact such business in this State, unless such insurer shall participate in such an approved or promulgated plan. [PL 1969, c. 132, §1 (NEW).]

5. If, after hearing, the superintendent finds that any activity or practice of any insurer or advisory organization in connection with the operation of the plan referred to in subsection 2 is unfair or unreasonable or otherwise inconsistent with this section, the superintendent may issue a written order specifying in what respects such activity or practice is unfair or unreasonable or otherwise inconsistent with this section and requiring the discontinuance of such activity or practice. [PL 1989, c. 797, §30 (AMD); PL 1989, c. 797, §§37, 38 (AFF).]

6. The maximum limits of liability insurance offered by the Maine Automobile Insurance Plan for a personal automobile policy may not be less than $250,000 per person for bodily injury liability, $500,000 per occurrence for bodily injury liability and $100,000 for property damage liability. A combined single limit of $500,000 may be offered as an alternative to the mandatory split limits for bodily injury liability and property damage liability. [PL 1991, c. 667, §3 (NEW).]

7. When a notice of cancellation for nonpayment of premium is issued by the Maine Automobile Insurance Plan or by an insurer to which the insured has been assigned by the plan, any premium paid by the insured but unearned within the policy term must be returned to the insured within 10 working days from the effective date of cancellation. [PL 1991, c. 667, §3 (NEW).]
24 M.R.S. § 2305-A — ME Code / Title 24 / Chapter 19 / Section 2305-A
24 §2305-A. Conditions of certificate of authority
Status: in_force

1. Duration. A certificate of authority continues in force as long as the nonprofit hospital or medical service organization is entitled under this Title and until suspended or revoked by the superintendent or terminated at the organization's request. [PL 1997, c. 592, §2 (NEW).]

2. Annual fee. The nonprofit hospital or medical service organization shall pay an annual fee, which is the same as for an insurer, as provided in Title 24-A, section 601 . [PL 1997, c. 592, §2 (NEW).]

3. Reinstatement. Upon payment by the nonprofit hospital or medical service organization of the fee for reinstatement specified in Title 24-A, section 601 , the superintendent may, upon the organization's request made within 3 months after suspension, reinstate a certificate of authority that the superintendent suspended due to the organization's failure to pay the annual fee. Otherwise the organization may be granted another certificate of authority only after filing an application and meeting all other requirements as for an original certificate of authority in this State. [PL 1997, c. 592, §2 (NEW).]
24-A M.R.S. § 224 — ME Code / Title 24-A / Chapter 3 / Section 224
24-A §224. Appraisal of asset
Status: in_force

1. If the superintendent considers it necessary to value any asset involved in such an examination, the superintendent may appoint one or more competent disinterested persons as appraisers with authority to appraise the real property of an insurer or any real property on which it holds security. [PL 1991, c. 828, §9 (AMD).]

2. Any such appraisal shall be expeditiously made, and a copy thereof furnished to the superintendent and to the person being examined. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

3. The reasonable expense of the appraisal shall be borne by the person being examined. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 3363 — ME Code / Title 24-A / Chapter 47 / Section 3363
24-A §3363. Voting rights of members
Status: in_force

1. Each member of a mutual insurer is entitled to one vote upon each matter coming to a vote at a meeting of members, or to such other vote as may be provided for on a reasonable basis in the insurer's bylaws with the superintendent's approval. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

2. A member has the right to vote in person or by the member's written proxy filed with the corporate secretary not less than 20 days prior to the meeting. Any such proxy may not be made irrevocable, or be valid beyond the earlier of the following dates: A. The date of expiration set forth in the proxy; [PL 2021, c. 676, Pt. A, §38 (AMD).] B. The date of termination of membership; or [PL 2021, c. 676, Pt. A, §39 (AMD).] C. Five years from the date of execution of the proxy. [RR 2021, c. 2, Pt. A, §75 (COR).] [RR 2021, c. 2, Pt. A, §75 (COR).]

3. No member's vote upon any proposal to divest the insurer of its business or assets, or the major part thereof, shall be registered or taken, except in person or by proxy newly executed and specific as to the matter to be voted upon. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 3303 — ME Code / Title 24-A / Chapter 47 / Section 3303
24-A §3303. Reservation of power
Status: in_force

The Legislature shall have power to amend, repeal or modify this Title at pleasure. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2629 — ME Code / Title 24-A / Chapter 31 / Section 2629
24-A §2629. Acquired Immune Deficiency Syndrome
Status: in_force

No group life insurance policy 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 the death resulting from any other disease or sickness or exclude coverage for death resulting from AIDS, ARC or HIV related diseases except through an exclusion under which deaths resulting from all sicknesses and diseases are treated the same or as provided by section 2159, subsection 4 . This section shall not apply to death by accident or accidental means. [PL 1989, c. 176, §4 (NEW).]
24-A M.R.S. § 3870 — ME Code / Title 24-A / Chapter 53 / Section 3870
24-A §3870. Assessments
Status: in_force

1. Assessments may from time to time be levied upon subscribers of a domestic reciprocal insurer liable therefor under the terms of their policies by the attorney upon approval in advance by the subscribers' advisory committee and the superintendent; or by the superintendent in liquidation of the insurer. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

2. Each subscriber's share of a deficiency for which an assessment is made, but not exceeding in any event the subscriber's aggregate contingent liability as computed in accordance with section 3872 , must be computed by applying to the premium earned on the subscriber's policy or policies during the period to be covered by the assessment, the ratio of the total deficiency to the total premiums earned during such period upon all policies subject to the assessment. [RR 2021, c. 1, Pt. B, §317 (COR).]

3. In computing the earned premiums for the purposes of this section, the gross premium received by the insurer for the policy shall be used as a base, deducting therefrom solely charges not recurring upon the renewal or extension of the policy. [PL 1969, c. 132, §1 (NEW).]

4. A subscriber may not have an offset against any assessment for which the subscriber is liable, on account of any claim for unearned premium or losses payable. [RR 2021, c. 1, Pt. B, §318 (COR).]
24-A M.R.S. § 2728 — ME Code / Title 24-A / Chapter 33 / Section 2728
24-A §2728. Intoxicants and narcotics
Status: in_force

1. Intoxicants; narcotics. A policy under this chapter may not include the following provision: "Intoxicants and narcotics. The insurer is not liable for any loss sustained or contracted in consequence of the insured's being intoxicated or under the influence of any narcotic or of any hallucinogenic drug, unless administered on the advice of a physician." [PL 2007, c. 216, §1 (NEW).]

2. Exemption. This section does not apply to the following types of insurance or any combination of the following types of insurance: accidental injury, specified disease, hospital indemnity, dental, vision, disability income, long-term care, Medicare supplement or other limited benefit health insurance. [PL 2007, c. 216, §1 (NEW).]
24-A M.R.S. § 3361 — ME Code / Title 24-A / Chapter 47 / Section 3361
24-A §3361. Meetings of members, in general
Status: in_force

1. Meetings of members of a domestic mutual insurer shall be held in the city or town of its principal office in this State, except as may otherwise be provided in the insurer's bylaws with the superintendent's approval. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

2. Each such insurer shall, during the first 6 months of each calendar year, hold the annual meeting of its members to fill vacancies existing or occurring in the board of directors, receive and consider reports of the insurer's officers as to its affairs and transact such other business as may properly be brought before it. [PL 1969, c. 132, §1 (NEW).]

3. Written notice of the time and place of the annual meeting of members shall be given members not less than 30 days prior to the meeting. Notice may be given by imprinting the notice plainly on the policies issued by the insurer or in any other appropriate manner. Any change of the date or place of the annual meeting shall be made only by an annual meeting of members. Notice of such change, among other appropriate methods, may be given: A. By imprinting such new date or place on all policies which will be in effect as of the date of such changed meeting; or [PL 1969, c. 132, §1 (NEW).] B. Unless the superintendent otherwise orders, notice of the new date or place need be given only through policies issued after the date of the annual meeting at which such change was made and in premium notices and renewal certificates issued during the 24 months immediately following such meeting. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).] [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

4. If more than 6 months are allowed to elapse after an annual meeting of members is due to be held and without such annual meeting being held, the superintendent shall, upon written request of any officer, director or member of the insurer, cause written notice of such meeting to be given to the insurer's members, and the meeting shall be held as soon as reasonably possible thereafter. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 428 — ME Code / Title 24-A / Chapter 5 / Section 428
24-A §428. Retaliatory provision
Status: in_force

1. When by or pursuant to the laws of any other state or foreign country or province any taxes, licenses and other fees, in the aggregate, and any fines, penalties, deposit requirements or other material requirements, obligations, prohibitions or restrictions are or would be imposed upon Maine insurers doing business or that might seek to do business in such state, country or province, or upon the agents or representatives of such insurers or upon brokers, which are in excess of such taxes, licenses and other fees, in the aggregate, or which are in excess of the fines, penalties, deposit requirements or obligations, prohibitions or restrictions directly imposed upon similar insurers, or upon the agents or representatives of such insurers, or upon brokers, of such other state, country or province under the statutes of this State, so long as such laws of such other state, country or province continue in force or are so applied, the same taxes, licenses and other fees, in the aggregate, or fines, penalties or deposit requirements or other material requirements, obligations, prohibitions or restrictions of whatever kind shall be imposed by the superintendent upon the insurer, or upon the agents or representatives of such insurers, or upon brokers, of such other state, country or province doing business or seeking to do business in Maine. Any tax, license or other fee or other obligation imposed by any city, county, or other political subdivision or agency of such other state, country or province on Maine insurers or their agents or representatives or upon Maine brokers shall be deemed to be imposed by such state, country or province within the meaning of this section. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

1-A. Notwithstanding subsection 1 , this section does not apply to application fees, examination fees, issuance fees, appointment fees, renewal fees and any other licensing fees associated with agent licenses, broker licenses, consultant licenses, adjuster licenses, managing general agent registrations and reinsurance intermediary licenses. [PL 1993, c. 637, §3 (NEW).]

2. This section shall not apply as to personal income taxes, or as to ad valorem taxes on real or personal property, or as to special purpose obligations or assessments imposed by another state in connection with particular kinds of insurance other than property insurance; except that deductions, from premium taxes or other taxes otherwise payable, allowed on account of real estate or personal property taxes paid shall be taken into consideration by the superintendent in determining the propriety and extent of retaliatory action under this section. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

3. For the purposes of this section the domicile of an alien insurer, other than insurers formed under the laws of Canada or a province thereof, shall be that state designated by the insurer in writing filed with the superintendent at time of admission to this State or within 6 months after January 1, 1970, whichever date is the later, and may be any one of the following states: A. That in which the insurer was first authorized to transact insurance; [PL 1969, c. 132, §1 (NEW).] B. That in which is located the insurer's principal place of business in the United States; or [PL 1969, c. 132, §1 (NEW).] C. That in which is held the largest deposit of trusteed assets of the insurer for the protection of its policyholders in the United States. [PL 1969, c. 132, §1 (NEW).] If the insurer makes no such designation, its domicile shall be deemed to be that state in which is located its principal place of business in the United States. [PL 1973, c. 625, §135 (AMD).]

4. The domicile of an insurer formed under the laws of Canada or a province thereof shall be that province of Canada in which its head office is located. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2384 — ME Code / Title 24-A / Chapter 25 / Section 2384
24-A §2384. Workers' compensation advisory organizations
Status: in_force

Sections 2321‑A to 2321‑D apply to workers' compensation insurers and advisory organizations to the extent not inconsistent with this Act. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]
24 M.R.S. § 2302 — ME Code / Title 24 / Chapter 19 / Section 2302
24 §2302. Incorporation
Status: in_force

The articles of incorporation, and amendments thereto, of every corporation organized under this chapter shall be submitted to the superintendent for approval, which, if granted, shall be indorsed thereon before the same are filed with the Secretary of State. [PL 1971, c. 444, §2 (RPR); PL 1973, c. 585, §12 (AMD).]

There shall be not less than 14 directors, at least a majority of whom shall be consumer representatives. For purposes of this section, "consumer representative" means a person who does not derive more than 20% of annual income, whether directly or through that person's spouse, from the delivery of health care services. The remaining directors shall at all times be licensed health professionals who contract with the corporation for the direct provision of health services, or persons employed by participating health care institutions or organizations that contract with the corporation to provide health services to the corporation's subscribers, or persons employed by associations of providers and professionals of health care services. No director shall serve more than 3 consecutive 3-year terms. [PL 1975, c. 708, §1 (RPR).]
24-A M.R.S. § 1481 — ME Code / Title 24-A / Chapter 16 / Section 1481
24-A §1481. Continuing Education Advisory Committee
Status: in_force

The Continuing Education Advisory Committee is established and consists of 6 members appointed by the superintendent for terms of 3 years each, on a staggered-term basis to prevent the terms of more than 2 members from expiring in any one year. A person may be reappointed to the committee for more than one 3-year term. A person is ineligible for appointment to the committee unless that person is an active, full-time insurance producer or consultant. Committee members are eligible for reimbursement of expenses. The superintendent may remove a committee member for cause. [PL 2023, c. 59, §4 (AMD).]
24-A M.R.S. § 2321-C — ME Code / Title 24-A / Chapter 25 / Section 2321-C
24-A §2321-C. Advisory organizations; prohibited activity
Status: in_force

In addition to the other prohibitions described in section 2321‑B , except as specifically permitted under section 2321‑D , no advisory organization may compile or distribute recommendations relating to rates that include profit or expenses other than loss adjustment expenses. [PL 1989, c. 797, §23 (NEW); PL 1989, c. 797, §§37, 38 (AFF).]
24-A M.R.S. § 3604 — ME Code / Title 24-A / Chapter 51 / Section 3604
24-A §3604. Insuring powers; reinsurance
Status: in_force

1. An assessment plan insurer shall have authority to transact, and shall transact only such insurance as is permitted by its charter and by its certificate of authority. [PL 1969, c. 132, §1 (NEW).]

2. Any such insurer shall have power to cede reinsurance of any risk or part thereof which it is authorized to insure direct; and shall have power to accept reinsurance from other domestic assessment plan insurers of any risk which it has authority to insure direct. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2214 — ME Code / Title 24-A / Chapter 24 / Section 2214
24-A §2214. Previous adverse underwriting decisions
Status: in_force

A carrier, producer or producer agency may not base an adverse underwriting decision in whole or in part: [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]

1. Previous adverse underwriting decisions. On the fact of a previous adverse underwriting decision or on the fact that a consumer previously obtained insurance coverage through a residual market, a surplus lines insurer or a carrier that specializes in substandard risks. However, a carrier or producer may base an adverse underwriting decision on further information obtained from a carrier, producer or producer agency responsible for a previous adverse underwriting decision; or [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]

2. Information from insurance support organizations. On personal information received from an insurance support organization whose primary source of information is insurance carriers. However, a carrier or producer may base an adverse underwriting decision on further personal information obtained as a result of information received from the insurance support organization, including primary source information confirming the information received from the insurance support organization. [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]
24-A M.R.S. § 214 — ME Code / Title 24-A / Chapter 3 / Section 214
24-A §214. Enforcement
Status: in_force

1. The superintendent may, through the Attorney General of this State, invoke the aid of the Superior Court through proceedings instituted in any county of this State to enforce any lawful order made or action taken by the superintendent. In such proceedings, the Superior Court may make such orders, either preliminary or final, as it considers proper under the facts established before it. [RR 2021, c. 1, Pt. B, §159 (COR).]

2. If the superintendent has reason to believe that any person has violated any provision of this Title, or of other law as applicable to insurance operations, for which criminal prosecution is provided and would be in order, the superintendent shall give the information relative thereto to the Attorney General. The Attorney General shall promptly institute such action or proceedings, including, but not limited to, actions or proceedings to seek restitution, against that person as in the Attorney General's opinion the information may require or justify. [PL 2003, c. 310, §1 (AMD).]

3. The Attorney General upon request of the superintendent is authorized to proceed in the courts of any other state or in any federal court or agency to enforce an order or decision of any court proceeding or in any administrative proceeding before the superintendent. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 4261 — ME Code / Title 24-A / Chapter 56 / Section 4261
24-A §4261. 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 individual or group 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, §4 (NEW).] B. "Dental provider" means a person licensed under Title 32, chapter 143, subchapter 3 . [PL 2025, c. 298, §4 (NEW).] [PL 2025, c. 298, §4 (NEW).]

2. Prohibition of required fees for dental services not covered. A health maintenance organization that issues individual or group dental insurance or individual or group contracts that include coverage for 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 health maintenance organization for a service that is not a covered dental service. [PL 2025, c. 298, §4 (NEW).]

3. Fees for covered dental services. A fee for a covered dental service must be set by the health maintenance organization in good faith and may not be nominal. [PL 2025, c. 298, §4 (NEW).]
24-A M.R.S. § 2745-D — ME Code / Title 24-A / Chapter 33 / Section 2745-D
24-A §2745-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, §2 (NEW).]

2. Required coverage. All individual insurance policies and contracts, except accidental injury, specified disease, hospital indemnity, Medicare supplement, long-term care and other limited benefit health insurance policies and contracts, must provide coverage for metabolic formula and special modified low-protein food products that have been prescribed by a licensed physician for a person with an inborn error of metabolism. The policies and contracts must reimburse: A. For metabolic formula; and [PL 1995, c. 369, §2 (NEW).] B. Up to $3,000 per year for special modified low-protein food products. [PL 1995, c. 369, §2 (NEW).] [PL 1995, c. 369, §2 (NEW).]

3. Application. The requirements of this section apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 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, §2 (NEW).]
24-A M.R.S. § 2912 — ME Code / Title 24-A / Chapter 39 / Section 2912
24-A §2912. Definitions
Status: in_force

As used in this subchapter, unless otherwise required by the context, the following words shall have the following meanings. [PL 1973, c. 339, §1 (NEW).]

1. Policy. "Policy" means an automobile insurance policy providing bodily injury liability, property damage liability, medical payments, uninsured motorist coverage, physical damage coverage, or any combination thereof, delivered or issued for delivery in this State, insuring a single individual or one or more related individuals resident in the same household, as named insured and insuring vehicles of the following types only: A. Motor vehicles of the private passenger or station wagon type that are not used as public conveyances nor rented to others; and [PL 2007, c. 188, Pt. C, §3 (AMD).] B. Any other 4-wheel motor vehicles with a load capacity of 1,500 pounds or less that are not used in the business or professions of the insured. [PL 2007, c. 188, Pt. C, §3 (AMD).] [PL 2007, c. 188, Pt. C, §3 (AMD).]

2. Renewal or renew. "Renewal" or "to renew" means the issuance and delivery by an insurer of a policy replacing at the end of the previous policy term a policy previously issued and delivered by the same insurer, or the issuance and delivery of a certificate or notice extending the coverage of the policy beyond its original term. For purposes of this subchapter, the transfer of a policy from an insurer to an affiliate is considered a policy renewal. Any policy written for a term longer than one year or with no fixed expiration date is considered written for successive policy terms of one year for the purposes of this subchapter. [PL 2007, c. 188, Pt. C, §4 (AMD).]

3. Nonpayment of premium. "Nonpayment of premium" means failure of the named insured to discharge when due any of the named insured's obligations in connection with the payment of premium on the policy, or any installment of a premium, whether the premium is payable directly to the insurer or its agent or indirectly under any premium finance plan or extension of credit. [RR 2015, c. 1, §28 (COR).]
24-A M.R.S. § 6616 — ME Code / Title 24-A / Chapter 81 / Section 6616
24-A §6616. Regulatory authority
Status: in_force

The superintendent may adopt, pursuant to Title 5, chapter 375, subchapter II , rules that the superintendent determines reasonable and necessary to carry out properly the functions and responsibilities assigned under the laws of this State. Rules adopted to implement the provisions of this chapter are routine technical rules as defined in Title 5, chapter 375, subchapter II‑A . [PL 1995, c. 618, §14 (AMD).]
24-A M.R.S. § 4132 — ME Code / Title 24-A / Chapter 55 / Section 4132
24-A §4132. Funds
Status: in_force

All assets shall be held, invested and disbursed for the use and benefit of the society and no member or beneficiary shall have or acquire individual rights therein or become entitled to any apportionment or the surrender of any part thereof, except as provided in the contract. [PL 1969, c. 132, §1 (NEW).]

A society may create, maintain, invest, disburse and apply any special fund or funds necessary to carry out any purpose permitted by the laws of such society. [PL 1969, c. 132, §1 (NEW).]

Every society, the admitted assets of which are less than the sum of its accrued liabilities and reserves under all of its certificates when valued according to standards required for certificates issued after one year from the effective date of this chapter, shall, in every provision of the laws of the society for payments by members of such society, in whatever form made, distinctly state the purpose of the same and the proportion thereof which may be used for expenses, and no part of the money collected for mortuary or disability purposes or the net accretions thereto shall be used for expenses. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 1112 — ME Code / Title 24-A / Chapter 13 / Section 1112
24-A §1112. Preferred or guaranteed stocks
Status: in_force

An insurer may invest in the preferred or guaranteed stocks or shares of any solvent institution created or existing under the laws of the United States or of Canada, or of any state, province, district or territory thereof, if all of the prior obligations and prior preferred stocks, if any, of such institution at the date of acquisition by the insurer are eligible as investments under this chapter; and if qualified under subsection 1 or subsection 2 following: [PL 1969, c. 132, §1 (NEW).]

1. Preferred stocks or shares shall be deemed qualified if both of the following requirements are met: A. The earnings of such institution available for its fixed charges for a period of 5 fiscal years next preceding the date of acquisition by the insurer shall have averaged per year not less than 1 1/2 times the sum of its average annual fixed charges, if any, its average annual maximum contingent interest, if any, and its average annual preferred dividend requirements applicable to such period; and [PL 1969, c. 132, §1 (NEW).] B. During either of the last 2 years of such period such net earnings shall have been not less than 1 1/2 times the sum of its fixed charges, contingent interest and preferred dividend requirements for such year. The term "preferred dividend requirements" shall be deemed to mean cumulative or noncumulative dividends whether paid or not. [PL 1969, c. 132, §1 (NEW).] [PL 1969, c. 132, §1 (NEW).]

2. Guaranteed stocks or shares shall be deemed qualified if the assuming or guaranteeing institution meets the requirements of section 1109, subsection 3 , (corporate obligations), construed so as to include as a fixed charge the amount of guaranteed dividends of such issue or the rental covering the guarantee of such dividends. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 6216 — ME Code / Title 24-A / Chapter 73 / Section 6216
24-A §6216. Sale or transfer of ownership
Status: in_force

Any provider desiring to sell or transfer ownership of a continuing care facility shall notify the superintendent and the acquiring interest shall obtain the superintendent's advance approval of the sale or transfer. The certificate of authority is nontransferable. The new owner must apply for a new certificate of authority to continue to provide continuing care at the facility. [PL 1987, c. 482, §1 (NEW).]
24-A M.R.S. § 703 — ME Code / Title 24-A / Chapter 9 / Section 703
24-A §703. "Annuity" defined
Status: in_force

For the purposes of this Title, an "annuity" is a contract under which obligations are assumed with respect to periodic payments for a specific term or terms or where the making or continuance of all or of some of the payments, or the amount of a payment, is dependent upon the continuance of human life, except payments made pursuant to optional modes of settlement under the authority of section 702 . A contract that includes extra benefits of the kinds defined in sections 702 and 704 is deemed to be an annuity, if the extra benefits constitute a subsidiary or incidental part of the entire contract. A charitable gift annuity agreement, as defined in section 703‑A , is not insurance. [PL 1995, c. 375, Pt. C, §2 (AMD).]
24-A M.R.S. § 2847-U — ME Code / Title 24-A / Chapter 35 / Section 2847-U
24-A §2847-U. Coverage for services provided by dental therapist
Status: in_force

1. Services provided by dental therapist. An insurer that issues group dental insurance or health insurance that includes coverage for dental services shall provide coverage for dental services performed by a dental therapist licensed under Title 32, chapter 143 when those services are covered services under the contract and when they are within the lawful scope of practice of the dental therapist. [PL 2019, c. 388, §4 (AMD).]

2. Limits; coinsurance; deductibles. A contract that provides coverage for the services required by this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section. [PL 2013, c. 575, §6 (NEW); PL 2013, c. 575, §10 (AFF).]

3. Coordination of benefits with dental insurance. If an enrollee eligible for coverage under this section is eligible for coverage under a dental insurance policy or contract and a health insurance policy or contract, the insurer providing dental insurance is the primary payer responsible for charges under subsection 1 and the insurer providing group health insurance is the secondary payer. [PL 2013, c. 575, §6 (NEW); PL 2013, c. 575, §10 (AFF).]
24-A M.R.S. § 2630 — ME Code / Title 24-A / Chapter 31 / Section 2630
24-A §2630. Suicide
Status: in_force

A group life insurance policy delivered or issued for delivery in this State may not contain a more restrictive exclusion from liability for death resulting from suicide than death by suicide, while sane or insane, within 2 years from the date coverage commences or within 2 years of an increase in coverage. [PL 2001, c. 89, §3 (NEW).]
24-A M.R.S. § 4129 — ME Code / Title 24-A / Chapter 55 / Section 4129
24-A §4129. Service of process
Status: in_force

Every society authorized to do business in this State shall appoint in writing an agent located in the State upon whom all lawful process in any action or proceeding against it is served and shall agree in writing that any lawful process against it that is served on the agent is of the same legal force and validity as if served upon the society and that the authority continues in force so long as any liability remains outstanding in this State. Copies of such appointment certified by the appointed agent are deemed sufficient evidence of the appointment and may be admitted in evidence with the same force and effect as the original. [PL 1997, c. 592, §69 (AMD).]

Service may only be made upon the appointed agent or, if absent, upon the person in charge. It must be made in duplicate and constitutes sufficient service upon the society. When legal process against a society is served upon the appointed agent, the appointed agent shall forthwith forward one of the duplicate copies by registered mail, prepaid, directed to the secretary or corresponding officer. Legal process may not be served upon a society except as provided in this section. [PL 1997, c. 592, §69 (AMD).]
24-A M.R.S. § 782 — ME Code / Title 24-A / Chapter 9 / Section 782
24-A §782. Limited certificate of authority required
Status: in_force

1. Limited certificate of authority. In order to securitize one or more ceding insurers' risks, a special purpose reinsurance vehicle shall obtain a limited certificate of authority from the superintendent according to the provisions of this section. [PL 2003, c. 249, §2 (NEW).]

2. Application. A special purpose reinsurance vehicle organizer seeking to obtain a limited certificate of authority for a special purpose reinsurance vehicle shall file an application for a limited certificate of authority with the superintendent and pay the application fee specified in section 601, subsection 1 . A complete application must include the following: A. An affidavit verifying that each prospective organizer meets the requirements of this subchapter; [PL 2003, c. 249, §2 (NEW).] B. A representation that the prospective organizer intends to form a special purpose reinsurance vehicle that operates in accordance with the requirements under this subchapter; [PL 2003, c. 249, §2 (NEW).] C. The proposed name of the special purpose reinsurance vehicle; [PL 2003, c. 249, §2 (NEW).] D. Biographical affidavits of all organizers setting forth their legal names, any names under which they have conducted or are conducting their affairs and any names of any person affiliated, as defined in section 222 , with any organizer, together with such other biographical information as the superintendent may request; [PL 2003, c. 249, §2 (NEW).] E. The source and form of the minimum capital to be contributed to the special purpose reinsurance vehicle; [PL 2003, c. 249, §2 (NEW).] F. Any persons with which the special purpose reinsurance vehicle is or upon formation will be affiliated as defined in section 222 ; [PL 2003, c. 249, §2 (NEW).] G. The names and biographical affidavits of the proposed members of the board of directors and principal officers of the special purpose reinsurance vehicle pursuant to section 790 , setting forth their legal names, any names under which they have conducted or are conducting their affairs and any names of any person affiliated, as defined in section 222 , with any proposed director or officer, together with such other biographical information as the superintendent may request; [PL 2003, c. 249, §2 (NEW).] H. A plan of operation, consisting of a description of the contemplated insurance securitization or securitizations, the special purpose reinsurance vehicle contract and related transactions, which must include: (1) Draft documentation or at the discretion of the superintendent a written summary of all material agreements that are planned in order to effectuate the insurance securitization or securitizations and the related contract, including the names of the ceding insurers, the nature of the risks being assumed and the maximum amounts, purpose and nature and the interrelationships of the various transactions required to effectuate the insurance securitization or securitizations; (2) The investment strategy of the special purpose reinsurance vehicle and a representation that the investment strategy complies with the investment requirements set forth in this subchapter and that the strategy includes investment practices or other provisions to preserve asset values that facilitate attainment of full funding during the term of the insurance securitization or securitizations with assets that can be monetized in response to a triggering event without a substantial loss in value; (3) A description of the method by which losses covered by the contract that may develop after the termination of the contract period are to be addressed under the provisions of the contract; (4) If applicable, a representation that the special purpose reinsurance vehicle contract with the ceding insurer, the security agreement or trust agreement under section 784, subsection 4, paragraph D‑1 or E and any trusts holding assets that secure the obligations of the special purpose reinsurance vehicle under the contract are structured in accordance with the requirements under this subchapter ; and (5) If protected cells are to be used, a description of the procedures for maintaining and safeguarding separate accounts as required by section 784‑A, subsection 1 and an application for approval of each initial protected cell as required by section 784‑A, subsection 2 . [PL 2007, c. 386, §7 (AMD).] [PL 2007, c. 386, §7 (AMD).]

3. Additional information. The superintendent shall notify the special purpose reinsurance vehicle organizer if any additional information is needed in order to review the application and shall approve or deny the application within 60 days after determining that the application is complete. A. The superintendent shall approve the application and issue a limited certificate of authority under this section if the superintendent finds that: (1) The proposed plan of operation provides a reasonable expectation of a successful operation; (2) The terms of the contract and related transactions comply with this subchapter and any applicable rules adopted by the superintendent; (3) The proposed plan of operation is not hazardous to any ceding insurer or to policyholders; and (4) The insurance regulator of the state of domicile of each ceding insurer has notified the superintendent in writing that it has not disapproved the transaction. The superintendent may waive this requirement for a ceding insurer whose domiciliary state does not have a substantially similar law if the superintendent finds that the domiciliary regulator has had notice and adequate opportunity to review the proposal and has not objected. [PL 2003, c. 249, §2 (NEW).] B. In evaluating the expectation of a successful operation, the superintendent shall consider, among other factors, whether the proposed organizer, directors and officers of the proposed special purpose reinsurance vehicle are of good character and not reasonably believed to be affiliated, directly or indirectly, through ownership, control, management, reinsurance transactions or other insurance or business relations, with any person known to have been involved in the improper manipulation of assets, accounts or reinsurance. [PL 2003, c. 249, §2 (NEW).] C. If the superintendent denies the application or if the superintendent withholds consent to a proposed transaction involving a domestic ceding insurer under a similar law of another jurisdiction the proposed organizer or ceding insurer has the right to a hearing upon a timely request filed pursuant to section 229 . [PL 2003, c. 249, §2 (NEW).] [PL 2003, c. 249, §2 (NEW).]

4. Approval. Upon approval of the application by the superintendent and the issuance of a limited certificate of authority, the special purpose reinsurance vehicle may be acquired or formed and, in accordance with the approved plan of operation, the special purpose reinsurance vehicle may enter into contracts and conduct other activities within the scope of the filed plan of operation. [PL 2003, c. 249, §2 (NEW).]

5. Reinsurance activities. The limited certificate of authority must state that the special purpose reinsurance vehicle's authorization to be involved in the business of insurance is limited only to the reinsurance activities that the special purpose reinsurance vehicle is allowed to conduct pursuant to this subchapter. [PL 2003, c. 249, §2 (NEW).]

6. Documentation of insurance securitization. The special purpose reinsurance vehicle organizer shall provide a complete set of the documentation of the insurance securitization to the superintendent upon closing of any transactions, including an opinion of legal counsel with respect to compliance with this subchapter and any other applicable laws as of the effective date of any transaction. [PL 2007, c. 386, §8 (AMD).]

7. Changes in plan of operation. Any material change to the special purpose reinsurance vehicle's plan of operation filed pursuant to subsection 2 , including, but not limited to, the initiation of a new insurance securitization to continue the activities of the special purpose reinsurance vehicle pursuant to this subchapter after expiration and full satisfaction of the initial securitization transactions, requires prior approval of the superintendent. A change in the counterparty to swap transactions for an existing insurance securitization as allowed under this subchapter is not considered a material change unless the special purpose reinsurance vehicle's managers know or should know that the new counterparty presents a substantial risk of default. [PL 2007, c. 386, §9 (NEW).]
24-A M.R.S. § 4117 — ME Code / Title 24-A / Chapter 55 / Section 4117
24-A §4117. Beneficiaries
Status: in_force

The member shall have the right at all times to change the beneficiary or beneficiaries in accordance with the constitution, laws or rules of the society. Every society by its constitution, laws or rules may limit the scope of beneficiaries and shall provide that no beneficiary shall have or obtain any vested interest in the proceeds of any certificate until the certificate has become due and payable in conformity with the provisions of the insurance contract. [PL 1969, c. 132, §1 (NEW).]

A society may make provision for the payment of funeral benefits to the extent of such portion of any payment under a certificate as might reasonably appear to be due to any person equitably entitled thereto by reason of having incurred expense occasioned by the burial of the member, provided the portion so paid shall not exceed the sum of $500. [PL 1969, c. 132, §1 (NEW).]

If, at the death of any member, there is no lawful beneficiary to whom the insurance benefits shall be payable, the amount of such benefits, except to the extent that funeral benefits may be paid as hereinbefore provided, shall be payable to the personal representative of the deceased member. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2152-C — ME Code / Title 24-A / Chapter 23 / Section 2152-C
24-A §2152-C. Disclosures in printed marketing materials of Medicare products
Status: in_force

1. Disclosures. Except as provided in subsections 2 and 3 , a person may not use printed materials marketing Medicare products unless the material: A. Includes a statement printed on the top and both the front and back of the material in type size no smaller than the largest type size on the material stating "This is an advertisement and solicitation"; [PL 2023, c. 243, §3 (NEW).] B. Contains in a type size no smaller than the 2nd largest type size on the material stating "[Name of person sponsoring the promotional material] is a private company that is not Medicare, Medicaid or MaineCare and is not a governmental agency"; [PL 2023, c. 243, §3 (NEW).] C. Contains in a type size no smaller than the 2nd largest type size on the material any other disclaimer on the material; and [PL 2023, c. 243, §3 (NEW).] D. Does not use a type color for the disclaimer required in paragraph A that is in grayscale or other faded tone, or a font that does not mimic or is not similar to a font used in an official document from a state or federal agency. [PL 2023, c. 243, §3 (NEW).] [PL 2023, c. 243, §3 (NEW).]

2. No disclosure required. The requirements of subsection 1 do not apply to: A. Informational brochures or other material developed or distributed by a state or federal regulatory agency or a nonprofit organization; or [PL 2023, c. 243, §3 (NEW).] B. Information related to an existing policy, from a policyholder's insurer, licensed agent or agency of record, including, but not limited to, information for the purpose of assisting, educating or communicating the status of plan benefits, claims, appeals, grievances or notice of termination. [PL 2023, c. 243, §3 (NEW).] [PL 2023, c. 243, §3 (NEW).]

3. Application. This subsection does not apply to any marketing material that has been filed with and approved by the superintendent, or filed with and approved by the federal Department of Health and Human Services, Centers for Medicare and Medicaid Services or filed with the Centers for Medicare and Medicaid Services under that agency's policies allowing for the filing and use of certain marketing materials. Evidence of that approval or filing with the Centers for Medicare and Medicaid Services must be produced upon request of the superintendent. [PL 2023, c. 243, §3 (NEW).]

4. Rules. The superintendent may adopt rules 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 2023, c. 243, §3 (NEW).]
24-A M.R.S. § 2106 — ME Code / Title 24-A / Chapter 21 / Section 2106
24-A §2106. Exemptions from service or process provisions
Status: in_force

Sections 2104 and 2105 shall not apply to surplus lines insurance lawfully effectuated under chapter 19 , or to reinsurance, or to any action or proceeding against an unauthorized insurer arising out of any of the following where the policy or contract contains a provision designating the superintendent as its attorney for the acceptance of service of lawful process in any action or proceeding instituted by or on behalf of an insured or beneficiary arising out of any such policy, or where the insurer enters a general appearance in any such action: [PL 1973, c. 585, §12 (AMD).]

1. Wet marine and transportation insurance; [PL 1969, c. 132, §1 (NEW).]

2. Insurance on or with respect to subjects located, resident, or to be performed wholly outside this State, or on vehicles or aircraft owned and principally garaged outside this State; [PL 1969, c. 132, §1 (NEW).]

3. Insurance on property or operations of railroads engaged in interstate commerce; or [PL 1969, c. 132, §1 (NEW).]

4. Insurance on aircraft or cargo of such aircraft, or against liability, other than employer's liability, arising out of the ownership, maintenance, or use of such aircraft. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 4354 — ME Code / Title 24-A / Chapter 57 / Section 4354
24-A §4354. Jurisdiction of delinquency proceedings; venue; exclusiveness of remedy; appeal
Status: in_force

1. The Superior Court has original jurisdiction of delinquency proceedings under this chapter, and any court with jurisdiction is authorized to make all necessary or proper orders to carry out the purposes of this chapter. A delinquency proceeding may not be commenced under this chapter by anyone other than the superintendent. [PL 1991, c. 828, §26 (AMD).]

2. The venue of delinquency proceedings against a domestic insurer shall be in the county in this State of the insurer's principal place of business; or, if the principal place of business is located in another state, in any county in this State selected by the superintendent for the purpose. The venue of proceedings against foreign insurers shall be in any county in this State selected by the superintendent for the purpose. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

3. At any time after commencement of a proceeding the superintendent or any other party may apply to the court for an order changing the venue of, and removing, the proceeding to any other county of this State in which the proceeding may most conveniently, economically and efficiently be conducted. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

4. No court shall have jurisdiction to entertain, hear or determine any petition or complaint praying for the dissolution, liquidation, rehabilitation, sequestration, conservation or receivership of any insurer, or for an injunction or restraining order or other relief preliminary, incidental or relating to such proceedings, other than in accordance with this chapter. [PL 1969, c. 132, §1 (NEW).]

5. An appeal shall lie to the Supreme Judicial Court from any court granting or refusing rehabilitation, liquidation, conservation or receivership and from every order in delinquency proceedings having the character of a final order as to the particular portion of the proceedings embraced therein. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2717-A — ME Code / Title 24-A / Chapter 33 / Section 2717-A
24-A §2717-A. Disability benefit offsets
Status: in_force

1. Disclosure to applicants. At or before the time of application for any policy subject to this chapter that provides disability income benefits, the insurer shall provide the applicant with a clear and conspicuous written notice, on the application form or in a separate document, that accurately explains to the applicant all types of other sources of income that may result in a reduction of the benefits payable under the policy. [PL 2005, c. 42, §1 (NEW).]

2. Recovery of disability benefit overpayments. For claims filed after January 1, 2006, an insurer that is entitled to reduce disability income benefit payments when the insured receives income from other sources and that is entitled to recover overpayments through offsets against current payments to the insured may not recover such overpayments at a rate greater than 20% of the net benefit per benefit payment period unless: A. For policies applied for after September 13, 2003, the insurer has complied with the requirements of subsection 1 ; [PL 2005, c. 42, §1 (NEW).] B. The insurer effects the offset of benefits within 60 days of notice to the insurer, or such later date as the insurer begins paying benefits to the insured, that the insured is receiving or is entitled to receive income that may result in a reduction of benefits payable under the policy; [PL 2005, c. 42, §1 (NEW).] C. The overpayment did not result from the insurer's miscalculation of benefit reductions or the insurer's miscalculation of benefits payable under the policy; and [PL 2005, c. 42, §1 (NEW).] D. The insurer provided the insured with clear and conspicuous written notice that accurately explains to the insured all types of other sources of income that may result in a reduction of the benefits payable under the policy within 30 days of the date a claim for disability benefits was filed. [PL 2005, c. 42, §1 (NEW).] [PL 2005, c. 42, §1 (NEW).]
24-A M.R.S. § 2534 — ME Code / Title 24-A / Chapter 29 / Section 2534
24-A §2534. Exceptions
Status: in_force

Sections 2529 to 2534 do not apply to any of the following: [RR 1993, c. 1, §61 (COR).]

1. Reinsurance; [PL 1983, c. 346, §17 (NEW).]

2. Group insurance; [PL 1983, c. 346, §17 (NEW).]

3. Pure endowment; [PL 1983, c. 346, §17 (NEW).]

4. Annuity or reversionary annuity contract; [PL 1983, c. 346, §17 (NEW).]

5. Any term policy of uniform amount, which provides no guaranteed nonforfeiture or endowment benefits, or renewal thereof, of 20 years or less expiring before age 71, for which uniform premiums are payable during the entire term of the policy; [PL 1983, c. 346, §17 (NEW).]

6. Any term policy of decreasing amount, which provides no guaranteed nonforfeiture or endowment benefits, on which each adjusted premium, calculated as specified in sections 2532 and 2532‑A , is less than the adjusted premium so calculated, on a term policy of uniform amount, or renewal thereof, which provides no guaranteed nonforfeiture or endowment benefits, issued at the same age and for the same initial amount of insurance and for a term of 20 years or less expiring before age 71, for which uniform premiums are payable during the entire term of the policy; [PL 1983, c. 346, §17 (NEW).]

7. Any policy, which provides no guaranteed nonforfeiture or endowment benefits, for which no cash surrender value, if any, or present value of any paid-up nonforfeiture benefit, at the beginning of any policy year, calculated as specified in sections 2530 to 2532‑A , exceeds 2 1/2% of the amount of insurance at the beginning of the same policy year; or [PL 1983, c. 346, §17 (NEW).]

8. Any policy that is delivered outside this State through an agent or other representative of the insurer issuing the policy. [RR 1993, c. 1, §61 (COR).]

For purposes of the Standard Nonforfeiture Law for Life Insurance, the age at expiry for a joint term life insurance policy is the age at expiry of the oldest life. [RR 1993, c. 1, §61 (NEW).]
24-A M.R.S. § 1461 — ME Code / Title 24-A / Chapter 16 / Section 1461
24-A §1461. Scope of subchapter
Status: in_force

1. Scope. This subchapter applies to consultants as defined in section 1402 . [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).]

2. Definition. Unless the context otherwise requires, "consultant," as used in this subchapter, means both property and casualty consultants and life and health consultants as defined in section 1402 . [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).]
24-A M.R.S. § 2473 — ME Code / Title 24-A / Chapter 28 / Section 2473
24-A §2473. Definitions -- Article 2
Status: in_force

As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 2003, c. 680, §1 (NEW).]

1. Advertisement. "Advertisement" means any material designed to create public interest in a product or induce the public to purchase, increase, modify, reinstate, borrow on, surrender, replace or retain a policy, as more specifically defined in the rules and operating procedures of the commission. [PL 2003, c. 680, §1 (NEW).]

2. Bylaws. "Bylaws" means the bylaws established by the commission for its governance or for directing or controlling the commission's actions or conduct. [PL 2003, c. 680, §1 (NEW).]

3. Compacting state. "Compacting state" means a state that has enacted the compact and that has not withdrawn pursuant to section 2485, subsection 1 or been terminated pursuant to section 2485, subsection 2 . [PL 2003, c. 680, §1 (NEW).]

4. Commission. "Commission" means the Interstate Insurance Product Regulation Commission established by the compact. [PL 2003, c. 680, §1 (NEW).]

5. Commissioner. "Commissioner" means the chief insurance regulatory official of a compacting state, including, but not limited to, commissioner, superintendent, director or administrator. [PL 2003, c. 680, §1 (NEW).]

6. Domiciliary state. "Domiciliary state" means the state in which an insurer is incorporated or organized or, in the case of an alien insurer, its state of entry. [PL 2003, c. 680, §1 (NEW).]

7. Insurer. "Insurer" means an entity licensed by a state to issue contracts of insurance for any of the lines of insurance covered by the compact. [PL 2003, c. 680, §1 (NEW).]

8. Management committee. "Management committee" means the management committee established under section 2476, subsection 5 . [PL 2003, c. 680, §1 (NEW).]

9. Member. "Member" means the person chosen by a compacting state as its representative to the commission, or the member's designee. [PL 2003, c. 680, §1 (NEW).]

10. Noncompacting state. "Noncompacting state" means a state that is not a compacting state. [PL 2003, c. 680, §1 (NEW).]

11. Operating procedures. "Operating procedures" means procedures adopted by the commission implementing a rule, uniform standard or provision of the compact. [PL 2003, c. 680, §1 (NEW).]

12. Product. "Product" means the form of a policy or contract, including an application, endorsement or related form that is attached to and made a part of the policy or contract, and any evidence of coverage or certificate, for an individual or group annuity, life insurance, disability income or long-term care insurance product that an insurer is authorized to issue. [PL 2003, c. 680, §1 (NEW).]

13. Rule. "Rule" means a statement of general or particular applicability and future effect adopted by the commission, including a uniform standard developed pursuant to section 2478 , designed to implement, interpret or prescribe law or policy or describing the organization, procedure or practice requirements of the commission, that has the force and effect of law in the compacting states. [PL 2003, c. 680, §1 (NEW).]

14. State. "State" means any state, district or territory of the United States of America. [PL 2003, c. 680, §1 (NEW).]

15. Third-party filer. "Third-party filer" means an entity that submits a product filing to the commission on behalf of an insurer. [PL 2003, c. 680, §1 (NEW).]

16. Uniform standard. "Uniform standard" means a standard adopted by the commission for a product line, pursuant to section 2478 , and includes all of the product requirements in aggregate. Each uniform standard must be construed, whether the prohibition is express or implied, to prohibit the use of any inconsistent, misleading or ambiguous provisions in a product and the form of the product made available to the public is not unfair, inequitable or against public policy as determined by the commission. [PL 2003, c. 680, §1 (NEW).]
24-A M.R.S. § 3051 — ME Code / Title 24-A / Chapter 41 / Section 3051
24-A §3051. 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. Like notice must also be given to any party named as mortgagee on the policy. A post office 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. The reason must accompany the notice of intent not to renew, together with notification of the right to apply for a hearing before the superintendent within 30 days as provided. [PL 2007, c. 188, Pt. C, §11 (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," "location of risk," "credit report" and similar insurance terms are not by themselves acceptable explanations of an insurer's intended nonrenewal of a policy insuring property of the kind defined in section 3048 . The reason for nonrenewal must be a good faith reason and related to the insurability of the property or a ground for cancellation pursuant to section 3049 . [PL 2003, c. 671, Pt. A, §8 (AMD).]

This section does not apply: [PL 2003, c. 671, Pt. A, §8 (AMD).]

1. If the insurer has manifested its willingness to renew; [PL 2005, c. 114, §6 (AMD).]

2. If the insured fails to pay any premium due or any advance premium required by the insurer for renewal; or [PL 2005, c. 114, §7 (AMD).]

3. If the insurer has transferred a policy to an affiliate. [PL 2007, c. 188, Pt. C, §11 (AMD).]

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, §11 (NEW).]
24-A M.R.S. § 2164-A — ME Code / Title 24-A / Chapter 23 / Section 2164-A
24-A §2164-A. Direct billing, notice
Status: in_force

No insurer, domestic or foreign, shall, except upon the written request of the insured, convert or convert upon renewal any contract of property or casualty insurance, excluding accident and health insurance and life insurance, to a direct billing basis until it has given 90 days advance written notice thereof to its resident agents. [PL 1969, c. 548 (NEW).]