24-A M.R.S. § 2206 — ME Code / Title 24-A / Chapter 24 / Section 2206
24-A §2206. Notice of insurance information practices
Status: in_force

The following requirements apply to notices provided by regulated insurance entities. [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]

1. Written notice. A regulated insurance entity shall provide a written notice of information practices to the applicant, policyholder or claimant in connection with all consumer insurance transactions in accordance with the following. A. In the case of an application for insurance, the notice must be provided no later than: (1) The time of the delivery of the insurance policy or certificate when personal information is collected only from the applicant or from public records; (2) The time the collection of personal information is initiated when personal information is collected from a source other than the applicant or public records; or (3) The time of initial notification to the consumer when the insurance transaction is not initiated by the consumer and the consumer was selected based on specific criteria derived from personal information obtained from any source. [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] B. In the case of a policy renewal, if a change has been made in the regulated insurance entity's information practices, the notice must be provided no later than the policy renewal date, unless: (1) Personal information is collected only from the policyholder or from public records; or (2) A notice meeting the requirements of this section has been given within the previous 24 months. [PL 2017, c. 36, §1 (AMD).] C. In the case of a policy reinstatement or change in insurance benefits, if a change has been made in the regulated insurance entity's information practices, the notice must be provided no later than the time the request for reinstatement or change in benefits is received by the carrier, unless personal information is collected only from the policyholder or from public records. [PL 2017, c. 36, §1 (AMD).] [PL 2017, c. 36, §1 (AMD).]

2. Required provisions. The notice must state: A. Whether personal information may be collected from persons other than the insurance consumer or consumers proposed for coverage; [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] B. The types of personal information that may be collected and the types of sources and investigative techniques that may be used to collect such information; [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] C. The types of disclosures that may be made without prior authorization under section 2215 and the circumstances under which any such disclosures may be made without prior authorization, except that only those circumstances need be described that occur with such frequency as to indicate a general business practice; [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] D. A description of the rights established under sections 2210 and 2211 and the manner in which those rights may be exercised; [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] E. That information obtained from a report prepared by an insurance support organization may be retained by the insurance support organization and disclosed to other persons; and [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] F. A description of the types of persons who may have access to the insurance consumer's personal information. [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]

3. Abbreviated notice. In lieu of the notice prescribed in subsection 2 , the regulated insurance entity may provide an abbreviated notice informing the applicant or policyholder that: A. Personal information may be collected from persons other than the insurance consumer or consumers proposed for coverage; [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] B. Information described in paragraph A as well as other personal information subsequently collected by the regulated insurance entity may in certain circumstances be disclosed to 3rd parties without authorization pursuant to section 2215 ; [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] C. A right of access and correction exists with respect to all personal information collected; and [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] D. The notice prescribed in subsection 2 will be furnished to the applicant or policyholder upon request. [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).] [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]

4. Satisfaction by other carrier, producer or administrator. The notice requirements imposed by this section upon a regulated insurance entity may be satisfied by a carrier, producer or administrator authorized to act on the entity's behalf. [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]

5. Standard notice forms. All carriers shall develop and use standard notice forms, but are not required to use the same form as other carriers. [PL 1997, c. 677, §3 (NEW); PL 1997, c. 677, §5 (AFF).]
24-A M.R.S. § 2412 — ME Code / Title 24-A / Chapter 27 / Section 2412
24-A §2412. Filing, approval of forms
Status: in_force

1. An insurance policy or annuity contract form may not be delivered or issued for delivery in this State unless the form has been filed with and approved by the superintendent in accordance with the following. A. For purposes of this section, "form" includes: (1) The basic form and any printed rider, endorsement or renewal form; (2) An application form if a written application is required and is made a part of the policy or contract; and (3) A certificate of coverage under a group policy or contract that is delivered or issued for delivery in this State. [PL 1997, c. 370, Pt. G, §1 (NEW).] B. This section does not apply to surety bonds or to specially rated inland marine risks, or to policies, riders, endorsements or forms of unique character designed for and used with relation to insurance upon a particular subject or that relate to the manner of distribution of benefits or to the reservation of rights and benefits under life or health insurance policies and are used at the request of the individual policy holder, contract holder or certificate holder. [PL 1997, c. 370, Pt. G, §1 (NEW).] C. An advisory organization licensed pursuant to section 2321‑A may file forms pursuant to this section on behalf of its members and subscribers. The approval of such a filing does not restrict the right of an insurer authorized to use an advisory organization form to develop and file forms on its behalf in addition to or instead of the advisory organization form. [PL 1997, c. 370, Pt. G, §1 (NEW).] [PL 1997, c. 370, Pt. G, §1 (RPR).]

1-A. An insurer may not provide coverage to a resident of this State under a group or blanket policy or contract issued and delivered outside this State unless the following requirements of this subsection are met. A. For "other group" insurance policies as defined in sections 2612‑A and 2808 , all forms must be filed with and approved by the superintendent. [PL 1997, c. 370, Pt. G, §2 (NEW).] B. For trustee group policies as defined in sections 2606‑A and 2806 and association group policies as defined in sections 2607‑A and 2805‑A , certificates of coverage to be delivered or issued for delivery in this State: (1) Must be filed with the superintendent at least 60 days before any solicitation in this State, with sufficient information concerning the nature of the group, including any trust agreements or association bylaws, to enable the superintendent to determine whether the group satisfies the statutory requirements for a trustee or association group; and (2) May not have been disapproved. [PL 1997, c. 370, Pt. G, §2 (NEW).] C. For group or blanket policies other than those specified in paragraphs A and B and in section 2858 , the group certificates to be delivered or issued for delivery in this State must be filed with the superintendent at the superintendent's request and may not have been disapproved. [PL 2001, c. 258, Pt. H, §1 (AMD).] D. The superintendent may disapprove a form filed pursuant to this subsection only if: (1) The policy or form is not in compliance with the laws of the state in which it was issued or delivered; (2) The policy or form is not in compliance with the laws of this State that apply when the policy is issued outside this State, such as chapter 36 or section 2843 ; or (3) The superintendent determines that the form is deceptive or misleading. [PL 1997, c. 370, Pt. G, §2 (NEW).] [PL 2001, c. 258, Pt. H, §1 (AMD).]

2. Every filing must be made not less than 30 days in advance of any delivery. At the expiration of the 30 days, the form so filed is deemed approved unless prior thereto it has been affirmatively approved or disapproved by order of the superintendent. Approval of the form by the superintendent constitutes a waiver of any unexpired portion of the waiting period. The superintendent shall act on a filing no later than 30 days from receipt unless an extension is requested by the filer. A filing required under this section must be made electronically in a format required by the superintendent unless exempted by rule adopted by the superintendent. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . At the expiration of the period so extended, and in the absence of prior affirmative approval or disapproval, any form is deemed approved. The superintendent may at any time, after hearing and for cause shown, withdraw any approval. [PL 2009, c. 14, §3 (AMD).]

3. Any order of the superintendent disapproving any such form or withdrawing a previous approval shall state the grounds therefor and the particulars thereof in such detail as reasonably to inform the insurer thereof. Any such withdrawal of a previously approved form shall be effective at expiration of such period, not less than 30 days after the giving of the order of withdrawal, as the superintendent shall in such order prescribe. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

4. The superintendent may, by order, exempt from the requirements of this section for so long as the superintendent considers proper any insurance document or form or type thereof as specified in such order, to which, in the superintendent's opinion, this section may not practicably be applied, or the filing and approval of which are, in the superintendent's opinion, not desirable or necessary for the protection of the public. [RR 2021, c. 1, Pt. B, §212 (COR).]

5. Appeals from orders of the superintendent disapproving any such form or withdrawing a previous approval may be taken as provided in sections 229 to 236 . [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

6. Motor vehicle insurance identification cards. [PL 1989, c. 824, §2 (AMD); MRSA T. 24-A §2412, sub-§6 (RP).]

7. Motor vehicle insurance identification cards. Pursuant to this section, the superintendent, with the advice of the Secretary of State, shall adopt rules that prescribe both paper and electronic forms of a motor vehicle insurance identification card for evidence of liability insurance or financial responsibility required under Title 29‑A . The superintendent shall require all insurance companies transacting business within this State to provide with each motor vehicle liability insurance policy a form of insurance identification card for each vehicle, describing the vehicle covered. When an insured has 5 or more motor vehicles registered in this State, the insurer may use the designation "all owned vehicles" on each card in lieu of a specific description. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2013, c. 72, §1 (AMD).]

8. Confidentiality of form filings. Forms filed as required by this section and any supporting information are confidential until the filing is approved. [PL 2005, c. 121, Pt. C, §2 (AMD).]
24-A M.R.S. § 2902 — ME Code / Title 24-A / Chapter 39 / Section 2902
24-A §2902. Uninsured vehicle coverage; insolvency of insurer
Status: in_force

1. A policy insuring against liability arising out of the ownership, maintenance or use of any motor vehicle may not be delivered or issued for delivery in this State with respect to any such vehicle registered or principally garaged in this State, unless coverage is provided in the policy or supplemental to the policy for the protection of persons insured under the policy who are legally entitled to recover damages from owners or operators of uninsured, underinsured or hit-and-run motor vehicles, for bodily injury, sickness or disease, including death, sustained by an insured person resulting from the ownership, maintenance or use of such uninsured, underinsured or hit-and-run motor vehicle. The coverage required by this section may be referred to as "uninsured vehicle coverage." For the purposes of this section, "underinsured motor vehicle" means a motor vehicle for which coverage is provided, but in amounts less than the minimum limits for bodily injury liability insurance provided for under the motorist's financial responsibility laws of this State or less than the limits of the injured party's uninsured vehicle coverage. [PL 2005, c. 591, §1 (AMD).]

2. With respect to motor vehicle insurance policies subject to the Maine Automobile Insurance Cancellation Control Act and policies in the assigned risk plan established pursuant to section 2325 securing private passenger auto insurance coverage, the amount of coverage to be so provided may not be less than the amount of coverage for liability for bodily injury or death in the policy offered or sold to a purchaser unless the purchaser expressly rejects such an amount, but in any event may not be less than the minimum limits for bodily injury liability insurance provided for under Title 29‑A, section 1605, subsection 1 . A rejection of equal coverage by the purchaser under this subsection must be in writing on a form provided by the insurer. The rejection must be signed by the purchaser, dated and include the following language: "I understand that Maine law requires uninsured motor vehicle coverage limits to equal the limits I have selected for liability coverage for bodily injury or death in this policy unless I expressly reject such an amount of coverage. Pursuant to the Maine Revised Statutes, Title 24‑A, section 2902, subsection 2 , I have elected to purchase uninsured motor vehicle coverage with lesser limits." For coverage purchased on or after October 1, 2000, the form must be provided to the purchaser prior to the effective date of coverage. For renewal policies in force as of September 30, 2000, the form must be provided upon the first offer of renewal to each purchaser who has current coverage limits less than those required under this subsection. To be effective, a form must be signed by any one named insured under the policy. If a signed form rejecting higher coverage is not received by the insurer prior to the effective date of the policy to which it applies, then the higher coverage must be provided consistent with this subsection from the policy issuance date for coverage purchased on or after October 1, 2000 and from the effective date of the first renewal on or after October 1, 2000 for policies in force as of September 30, 2000. This subsection may not be construed to prohibit an insured from prospectively changing coverage to alternative limits of uninsured motor vehicle coverage so long as a signed form, if necessary, is submitted to the insurer prior to the effective date of the change. If an insured has maintained the same uninsured vehicle coverage limits for 2 consecutive years with the same insurer, then the insured will be conclusively presumed to have accepted that amount of uninsured coverage in all future policies, until such time as the insured notifies the insurer in writing of an election to change the amount of uninsured coverage. Reinstatement or renewal of coverage by the insured with the same insurer within 30 days of expiration of a policy must be considered, for purposes of this section, as continuous coverage and does not require a new rejection to be executed by the insured. With respect to motor vehicle insurance policies not subject to the Maine Automobile Insurance Cancellation Control Act, the amount of coverage so provided may not be less than the minimum limits for bodily injury liability insurance provided for under Title 29‑A, section 1605, subsection 1 . [PL 1999, c. 663, §1 (AMD); PL 1999, c. 663, §4 (AFF).]

3. For the purposes of this section, the term "uninsured motor vehicle" shall be deemed also to include, subject to the terms and conditions of such coverage, an insured other motor vehicle where: A. The liability insurer of such other motor vehicle is unable because of its insolvency to make payment with respect to the legal liability of its insured within the limits specified in its policy; [PL 1969, c. 132, §1 (NEW).] B. The occurrence out of which such legal liability arose took place while the uninsured vehicle coverage required under subsection 1 , was in effect; and [PL 1969, c. 132, §1 (NEW).] C. Written notice of such occurrence shall have been given to the insurer within 2 years thereof. [PL 1969, c. 132, §1 (NEW).] Nothing contained in this subsection shall be deemed to prevent any insurer from providing insolvency protection to its insureds under more favorable terms. [PL 1969, c. 132, §1 (NEW).]

4. In the event of payment to any person under uninsured vehicle coverage, and subject to the terms of such coverage, to the extent of such payment the insurer shall be entitled to the proceeds of any settlement or recovery from any person legally responsible for the bodily injury as to which such payment was made, and to amounts recoverable from the assets of the insolvent insurer of the other motor vehicle. [PL 1969, c. 132, §1 (NEW).]

5. An insurer or licensed producer holding an appointment from the insurer shall disclose to the purchaser of a motor vehicle liability insurance policy the requirements for uninsured motor vehicle coverage under subsection 2 . [PL 1999, c. 271, §2 (NEW).]

6. When 2 or more persons are legally entitled to recover damages from a particular owner or operator of an underinsured motor vehicle, the amount of underinsured vehicle coverage applicable to each injured person is determined as provided in this subsection. A. If the underinsured motor vehicle policy applicable to 2 or more persons who are legally entitled to recover damages contains both a per person and a per accident limit, the amount of underinsured vehicle coverage applicable to each injured person is determined by subtracting any payments actually made to that person from any bodily injury liability insurance coverage applicable to the particular owner or operator of the underinsured motor vehicle from that person's, operator's or owner's underinsured vehicle coverage policy limits if applicable to that person. [PL 2013, c. 284, §1 (NEW).] B. If the underinsured motor vehicle policy applicable to 2 or more persons who are legally entitled to recover damages contains only a single per accident limit, the amount of underinsured vehicle coverage available to each injured person is determined by subtracting any payment received by that person from the owner or operator of the underinsured motor vehicle from that single per accident limit. In no event may the maximum amount payable by the insurer to all injured persons exceed the single per accident limit. [PL 2013, c. 284, §1 (NEW).] C. The amount of underinsured vehicle coverage determined under paragraph A or B must be further reduced by the amount by which the bodily injury liability insurance coverage applicable to the particular owner or operator of the underinsured motor vehicle exceeds all payments from that coverage to all persons legally entitled to recover damages from that particular owner or operator of the underinsured motor vehicle. [PL 2013, c. 284, §1 (NEW).] D. This subsection does not prohibit an insurer from providing greater amounts of underinsured vehicle coverage than are required under this section. [PL 2013, c. 284, §1 (NEW).] [PL 2013, c. 284, §1 (RPR).]

7. Notwithstanding the requirements of subsection 2 relating to the amount of uninsured motor vehicle coverage required to be maintained under motor vehicle insurance policies subject to the Maine Automobile Insurance Cancellation Control Act and policies in the assigned risk plan established pursuant to section 2325 securing private passenger auto insurance coverage, a policy providing uninsured motor vehicle coverage underwritten on a commercial policy form approved for use in this State must provide coverage in an amount not less than the minimum limits for bodily injury liability insurance provided for under Title 29‑A, section 1605, subsection 1 . Coverage provided to an insured pursuant to this subsection does not obligate the insured to affirmatively reject an offer of higher limits of uninsured motor vehicle coverage. This subsection may not be construed to limit or compel an insured's election of higher limits of uninsured motor vehicle coverage. [PL 2001, c. 109, §1 (NEW).]
24-A M.R.S. § 6715 — ME Code / Title 24-A / Chapter 83 / Section 6715
24-A §6715. Confidential information
Status: in_force

All information submitted to the superintendent pursuant to section 6702, subsection 3 and section 6724, subsection 3 is confidential and is not a public record within the meaning of Title 1, chapter 13, subchapter 1 . Each report or statement filed with the superintendent pursuant to section 6707 , except those filed by or with respect to industrial insured groups as defined in section 6701, subsection 8 , is confidential and is not a public record within the meaning of Title 1, chapter 13, subchapter 1 . The confidential nature of this information does not limit the ability of the superintendent, in the superintendent's discretion, to disclose such information to a public official in another state, as long as the public official agrees in writing to maintain the confidentiality of such information and the laws of the state in which the public official serves designate such information as confidential. [PL 2017, c. 169, Pt. G, §9 (AMD).]
24-A M.R.S. § 2538 — ME Code / Title 24-A / Chapter 29 / Section 2538
24-A §2538. Prohibited policy plans
Status: in_force

1. No life insurer shall hereafter deliver or issue for delivery in this State: A. As part of or in combination with any life insurance, endowment or annuity contract, any agreement or plan, additional to the rights, dividends, and benefits arising out of any such contract, which provides for the accumulation of profits over a period of years and for payment of all or any part of such accumulated profits only to members or policyholders of a designated group or class who continue as members or policyholders until the end of a specified or ascertainable period of years. [PL 1969, c. 132, §1 (NEW).] B. Any "registered" policy; that is, any policy (other than one "registered" as a security under applicable State law) purporting to be "registered" or otherwise specially recorded, with any agency of the State of Maine, or of any other state, or with any bank, trust company, escrow company, or other institution other than the insurer; or purporting that any reserves, assets or deposits are held, or will be so held, for the special benefit or protection of the holder of such policy, by or through any such agency or institution. [PL 1969, c. 132, §1 (NEW).] C. Any policy or contract under which any part of the premium or of funds or values arising from the policy or contract or from investment of reserves, or from mortality savings, lapses or surrenders, in excess of the normal reserves or amounts required to pay death, endowment, and nonforfeiture benefits in respective amounts as specified in or pursuant to the policy or contract, are on a basis not involving insurance or life contingency features, (1) To be placed in special funds or segregated accounts or specially designated places or (2) To be invested in specially designated investments or types thereof, and the funds or earnings thereon to be divided among the holders of such policies or contracts, or their beneficiaries or assignees. This provision does not apply as to any contract authorized under section 2537 . [PL 1969, c. 132, §1 (NEW).] D. Any policy which provides that on the death of anyone not specifically named therein the owner or beneficiary shall receive the payment or granting of anything of value. This provision shall not prohibit family policies insuring unspecified members of a family, nor prohibit payment to unspecified beneficiaries of a class designated by the insured or policy owner. [PL 1969, c. 132, §1 (NEW).] E. Any policy providing benefits or values for surviving or continuing policyholders contingent upon the lapse or termination of the policies of other policyholders, whether by death or otherwise. [PL 1969, c. 132, §1 (NEW).] F. Any policy, other than as authorized under section 2537 (separate accounts), containing or referring to one or more of the following provisions or statements: (1) Investment returns or profit-sharing, other than as a participation in the divisible surplus of the insurer under a regular participation provision as provided for in section 2509 . (2) Special treatment in the determination of any dividend that may be paid as to such policy. (3) Reference to premiums as "deposits". (4) Relating policyholder interest or returns from such policy or contract to those of stockholders. (5) That the policyholder as a member of a select group will be entitled to extra benefits or extra dividends not available to policyholders generally. [PL 1969, c. 132, §1 (NEW).] [PL 1969, c. 132, §1 (NEW).]

2. This section shall not be deemed to prohibit the provision, payment, allowance or apportionment of regular dividends or "savings" under regular participating forms of policies or contracts. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 3615 — ME Code / Title 24-A / Chapter 51 / Section 3615
24-A §3615. Delivery, acceptance of policy
Status: in_force

The delivery of the policy to the insured and payment by the insured of the initial charge shall be deemed an acceptance of the contract. [PL 1969, c. 177, §61 (AMD).]
24-A M.R.S. § 1 — ME Code / Title 24-A / Chapter 1 / Section 1
24-A §1. Short title
Status: in_force

This Title shall be known and be cited as the Maine Insurance Code. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2159-D — ME Code / Title 24-A / Chapter 23 / Section 2159-D
24-A §2159-D. Discrimination against live organ donation prohibited in life insurance, disability insurance and long-term care insurance
Status: in_force

1. Living organ donor. For the purposes of this section, "living organ donor" means an individual who is not deceased who donates all or part of an organ from that individual. [PL 2017, c. 20, §1 (NEW).]

2. Discrimination prohibited. Notwithstanding any other provision of law, an insurer authorized to do business in this State may not: A. Limit coverage or refuse to issue or renew coverage of an individual under any life insurance, disability insurance or long-term care insurance policy due to the status of that individual as a living organ donor; [PL 2017, c. 20, §1 (NEW).] B. Preclude an individual from donating all or part of an organ as a condition of receiving coverage under a life insurance, disability insurance or long-term care insurance policy; [PL 2017, c. 20, §1 (NEW).] C. Consider the status of an individual as a living organ donor in determining the premium rate for coverage of that individual under a life insurance, disability insurance or long-term care insurance policy; or [PL 2017, c. 20, §1 (NEW).] D. Otherwise discriminate in the offering, issuance, cancellation, amount of coverage, price or any other condition of a life insurance, disability insurance or long-term care insurance policy based solely and without any additional actuarial justification upon the status of an individual as a living organ donor. [PL 2017, c. 20, §1 (NEW).] [PL 2017, c. 20, §1 (NEW).]
24-A M.R.S. § 1136 — ME Code / Title 24-A / Chapter 13 / Section 1136
24-A §1136. Prohibited investments and investment underwriting
Status: in_force

1. In addition to investments excluded pursuant to other provisions of this Title, an insurer shall not invest in or lend its funds upon the security of: A. Issued shares of its own capital stock, except: (1) For the purpose of mutualization under chapter 47 , or (2) For retirement, or (3) Pursuant to a plan for such investment or loan submitted in writing by the insurer to the superintendent in advance, and which the superintendent has not, within 20 days after such submission or within such additional reasonable period as the superintendent may request, disapproved as being unfair or inequitable to the insurer's policyholders or stockholders. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).] B. Securities issued by any corporation or enterprise the controlling interest of which is, or will after such acquisition by the insurer be, held directly or indirectly by the insurer or any combination of the insurer and the insurer's directors, officers, subsidiaries, or controlling stockholders, and the spouses and children of any of the foregoing individuals. Investments in controlled insurance corporations or subsidiaries under sections 1114 and 1115 are not subject to this provision. [PL 1969, c. 132, §1 (NEW).] C. Any note or other evidence of indebtedness of any director, officer or controlling stockholder of the insurer or of the spouse or child of any of the foregoing. [PL 1987, c. 399, §13 (AMD).] [PL 1987, c. 399, §13 (AMD).]

2. No insurer shall underwrite or participate in the underwriting of an offering of securities or property of any other person. This provision shall not be deemed to prohibit: A. The acquisition and ownership by the insurer of its subsidiary corporation acting as investment adviser or principal underwriter of a management company or investment company registered with the Securities and Exchange Commission under the Investment Company Act of 1940, as amended. [PL 1969, c. 132, §1 (NEW).] B. The registration by the insurer, under the Securities Act of 1933 or other applicable law, of restricted or other securities acquired and owned by it in regular course of business. [PL 1969, c. 132, §1 (NEW).] [PL 1969, c. 132, §1 (NEW).]

3. No insurer shall enter into any agreement to withhold from sale any of its securities or property, and the disposition of its assets shall at all times be within the control of the insurer. This provision shall not be deemed to affect any right or obligation of the insurer under a contract or agreement referred to in section 2537 (separate accounts), and shall not be deemed to prohibit an insurer from lending any of its publicly traded portfolio securities or bond investments to a financial institution, to a securities broker or securities dealer under a program which provides adequate collateral security for the return of the value of the loaned portfolio securities or bond investments and which provides that any such loan of securities may be terminated by the insurer on not more than 10 days' notice. These programs shall conform to provisions contained in a regulation promulgated by the Superintendent of Insurance on a prospective basis covering those programs and which sets consistent standards for the collateral security deposits. [PL 1979, c. 458, §13 (AMD).]
24-A M.R.S. § 2151-A — ME Code / Title 24-A / Chapter 23 / Section 2151-A
24-A §2151-A. Hearings
Status: in_force

All hearings held under this chapter shall be in accordance with the procedures set forth in the Maine Administrative Procedure Act, Title 5, chapter 375, subchapter IV . [PL 1977, c. 694, §414 (NEW).]
24-A M.R.S. § 1418 — ME Code / Title 24-A / Chapter 16 / Section 1418
24-A §1418. Relicensing after revocation; refusal of license
Status: in_force

1. Relicensing. The superintendent may not issue a license under this Title to a person whose license has been revoked until at least one year has expired from the effective date of that revocation. If the licensee pursues an appeal from the superintendent's decision, the superintendent may not consider issuance of a new license until at least one year from the date of a final court order affirming that revocation. The license applicant shall reestablish qualification for the license in accordance with the applicable provisions of this Title. The superintendent may refuse any such new license applications unless the applicant shows good cause why the prior revocation should not be deemed a bar to the issuance of a new license. [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).]

2. Ineligibility for relicensing. A person whose license has been revoked twice pursuant to section 1417 or section 1420‑K may not again be eligible for any license under this Title. [PL 2001, c. 259, §22 (AMD).]

3. Business entity relicensing. If the license of a business entity is suspended or revoked pursuant to section 1417 or section 1420‑K , an officer, director or member of that entity may not be licensed as an insurance producer, adjuster or consultant during the period of that suspension or revocation unless the superintendent determines that member, officer or director was not personally at fault and did not acquiesce in the matter for which the license was suspended or revoked. [PL 2001, c. 259, §22 (AMD).]
24-A M.R.S. § 6092 — ME Code / Title 24-A / Chapter 72-A / Section 6092
24-A §6092. Purpose
Status: in_force

The purpose of this Act is to regulate the formation and operation of risk retention groups and purchasing groups in this State formed pursuant to the provisions of the Risk Retention Amendments of 1986, United States Code, Title 15, Section 3901, et seq., to the extent permitted by that law. [PL 1987, c. 481, §3 (NEW).]
24-A M.R.S. § 4257 — ME Code / Title 24-A / Chapter 56 / Section 4257
24-A §4257. Coverage for services provided by independent practice dental hygienist or dental hygienist
Status: in_force

1. Services provided by independent practice dental hygienist or dental hygienist. All individual and group health maintenance organization contracts that include coverage for dental services shall provide coverage for dental services performed by an independent practice dental hygienist or dental hygienist licensed under Title 32, chapter 143 when those services are covered services under the contract and when they are within the lawful scope of practice of the independent practice dental hygienist or dental hygienist. [PL 2025, c. 478, §7 (AMD).]

2. Limits; coinsurance; deductibles. A contract that provides coverage for the services required by this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section. [PL 2009, c. 307, §4 (NEW); PL 2009, c. 307, §6 (AFF).]

3. Coordination of benefits with dental insurance. If an enrollee eligible for coverage under this section is eligible for coverage under a dental insurance policy or contract and a health maintenance organization policy or contract, the insurer providing dental insurance is the primary payer responsible for charges under subsection 1 and the health maintenance organization providing health coverage is the secondary payer. [PL 2009, c. 307, §4 (NEW); PL 2009, c. 307, §6 (AFF).]

4. Application. The requirements of this section apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 2009, c. 307, §4 (NEW); PL 2009, c. 307, §6 (AFF).]
24-A M.R.S. § 2815 — ME Code / Title 24-A / Chapter 35 / Section 2815
24-A §2815. Legal liability of policyholders
Status: in_force

Nothing contained in this chapter shall be deemed to affect the legal liability of policyholders for the death of or injury to any member of any such group. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 4227 — ME Code / Title 24-A / Chapter 56 / Section 4227
24-A §4227. Choice of alternative coverage
Status: in_force

Any employer of more than 50 employees who offers a health maintenance organization, as defined in section 4202‑A , shall also offer its employees, at the time of offering and renewal of the health maintenance organization, the option of selecting alternative health benefits coverage that does not restrict the ability of the covered persons to obtain health care services from the providers of their choice. [PL 1991, c. 709, §8 (AMD).]

Any employer subject to this section shall contribute to the alternative health benefits coverage to the same extent as it contributes to the health maintenance organization. [PL 1985, c. 704, §8 (NEW).]

An employer may not be required to pay more for health benefits as a result of the application of this section than would otherwise be paid. [PL 1991, c. 709, §8 (AMD).]

An employer may satisfy the requirements of this section by offering a point-of-service option but may not satisfy the requirements of this section by contributing to the cost of an individual health plan. [PL 1997, c. 370, Pt. B, §4 (AMD).]
24-A M.R.S. § 3707 — ME Code / Title 24-A / Chapter 52 / Section 3707
24-A §3707. Powers of the board
Status: in_force

The board has full power, authority and jurisdiction over the company. [PL 1991, c. 885, Pt. C, §8 (NEW).]

1. General authority. The board may perform all acts necessary or convenient in the exercise of any power, authority or jurisdiction over the company, either in the administration of the company or in connection with the business of the company to fulfill the purposes of this chapter. [PL 1997, c. 661, §8 (AMD).]

2. Standard of performance. The board shall discharge its duties with the care, skill, prudence, and diligence as that of prudent directors acting in a similar enterprise and purpose. [PL 1991, c. 885, Pt. C, §8 (NEW).]

3. Personal liability. The members of the board and officers or employees of the company are not liable personally, either jointly severally, for any debt or obligation created or incurred by the company. [PL 1991, c. 885, Pt. C, §8 (NEW).]

4. President. The board shall appoint a president who shall serve as chief executive officer and may appoint other executive officers as it determines necessary. [PL 1991, c. 885, Pt. C, §8 (NEW).]

5. Investment managers. The board shall appoint investment managers to oversee and manage the investment of assets of the corporation in a manner that safeguards the value of those assets and maximizes investment return commensurate with risk and liquidity restrictions contained in chapter 13 . A. An investment manager appointed by the board is subject to standards applicable to fiduciaries responsible for safeguarding assets of such a corporation. The investment manager must be appointed pursuant to a contract in writing that clearly establishes the fiduciary nature of the relationship of the fiduciary to the company. [PL 1991, c. 885, Pt. C, §8 (NEW).] B. The board shall set investment policy for the investment managers of the company through an investment committee composed of not less than 3 members nor more than 5 members of the board. Transactions in the sale or purchase of securities by an investment manager may be in a nominee name as designated by the board. Authority to acquire or sell securities for the company must be conveyed to the investment manager in writing by the investment committee. [PL 1991, c. 885, Pt. C, §8 (NEW).] C. In any agreement empowering the investment managers to act for or on behalf of the company, there must be provisions for periodic reporting by the managers respecting investments held in the name of the company, the yield received on such investments and any principal cash balances held by depositories or the investment managers. [PL 1991, c. 885, Pt. C, §8 (NEW).] D. Securities and property of the corporation must be held in a manner consistent with the requirements for mutual insurance companies set forth in this Title. [PL 1991, c. 885, Pt. C, §8 (NEW).] [PL 1991, c. 885, Pt. C, §8 (NEW).]
24-A M.R.S. § 602 — ME Code / Title 24-A / Chapter 7 / Section 602
24-A §602. Tax on premiums and annuity considerations
Status: in_force

As to returns and taxes on premiums and annuity considerations refer to Title 36, chapter 357 . [PL 1989, c. 502, Pt. A, §92 (AMD).]
24-A M.R.S. § 3152 — ME Code / Title 24-A / Chapter 44 / Section 3152
24-A §3152. Scope and applicability
Status: in_force

This chapter establishes requirements for the sale, solicitation, negotiation or offer of pet insurance in this State. [PL 2021, c. 562, §1 (NEW).]

1. Applicability. The requirements of this chapter apply to pet insurance policies that are sold, solicited, negotiated or offered in this State and that are issued to any resident of this State and to policies or certificates that are delivered or issued for delivery in this State. [PL 2021, c. 562, §1 (NEW).]

2. General provisions of Title 24-A. All applicable provisions of this Title apply to pet insurance, except that the specific provisions of this chapter supersede any general provisions of this Title that would otherwise be applicable to pet insurance. [PL 2021, c. 562, §1 (NEW).]
24-A M.R.S. § 4134 — ME Code / Title 24-A / Chapter 55 / Section 4134
24-A §4134. Reports and valuations
Status: in_force

Reports shall be filed and synopses of annual statements shall be published in accordance with the provisions of this section. [PL 1969, c. 132, §1 (NEW).]

1. Every society transacting business in this State shall annually, on or before the first day of March, unless for cause shown such time has been extended by the superintendent, file with the superintendent a true statement of its financial condition, transactions and affairs for the preceding calendar year. The statement must be in general form and context as approved by the National Association of Insurance Commissioners for fraternal benefit societies and as supplemented by additional information required by the superintendent. The society shall also file quarterly statements in accordance with the National Association of Insurance Commissioners quarterly statement instructions for fraternal benefit societies, if applicable, and shall report material investment and reinsurance transactions consistent with section 423‑C . If the society provides health care benefits, it shall file a health insurance supplement consistent with section 423‑D . The fee for filing the annual statement is the same as for an insurer as provided in section 601 . [PL 2017, c. 169, Pt. A, §8 (AMD).]

2. A synopsis of its annual statement providing an explanation of the facts concerning the condition of the society thereby disclosed shall be printed and mailed to each benefit member of the society not later than June 1 of each year, or, in lieu thereof, such synopsis may be published in the society's official publication. [PL 1969, c. 132, §1 (NEW).]

3. As a part of the annual statement herein required, each society shall, on or before the 1st day of March, file with the superintendent a valuation of its certificates in force on December 31 last preceding, except that the superintendent may, in the superintendent's discretion for cause shown, extend the time for filing such valuation for not more than 2 calendar months. Such report of valuation must show, as reserve liabilities, the difference between the present midyear value of the promised benefits provided in the certificates of such society in force and the present midyear value of the future net premiums as the same are in practice actually collected, not including therein any value for the right to make extra assessments and not including any amount by which the present midyear value of future net premiums exceeds the present midyear value of promised benefits on individual certificates. At the option of any society, in lieu of the above, the valuation may show the net tabular value. Such net tabular value as to certificates issued prior to one year after January 1, 1970 must be determined in accordance with the provisions of law applicable prior to January 1, 1970 and as to certificates issued on or after one year from January 1, 1970 may not be less than the reserves determined according to the superintendent's reserve valuation method as hereinafter defined. If the premium charged is less than the tabular net premium according to the basis of valuation used, an additional reserve equal to the present value of the deficiency in such premiums must be set up and maintained as a liability. The reserve liabilities must be properly adjusted in the event that the midyear or tabular values are not appropriate. [RR 2021, c. 1, Pt. B, §335 (COR).]

4. Reserves according to the superintendent's reserve valuation method for the life insurance and endowment benefits of certificates providing for a uniform amount of insurance and requiring the payment of uniform premiums must be the excess, if any, of the present value, at the date of valuation, of such future guaranteed benefits provided for by such certificates, over the then present value of any future modified net premiums therefor. The modified net premiums for any such certificate must be such uniform percentage of the respective contract premiums for such benefits that the present value, at the date of issue of the certificate, of all such modified net premiums is equal to the sum of the then present value of such benefits provided for by the certificate and the excess of A over B , as follows: A. A net level premium equal to the present value, at the date of issue, of such benefits provided for after the first certificate year, divided by the present value, at the date of issue, of an annuity of one per annum payable on the first and each subsequent anniversary of such certificate on which a premium falls due; provided however that such net level annual premium may not exceed the net level annual premium on the 19-year premium whole life plan for insurance of the same amount at an age 1 year higher than the age at issue of such certificate; and [PL 2013, c. 588, Pt. A, §28 (AMD).] B. A net one-year term premium for such benefits provided for in the first certificate year. [PL 2013, c. 588, Pt. A, §28 (AMD).] Reserves according to the superintendent's reserve valuation method must be calculated by a method consistent with the principles of this subsection for life insurance benefits for varying amounts of benefits or requiring the payment of varying premiums; annuity and pure endowment benefits; disability and accidental death benefits in all certificates and contracts; and all other benefits except life insurance and endowment benefits. [PL 2013, c. 588, Pt. A, §28 (AMD).]

5. The present value of deferred payments due under incurred claims or matured certificates shall be deemed a liability of the society and shall be computed upon mortality and interest standards prescribed in the following subsection. [PL 1969, c. 132, §1 (NEW).]

6. Such valuation and underlying data must be certified by a competent actuary or, at the expense of the society, verified by the actuary of the department of insurance of the state of domicile of the society. A. The minimum standards of valuation for certificates issued prior to January 1, 1970 must be those provided by the law applicable immediately prior to January 1, 1970 but not lower than the standards used in the calculating of rates for such certificates. [RR 2021, c. 1, Pt. B, §336 (COR).] B. The minimum standard of valuation for certificates issued after January 1, 1970 must be such interest assumptions and tables as authorized for use by domestic life insurers or 3 1/2% interest and the following tables: (1) For certificates of life insurance: American Men Ultimate Table of Mortality, with Bowerman's or Davis' extension thereof or with the consent of the superintendent, the Commissioners 1941 Standard Ordinary Mortality Table, the Commissioners 1941 Standard Industrial Mortality Table or the Commissioners 1958 Standard Ordinary Mortality Table, using actual age of the insured for male risks and an age more than 3 years younger than the actual age of the insured for female risks; (2) For annuity and pure endowment certificates, excluding any disability and accidental death benefits in such certificates: The 1937 Standard Annuity Mortality Table or the Annuity Mortality Table for 1949, ultimate, or any modification of either of these tables approved by the superintendent; (3) For total and permanent disability benefits in or supplementary to life insurance certificates: Hunter's Disability Table, or the class III disability table (1926) modified to conform to the contractual waiting period, or the tables of period 2 disablement rates and the 1930 to 1950 termination rates of the 1952 disability study of the Society of Actuaries with due regard to the type of benefit. Any such table must, for active lives, be combined with a mortality table permitted for calculating the reserves for life insurance certificates; (4) For accidental death benefits in or supplementary to life insurance certificates: The Inter-company Double Indemnity Mortality Table or the 1959 Accidental Death Benefits Table. Either table must be combined with a mortality table permitted for calculating the reserves for life insurance certificates; and (5) For noncancellable accident and health benefits: The class III disability table (1926) with conference modifications or, with the consent of the superintendent, tables based upon the society's own experience. [RR 2021, c. 1, Pt. B, §336 (COR).] The superintendent may, in the superintendent's discretion, accept other standards for valuation if the superintendent finds that the reserves produced thereby will not be less in the aggregate than reserves computed in accordance with the minimum valuation standard herein prescribed. The superintendent may, in the superintendent's discretion, vary the standards of mortality applicable to all certificates of insurance on substandard lives or other extra hazardous lives by any society authorized to do business in this State. Whenever the mortality experience under all certificates valued on the same mortality table is in excess of the expected mortality according to such table for a period of 3 consecutive years, the superintendent may require additional reserves when considered necessary in the superintendent's judgment on account of such certificates. Any society, with the consent of the insurance supervisory officer of the state of domicile of the society and under such conditions, if any, that the insurance supervisory officer may impose, may establish and maintain reserves on its certificates in excess of the reserves required thereunder, but the contractual rights of any insured member are not affected thereby. [RR 2021, c. 1, Pt. B, §336 (COR).]

7. A society neglecting to file the annual or quarterly statement in the form and within the time provided by this section shall forfeit $100 for each day during which such neglect continues, and, upon notice by the superintendent to that effect, its authority to do business in this State ceases while such default continues. [PL 2017, c. 169, Pt. A, §9 (AMD).]
24-A M.R.S. § 2444 — ME Code / Title 24-A / Chapter 27 / Section 2444
24-A §2444. Approval of forms
Status: in_force

A policy form meeting the requirements of section 2441, subsection 1 shall be approved notwithstanding the provisions of any other laws which specify the content of policies, if the policy form provides the policyholders and claimants protection not less favorable than they would be entitled to under such laws. [PL 1979, c. 267, §2 (NEW).]
24-A M.R.S. § 3007 — ME Code / Title 24-A / Chapter 41 / Section 3007
24-A §3007. Cancellation and nonrenewal
Status: in_force

1. As used in this section, unless the context indicates otherwise, the following terms have the following meanings. A. "Cancellation" means termination of a policy at a date other than its expiration date. [PL 1985, c. 671, §2 (NEW).] B. "Expiration date" means the date upon which coverage under a policy ends. It also means, for a policy written for a term longer than one year or with no fixed expiration date, each annual anniversary date of the policy. [PL 1985, c. 671, §2 (NEW).] C. "Nonpayment of premium" means the failure or inability of the named insured to discharge any obligation in connection with the payment of premium on a policy of insurance subject to this section, whether the payments are payable directly to the insurer or its agent or indirectly payable under a premium finance plan or extension of credit. [PL 1985, c. 671, §2 (NEW).] D. "Nonrenewal" means termination of a policy at its expiration date. [PL 1985, c. 671, §2 (NEW).] E. "Renewal" or "to renew" means the issuance of, or the offer to issue by an insurer or an affiliate of an insurer, a policy succeeding a policy previously issued and delivered by the same insurer or an affiliated insurer or the issuance of a certificate or notice extending the terms of an existing policy for a specified period beyond its expiration date. For purposes of this section, the transfer of a policy from an insurer to an affiliate is considered a policy renewal. [PL 2005, c. 114, §3 (AMD).] [PL 2005, c. 114, §3 (AMD).]

2. Except as provided by subsection 8 , no contract of property insurance may be cancelled by an insurer prior to the expiration of the policy, except for one or more of the following grounds: A. Nonpayment of premium; [PL 1985, c. 671, §2 (NEW).] B. Fraud or material misrepresentation made by or with the knowledge of the named insured in obtaining the policy, continuing the policy or in presenting a claim under the policy; [PL 1985, c. 671, §2 (NEW).] C. Substantial change in the risk which increases the risk of loss after insurance coverage has been issued or renewed, including, but not limited to, an increase in exposure due to regulation, legislation or court decision; [PL 1985, c. 671, §2 (NEW).] D. Failure to comply with reasonable loss control recommendations; [PL 1985, c. 671, §2 (NEW).] E. Substantial breach of contractual duties, conditions or warranties; or [PL 1985, c. 671, §2 (NEW).] F. Determination by the superintendent that the continuation of a class or block of business to which the policy belongs will jeopardize a company's solvency or will place the insurer in violation of the insurance laws of this State or any other state. [PL 1985, c. 671, §2 (NEW).] The grounds listed in paragraphs A to E shall be contained in all policies issued, issued for delivery or renewed on or after the effective date of this section. Insurers shall have 30 days from the effective date of this section to notify insureds of these grounds for cancellation on policies issued or issued for delivery before the effective date of this section. [PL 1985, c. 671, §2 (NEW).]

3. If a policy has been issued for a term longer than one year and, for additional premium consideration, a premium has been guaranteed, the insurer may not refuse to renew or increase the policy premium for the term of that policy. [PL 1985, c. 671, §2 (NEW).]

4. If an insurer offers or purports to renew a contract, but on less favorable terms to the insured or at higher rates, and a higher rating plan, the new terms or rates and rating plan may take effect on the renewal date if the insurer has provided the insured notice as required by this section. If the insurer has not so notified the contract holder, the contract holder may elect to cancel the renewal policy within the 30-day period after receipt of the notice or delivery. Earned premium for the period of coverage for such time as the renewal contract may have been in force shall be calculated pro rata at the lower of the current or previous year's rate. If the insured accepts the renewal, the premium increase, if any, and other changes shall be effective immediately following the prior policy's expiration or anniversary date. This section does not apply if the change is a rate, form or plan filed with the superintendent and applicable to the entire class of business to which the policy belongs or to a premium increase based on the altered nature or extent of the risk insured against. [PL 1985, c. 671, §2 (NEW).]

5. Cancellation or nonrenewal is not effective until notice is received by the insured as follows. A. To the extent that section 3002 is applicable, the notice of cancellation shall be given as provided for in that section. If section 3002, is not applicable, cancellation shall not be effective prior to 10 days after receipt by the insured of a notice of cancellation. The notice shall state the effective date of and the reason or reasons for cancellation. [PL 1985, c. 671, §2 (NEW).] B. Nonrenewal subject to this section is not effective prior to 30 days after receipt of written notice by the insured. 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 2009, c. 415, Pt. A, §13 (AMD).] C. A post-office certificate of mailing to the named insured at the named insured's last known address is conclusive proof of receipt of notice on the 3rd calendar day after mailing. [RR 2021, c. 1, Pt. B, §262 (COR).] [RR 2021, c. 1, Pt. B, §262 (COR).]

6. Any insured who has received a notice of an insurer's intent to cancel a policy may, within 45 days of the receipt of the notice, request a hearing before the superintendent. The purpose of this hearing shall be limited to establishing the existence of the proof or evidence given by the insurer in its notice of cancellation. The burden of proof of the reason for cancellation shall be upon the insurer. The superintendent shall have the authority to order that a policy remain in force both pending and, if the superintendent finds in favor of the insured, subsequent to a hearing. If the superintendent finds in favor of the insurer at a hearing, the superintendent may order the policy to remain in force for 14 days to allow the insured to obtain other coverage. [PL 1989, c. 172, §6 (AMD).]

7. Except as provided in Title 10, chapter 209‑B , no insurer or licensed agent or employee of the insurer may be held liable in any civil action for statements made in a notice of cancellation or nonrenewal or at a hearing held under this section if the statements were made in good faith and, in the case of cancellation, are reasonably related to the grounds for cancellation. [PL 2013, c. 588, Pt. C, §14 (AMD).]

8. This section does not apply to any insurance policy that has not been previously renewed if the policy has been in effect less than 60 days at the time notice of cancellation is mailed or otherwise delivered, except as provided in subsection 1, paragraph A and subsection 5, paragraphs A and C . This section does not apply to any policy subject to subchapter 5 . This section does not apply to any policy issued pursuant to any assigned risk plan. The superintendent may suspend, in whole or in part, the applicability of this section to any insurer if, in the superintendent's discretion, its application will endanger the ability of the insurer to fulfill its contractual obligation. [PL 2007, c. 188, Pt. C, §8 (AMD).]

9. This section applies to all contracts of property insurance, except surplus lines contracts, delivered or issued for delivery in this State, both before and after the effective date of this section. Provisions in this section relating to nonrenewal of policies shall take effect 30 days after the effective date of this section. [PL 1989, c. 172, §6 (AMD).]
24-A M.R.S. § 2532-A — ME Code / Title 24-A / Chapter 29 / Section 2532-A
24-A §2532-A. Adjusted premiums for policies issued on or after January 1, 1989, or elected operative date of this section
Status: in_force

1. This section shall apply to all policies issued on or after the operative date of this section as defined herein. Except as provided in subsection 7 , the adjusted premiums for any policy shall be calculated on an annual basis and shall be that uniform percentage of the respective premiums specified in the policy for each policy year, excluding amounts payable as extra premiums to cover impairments or special hazards and also excluding any uniform annual contract charge or policy fee specified in the policy in a statement of the method to be used in calculating the cash surrender values and paid-up nonforfeiture benefits, that the present value, at the date of issue of the policy, of all adjusted premiums shall be equal to the sum of: A. The then present value of the future guaranteed benefits provided for by the policy; [PL 1983, c. 346, §13 (NEW).] B. One percent of either the amount of insurance, if the insurance be uniform in amount, or the average amount of insurance at the beginning of each of the first 10 policy years; and [PL 1983, c. 346, §13 (NEW).] C. One hundred twenty-five percent of the nonforfeiture net level premium as hereinafter defined. [PL 1983, c. 346, §13 (NEW).] In applying the percentage specified in paragraph C , no nonforfeiture net level premium may be deemed to exceed 4% of either the amount of insurance, if the insurance be uniform in amount, or the average amount of insurance at the beginning of each of the first 10 policy years. The date of issue of a policy for the purpose of this section shall be the date as of which the rated age of the insured is determined. [PL 1983, c. 346, §13 (NEW).]

2. The nonforfeiture net level premium shall be equal to the present value, at the date of issue of the policy, of the guaranteed benefits provided for by the policy divided by the present value, at the date of issue of the policy, of an annuity of one per annum payable on the date of issue of the policy and on each anniversary of the policy on which a premium falls due. [PL 1983, c. 346, §13 (NEW).]

3. In the case of policies which cause, on a basis guaranteed in the policy, unscheduled changes in benefits or premiums, or which provide an option for changes in benefits or premiums other than a change to a new policy, the adjusted premiums and present values shall initially be calculated on the assumption that future benefits and premiums do not change from those stipulated at the date of issue of the policy. At the time of any change of that type in the benefits or premiums the future adjusted premiums, nonforfeiture net level premiums and present values shall be recalculated on the assumption that future benefits and premiums do not change from those stipulated by the policy immediately after the change. [PL 1983, c. 346, §13 (NEW).]

4. Except as otherwise provided in subsection 7 , the recalculated future adjusted premiums for any policy of that type shall be that uniform percentage of the respective future premiums specified in the policy for each policy year, excluding amounts payable as extra premiums to cover impairments and special hazards, and also excluding any uniform annual contract charge or policy fee specified in the policy in a statement of the method to be used in calculating the cash surrender values and paid-up nonforfeiture benefits, that the present value, at the time of change to the newly defined benefits or premiums of all those future adjusted premiums shall be equal to the excess of: A. The sum of the then present value of the then future guaranteed benefits provided for by the policy and the additional expense allowance, if any; over [PL 1983, c. 346, §13 (NEW).] B. The then cash surrender value, if any, or present value of any paid-up nonforfeiture benefit under the policy. [PL 1983, c. 346, §13 (NEW).] [PL 1983, c. 346, §13 (NEW).]

5. The additional expense allowance, at the time of the change to the newly defined benefits or premiums, shall be the sum of: A. One percent of the excess, if positive, of the average amount of insurance at the beginning of each of the first 10 policy years subsequent to the change over the average amount of insurance prior to the change at the beginning of each of the first 10 policy years subsequent to the time of the most recent previous change, or, if there has been no previous change, the date of issue of the policy; and [PL 1983, c. 346, §13 (NEW).] B. One hundred twenty-five percent of the increase, if positive, in the nonforfeiture net level premium. [PL 1983, c. 346, §13 (NEW).] [PL 1983, c. 346, §13 (NEW).]

6. The recalculated nonforfeiture net level premium shall be equal to the result obtained by dividing paragraph A by paragraph B where: A. Paragraph A equals the sum of: (1) The nonforfeiture net level premium applicable prior to the change times the present value of an annuity of one per annum payable on each anniversary of the policy on or subsequent to the date of the change on which a premium would have fallen due had the change not occurred; and (2) The present value of the increase in future guaranteed benefits provided for by the policy; and [PL 1983, c. 346, §13 (NEW).] B. Paragraph B equals the present value of an annuity of one per annum payable on each anniversary of the policy on or subsequent to the date of change on which a premium falls due. [PL 1983, c. 346, §13 (NEW).] [PL 1983, c. 346, §13 (NEW).]

7. Notwithstanding any other provisions of this section to the contrary, in the case of a policy issued on a substandard basis which provides reduced graded amounts of insurance so that, in each policy year, that policy has the same tabular mortality cost as an otherwise similar policy issued on the standard basis which provides higher uniform amounts of insurance, adjusted premiums and present values for that substandard policy may be calculated as if it were issued to provide those higher uniform amounts of insurance on the standard basis. [PL 1983, c. 346, §13 (NEW).]

8. All adjusted premiums and present values referred to in this Standard Nonforfeiture Law for Life Insurance shall, for all policies of ordinary insurance issued after the operative date of this section, be calculated on the basis of the Commissioners 1980 Standard Ordinary Mortality Table or, at the election of the insurer for any one or more specified plans of life insurance, the Commissioners 1980 Standard Ordinary Mortality Table with 10-year select mortality factors; shall, for all policies of industrial insurance, be calculated on the basis of the Commissioners 1961 Standard Industrial Mortality Table; and shall, for all policies issued in a particular calendar year, be calculated on the basis of a rate of interest not exceeding the nonforfeiture interest rate as defined in this section for policies issued in that calendar year, provided that: A. At the option of the insurer, calculations for all policies issued in a particular calendar year may be made on the basis of a rate of interest not exceeding the nonforfeiture interest rate, as defined in this section, for policies issued in the immediately preceding calendar year; [PL 1983, c. 346, §13 (NEW).] B. Under any paid-up nonforfeiture benefit, including any paid-up dividend additions, any cash surrender value available, whether or not required by section 2529 , shall be calculated on the basis of the mortality table and rate of interest used in determining the amount of that paid-up nonforfeiture benefit and paid-up dividend additions, if any; [PL 1983, c. 346, §13 (NEW).] C. An insurer may calculate the amount of any guaranteed paid-up nonforfeiture benefit, including any paid-up additions under the policy on the basis of an interest rate no lower than that specified in the policy for calculating cash surrender values; [PL 1983, c. 346, §13 (NEW).] D. In calculating the present value of any paid-up term insurance with accompanying pure endowment, if any, offered as a nonforfeiture benefit, the rates of mortality assumed may be not more than those shown in the Commissioners 1980 Extended Term Insurance Table for policies of ordinary insurance and not more than the Commissioners 1961 Industrial Extended Term Insurance Table for policies of industrial insurance; [PL 1983, c. 346, §13 (NEW).] E. For insurance issued on a substandard basis, the calculation of any such adjusted premiums and present values may be based on appropriate modifications of the tables mentioned in this section; [PL 1983, c. 346, §13 (NEW).] F. Any approved commissioners standard ordinary mortality tables, adopted in accordance with paragraph H , may be substituted for the Commissioners 1980 Standard Ordinary Mortality Table with or without 10-year select mortality factors or for the Commissioners 1980 Extended Term Insurance Table; [PL 2013, c. 238, Pt. C, §11 (AMD).] G. Any approved commissioners standard industrial mortality tables, adopted in accordance with paragraph H , may be substituted for the Commissioners 1961 Standard Industrial Mortality Table or the Commissioners 1961 Industrial Extended Term Insurance Table; and [PL 2013, c. 238, Pt. C, §11 (AMD).] H. For policies issued before the operative date of the valuation manual, as defined in section 951‑A, subsection 3 , the superintendent may adopt rules approving commissioners standard mortality tables for use in determining the minimum nonforfeiture standard. Rules adopted pursuant to this paragraph are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . For policies issued on or after the operative date of the valuation manual, the applicable commissioners standard mortality tables specified in the valuation manual are approved for use in determining the minimum nonforfeiture standard unless superseded by rule adopted by the superintendent. [PL 2013, c. 238, Pt. C, §12 (NEW).] [PL 2013, c. 238, Pt. C, §§11, 12 (AMD).]

9. The nonforfeiture interest rate per annum for any policy issued in a particular calendar year must be equal to 125% of the calendar year statutory valuation interest rate for that policy as defined in the Standard Valuation Law, rounded to the nearer 1/4 of 1%, except as otherwise provided in the valuation manual for policies issued on and after the operative date of the valuation manual, as defined in section 951‑A, subsection 3 . [PL 2013, c. 238, Pt. C, §13 (AMD).]

10. Notwithstanding any other provision in this code to the contrary, any refiling of nonforfeiture values or their methods of computation for any previously approved policy form which involves only a change in the interest rate or mortality table used to compute nonforfeiture values shall not require refiling of any other provisions of that policy form. [PL 1983, c. 346, §13 (NEW).]

11. After the effective date of this section, any insurer may file with the superintendent a written notice of its election to comply with the provisions of this section after a specified date before January 1, 1989, which shall be the operative date of this section for that insurer. If an insurer makes no such election, the operative date of this section for that company shall be January 1, 1989. [PL 1983, c. 346, §13 (NEW).]
24 M.R.S. § 2332-E — ME Code / Title 24 / Chapter 19 / Section 2332-E
24 §2332-E. Standardized claim forms
Status: in_force

All nonprofit hospital or medical service organizations and nonprofit health care plans providing payment or reimbursement for diagnosis or treatment of a condition or a complaint by a licensed health care practitioner must accept the current standardized claim form for professional services approved by the Federal Government and submitted electronically. All nonprofit hospital or medical service organizations and nonprofit health care plans providing payment or reimbursement for diagnosis or treatment of a condition or a complaint by a licensed hospital must accept the current standardized claim form for professional or facility services, as applicable, approved by the Federal Government and submitted electronically, and any claims for facility services must identify the physical location, including hospital off-campus locations, where services are provided. A nonprofit hospital or medical service organization or nonprofit health care plan may not be required to accept a claim submitted on a form other than the applicable form specified in this section and may not be required to accept a claim that is not submitted electronically, except from a health care practitioner who is exempt pursuant to section 2985 . [PL 2023, c. 521, §1 (AMD).]
24-A M.R.S. § 3002 — ME Code / Title 24-A / Chapter 41 / Section 3002
24-A §3002. Standard fire policy required; exceptions
Status: in_force

1. No insurer may issue fire insurance policies on property in this State other than those of the Maine standard fire insurance policy which shall contain the following consideration and insuring clause, assignment clause and the general conditions and stipulations set forth after these consideration, insuring and assignment clauses: Consideration and Insuring Clause In Consideration of the Provisions and Stipulations herein or added hereto and of the premium above specified, this Company, for the term of .......... from .......... at 12:01 a.m. (Standard Time) to .......... at 12:01 a.m. (Standard Time) at location of property involved, to an amount not exceeding the amount(s) above specified, does insure .......... and legal representatives, to the extent of the actual cash value of the property at the time of loss, but not exceeding the amount which it would cost to repair or replace the property with material of like kind and quality within a reasonable time after such loss, without allowance for any increased cost of repair or reconstruction by reason of any ordinance or law regulating construction or repair, and without compensation for loss resulting from interruption of business or manufacture, nor in any event for more than the interest of the insured, against all DIRECT LOSS BY FIRE, LIGHTNING AND BY REMOVAL FROM PREMISES ENDANGERED BY THE PERILS INSURED AGAINST IN THIS POLICY, EXCEPT AS HEREINAFTER PROVIDED, to the property described herein while located or contained as described in this policy, or pro rata for five days at each proper place to which any of the property shall necessarily be removed for preservation from the perils insured against in this policy, but not elsewhere. Assignment Clause Assignment of this policy shall not be valid except with the written consent of this Company. This policy is made and accepted subject to the foregoing provisions and stipulations and those hereinafter stated, which are hereby made a part of this policy, together with such other provisions, stipulations and agreements as may be added hereto, as provided in this policy. General Conditions and Stipulations Concealment, fraud. This entire policy shall be void if, whether before or after a loss, the insured has willfully concealed or misrepresented any material fact or circumstance concerning this insurance or the subject thereof, or the interest of the insured therein, or in case of any fraud or false swearing by the insured relating thereto. Uninsurable and excepted property. This policy shall not cover accounts, bills, currency, deeds, evidences of debt, money or securities; nor, unless specifically, named hereon in writing, bullion or manuscripts. Perils not included. This Company shall not be liable for loss by fire or other perils insured against in this policy caused, directly or indirectly by: (a) enemy attack by armed forces, including action taken by military, naval or air forces in resisting an actual or an immediately impending enemy attack; (b) invasion; (c) insurrection; (d) rebellion; (e) revolution; (f) civil war; (g) usurped power; (h) order of any civil authority except acts of destruction at the time of and for the purpose of preventing the spread of fire, provided that such fire did not originate from any of the perils excluded by this policy; (i) neglect of the insured to use all reasonable means to save and preserve the property at and after a loss, or when the property is endangered by fire in neighboring premises; (j) nor shall this Company be liable for loss by theft. Other insurance. Other insurance may be prohibited or the amount of insurance may be limited by endorsement attached hereto. Conditions suspending or restricting insurance. Unless otherwise provided in writing added hereto this Company shall not be liable for loss occurring (a) while the hazard is increased by any means within the control or knowledge of the insured; or (b) while a described building, whether intended for occupancy by owner or tenant, is vacant or unoccupied beyond a period of sixty consecutive days; or (c) as a result of explosion or riot, unless fire ensues, and in that event for loss by fire only. Other perils or subjects. Any other peril to be insured against or subject of insurance to be covered in this policy shall be by endorsement in writing hereon or added hereto. Added provisions. The extent of the application of insurance under this policy and of the contribution to be made by this Company in case of loss, and any other provision or agreement not inconsistent with the provisions of this policy, may be provided for in writing added hereto, but no provision may be waived except such as by the terms of this policy is subject to change. Waiver provisions. No permission affecting this insurance shall exist, or waiver of any provision be valid, unless granted herein or expressed in writing added hereto. No provision, stipulation or forfeiture shall be held to be waived by any requirement or proceeding on the part of this Company relating to appraisal or to any examination provided for herein. Cancellation of policy. This policy shall be cancelled at any time at the request of the insured, in which case this Company shall, upon demand and surrender of this policy, refund the excess of paid premium above the customary short rates for the expired time. This policy may be cancelled at any time by this Company by giving to the insured a ten days' written notice of cancellation with or without tender of the excess of paid premium above the pro rata premium for the expired time, which excess, if not tendered, shall be refunded on demand. Notice of cancellation shall state that said excess premium (if not tendered) will be refunded on demand. Mortgagee interests and obligations. If loss hereunder is made payable, in whole or in part, to a designated mortgagee not named herein as the insured, such interest in this policy may be cancelled by giving to such mortgagee a ten days' written notice of cancellation. If the insured fails to render proof of loss such mortgagee, upon notice, shall render proof of loss in the form herein specified within sixty (60) days thereafter and shall be subject to the provisions hereof relating to appraisal and time of payment and of bringing suit. If this Company shall claim that no liability existed as to the mortgagor or owner, it shall, to the extent of payment of loss to the mortgagee, be subrogated to all the mortgagee's rights of recovery, but without impairing mortgagee's right to sue; or it may pay off the mortgage debt and require an assignment thereof and of the mortgage. Other provisions relating to the interests and obligations of such mortgagee may be added hereto by agreement in writing. Pro rata liability. This Company shall not be liable for a greater proportion of any loss than the amount hereby insured shall bear to the whole insurance covering the property against the peril involved, whether collectible or not. Requirements in case loss occurs. The insured shall give immediate written notice to this Company of any loss, protect the property from further damage, forthwith separate the damaged and undamaged personal property, put it in the best possible order, furnish a complete inventory of the destroyed, damaged and undamaged property, showing in detail quantities, costs, actual cash value and amount of loss claimed; and within sixty days after the loss, unless such time is extended in writing by this Company, the insured shall render to this Company a proof of loss, signed and sworn to by the insured, stating the knowledge and belief of the insured as to the following: The time and origin of the loss, the interest of the insured and of all others in the property, the actual cash value of each item thereof and the amount of loss thereto, all encumbrances thereon, all other contracts of insurance, whether valid or not, covering any of said property, any changes in the title, use, occupation, location, possession or exposures of said property since the issuing of this policy, by whom and for what purpose any building herein described and the several parts thereof were occupied at the time of loss and whether or not it then stood on leased ground, and shall furnish a copy of all the descriptions and schedules in all policies and, if required, verified plans and specifications of any building, fixtures or machinery destroyed or damaged. The insured, as often as may be reasonably required, shall exhibit to any person designated by this Company all that remains of any property herein described, and submit to examinations under oath by any person named by this Company, and subscribe the same; and, as often as may be reasonably required, shall produce for examination all books of account, bills, invoices and other vouchers, or certified copies thereof if originals be lost, at such reasonable time and place as may be designated by this Company or its representative, and shall permit extracts and copies thereof to be made. Appraisal. In case the insured and this Company shall fail to agree as to the actual cash value or the amount of loss, then, on the written demand of either, each shall select a competent and disinterested appraiser and notify the other of the appraiser selected within twenty days of such demand. The appraisers shall first select a competent and disinterested umpire; and failing for fifteen days to agree upon such umpire, then, on request of the insured or this Company, such umpire shall be selected by a judge of a court of record in the state in which the property covered is located. The appraisers shall then appraise the loss, stating separately actual cash value and loss to each item; and, failing to agree, shall submit their differences, only, to the umpire. An award in writing, so itemized, of any two when filed with this Company shall determine the amount of actual cash value and loss. Each appraiser shall be paid by the party selecting that appraiser and the expenses of appraisal and umpire shall be paid by the parties equally. Company's options. It shall be optional with this Company to take all, or any part, of the property at the agreed or appraised value, and also to repair, rebuild or replace the property destroyed or damaged with other of like kind and quality within a reasonable time, on giving notice of its intention so to do within thirty days after the receipt of the proof of loss herein required. Abandonment. There can be no abandonment to this Company of any property. When loss payable. The amount of loss for which this Company may be liable shall be payable sixty days after proof of loss, as herein provided, is received by this Company and ascertainment of the loss is made either by agreement between the insured and this Company expressed in writing or by the filing with this Company of an award as herein provided. Suit. No suit or action on this policy for the recovery of any claim shall be sustainable in any court of law or equity unless all the requirements of this policy shall have been complied with, and unless commenced within two years next after inception of the loss. Subrogation. This Company may require from the insured an assignment of all right of recovery against any party for loss to the extent that payment therefor is made by this Company. [PL 1989, c. 316, §1 (AMD).]

2. The insurer may use an endorsement or rider attached to its printed policy forms used in other states in order, where necessary, to bring the terms of such form into compliance with the above provisions. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 4318-A — ME Code / Title 24-A / Chapter 56-A / Section 4318-A
24-A §4318-A. Comparable health care service incentive program
Status: in_force

Beginning January 1, 2019, a carrier offering a health plan in this State shall establish, at a minimum, for all small group health plans as defined in section 2808‑B, subsection 1, paragraph G compatible with a health savings account authorized under federal law, a health plan design in which enrollees are directly incentivized to shop for low-cost, high-quality participating providers for comparable health care services. Incentives may include, but are not limited to, cash payments, gift cards or credits or reductions of premiums, copayments or deductibles. A small group health plan design created under this section must remain available to enrollees for at least 2 consecutive years, except that any changes made to the program after 2 years, including, but not limited to, ending the incentive, may not be construed as a change to the small group health plan design for the purpose of guaranteed renewability under section 2808‑B, subsection 4 or section 2850‑B . A multiple-employer welfare arrangement is not considered a carrier for the purposes of this section. [PL 2017, c. 232, §8 (NEW).]

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Comparable health care service" means nonemergency, outpatient health care services in the following categories: (1) Physical and occupational therapy services; (2) Radiology and imaging services; (3) Laboratory services; and (4) Infusion therapy services. [PL 2017, c. 232, §8 (NEW).] B. "Program" means the comparable health care service incentive program established by a carrier pursuant to this section. [PL 2017, c. 232, §8 (NEW).] [PL 2017, c. 232, §8 (NEW).]

2. Filing with superintendent. Plans filed with the superintendent pursuant to this section must disclose, in the summary of benefits and explanation of coverage, a detailed description of the incentives available to a plan enrollee. The description must clearly detail any incentives that may be earned by the enrollee, including any limits on such incentives, the actions that must be taken in order to earn such incentives and a list of the types of services that qualify under the program. This subsection may not be construed to prevent a carrier from directing an enrollee to the carrier's website or toll-free telephone number for further information on the program in the summary of benefits and explanation of coverage. The superintendent shall review the filing made by the carrier to determine if the carrier's program complies with the requirements of this section. [PL 2017, c. 232, §8 (NEW).]

3. Availability of program; notice to enrollees. Annually at enrollment or renewal, a carrier shall provide notice about the availability of the program to an enrollee who is enrolled in a health plan eligible for the program as required by section 4302, subsection 1, paragraph M . [PL 2017, c. 232, §8 (NEW).]

4. Additional types of nonemergency health care services or procedures. Nothing in this section precludes a carrier from including additional types of nonemergency health care services or procedures in its program. [PL 2017, c. 232, §8 (NEW).]

5. No administrative expense. An incentive payment made by a carrier in accordance with this section is not an administrative expense of the carrier for rate development or rate filing purposes. [PL 2017, c. 232, §8 (NEW).]

6. Study and evaluation. Beginning March 1, 2020 and annually thereafter, the superintendent shall undertake a study and evaluation of the programs created by carriers as required by this section. The superintendent may request information on enrollment and use of incentives earned by enrollees of a carrier as necessary. By April 15, 2020 and annually thereafter, the superintendent shall submit an aggregate report relating to the performance of the programs, the use of incentives, the incentives earned by enrollees and the cumulative effect of the programs to the joint standing committee of the Legislature having jurisdiction over health insurance matters. [PL 2017, c. 232, §8 (NEW).]

7. Rules. The superintendent may adopt rules as necessary to implement this section. Rules adopted pursuant to this subsection are major substantive rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2017, c. 232, §8 (NEW).]

8. Repeal. [PL 2023, c. 224, §1 (RP).]
24-A M.R.S. § 958 — ME Code / Title 24-A / Chapter 11 / Section 958
24-A §958. Interest rates
Status: in_force

All changes in the interest rates specified in this subchapter and in sections 2528 to 2534 , which were made by the Amendatory Acts of 1979, shall become ineffective as to contracts or policies issued on or after November 1, 1987, unless expressly extended by law. [PL 1979, c. 453, §8 (NEW).]
24 M.R.S. § 2320-G — ME Code / Title 24 / Chapter 19 / Section 2320-G
24 §2320-G. Off-label use of prescription drugs for HIV or AIDS
Status: in_force

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

2. Required coverage for off-label use. All individual and group nonprofit hospital and medical services plan contracts and nonprofit health care plan contracts that provide coverage for prescription drugs must provide coverage for off-label use in accordance with the following. A. Individual and group nonprofit hospital and medical services plan contracts and nonprofit health care plan contracts that provide coverage for prescription drugs may not exclude coverage for any such drug used for the treatment of HIV or AIDS on the grounds that the drug has not been approved by the federal Food and Drug Administration for that indication, as long as that drug is recognized for the treatment of that indication in one of the standard reference compendia or in peer-reviewed medical literature. [PL 1997, c. 701, §1 (NEW).] B. Coverage of a drug required by this subsection also includes medically necessary services associated with the administration of the drug. [PL 1997, c. 701, §1 (NEW).] C. This subsection may not be construed to require coverage for a drug when the federal Food and Drug Administration has determined its use to be contraindicated for treatment of the current indication. [PL 1997, c. 701, §1 (NEW).] D. A drug use that is covered pursuant to paragraph A may not be denied coverage based on a "medical necessity" requirement except for a reason that is unrelated to the legal status of the drug use. [PL 1997, c. 701, §1 (NEW).] E. A contract that provides coverage of a drug as required by this subsection may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the same extent that these provisions are applicable to coverage of all prescription drugs and are not inconsistent with the requirements of this subsection. [PL 1997, c. 701, §1 (NEW).] [PL 1997, c. 701, §1 (NEW).]

3. Application. The requirements of this section apply to all policies, contracts and certificates executed, delivered, issued for delivery, continued or renewed in this State on or after January 1, 1999. For purposes of this section, all contracts are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 1997, c. 701, §1 (NEW).]
24-A M.R.S. § 3033 — ME Code / Title 24-A / Chapter 41 / Section 3033
24-A §3033. Priority of mortgagees
Status: in_force

When 2 or more mortgagees claim the benefit of sections 3030 to 3032 , their rights shall be determined according to the priority of their claims and mortgages by the principles of law. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 3714 — ME Code / Title 24-A / Chapter 52 / Section 3714
24-A §3714. Accounting; assessments
Status: in_force

The following provisions apply to the financial operation of the company. [PL 2001, c. 350, §6 (AMD).]

1. Separate accounting. [PL 2001, c. 350, §7 (RP).]

2. Rates. Rates developed and filed by the company must be in accordance with chapter 25, subchapter II‑B . Rates filed within the rate-band are considered voluntary for purposes of chapter 25, subchapter II‑B . If a rate is filed outside the rate band, the superintendent may disapprove the rate if it is excessive, inadequate or unfairly discriminatory, using the standards set forth in section 2382 . "Rate band" means the range of rates from 85% to 145% of the benchmark rate. For the purposes of this subsection, "benchmark rate" is the pure premium rate filing filed by the State's advisory organization as defined in section 2381‑C and currently approved by the superintendent. [PL 1997, c. 661, §13 (AMD).]

3. Deficit. [PL 2001, c. 350, §8 (RP).]

4. Surplus. The surplus of the company is indivisible and is available for the benefit of all policyholders once certified by the superintendent. [PL 1991, c. 885, Pt. C, §8 (NEW).]

5. Assessment. Any assessment levied against policyholders is for the exclusive benefit of the policyholders subject to the assessment. Any policyholder not paying an undisputed assessment is not eligible for coverage from the company or in the voluntary market. [PL 1997, c. 661, §13 (AMD).]

6. Deficits in the high-risk division. [PL 2001, c. 350, §9 (RP).]

7. High-risk program. [PL 2017, c. 15, §1 (RP).]

8. Filing of retrospective rating plans. The board may file with the superintendent retrospective rating plans that, after hearing, may be imposed on an employer with a demonstrated record of repeated serious violations of workplace health and safety rules and regulations such as those adopted under Title 26, chapter 6 or 29 United States Code, Chapter 15, whichever is applicable. [PL 2017, c. 15, §2 (NEW).]

9. Availability of retrospective rating plans. The board shall develop and file with the superintendent and, if not disapproved by the superintendent, make available to policyholders on a voluntary basis retrospective rating plans. [PL 2017, c. 15, §2 (NEW).]
24-A M.R.S. § 3486 — ME Code / Title 24-A / Chapter 47 / Section 3486
24-A §3486. Plans for acquisition of minority interests in domestic stock insurance companies and appraisal of stock of dissenting shareholders
Status: in_force

1. Any parent corporation directly or indirectly owning at least 95% of the aggregate issued and outstanding shares of all classes of voting stock of a domestic stock insurance company or any such domestic stock insurance company whose voting stock is so owned may, pursuant to a plan for acquisition of minority interests in such subsidiary, acquire all of its remaining issued and outstanding shares of voting stock, by exchange of stock, other securities, cash, other consideration or any combination thereof. [PL 1977, c. 377 (NEW).]

2. The board of directors, trustees or other governing body of the parent corporation or the domestic stock insurance company may adopt a plan for the acquisition of minority interests in such subsidiary insurer. Every plan shall set forth: A. The name of the company whose shares are to be acquired; [PL 1977, c. 377 (NEW).] B. The total number of issued and outstanding shares of each class of voting stock of the company, the number of its shares owned by the parent corporation and, if either of the foregoing is subject to change prior to the effective date of acquisition, the manner in which any change may occur; [PL 1977, c. 377 (NEW).] C. The terms and conditions of the plan, including the manner and basis of exchanging the shares to be acquired for shares or other securities of the parent corporation, for cash, other consideration, or any combination of the foregoing, the proposed effective date of acquisition and a statement clearly describing the rights of dissenting shareholders to demand appraisal; [PL 1977, c. 377 (NEW).] D. If the parent corporation has adopted the plan and is neither a domestic corporation nor an authorized insurer, its agreement to be bound by this section with respect to the plan, its consent to the enforcement against it in this State of the rights of shareholders pursuant to the plan, and a designation of the superintendent as the agent upon whom process may be served against the parent corporation in the manner set forth in section 421 in any action or proceeding to enforce any such rights; and [PL 1977, c. 377 (NEW).] E. Such other provisions with respect to the plan as the board of directors, trustees or other governing body deems necessary or desirable, or which the superintendent may prescribe. [PL 1977, c. 377 (NEW).] [PL 1977, c. 377 (NEW).]

3. Upon adoption of the plan, it must be duly executed by the president and attested by the secretary, or the executive officers corresponding thereto, under the corporate seal of the parent corporation or the domestic stock insurance company that has adopted the plan, as the case may be. Thereupon, a certified copy of the plan, together with a certificate of its adoption subscribed by such officers and affirmed by them as true under the penalties of perjury and under the seal of the parent corporation or the domestic stock insurance company, as the case may be, must be submitted to the superintendent for the superintendent's approval. The superintendent shall thereupon consider the plan and, if satisfied that it complies with this section, is fair and equitable and not inconsistent with law, the superintendent shall approve the plan. If the superintendent disapproves the plan, notification of the superintendent's disapproval, assigning the reasons therefor, must be given in writing by the superintendent to the parent corporation or domestic stock insurance company that submitted the plan. A plan does not take effect unless the approval of the superintendent has been obtained. [RR 2021, c. 1, Pt. B, §296 (COR).]

4. If the superintendent approves the plan, the parent corporation or the domestic stock insurance company that has adopted the plan shall deliver to each person who, as of the date of delivery, is a holder of record of stock to be acquired pursuant to the plan, a copy of the plan, or a summary thereof approved by the superintendent, in person or by depositing the same in the post office, postage prepaid, addressed to the stockholder at the stockholder's address of record. On or before the date of acquisition proposed in the plan, the parent corporation or the domestic stock insurance company that has adopted the plan shall file with the superintendent a certificate, executed by its president and attested by its secretary, or the executive officers corresponding thereto, and subscribed by such officers and affirmed by them as true under the penalties of perjury, and under the seal of the parent corporation or the domestic stock insurance company, as the case may be, attesting to compliance with this subsection. [RR 2021, c. 1, Pt. B, §297 (COR).]

5. Upon compliance with this section, ownership of the shares to be acquired pursuant to the plan vests in the parent corporation or the domestic stock insurance company that has adopted the plan on the date of acquisition proposed in the plan whether or not the certificates for such shares have been surrendered for exchange. If the plan was adopted by the parent corporation it is entitled to have new certificates registered in its name. If the plan was adopted by the domestic stock insurance company the shares must be retired and the capital of the domestic company reduced by the par value of the retired shares. Shareholders whose shares have been so acquired thereafter retain only the right either to receive the consideration to be paid in exchange for their shares pursuant to the plan or to dissent to the plan and demand appraisal and receive payment of the fair value of their shares as hereinafter provided. The fair value of shares must be determined as of the day prior to the date on which the plan was adopted, excluding any appreciation or depreciation of shares in anticipation of such corporate action. A shareholder may not dissent as to less than all of the shares registered in the shareholder's name. [RR 2021, c. 1, Pt. B, §298 (COR).]

6. A dissenting shareholder shall file, within 20 days after the delivery to that shareholder of either a copy of the plan or a summary of the plan pursuant to subsection 4 , a written notice of the shareholder's election to dissent from the plan and a demand for payment of the fair value of the shareholder's shares. The notice and demand must be filed with the company that adopted the plan by personally delivering it, or by mailing it via certified or registered mail, to the company at its registered office within this State or to its principal place of business as shown on its most recent annual report or, in the case of a foreign corporation that has not yet delivered an annual report, in its application for a certificate of authority pursuant to Title 13‑C, section 130 . [PL 2003, c. 344, Pt. D, §13 (AMD).]

7. At the time of filing the dissenting shareholder's notice and demand for the payment of the fair value of the dissenting shareholder's shares, or within 20 days thereafter, a dissenting shareholder shall surrender the certificate or certificates representing the dissenting shareholder's shares to the company that adopted the plan. [RR 2021, c. 1, Pt. B, §299 (COR).]

8. Within 10 days after the expiration of the period provided in subsection 6 for the shareholder to file the shareholder's notice and demand, the company that adopted the plan shall make a written offer to each dissenting shareholder to pay for such shares at a specified price considered by such company to be the fair value thereof. Such offer must be made at the same price per share to all dissenting shareholders of the same class. The notice and offer must be accompanied by a balance sheet of the corporation, the shares of which the dissenting shareholder holds, as of the latest available date and not more than 12 months prior to the making of such offer and a profit and loss statement of such corporation, for the 12-months' period ended on the date of such balance sheet. [RR 2021, c. 1, Pt. B, §300 (COR).]

9. If, within 20 days after the date by which the company is required by the terms of subsection 8 to make a written offer to each dissenting shareholder to pay for the dissenting shareholder's shares, the fair value of such shares is agreed upon between any dissenting shareholder and the company, payment therefor must be made within 90 days after the date of delivery of the plan or a summary thereof as provided in subsection 4 . Upon payment of the agreed value, the dissenting shareholder ceases to have any interest in such shares. [RR 2021, c. 1, Pt. B, §301 (COR).]

10. If, within the additional 20-day period prescribed by subsection 9 , one or more dissenting shareholders and the company have failed to agree as to the fair value of the shares, then Title 13‑C, chapter 13, subchapter 3 applies, except that: A. The term "the corporation" as used in that subchapter is deemed to refer to the company that adopted a plan pursuant to subsection 2 ; [PL 2003, c. 344, Pt. D, §14 (AMD).] B. [PL 2003, c. 344, Pt. D, §14 (RP).] C. The references in Title 13‑C, chapter 13, subchapter 3 to a shareholder's "demand for payment under section 1327 " is deemed to refer to a shareholder's notice and demand filed pursuant to subsection 6 ; [PL 2003, c. 344, Pt. D, §14 (AMD).] D. [PL 2003, c. 344, Pt. D, §14 (RP).] E. The reference in Title 13‑C, section 1331, subsection 2 to the county in the State where the principal office or the registered office of the domestic corporation merged with the foreign corporation is located is deemed, where the parent corporation that has adopted the plan is neither a domestic corporation nor an authorized insurer, to include the county where the registered office of the subsidiary domestic stock insurance company whose stock is being acquired is located; [PL 2003, c. 344, Pt. D, §14 (AMD).] F. [PL 2003, c. 344, Pt. D, §14 (RP).] G. [PL 2003, c. 344, Pt. D, §14 (RP).] H. Title 13‑C, section 1331, subsection 5, paragraph B does not apply; and [PL 2003, c. 344, Pt. D, §14 (NEW).] I. The reference in Title 13‑C, section 1332, subsection 2, paragraph A to the corporation's failure to substantially comply with the requirements of section 1321 , 1323 , 1325 or 1326 is deemed to refer to the corporation's failure to comply with this section, and the reference in Title 13‑C, section 1332 , subsection 4 to the failure of the corporation to make required payments pursuant to section 1325 , 1326 or 1327 is deemed to refer to the failure of the corporation to make required payments under this section. [PL 2003, c. 344, Pt. D, §14 (NEW).] [PL 2003, c. 344, Pt. D, §14 (AMD).]

11. [PL 2003, c. 344, Pt. D, §15 (RP).]

12. If the court determines pursuant to Title 13‑C, chapter 13, subchapter 3 that a shareholder is not entitled to receive payment of the fair value of the shareholder's shares because of the shareholder's failure to satisfy the requirements of Title 13‑C, chapter 13, subchapter 3 and of this section, then the shareholder must receive the consideration that was specified as payment in exchange for the shareholder's shares pursuant to the plan. Such payment may not include the allowance for interest specified in Title 13‑C, section 1331, subsection 5 . [RR 2021, c. 2, Pt. A, §78 (COR).]

13. Neither the right granted by this section nor the exercise thereof by a parent corporation or domestic stock insurance company shall preclude the exercise by it of any other rights it may have under this section. [PL 1977, c. 377 (NEW).]

14. The provisions of Title 33, chapter 45 apply to any unclaimed payment to which a shareholder may be entitled under this section. [PL 2019, c. 498, §13 (AMD).]

15. All laws and parts of laws of this State inconsistent with this section are superseded with respect to matters covered by this section. [PL 1977, c. 377 (NEW).]
24-A M.R.S. § 2847-X — ME Code / Title 24-A / Chapter 35 / Section 2847-X
24-A §2847-X. Fees for covered dental services
Status: in_force

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

2. Prohibition of required fees for dental services not covered. An insurer that issues group dental insurance or that issues group health insurance that covers dental services may not require, directly or indirectly, that a participating dental provider provide dental services at a fee set by, or subject to the approval of, the insurer for a service that is not a covered dental service. [PL 2025, c. 298, §3 (NEW).]

3. Fees for covered dental services. A fee for a covered dental service must be set by the insurer in good faith and may not be nominal. [PL 2025, c. 298, §3 (NEW).]
24-A M.R.S. § 2674-A — ME Code / Title 24-A / Chapter 32 / Section 2674-A
24-A §2674-A. Requirements for administrators and carriers
Status: in_force

1. Registration fee. All administrators of a preferred provider arrangement shall register with the superintendent and pay an annual registration fee pursuant to section 601, subsection 20 . The superintendent shall by rule establish criteria for the registration, including minimum solvency requirements. Rules adopted pursuant to this subsection are routine technical rules pursuant to Title 5, chapter 375, subchapter II‑A . [PL 1999, c. 609, §10 (NEW).]

2. Compilation of current listing. The bureau shall compile and maintain a current listing of administrators and carriers offering preferred provider arrangements authorized under this chapter. [PL 1999, c. 609, §10 (NEW).]

3. Prohibition against insurance risk. Except as specifically authorized in section 2676 , an administrator may provide administrative services only and may not accept insurance risk. [PL 1999, c. 609, §10 (NEW).]

4. Approval required before marketing or making available. A carrier may not issue a health plan incorporating a preferred provider arrangement and an administrator may not market or otherwise make available a preferred provider arrangement until the superintendent pursuant to section 2673‑A has approved the arrangement. [PL 1999, c. 609, §10 (NEW).]

5. Registration as insurance administrator. In addition to meeting the requirements of the preferred provider arrangement, each preferred provider administrator who directly or indirectly transfers funds, manages funds, adjusts claims or asserts control over the transfer of funds for the purpose of payment of provider services shall register with the superintendent as an insurance administrator pursuant to chapter 18 . [PL 1999, c. 609, §10 (NEW).]

6. Provision of document to beneficiary. Each preferred provider administrator shall inform all carriers that the carriers must provide to each enrollee of any health plan subject to this chapter a plan description that complies with the requirements of and rules adopted under chapter 56‑A, subchapter I . [PL 1999, c. 609, §10 (NEW).]
24-A M.R.S. § 6404 — ME Code / Title 24-A / Chapter 77 / Section 6404
24-A §6404. Minimum standards
Status: in_force

1. Applicability. This section applies as follows. A. This section applies if, in any calendar year, the aggregated amount of gross written premium on business placed with a controlled insurer by a controlling producer is equal to or greater than 5% of the admitted assets of the controlled insurer as of September 30th of the preceding year, as reported in the controlled insurer's quarterly statement. [PL 2017, c. 169, Pt. E, §9 (AMD).] B. Notwithstanding paragraph A , this section does not apply if: (1) The controlling producer: (a) Places insurance only with the controlled insurer, only with the controlled insurer and a member or members of the controlled insurer's holding company system or only with the controlled insurer's parent, affiliate or subsidiary and receives no compensation based upon the amount of premiums written in connection with such insurance; and (b) Accepts insurance placements only from nonaffiliated subproducers and not directly from insureds; and (2) The controlled insurer, except for insurance business written through a residual market facility such as the workers' compensation residual market mechanism or the State's automobile assigned risk plan, accepts insurance business only from a controlling producer, a producer controlled by the controlled insurer or a producer that is a subsidiary of the controlled insurer. [PL 2017, c. 169, Pt. E, §9 (AMD).] [PL 2017, c. 169, Pt. E, §9 (AMD).]

2. Required contract provisions. A controlled insurer may not accept business from a controlling producer and a controlling producer may not place business with a controlled insurer unless there is a written contract between the controlling producer and the controlled insurer specifying the responsibilities of each party. The contract must be approved by the board of directors of the insurer and must contain the following minimum provisions. A. The controlled insurer may terminate the contract for cause upon written notice to the controlling producer. The controlled insurer shall suspend the authority of the controlling producer to write business during the pendency of any dispute regarding the cause for the termination. [PL 2017, c. 169, Pt. E, §9 (AMD).] B. The controlling producer shall render timely accounts to the controlled insurer detailing all material transactions including information necessary to support all commissions, charges and other fees received by or owed to the controlling producer. [PL 2017, c. 169, Pt. E, §9 (AMD).] C. The controlling producer shall remit all funds due under the terms of the contract to the controlled insurer on at least a monthly basis. The due date must be fixed so that premiums or installments of premiums collected are remitted no later than 90 days after the effective date of any policy placed with the controlled insurer under the contract. [PL 2017, c. 169, Pt. E, §9 (AMD).] D. All funds collected for the controlled insurer's account must be held in trust by the controlling producer in a fiduciary capacity, in one or more appropriately identified bank accounts in banks that are members of the Federal Reserve System, in accordance with applicable insurance laws. Funds of a controlling producer not licensed in this State must be maintained in compliance with the requirements of the controlling producer's domiciliary jurisdiction. [PL 2017, c. 169, Pt. E, §9 (AMD).] E. The controlling producer shall maintain separately identifiable records of business written for the controlled insurer. The controlled insurer must have access and may copy all accounts and records related to its business in a form usable by the insurer. The records must be retained according to section 3408 . [PL 2017, c. 169, Pt. E, §9 (AMD).] F. The contract may not be assigned in whole or in part by the controlling producer. [PL 2017, c. 169, Pt. E, §9 (AMD).] G. The controlled insurer shall provide the controlling producer with its underwriting standards, rules, procedures, rates and conditions, including manuals setting forth the rates to be charged and the conditions for the acceptance or rejection of risks. The controlling producer shall comply with those standards, rules, procedures, rates and conditions, which must be the same as those applicable to comparable business placed with the controlled insurer by a producer other than the controlling producer. [PL 2017, c. 169, Pt. E, §9 (AMD).] H. The rates of the controlling producer's commissions, charges and other fees may not be greater than those applicable to comparable business placed with the controlled insurer by producers other than controlling producers. For purposes of this paragraph and paragraph G , examples of "comparable business" include the same lines of insurance, the same kinds of insurance, the same kinds of risks, similar policy limits and similar quality of business. [PL 2017, c. 169, Pt. E, §9 (AMD).] I. If the contract provides that the controlling producer, on insurance business placed with the insurer, must be compensated contingent upon the insurer's profits on that business, then that compensation may not be determined and paid until at least 5 years after the premiums on liability insurance are earned and at least one year after the premiums are earned on any other insurance. The commissions may not be paid until the adequacy of the controlled insurer's reserves on remaining claims are independently verified pursuant to subsection 3 . [PL 2017, c. 169, Pt. E, §9 (AMD).] J. The controlled insurer shall place a limit on the controlling producer's writings in relation to the controlled insurer's surplus and total writings. The insurer may establish a different limit for each line or subline of business. The controlled insurer shall notify the controlling producer when the applicable limit is approached and may not accept business from the controlling producer if the limit is reached. The controlling producer may not place business with the controlled insurer if notified by the controlled insurer that the limit has been reached. [PL 2017, c. 169, Pt. E, §9 (AMD).] K. The controlling producer may negotiate but may not bind reinsurance on behalf of the controlled insurer on business the controlling producer places with the controlled insurer, except that the controlling producer may bind facultative reinsurance contracts pursuant to obligatory facultative agreements. All such contracts with the controlled insurer must contain underwriting guidelines including, for reinsurance both assumed and ceded, a list of reinsurers with which the automatic agreements are in effect, the coverages and amounts or percentages that may be reinsured and schedules of the commissions allowed. [PL 2017, c. 169, Pt. E, §9 (AMD).] [PL 2017, c. 169, Pt. E, §9 (AMD).]

3. Audit committee. Every controlled insurer must have an audit committee of the board of directors composed of independent directors. The audit committee shall annually meet with management, the insurer's independent certified public accountants and an independent casualty actuary acceptable to the superintendent to review the adequacy of the insurer's loss reserves. [PL 1991, c. 828, §33 (NEW).]

4. Reporting requirements. A controlled insurer shall make the following reports. A. In addition to any other required loss reserve certification, by April 1st of each year, the controlled insurer shall file with the superintendent an opinion of an independent casualty actuary acceptable to the superintendent reporting loss ratios for each line of business written and attesting to the adequacy of loss reserves established for losses incurred and outstanding at the preceding year end, including incurred but not reported losses, on business placed by the controlled producer. [PL 2017, c. 169, Pt. E, §9 (AMD).] B. The controlled insurer shall report annually to the superintendent the amount of commissions paid to the controlling producer, the percentage that amount represents of the net premiums written and comparable amounts and percentage paid to noncontrolling producers for placement of the same kinds of insurance. [PL 2017, c. 169, Pt. E, §9 (AMD).] [PL 2017, c. 169, Pt. E, §9 (AMD).]
24-A M.R.S. § 1158 — ME Code / Title 24-A / Chapter 13-A / Section 1158
24-A §1158. Policy loans
Status: in_force

A life insurer may lend to its policyholder, upon pledge of the policy as collateral security, any sum not exceeding the cash surrender value of the policy; or may lend against pledge or assignment of any of its supplementary contracts or other contracts or obligations, as long as the loan is adequately secured by that pledge or assignment. Loans so made are eligible investments of the insurer. [PL 1987, c. 399, §14 (NEW).]
24-A M.R.S. § 3617 — ME Code / Title 24-A / Chapter 51 / Section 3617
24-A §3617. Assessment -- court review; adjustment of claims where no assessment made
Status: in_force

1. Whenever the directors of a mutual assessment insurer make an assessment or call on its members for money, or by vote determine that there exists a necessity for such assessment or call, they, or any person interested in the insurer as an officer, policyholder or creditor, may file in the Superior Court in any county, a complaint praying the court to examine the assessment or call or to determine the necessity therefor and all matters connected therewith, and to ratify, amend or annul the assessment or call or to order that the same be made as law and justice may require. [PL 1969, c. 132, §1 (NEW).]

2. The decision on such complaint, when filed by any party except the insurer, or a receiver, or the superintendent, shall rest in the discretion of the court. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

3. Whenever the directors unreasonably neglect to make an assessment or call to satisfy an admitted or ascertained claim upon the insurer, any judgment creditor, or any person holding such admitted or ascertained claim, or the superintendent may make the application. Upon such application, if made by the directors, or upon order of court if made by application of any other party, the directors shall set forth the claims against the insurer, its assets and all other facts and particulars appertaining to the matter. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 1420 — ME Code / Title 24-A / Chapter 16 / Section 1420
24-A §1420. Short title; scope and application
Status: in_force

1. Short title. This subchapter may be known and cited as the "Maine Producer Licensing Act." [PL 2001, c. 259, §24 (NEW).]

2. Scope and application. This subchapter governs the qualifications and procedures for the licensing of insurance producers. It simplifies and organizes some statutory language to improve efficiency, permits the use of new technology and reduces costs associated with issuing and renewing insurance licenses. This subchapter does not apply to excess and surplus lines agents and brokers required to be licensed as producers with surplus lines authority pursuant to chapter 19 , except as provided in sections 1420‑G and 1420‑O . [PL 2001, c. 259, §24 (NEW).]
24-A M.R.S. § 2421 — ME Code / Title 24-A / Chapter 27 / Section 2421
24-A §2421. Renewal of policy
Status: in_force

Any policy terminating by its terms at a specified expiration date and not otherwise renewable, may be renewed or extended at the option of the insurer and upon a currently authorized policy form and at the premium rate then required therefor for a specified additional period or periods by a certificate or other endorsement of the policy, and without requiring issuance of a new policy. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 423-C — ME Code / Title 24-A / Chapter 5 / Section 423-C
24-A §423-C. Reports of material transactions
Status: in_force

1. Report required. Every domestic insurer must file a report with the superintendent, on or before the 15th day of each month, if it has engaged in a material investment or reinsurance transaction during the preceding month that has not already been separately reported to the superintendent or submitted to the superintendent for prior review. [PL 1995, c. 375, Pt. A, §1 (NEW).]

2. Material transactions defined. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Material investment transaction" means an acquisition or disposition of an asset or the aggregate of a series of related acquisitions or related dispositions during a 30-day period that is nonrecurring, not in the ordinary course of business and involving more than 5% of the reporting insurer's total admitted assets as reported in its most recent statutory statement filed with the superintendent. Asset acquisitions and dispositions include without limitation a purchase, sale, lease, exchange, merger, consolidation, succession, mortgage, hypothecation, assignment, whether for the benefit of creditors or otherwise, abandonment or destruction. Asset acquisition does not include the construction or development of real property for the use of the reporting insurer or the acquisition of materials for such construction or development. [PL 1995, c. 375, Pt. A, §1 (NEW).] B. "Material reinsurance transaction" means: (1) A transaction involving property and casualty business, including accident and health business written by a property and casualty insurer, that involves more than 50% of either the insurer's total ceded written premium or the insurer's total ceded indemnity and loss adjustment reserves; (2) A transaction involving life, annuity or accident and health business that causes a change, either positive or negative, in the current total reserve credit taken for all life, annuity and accident and health business of more than 50% from the total reserve credit taken for such business in the insurer's most recent annual statement. "Total reserve credit" includes reserve credit taken for unearned premiums, reserve credit taken other than for unearned premiums and amounts recoverable on paid and unpaid losses for all reinsurance ceded; (3) Any transaction in which either: (a) An authorized reinsurer representing more than 10% of the insurer's total reserve credit for business ceded is replaced by one or more unauthorized reinsurers; or (b) Previously established collateral requirements have been reduced or waived for one or more unauthorized reinsurers representing collectively more than 10% of the insurer's total reserve credit for business ceded; or (4) Transactions otherwise falling within the scope of this paragraph do not need to be reported if: (a) In the case of a property and casualty insurer, the insurer's total ceded written premium represents, on an annualized basis, less than 10% of its total written premium for direct and assumed business; (b) In the case of a life, annuity and accident and health insurer, the total reserve credit taken for business ceded represents, on an annualized basis, less than 10% of the statutory reserve requirement before any cession; or (c) The transaction falls within the scope of a previously reported reinsurance agreement. [RR 1995, c. 2, §51 (COR).] [RR 1995, c. 2, §51 (COR).]

3. Reporting procedures. Reports for material investment transactions and material reinsurance transactions must follow the following procedures. A. A report of a material investment transaction must include the following information: (1) Date of the transaction; (2) Manner of acquisition or disposition; (3) Description of the assets involved; (4) Nature and amount of the consideration given or received; (5) Purpose of or reason for the transaction; (6) Manner by which the amount of consideration was determined; (7) Gain or loss recognized or realized as a result of the transaction; and (8) Name of the person from whom the assets were acquired or to whom they were disposed. [PL 1995, c. 375, Pt. A, §1 (NEW).] B. A report of a material reinsurance transaction must include the following information: (1) Effective date of the nonrenewal, cancellation or revision of the reinsurance agreement affected by the transaction; (2) The description of the transaction with an identification of the initiator of the transaction; (3) Purpose of or reason for the transaction; and (4) If applicable, the identity of the replacement reinsurers. [PL 1995, c. 375, Pt. A, §1 (NEW).] C. Material transactions must be reported on a nonconsolidated basis unless the insurer is part of a consolidated group of insurers that uses a pooling arrangement of 100% reinsurance agreement that affects the solvency and integrity of the insurer's reserves, and the insurer has ceded substantially all of its direct and assumed business to the pool. An insurer is considered to have ceded substantially all of its direct and assumed business to a pool if the insurer has less than $1,000,000 total direct and assumed written premiums during a calendar year that are not subject to a pooling arrangement and the net income of the business not subject to the pooling arrangement represents less than 5% of the insurer's capital and surplus. [PL 1995, c. 375, Pt. A, §1 (NEW).] [PL 1995, c. 375, Pt. A, §1 (NEW).]

4. Confidentiality. All reports obtained by or disclosed to the superintendent pursuant to this section are confidential, are not subject to subpoena and may not be made public by the superintendent, the National Association of Insurance Commissioners or any other person, except to insurance departments of other states, without the prior written consent of the insurer to which it pertains. If the superintendent, after giving the insurer that would be affected notice and an opportunity for hearing, determines that publication is in the interest of policyholders, shareholders or the public, the superintendent may publish all or any part of a report in the manner the superintendent determines to be appropriate. [PL 1995, c. 375, Pt. A, §1 (NEW).]
24-A M.R.S. § 1462 — ME Code / Title 24-A / Chapter 16 / Section 1462
24-A §1462. License required
Status: in_force

A person may not act as a consultant in this State without first obtaining a license from the superintendent in accordance with this subchapter. [PL 1997, c. 457, §23 (NEW); PL 1997, c. 457, §55 (AFF).]
24-A M.R.S. § 2153 — ME Code / Title 24-A / Chapter 23 / Section 2153
24-A §2153. Misrepresentation; false advertising of policies
Status: in_force

No person shall make, issue, circulate, or cause to be made, issued or circulated, any estimate, illustration, circular or statement misrepresenting the terms of any policy issued or to be issued or the benefits or advantages promised thereby or the dividends or share of the surplus to be received thereon, or make any false or misleading statement as to the dividends or share of surplus previously paid on similar policies, or make any misleading representation or any misrepresentation as to the financial condition of any insurer, or as to the legal reserve system upon which any life insurer operates, or use any name or title on any policy or class of policies misrepresenting the true nature thereof. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2423 — ME Code / Title 24-A / Chapter 27 / Section 2423
24-A §2423. Forms for proof of loss to be furnished
Status: in_force

An insurer shall furnish, upon written request of any person claiming to have a loss under an insurance contract issued by such insurer, forms of proof of loss for completion by such person, but such insurer shall not, by reason of the requirement so to furnish forms, have any responsibility for or with reference to the completion of such proof or the manner of any such completion or attempted completion. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2243 — ME Code / Title 24-A / Chapter 24-A / Section 2243
24-A §2243. Transfer of structured settlement payment rights
Status: in_force

1. Application. This section applies to any transfer of structured settlement payment rights under a transfer agreement entered into on or after the effective date of this section. This section may not be construed to imply that any transfer under a transfer agreement reached prior to the effective date of this section is effective. [PL 1999, c. 268, §2 (NEW).]

2. Requirements for transfer. A direct or indirect transfer of structured settlement payment rights is not effective and a structured settlement obligor or annuity issuer is not required to make any payment directly or indirectly to any transferee of structured settlement payment rights unless the transfer has been authorized in advance in a final order of a court of competent jurisdiction or a responsible administrative authority, based on express findings by that court or responsible administrative authority that: A. The transfer complies with the requirements of this chapter and does not contravene other applicable law; [PL 1999, c. 268, §2 (NEW).] B. Not less than 10 days prior to the date on which the payee first incurred any obligation with respect to the transfer, the transferee provided to the payee a disclosure statement in bold type, no smaller than 14 points, setting forth: (1) The amounts and due dates of the structured settlement payments to be transferred; (2) The aggregate amount of those payments; (3) The discounted present value of those payments together with the discount rate used in determining that discounted present value; (4) The gross amount payable to the payee in exchange for the payments; (5) An itemized listing of all brokers' commissions, service charges, application fees, processing fees, closing costs, filing fees, administrative fees, legal fees, notary fees and other commissions, fees, costs, expenses and charges payable by the payee or deductible from the gross amount otherwise payable to the payee; (6) The net amount payable to the payee after deduction of all commissions, fees, costs, expenses and charges described in subparagraph (5); (7) The quotient, expressed as a percentage, obtained by dividing the net payment amount by the discounted present value of the payments; and (8) The amount of any penalty and the aggregate amount of any liquidated damages, inclusive of penalties, payable by the payee in the event of any breach of the transfer agreement by the payee; [PL 1999, c. 268, §2 (NEW).] C. The payee has established that the transfer is necessary to enable the payee, the payee's dependents or both to avoid imminent financial hardship, and the transfer is not expected to subject the payee, the payee's dependents or both to undue financial hardship in the future, except that if a federal hardship standard was in effect at the time the payee and the transferee entered into the transfer agreement, in lieu of the foregoing finding the court or responsible administrative authority must make an express finding that the transfer qualifies under that federal hardship standard; [PL 1999, c. 268, §2 (NEW).] D. The payee has received independent professional advice regarding the legal, tax and financial implications of the transfer; [PL 1999, c. 268, §2 (NEW).] E. If the transfer would contravene the terms of the structured settlement: (1) The transfer has been expressly approved in writing by: (a) Each interested party; and (b) Any court or government authority, other than the court or responsible administrative authority from which authorization of the transfer is sought under this chapter, that previously approved the structured settlement; and (2) Signed originals of all approvals required under subparagraph (1) have been filed with the court or responsible administrative authority from which authorization of the transfer is sought under this chapter and originals or copies have been furnished to all interested parties; [PL 1999, c. 268, §2 (NEW).] F. If the transfer would contravene the terms of the structured settlement, the transfer agreement does not have adverse tax consequences to the structured settlement obligor or annuity issuer. The structured settlement obligor or annuity issuer must demonstrate to the court or responsible administrative authority that the transfer agreement, if approved, will have adverse tax consequences; and [PL 1999, c. 268, §2 (NEW).] G. The transferee has given written notice of the transferee's name, address and taxpayer identification number to the annuity issuer and the structured settlement obligor and has filed a copy of that notice with the court or responsible administrative authority. [PL 1999, c. 268, §2 (NEW).] [PL 1999, c. 268, §2 (NEW).]
24-A M.R.S. § 2851 — ME Code / Title 24-A / Chapter 37 / Section 2851
24-A §2851. Scope of provisions
Status: in_force

All life insurance and all health insurance in connection with loans or other credit transactions, credit property insurance, credit involuntary unemployment insurance and other consumer credit insurance specifically authorized by the superintendent in rules adopted pursuant to section 2865 are subject to this chapter, except the following: [PL 2001, c. 471, Pt. D, §25 (AMD).]

1. Long-term loan. Insurance in connection with a loan or other credit transaction of more than 15 years' duration; [PL 1999, c. 256, Pt. H, §1 (NEW).]

2. Isolated transactions. Insurance issued in an isolated transaction on the part of the insurer not related to an agreement or a plan for insuring debtors of the creditor; [PL 2001, c. 138, §4 (AMD).]

3. Real estate loan. Insurance in connection with real estate loans when the charge, if any, to the debtor is periodic and not financed; [PL 2001, c. 138, §4 (AMD).]

4. Casualty insurance. Insurance issued pursuant to section 707, subsection 1, paragraph I against loss or damage resulting from failure of debtors to pay their obligations to the insured; or [PL 2001, c. 138, §4 (NEW).]

5. Debt cancellation agreements. Debt cancellation agreements entered into between financial institutions or credit unions and their debtors. [PL 2001, c. 138, §4 (NEW).]
24-A M.R.S. § 209 — ME Code / Title 24-A / Chapter 3 / Section 209
24-A §209. Prohibited interests, rewards
Status: in_force

1. The superintendent, or the superintendent's deputy, or any examiner or employee of the bureau may not be connected with the management or be holder of a material number of shares of any insurer, insurance holding company, insurance agency or broker, or be pecuniarily interested in any insurance transaction, except as a policyholder or claimant under a policy; except that as to matters wherein a conflict of interests does not exist on the part of any such individual, the superintendent may employ and retain from time to time insurance actuaries, examiners, accountants, and other technicians who are independently practicing their professions even though from time to time similarly employed or retained by insurers or others. [RR 2021, c. 1, Pt. B, §151 (COR).]

2. Subsection 1 above shall not be deemed to prohibit: A. Receipt by any such individual of fully vested commissions or fully vested retirement benefits to which the individual is entitled by reason of services performed prior to becoming superintendent or prior to employment in the bureau; [RR 2021, c. 1, Pt. B, §152 (COR).] B. Investment in shares of regulated diversified investment companies; or [PL 1969, c. 132, §1 (NEW).] C. Mortgage loans made under customary terms and in ordinary course of business. [PL 1969, c. 132, §1 (NEW).] [RR 2021, c. 1, Pt. B, §152 (COR).]

3. The superintendent, or the superintendent's deputy, or any employee or technician employed or retained by the bureau may not be given or receive, directly or indirectly, any fee, compensation, loan, gift or other thing of value in addition to the compensation and expense allowance provided by or pursuant to the law of this State, or by contract with the superintendent, for any service rendered or to be rendered as such superintendent, deputy, assistant, employee or technician, or in connection therewith. [RR 2021, c. 1, Pt. B, §153 (COR).]
24-A M.R.S. § 4234 — ME Code / Title 24-A / Chapter 56 / Section 4234
24-A §4234. Child coverage
Status: in_force

1. Definitions. For the purposes of this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Dependent children" means children who are under 19 years of age and are children, stepchildren or adopted children of, or children placed for adoption with, the enrollee, member or spouse of the enrollee or member. [PL 1993, c. 666, Pt. A, §7 (NEW).] B. "Placed for adoption" means the assumption and retention of a legal obligation by a person for the total or partial support of a child in anticipation of adoption of the child. If the legal obligation ceases to exist, the child is no longer considered placed for adoption. [PL 1993, c. 666, Pt. A, §7 (NEW).] [PL 1993, c. 666, Pt. A, §7 (RPR).]

2. Coverage. All individual or group coverage subject to this chapter must provide unmarried enrollees with the same benefits or option of benefits for dependent children as is extended to dependent children of married enrollees, at appropriate rates and under the same terms and conditions. [PL 1991, c. 200, Pt. B, §5 (NEW).]

3. Financial dependency. Financial dependency of dependent children on the enrollee or the spouse of the enrollee may not be required as a condition for eligibility for coverage. [PL 1991, c. 200, Pt. B, §5 (NEW).]

4. Adopted children. All individual or group contracts issued in accordance with the requirements of this section must provide the same benefits to dependent children placed for adoption with the enrollee or spouse of the enrollee under the same terms and conditions as apply to natural dependent children or stepchildren of the enrollee or spouse of the enrollee, irrespective of whether the adoption has become final. [PL 1993, c. 666, Pt. A, §8 (NEW).]

5. Medicaid. Health maintenance organizations may not consider the availability or eligibility for medical assistance under 42 United States Code, Section 13969, referred to as "Medicaid," when considering coverage eligibility or benefit calculations for enrollees and covered family members. A. To the extent that payment for coverage expenses has been made under the Medicaid program for health care items or services furnished to an individual, the State is considered to have acquired the rights of the enrollee or family member to payment by the health maintenance organization for those health care items or services. Upon presentation of proof that the Medicaid program has paid for covered items or services, the health maintenance organization shall make payment to the Medicaid program according to the coverage provided in the contract or certificate. [PL 1993, c. 666, Pt. B, §3 (NEW).] B. A health maintenance organization may not impose requirements on a state agency that has been assigned the rights of an individual eligible for Medicaid and covered by an enrollee contract that are different from requirements applicable to an agent or assignee of any other covered individual. [PL 1993, c. 666, Pt. B, §3 (NEW).] [PL 1993, c. 666, Pt. B, §3 (NEW).]
24-A M.R.S. § 2546 — ME Code / Title 24-A / Chapter 29 / Section 2546
24-A §2546. Calculation of cash surrender values
Status: in_force

For contracts that provide cash surrender benefits, the cash surrender benefits available prior to maturity may not be less than the present value as of the date of surrender of that portion of the maturity value of the paid-up annuity benefit that would be provided under the contract at maturity arising from considerations paid prior to the time of cash surrender reduced by the amount appropriate to reflect any prior withdrawals from or partial surrenders of the contract, the present value being calculated on the basis of an interest rate not more than 1% higher than the interest rate specified in the contract for accumulating the net considerations to determine the maturity value, decreased by the amount of any indebtedness to the insurer on the contract, including interest due and accrued, and increased by any existing additional amounts credited by the insurer to the contract. In no event may any cash surrender benefit be less than the minimum nonforfeiture amount at that time. The death benefit under the contracts must be at least equal to the cash surrender benefit. [PL 2017, c. 475, Pt. A, §40 (AMD).]
24-A M.R.S. § 2381-C — ME Code / Title 24-A / Chapter 25 / Section 2381-C
24-A §2381-C. Definitions
Status: in_force

As used in this Act, unless the context otherwise indicates, the following terms have the following meanings. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

1. Advisory organization. "Advisory organization" means any entity that either has 2 or more member insurers or is controlled either directly or indirectly by 2 or more insurers and that assists insurers in activities related to workers' compensation rate making. Two or more insurers having a common ownership or operating in this State under common management or control constitute a single insurer for the purpose of this definition. "Advisory organization" does not include a joint underwriting association, any actuarial or legal consultant, any employee of an insurer or insurers under common control or management or their employees or manager. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

2. Classification system or classification. "Classification system" or "classification" means the plan, system or arrangement for recognizing differences in exposure to hazards among industries, occupations or operations of insurance policyholders. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

3. Expenses. "Expenses" means that portion of any rate attributable to acquisition and field supervision; collection expenses and general expenses; and taxes, licenses and fees. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

4. Experience rating. "Experience rating" means a rating procedure utilizing past insurance experience of the individual policyholder to forecast future losses by measuring the policyholder's loss experience against the loss experience of policyholders in the same classification to produce a prospective premium credit, debit or unity modification. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

5. Loss trending. "Loss trending" means any procedure for projecting developed losses to the average date of loss for the period during which the policies are to be effective. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

6. Market. "Market" means the interaction between buyers and sellers of workers' compensation and employers liability insurance within this State pursuant to this Act. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

7. Pure premium rate. "Pure premium rate" means that portion of the rate that represents the loss cost per unit of exposure including loss adjustment expense. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

8. Rate. "Rate" means the cost of insurance per exposure base unit, prior to any application of individual risk variations based on loss or expense considerations, and does not include minimum premiums. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

9. Residual market. "Residual market" means the instrument to provide coverage to employers not able to obtain coverage in the voluntary market. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

10. Statistical plan. "Statistical plan" means the plan, system or arrangement used in collecting data. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

11. Superintendent. "Superintendent" means the Superintendent of Insurance. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

12. Supplementary rate information. "Supplementary rate information" means any manual or plan of rates, classification system, rating schedule, minimum premium, policy fee, rating rule, rating plan and any other similar information needed to determine the applicable premium for an insured. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

13. Supporting information. "Supporting information" means the experience and judgment of the filer and the experience or data of other insurers or organizations relied on by the filer, the interpretation of any statistical data relied on by the filer, descriptions of methods used in making the rates, and any other similar information required by the superintendent to be filed. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]

14. Voluntary market. "Voluntary market" means the workers' compensation insurance market in which insurance companies voluntarily offer coverage to applicants who meet the insurers' underwriting standards or guidelines. [PL 1991, c. 885, Pt. B, §12 (NEW); PL 1991, c. 885, Pt. B, §13 (AFF).]
24-A M.R.S. § 2749-A — ME Code / Title 24-A / Chapter 33 / Section 2749-A
24-A §2749-A. Penalty for failure to notify of hospitalization
Status: in_force

An insurance policy may not include a provision permitting the insurer to impose a penalty for the failure of any person to notify the insurer of an insured person's hospitalization for emergency treatment. For purposes of this section, "emergency treatment" has the same meaning as defined in Title 22, section 1829 . [PL 1989, c. 767, §3 (NEW).]

This section applies to policies and certificates executed, delivered, issued for delivery, continued or renewed in this State after the effective date of this section. For purposes of this section, all policies are deemed to be renewed no later than the next yearly anniversary of the contract date. [PL 1989, c. 767, §3 (NEW).]
24-A M.R.S. § 2723 — ME Code / Title 24-A / Chapter 33 / Section 2723
24-A §2723. Insurance with other insurers -- other benefits
Status: in_force

1. There may be a provision as follows: Insurance with other insurers: If there be other valid coverage, not with this insurer, providing benefits for the same loss on other than an expense incurred basis and of which this insurer has not been given written notice prior to the occurrence or commencement of loss, the only liability for such benefits under this policy shall be for such proportion of the indemnities otherwise provided hereunder for such loss as the like indemnities of which the insurer had notice, including the indemnities under this policy, bear to the total amount of all like indemnities for such loss, and for the return of such portion of the premium paid as shall exceed the pro rata portion for the indemnities thus determined. [PL 1969, c. 132, §1 (NEW).]

2. If the foregoing policy provision is included in a policy which also contains the policy provision set out in section 2722 , there shall be added to the caption of the foregoing provision the phrase "other benefits." The insurer may, at its option, include in this provision a definition of "other valid coverage," approved as to form by the superintendent, which definition shall be limited in subject matter to coverage provided by organizations subject to regulation by insurance law or by insurance authorities of this or any other state of the United States or any province of Canada, and to any other coverage the inclusion of which may be approved by the superintendent. In the absence of such definition such term shall not include group insurance, or benefits provided by union welfare plans or by employer or employee benefit organizations. For the purpose of applying the foregoing policy provision with respect to any insured, any amount of benefit provided for such insured pursuant to any compulsory benefit statute, including any workers' compensation or employer's liability statute, whether provided by a governmental agency or otherwise shall in all cases be deemed to be "other valid coverage" of which the insurer has had notice. In applying the foregoing policy provision no third party liability coverage shall be included as "other valid coverage." [PL 1989, c. 502, Pt. A, §96 (AMD).]
24-A M.R.S. § 2154 — ME Code / Title 24-A / Chapter 23 / Section 2154
24-A §2154. False information; advertising
Status: in_force

A person may not make, publish, disseminate, circulate or place before the public, or cause, directly or indirectly, to be made, published, disseminated, circulated or placed before the public, in a newspaper, magazine or other publication or on a business card, or in the form of a notice, circular, pamphlet, letter or poster, or over any radio or television station, or in any other way, an advertisement, announcement or statement containing any assertion, representation or statement with respect to the business of insurance or with respect to any person in the conduct of that person's insurance business or with respect to the name of a financial institution in a manner that is untrue, deceptive or misleading. [PL 2007, c. 118, §1 (AMD).]
24 M.R.S. § 2343 — ME Code / Title 24 / Chapter 19 / Section 2343
24 §2343. Minimum standards
Status: in_force

A utilization review program of the applicant must meet the following minimum standards. [PL 1989, c. 556, Pt. C, §1 (NEW).]

1. Notification of adverse decisions. Notification of an adverse decision by the utilization review agent must be provided to the insured or other party designated by the insured within a time period to be determined by the superintendent through rulemaking. [PL 1989, c. 556, Pt. C, §1 (NEW).]

2. Reconsideration of determination. All licensees shall maintain a procedure by which insureds, patients or providers may seek reconsideration of determinations of the licensee. [PL 1989, c. 556, Pt. C, §1 (NEW).]

3. Accessibility of representatives. A representative of the licensee must be accessible by telephone to insureds, patients or providers and the superintendent may adopt standards of accessibility by rule. [PL 1989, c. 556, Pt. C, §1 (NEW).]

4. Information materials; confidentiality. A copy of the materials designed to inform applicable patients of the requirements of the utilization plan and the responsibilities and rights of patients under the plan and an acknowledgment that all applicable state and federal laws to protect the confidentiality of individual medical records are followed must be filed with the bureau. [PL 1989, c. 556, Pt. C, §1 (NEW).]

5. Prohibited activities. A medical utilization review entity shall ensure that an employee does not perform medical utilization review services involving a health care provider or facility in which that employee has a financial interest. [PL 1993, c. 602, §2 (NEW).]
24-A M.R.S. § 3020 — ME Code / Title 24-A / Chapter 41 / Section 3020
24-A §3020. Policy and deposit note one contract; insolvency; liability of insured; note surrendered
Status: in_force

1. A policy of insurance issued by a fire or marine insurer, domestic or foreign, and a deposit note given therefor are one contract. A loss under such policy or other equitable claims may be proved in defense to the note, though it was indorsed or assigned before it was due. [PL 1969, c. 132, §1 (NEW).]

2. When an insurer becomes insolvent, the maker of the note is only liable for the equitable proportion thereof that accrued during the solvency. If the insolvency occurs within 60 days of the date of the note, it is void except for the amount of the maker's claim, if any, on the insurer. An insured may not be held to contribute to any losses or expenses beyond the amount of the insured's deposit note. At the expiration of the insured's term of insurance, the insured's note, on payment of all assessments for which it is liable, must be relinquished to the insured, except as provided in section 3021 . [RR 2021, c. 1, Pt. B, §263 (COR).]
24-A M.R.S. § 2402 — ME Code / Title 24-A / Chapter 27 / Section 2402
24-A §2402. "Policy" defined
Status: in_force

"Policy" means the written contract of or written agreement for or effecting insurance, by whatever name called, and includes all clauses, riders, endorsements and papers which are a part thereof. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 4387 — ME Code / Title 24-A / Chapter 57 / Section 4387
24-A §4387. Qualified financial contracts
Status: in_force

1. Qualified financial contracts. Notwithstanding any other provision of this chapter, including any other provision of this chapter permitting the modification of contracts, or other provision of law to the contrary, a person may not be stayed or prohibited from exercising: A. A contractual right to cause the termination, liquidation, acceleration or closeout of obligations under or in connection with any netting agreement or qualified financial contract with an insurer because of: (1) The insolvency, financial condition or default of the insurer at any time, if the right is enforceable under applicable law other than this chapter; or (2) The commencement of a formal delinquency proceeding under this chapter; [PL 2011, c. 107, §3 (NEW).] B. Any right under a pledge, security, collateral, reimbursement or guarantee agreement or arrangement or any other similar security agreement or arrangement or other credit enhancement relating to one or more netting agreements or qualified financial contracts; [PL 2011, c. 107, §3 (NEW).] C. Subject to section 4381, subsection 2 , any right to offset, set off or net out any termination value, payment amount or other transfer obligation arising under or in connection with one or more qualified financial contracts when the counterparty or its guarantor is organized under the laws of the United States or a state or a foreign jurisdiction approved by the Securities Valuation Office of the National Association of Insurance Commissioners as eligible for netting; or [PL 2011, c. 107, §3 (NEW).] D. If a counterparty to a master netting agreement or a qualified financial contract with an insurer subject to a proceeding under this chapter terminates, liquidates, closes out or accelerates the agreement or contract, damages must be measured as of the date or dates of termination, liquidation, closeout or acceleration. The amount of a claim for damages is the actual direct compensatory damages calculated in accordance with subsection 6 . [PL 2011, c. 107, §3 (NEW).] [PL 2011, c. 107, §3 (NEW).]

2. Termination of contract. Upon termination of a netting agreement or qualified financial contract, the net or settlement amount, if any, owed by a nondefaulting party to an insurer that is the subject of a delinquency proceeding under this chapter must be transferred to or on the order of the receiver for the insurer, even if the insurer is the defaulting party, notwithstanding any walkaway clause in the netting agreement or qualified financial contract. For purposes of this subsection, "walkaway clause" means a provision in a netting agreement or a qualified financial contract that, after calculation of a value of a party's position or an amount due to or from one of the parties in accordance with its terms upon termination, liquidation or acceleration of the netting agreement or qualified financial contract, either does not create a payment obligation of a party or extinguishes a payment obligation of a party in whole or in part solely because of the party's status as a nondefaulting party. Any limited 2-way payment or first method provision in a netting agreement or qualified financial contract with an insurer that has defaulted is considered to be a full 2-way payment or 2nd method provision as against the defaulting insurer. Any such property or amount, except to the extent it is subject to one or more secondary liens or encumbrances or rights of netting, offset or setoff, must be a general asset of the insurer. [PL 2011, c. 107, §3 (NEW).]

3. Transfer of contract. In making any transfer of a netting agreement or qualified financial contract of an insurer subject to a proceeding under this chapter, the receiver shall either: A. Transfer to one party, other than an insurer subject to a delinquency proceeding under this chapter, all netting agreements and qualified financial contracts between a counterparty or any affiliate of the counterparty and the insurer that is the subject of the proceeding, including: (1) All rights and obligations of each party under each netting agreement and qualified financial contract; and (2) All property, including any guarantees or other credit enhancement, securing any claims of each party under each netting agreement and qualified financial contract; or [PL 2011, c. 107, §3 (NEW).] B. Transfer none of the netting agreements, qualified financial contracts, rights, obligations or property referred to in paragraph A with respect to the counterparty and any affiliate of the counterparty. [PL 2011, c. 107, §3 (NEW).] [PL 2011, c. 107, §3 (NEW).]

4. Notice. If a receiver for an insurer makes a transfer of one or more netting agreements or qualified financial contracts, then the receiver must use its best efforts to notify any person who is a party to the netting agreements or qualified financial contracts of the transfer by noon, the receiver's local time, on the business day following the transfer. For purposes of this subsection, "business day" means a day other than a Saturday, Sunday or any day on which the New York Stock Exchange or the Federal Reserve Bank of New York is closed. [PL 2011, c. 107, §3 (NEW).]

5. Transfer prior to delinquency. Notwithstanding any other provision of this chapter and except as provided in this subsection, a receiver may not avoid a transfer of money or other property arising under or in connection with a netting agreement or qualified financial contract or any pledge, security, collateral or guarantee agreement or any other similar security arrangement or credit support document relating to a netting agreement or qualified financial contract that is made before the commencement of a delinquency proceeding under this chapter. A transfer may be avoided under section 4375‑A, subsection 1, paragraph A if the transfer was made with actual intent to hinder, delay or defraud the insurer, a receiver appointed for the insurer or existing or future creditors. [PL 2011, c. 107, §3 (NEW).]

6. Rights of disaffirmance or repudiation. Disaffirmance or repudiation is governed by this subsection. A. In exercising the rights of disaffirmance or repudiation of a receiver with respect to any netting agreement or qualified financial contract to which an insurer is a party, the receiver for the insurer shall either: (1) Disaffirm or repudiate all netting agreements and qualified financial contracts between a counterparty or any affiliate of the counterparty and the insurer that is the subject of the proceeding; or (2) Disaffirm or repudiate none of the netting agreements and qualified financial contracts referred to in subparagraph (1) with respect to the person or any affiliate of the person. [PL 2011, c. 107, §3 (NEW).] B. Notwithstanding any other provision of this chapter, any claim of a counterparty against the estate arising from the receiver's disaffirmance or repudiation of a netting agreement or qualified financial contract that has not been previously affirmed in the liquidation or immediately preceding rehabilitation proceeding must be determined and either allowed or disallowed: (1) As if the claim had arisen before the date of the filing of the petition for liquidation; (2) If a rehabilitation proceeding is converted to a liquidation proceeding, as if the claim had arisen before the date of the filing of the petition for rehabilitation; or (3) As if the claim had arisen before the issuance of any order or the commencement of any summary proceeding under this chapter. The amount of the claim is the actual direct compensatory damages determined as of the date of the disaffirmance or repudiation of the netting agreement or qualified financial contract. "Actual direct compensatory damages" does not include punitive or exemplary damages, damages for lost profit or lost opportunity or damages for pain and suffering, but does include normal and reasonable costs of cover or other reasonable measures of damages used in the derivatives, securities or other market for the contract and agreement claims. [PL 2011, c. 107, §3 (NEW).] [PL 2011, c. 107, §3 (NEW).]

7. Contractual right defined. "Contractual right," as used in this section, includes any right set forth in a rule or bylaw of a derivatives clearing organization as defined in the federal Commodity Exchange Act, a multilateral clearing organization as defined in the Federal Deposit Insurance Corporation Improvement Act of 1991, a national securities exchange, a national securities association, a securities clearing agency or a contract market designated under the federal Commodity Exchange Act, a derivatives transaction execution facility registered under the federal Commodity Exchange Act, or a board of trade as defined in the federal Commodity Exchange Act or in a resolution of the governing board thereof and any right, whether or not evidenced in writing, arising under statutory or common law, or under law merchant, or by reason of normal business practice. [PL 2011, c. 107, §3 (NEW).]

8. Affiliates. This section does not apply to any persons who are affiliates of the insurer that is the subject of the proceeding. [PL 2011, c. 107, §3 (NEW).]

9. Rights of counterparties. All rights of counterparties under this chapter apply to netting agreements and qualified financial contracts entered into on behalf of the general account or separate accounts if the assets of each separate account are available only to counterparties to netting agreements and qualified financial contracts entered into on behalf of that separate account. [PL 2011, c. 107, §3 (NEW).]
24-A M.R.S. § 1494 — ME Code / Title 24-A / Chapter 16 / Section 1494
24-A §1494. Required contract provisions
Status: in_force

A person acting in the capacity of an MGA may not place business with an insurer unless there is in force a written contract between the parties that sets forth the responsibilities of each party and, when both parties share responsibility for a particular function, specifies the division of those responsibilities. The contract must contain the following minimum provisions. [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]

1. Termination. The insurer may terminate the contract for cause upon written notice to the MGA. The insurer may suspend the underwriting authority of the MGA during the pendency of any dispute regarding the cause for termination. However, the suspension of an MGA does not relieve the MGA of the responsibility to service business in existence at the time of the suspension. [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]

2. Accounting. The MGA shall render accounts to the insurer detailing all transactions and remit all funds due under the contract to the insurer on not less than a monthly basis. [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]

3. Bank as fiduciary. All funds collected for the account of an insurer must be held by the MGA in a fiduciary capacity in a bank that is a member of the Federal Reserve System. This account must be used for all payments on behalf of the insurer. The MGA may retain no more than 3 months' estimated claims payments and allocated loss adjustment expenses. [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]

4. Records. Separate records of business written by the MGA must be maintained. The insurer must have access and may copy all accounts and records related to its business in a form usable by the insurer. The superintendent must have access to all books, bank accounts and records of the MGA in a form usable to the superintendent. These records must be retained according to section 3408 . [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]

5. Nonassignable. The contract may not be assigned in whole or part by the MGA. [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]

6. Guidelines. The contract must include appropriate underwriting guidelines including: A. The maximum annual premium volume; [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] B. The basis of the rates to be charged; [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] C. The types of risks that may be written; [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] D. Maximum limits of liability; [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] E. Applicable exclusions; [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] F. Territorial limitations; [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] G. Policy cancellation provisions; and [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] H. The maximum policy period. [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] The insurer has the right to cancel or not to renew any policy of insurance subject to all applicable laws and rules regarding the cancellation and nonrenewal of insurance policies. [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]

7. Settlement authority. If the contract permits the MGA to settle claims on behalf of the insurer: A. All claims must be reported to the insurer in a timely manner; [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] B. A copy of the claim file must be sent to the insurer at its request or as soon as it becomes known that the claim: (1) Has the potential to exceed an amount determined by the superintendent or exceeds the limit set by the insurer, whichever is less; (2) Involves a coverage dispute; (3) May exceed the MGA's claims settlement authority; (4) Is open for more than 6 months; or (5) Is closed by payment of an amount awarded as a result of a judicial proceeding or an amount set by the insurer, whichever is less; [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] C. All claim files must be the joint property of the insurer and MGA; except that, upon an order of liquidation of the insurer, the files become the sole property of the insurer or its estate. The MGA must have reasonable access to and may copy the files on a timely basis; and [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] D. Any settlement authority granted to the MGA may be terminated for cause upon written notice by the insurer to the MGA or upon the termination of the contract. The insurer may suspend the settlement authority during the pendency of any dispute regarding the cause for termination. Upon termination of the MGA's authority to settle claims, the MGA shall desist from any draw on funds of the insurer and shall immediately forward to the insurer all claims files with the MGA's immediate possession and any claims received thereafter. The MGA shall promptly transfer to the insurer any funds owed to the insurer or to any policyholder and shall transfer to the insurer any property of the insurer that is within the MGA's actual or constructive possession. [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]

8. Transmission. When electronic claims files are in existence, the contract must address the timely transmission of the data. [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]

9. Interim profits. If the contract provides for a sharing of interim profits by the MGA and the MGA has the authority to determine the amount of the interim profits by establishing loss reserves or controlling claim payments or in any other manner, interim profits may not be paid to the MGA until one year after they are earned for property insurance business and 5 years after they are earned on casualty business and not until the profits have been verified pursuant to section 1495 . [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]

10. Prohibitions. The MGA may not: A. Bind reinsurance or retrocessions on behalf of the insurer, except that the MGA may bind facultative reinsurance contracts pursuant to obligatory facultative agreements if the contract with the insurer contains reinsurance underwriting guidelines including, for reinsurance both assumed and ceded, a list of reinsurers with which such automatic agreements are in effect, the coverages and amounts or percentages that may be reinsured and commission schedules; [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] B. Commit the insurer to participate in insurance or reinsurance syndicates; [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] C. Make use of any producer without ensuring that the producer is lawfully licensed in this State to transact the kind of insurance for which the producer is used; [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] D. Without prior approval of the insurer, pay or commit the insurer to pay a claim over an amount specified by the insurer, net of reinsurance, which may not exceed 1% of the insurer's policyholder surplus as of December 31st of the preceding year; [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] E. Collect any payment from a reinsurer or commit the insurer to any claim settlement with a reinsurer without prior approval of the insurer. If prior approval is given, a report must be promptly forwarded to the insurer; [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] F. Make use of any producer who serves on the insurer's board of directors; [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] G. Jointly employ an individual who is employed with the insurer; or [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] H. Assign specific duties under a contract with an insurer to other parties. [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).] [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]
24-A M.R.S. § 3471 — ME Code / Title 24-A / Chapter 47 / Section 3471
24-A §3471. Scope of subchapter
Status: in_force

This subchapter applies as to domestic stock and mutual insurers whether heretofore or hereafter formed, including insurers chartered under special legislative Acts, notwithstanding any inconsistent provisions in the charters of the insurers. [PL 1985, c. 399, §2 (RPR).]
24-A M.R.S. § 2852 — ME Code / Title 24-A / Chapter 37 / Section 2852
24-A §2852. Purpose; construction
Status: in_force

The purpose of this chapter is to promote the public welfare by regulating consumer credit insurance. Nothing in this chapter is intended to prohibit or discourage reasonable competition. This chapter must be liberally construed. [PL 2001, c. 138, §6 (AMD).]
24-A M.R.S. § 2820 — ME Code / Title 24-A / Chapter 35 / Section 2820
24-A §2820. Renewal of policy
Status: in_force

There shall be a provision stating the conditions under which the insurer may decline to renew the policy. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 6205 — ME Code / Title 24-A / Chapter 73 / Section 6205
24-A §6205. Suspension or revocation of certificate of authority
Status: in_force

1. Complaint to District Court. The superintendent may file a complaint with the District Court seeking the suspension or revocation of any certificate of authority issued to a provider under this chapter if the superintendent finds, or the department certifies, that any of the following conditions exist: A. The provider is operating significantly in contravention of its basic organizational document or in a manner contrary to that described in and reasonably inferred from any other information submitted under this chapter, unless amendments to those submissions have been filed with and approved by the superintendent; [PL 1987, c. 482, §1 (NEW).] B. The provider charges an entrance fee, maintenance fee or other amount not consistent with the continuing care contract approved pursuant to section 6206 ; [PL 1987, c. 482, §1 (NEW).] C. The department certifies to the superintendent that the provider is unable to fulfill its obligations to furnish shelter, health care or supportive services; [PL 1987, c. 482, §1 (NEW).] D. The provider is no longer financially responsible and may not reasonably be expected to meet its obligations to subscribers or prospective subscribers; [PL 1987, c. 482, §1 (NEW).] E. The provider has failed to implement a mechanism affording the subscribers an opportunity to participate in matters of policy and operation; [PL 1989, c. 502, Pt. A, §100 (AMD).] F. The provider has failed to implement the complaint system in a manner to reasonably resolve valid complaints; [PL 1987, c. 482, §1 (NEW).] G. The provider or any person on its behalf has advertised or merchandised its services in an untrue, misrepresentative, misleading, deceptive or unfair manner; [PL 1987, c. 482, §1 (NEW).] H. The continued operation of the provider will be hazardous to its subscribers; [PL 1987, c. 482, §1 (NEW).] I. The provider has submitted false financial statements, organizational statements or documents; or [PL 1987, c. 482, §1 (NEW); PL 1989, c. 343, §17 (AMD); PL 1989, c. 343, §23 (AFF).] J. The provider has otherwise failed to substantially comply with this chapter or any rules issued by the superintendent or the department pursuant to this chapter. [PL 1987, c. 482, §1 (NEW); PL 1989, c. 343, §17 (AMD); PL 1989, c. 343, §23 (AFF).] K. [PL 1989, c. 343, §18 (NEW); PL 1989, c. 343, §23 (RP).] [RR 2021, c. 1, Pt. B, §393 (COR).]

2. Governing procedure. The proceedings governing the appeal of a revocation or suspension shall be conducted in accordance with the requirements of the Maine Administrative Procedure Act, Title 5, chapter 375 . [PL 1987, c. 482, §1 (NEW).]

3. Suspension. When the certificate of authority of a provider is suspended, the provider shall not, during the period of that suspension, enroll any additional subscribers and shall not engage in any advertising or solicitation. [PL 1987, c. 482, §1 (NEW).]

4. Revocation. When the certificate of authority of a provider is revoked, that organization shall proceed, immediately following the effective date of the order of revocation, to wind up its affairs and shall conduct no further business, except as may be essential to the orderly conclusion of the affairs of that organization. It shall engage in no further advertising or solicitation. [PL 1987, c. 482, §1 (NEW).]
24-A M.R.S. § 3960 — ME Code / Title 24-A / Chapter 54-A / Section 3960
24-A §3960. Actions against association or insurers based upon joint or collective actions
Status: in_force

Participation in the association, the establishment of reinsurance rates, forms or procedures or any other joint or collective action required by this chapter may not be the basis of any legal action or criminal or civil liability or penalty against the association or an insurer. [PL 2011, c. 90, Pt. B, §8 (NEW).]
24-A M.R.S. § 3857 — ME Code / Title 24-A / Chapter 53 / Section 3857
24-A §3857. Certificate of authority
Status: in_force

1. The certificate of authority of a reciprocal insurer shall be issued to its attorney in the name of the insurer. [PL 1969, c. 132, §1 (NEW).]

2. The superintendent may refuse to grant a certificate of authority, and may file a complaint with the District Court seeking suspension or revocation of a certificate of authority, for failure of the attorney to comply with any applicable provision of this Title, in addition to other grounds for those sanctions. [PL 1977, c. 694, §429 (RPR); PL 1999, c. 547, Pt. B, §78 (AMD); PL 1999, c. 547, Pt. B, §80 (AFF).]
24-A M.R.S. § 2304-B — ME Code / Title 24-A / Chapter 25 / Section 2304-B
24-A §2304-B. Reference filings
Status: in_force

1. An insurer may satisfy its obligations to make rate filings by becoming a participating insurer of a licensed advisory organization that makes reference filings of advisory prospective loss costs and by authorizing the superintendent to accept reference filings on its behalf. The insurer's rates are the prospective loss costs filed by the advisory organization that have been approved in accordance with section 2321‑E combined with the modifications and expense and profit factors filed by the insurer. [PL 1989, c. 797, §8 (NEW); PL 1989, c. 797, §§37, 38 (AFF).]

2. An insurer may request that its expense and profit factors and its loss cost modifications remain on file with the superintendent. Upon approval of an advisory organization loss cost reference filing, the insurer's rates are the combination of the approved prospective loss costs and the insurer's expense and profit factors and its loss cost modification filed with the superintendent. [PL 1989, c. 797, §8 (NEW); PL 1989, c. 797, §§37, 38 (AFF).]

3. If an insurer has authorized an advisory organization to file prospective loss cost information on its behalf, the insurer must make a filing with the superintendent pursuant to section 2304‑A if it intends to delay, modify or in any way not adopt an approved loss cost filing. [PL 1989, c. 797, §8 (NEW); PL 1989, c. 797, §§37, 38 (AFF).]

4. An insurer's expense and profit factors and loss cost modifications must remain in effect until the insurer withdraws or refiles new factors pursuant to section 2304‑A . The superintendent may request that an insurer provide supporting information for the filed expense and profit factors and loss cost modifications at any time. [PL 1989, c. 797, §8 (NEW); PL 1989, c. 797, §§37, 38 (AFF).]
24-A M.R.S. § 5084 — ME Code / Title 24-A / Chapter 68-A / Section 5084
24-A §5084. Notice to policyholders of rate increase
Status: in_force

1. Notice. An insurer shall notify a policyholder of a long-term care insurance policy issued in accordance with this chapter or chapter 68 of a proposed premium rate increase that affects the policyholder no later than 30 days after the filing by the insurer of the premium rate increase. An insurer shall provide written notice by first-class mail to the last known mailing address of all affected individual and group policyholders and others who are directly billed for group coverage. The notice must: A. Show the proposed rate; [PL 2019, c. 25, §1 (NEW).] B. State that the rate is subject to regulatory approval; [PL 2019, c. 25, §1 (NEW).] C. Inform a policyholder of the policyholder's right to request a hearing pursuant to section 229 ; [PL 2019, c. 25, §1 (NEW).] D. Inform a policyholder of the policyholder's right to provide written comments on the proposed rate increase to the bureau; and [PL 2019, c. 25, §1 (NEW).] E. Provide to the policyholder contact information for the bureau, including the bureau's toll-free telephone number. [PL 2019, c. 25, §1 (NEW).] [PL 2019, c. 25, §1 (NEW).]

2. Implementation of rate increase. An increase in a premium rate may not be implemented until approved by the bureau or until the effective date of the premium rate increase, whichever is later. [PL 2019, c. 25, §1 (NEW).]
24-A M.R.S. § 4448 — ME Code / Title 24-A / Chapter 57 / Section 4448
24-A §4448. Immunity
Status: in_force

There is no liability on the part of and no cause of action of any nature arises against any member insurer, the association or its agents or employees, the board of directors, or the superintendent or the superintendent's representatives for any action taken by them in the performance of their powers and duties under this subchapter. [RR 2021, c. 1, Pt. B, §390 (COR).]
24-A M.R.S. § 4254 — ME Code / Title 24-A / Chapter 56 / Section 4254
24-A §4254. Coverage for colorectal cancer screening
Status: in_force

1. Colorectal cancer screening. For the purposes of this section, "colorectal cancer screening" means all colorectal cancer examinations and laboratory tests recommended by a health care provider in accordance with the most recently published colorectal cancer screening guidelines of a national cancer society. [PL 2019, c. 86, §7 (AMD); PL 2019, c. 86, §10 (AFF).]

2. Required coverage. All health maintenance organization individual and group health insurance policies, contracts and certificates must provide coverage for colorectal cancer screening for asymptomatic individuals who are: A. At average risk for colorectal cancer according to the most recently published colorectal cancer screening guidelines of a national cancer society; or [PL 2019, c. 86, §8 (AMD); PL 2019, c. 86, §10 (AFF).] B. At high risk for colorectal cancer. [PL 2019, c. 86, §9 (AMD); PL 2019, c. 86, §10 (AFF).] [PL 2019, c. 86, §§8, 9 (AMD); PL 2019, c. 86, §10 (AFF).]

3. Billing. If a colonoscopy is recommended by a health care provider as the colorectal cancer screening test in accordance with this section and a lesion is discovered and removed during that colonoscopy, the health care provider must bill the insurance company for a screening colonoscopy as the primary procedure. [PL 2007, c. 516, §4 (NEW); PL 2007, c. 516, §5 (AFF).]

Revisor's Note: §4254. Coverage for medically necessary infant formula (As enacted by PL 2007, c. 595, §4 is REALLOCATED TO TITLE 24-A, SECTION 4256)
24-A M.R.S. § 402 — ME Code / Title 24-A / Chapter 5 / Section 402
24-A §402. "Reciprocal"; "Lloyd's" insurer defined
Status: in_force

1. Reciprocal insurer. A "reciprocal" insurer is an unincorporated aggregation of subscribers operating individually and collectively through an attorney-in-fact common to all such persons to provide reciprocal insurance among themselves. Any public self-funded pool operating under Title 30, chapter 203‑B is not an insurance company or insurer under the laws of this State. The development, administration and provision of a public self-funded pool's programs and coverages do not constitute doing an insurance business. [PL 1985, c. 713, §4 (AMD).]

2. Lloyd's insurer. A "Lloyd's" insurer is an unincorporated but formally organized association of individual underwriters, any one or more of whom underwrite and thereby assume as insurer such portion of the risk insured by them as shall be set forth in the contract of insurance issued by such an insurer. [PL 1969, c. 177, §5 (RPR).]
24-A M.R.S. § 2104 — ME Code / Title 24-A / Chapter 21 / Section 2104
24-A §2104. Superintendent process agent
Status: in_force

Solicitation, effectuation or delivery of any insurance contract, by mail or otherwise, within this State by an unauthorized insurer, or the performance within this State of any other service or transaction connected with such insurance by or on behalf of such insurer, is deemed to constitute an appointment by such insurer of the superintendent and the superintendent's successors in office as its attorney, upon whom may be served all lawful process issued within this State in any action or proceeding against such insurer arising out of any such contract or transaction; and is deemed to signify the insurer's agreement that any such service of process has the same legal effect and validity as personal service of process upon it in this State. [RR 2021, c. 1, Pt. B, §202 (COR).]
24 M.R.S. § 2345 — ME Code / Title 24 / Chapter 19 / Section 2345
24 §2345. Enforcement
Status: in_force

The following provisions govern enforcement of this chapter. [PL 1989, c. 556, Pt. C, §1 (NEW).]

1. Periodic reviews. The superintendent may conduct periodic reviews of the operations of the entities licensed pursuant to this subchapter to ensure that they continue to meet the minimum standards set forth in section 2343 and any applicable rules adopted by the superintendent. The superintendent may perform periodic telephone audits of licensees to determine if representatives of the licensee are reasonably accessible, as required by section 2343 . [PL 1989, c. 556, Pt. C, §1 (NEW).]

2. Action against licensee. The superintendent is authorized to take appropriate action against a licensee which fails to meet the standards of this subchapter or any rules adopted by the superintendent, or who fails to respond in a timely manner to corrective actions ordered by the superintendent. The superintendent may impose a civil penalty not to exceed $1,000 for each violation, as permitted by Title 24-A, section 12-A or may deny, suspend or revoke the license. [PL 1989, c. 556, Pt. C, §1 (NEW).]

3. Opportunity to provide information and request hearing. Before taking the actions authorized by this section to deny, suspend or revoke the license, the superintendent shall provide the licensee with reasonable time to supply additional information demonstrating compliance with the requirements of this subchapter and the opportunity to request a hearing to be held consistent with the provisions of the Maine Administrative Procedure Act, Title 5, chapter 375 . [PL 1989, c. 556, Pt. C, §1 (NEW).]

4. Authority to adopt rules. The superintendent may adopt rules necessary to implement the provisions of this subchapter. [PL 1989, c. 556, Pt. C, §1 (NEW).]

5. Rulings on appropriateness of medical judgments not authorized. Nothing in this subchapter requires or authorizes the superintendent to rule on the appropriateness of medical decisions or judgments rendered by review entities and their agents. [PL 1989, c. 556, Pt. C, §1 (NEW).]
24-A M.R.S. § 4317-C — ME Code / Title 24-A / Chapter 56-A / Section 4317-C
24-A §4317-C. Coverage for prescription insulin drugs; limit on out-of-pocket costs
Status: in_force

1. Definition. As used in this section, "insulin" has the same meaning as in Title 32, section 13786‑D, subsection 1, paragraph A . [PL 2019, c. 666, Pt. A, §1 (NEW); PL 2019, c. 666, Pt. A, §2 (AFF).]

2. Limit on out-of-pocket costs. A carrier that provides coverage for prescription insulin drugs may not impose any deductible, copayment, coinsurance or other cost-sharing requirement on an enrollee for that coverage that results in out-of-pocket costs to the enrollee that exceed $35 per prescription for a 30-day supply of covered prescription insulin drugs, regardless of the amount of insulin needed to fill the enrollee's insulin prescriptions. [PL 2019, c. 666, Pt. A, §1 (NEW); PL 2019, c. 666, Pt. A, §2 (AFF).]

3. Other cost sharing. This section does not prevent a carrier from setting an enrollee's cost-sharing requirement for one or more insulin drugs at an amount lower than the maximum amount specified in this section. [PL 2019, c. 666, Pt. A, §1 (NEW); PL 2019, c. 666, Pt. A, §2 (AFF).]

4. Rules. The superintendent may adopt rules to implement and administer this section to align with applicable federal requirements. Rules adopted pursuant to this section are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2019, c. 666, Pt. A, §1 (NEW); PL 2019, c. 666, Pt. A, §2 (AFF).]
24-A M.R.S. § 413-A — ME Code / Title 24-A / Chapter 5 / Section 413-A
24-A §413-A. Alien insurer; port of entry
Status: in_force

1. Port of entry. An alien insurer that has been authorized by the superintendent to use the State as its port of entry for the transaction of business in the United States is considered a domestic insurer to the extent provided in this section. An alien insurer that has been approved by another state to use that state as its port of entry is considered to be domiciled in that state in the same manner, if there is a valid reciprocity agreement between that state and this State or if the superintendent has determined that the applicable laws of that state are substantially similar to this section and its implementing rules. [PL 1999, c. 113, §17 (AMD).]

2. Rules. The superintendent shall adopt rules establishing the terms and conditions of port of entry authorization, which include without limitation: A. The requirements an alien insurer must satisfy to qualify for port of entry authorization. These requirements must include, at a minimum: (1) Agreement to adhere to all laws applicable to domestic insurers; (2) Maintenance of appropriate trust surplus or other adequate security within the State; (3) Maintenance of records of all United States operations within the State; and (4) Maintenance of a separate financial reporting system for United States operations; [PL 1995, c. 375, Pt. D, §1 (NEW).] B. The procedures for obtaining, maintaining and terminating port of entry authorization; and [PL 1995, c. 375, Pt. D, §1 (NEW).] C. Modifications of the provisions of this Title, and of the rules adopted by the superintendent that apply to domestic insurers, as the superintendent determines necessary for the appropriate regulation of alien insurers with port of entry authorization. [PL 1995, c. 375, Pt. D, §1 (NEW).] [PL 1995, c. 375, Pt. D, §1 (NEW).]
24-A M.R.S. § 2735 — ME Code / Title 24-A / Chapter 33 / Section 2735
24-A §2735. Age limit
Status: in_force

If any such policy contains a provision establishing, as an age limit or otherwise, a date after which the coverage provided by the policy will not be effective, and if such date falls within a period for which premium is accepted by the insurer or if the insurer accepts a premium after such date, the coverage provided by the policy will continue in force, subject to any right of termination, until the end of the period for which premium has been accepted. In the event the age of the insured has been misstated and if, according to the correct age of the insured, the coverage provided by the policy would not have become effective, or would have ceased prior to the acceptance of such premium or premiums, then the liability of the insurer shall be limited to the refund, upon request, of all premiums paid for the period not covered by the policy. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 5012 — ME Code / Title 24-A / Chapter 67 / Section 5012
24-A §5012. Annual guaranteed issue period
Status: in_force

During a guaranteed issue period of at least one month each calendar year, as established by the issuer, every issuer shall offer standardized Medicare Supplement Plan A, as defined by rule, to all applicants on a basis that does not deny coverage to any individual or group based on health status, claims experience, receipt of health care, or medical condition. [PL 1991, c. 740, §13 (NEW).]
24-A M.R.S. § 5004 — ME Code / Title 24-A / Chapter 67 / Section 5004
24-A §5004. Loss ratio standards
Status: in_force

1. Any Medicare supplement policy or contract is subject to the minimum loss ratio standards of section 2413, subsection 1, paragraph F , as well as any other laws of this State as apply to rate filings with respect to health insurance and nonprofit hospital and medical service organizations and nonprofit health care plan contracts. [PL 1989, c. 27, §4 (NEW).]

2. Medicare supplement policies must return to policyholders benefits that are reasonable in relation to the premium charged. The superintendent shall issue reasonable rules to establish minimum standards for loss ratios of Medicare supplement policies on the basis of incurred claims experience, or incurred health care expenses where coverage is provided by a health maintenance organization on a service rather than reimbursement basis, and earned premiums in accordance with accepted actuarial principles and practices. [PL 2001, c. 258, Pt. F, §2 (AMD).]

3. [PL 1989, c. 852, §2 (RP); PL 1989, c. 852, §3 (AFF).]
24-A M.R.S. § 5007 — ME Code / Title 24-A / Chapter 67 / Section 5007
24-A §5007. Notice of free examination
Status: in_force

Medicare supplement policies and certificates must have a notice prominently printed on the first page of the policy or certificate or attached to the policy or certificate, stating in substance that the applicant has the right to return the policy or certificate within 30 days of its delivery and to have the premium refunded if, after examination of the policy or certificate, the applicant is not satisfied for any reason. Any refund made pursuant to this section must be paid directly to the applicant by the issuer in a timely manner. [PL 1991, c. 740, §10 (AMD).]