24-A M.R.S. § 601 — ME Code / Title 24-A / Chapter 7 / Section 601
24-A §601. Fee schedule
Status: in_force

The superintendent shall collect, and persons so served shall pay to the superintendent, the fees and miscellaneous charges as set forth in this section. The superintendent may adopt rules establishing the fees and charges in different amounts from those specified under this section, except that the amount of any such fee or charge may not exceed the cap established in this section. In the absence of such rules, the maximum amounts set forth in this section apply. Rules adopted pursuant to this section are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2003, c. 203, §1 (AMD).]

1. Certificate of authority. Insurer's certificate of authority fees may not exceed: A. For filing application for initial certificate of authority, including all documents submitted as part of the application. If an applicant requests deferral and new data filings respecting the application are required, a fee in equal amount is required upon the filing of the new information $1,000. [PL 1991, c. 334, §5 (AMD).] B. Issuance, and each annual continuation $100; and [PL 1995, c. 544, §6 (AMD).] C. Reinstatement, under section 415 $350; [PL 2003, c. 203, §1 (AMD).] [PL 2003, c. 203, §1 (AMD).]

2. Charter documents, other than those filed with application for certificate of authority. The fee: for filing by an insurer for a reservation of a name; in addition to any other fee, a late filing of any information required to be filed by a licensee; registration of a branch location; and filing any amendment to certificate of organization, articles or certificate of incorporation, charter, bylaws, power of attorney, as to reciprocal insurers, and other constituent documents of the insurer may not exceed $25; [RR 2023, c. 2, Pt. A, §34 (COR).]

3. Annual statement. Filing annual statement of insurer, payable annually may not exceed $100; [PL 2003, c. 203, §1 (AMD).]

4. Process. [PL 1997, c. 592, §15 (RP).]

5. Producers. Producers' license and appointment fees may not exceed: A. Issuance fee for original resident producer license, including limited license $30; [PL 1997, c. 457, §18 (AMD); PL 1997, c. 457, §55 (AFF).] B. Appointment of resident producer, each insurer, health maintenance organization, fraternal benefit society, nonprofit hospital or medical service organization, viatical settlement provider or risk retention group $30; Biennial fee for appointment, each insurer, health maintenance organization, fraternal benefit society, nonprofit hospital or medical service organization, viatical settlement provider or risk retention group $30; [PL 1997, c. 592, §16 (AMD).] C. Temporary license issuance fee $50; [PL 1993, c. 637, §4 (AMD).] D. [PL 1997, c. 457, §18 (RP); PL 1997, c. 457, §55 (AFF).] E. Issuance fee for original nonresident producer license or for a nonresident producer acting pursuant to a national nonresident producer license issued through the National Association of Registered Agents and Brokers $70; Appointment of such producer, each insurer, health maintenance organization, fraternal benefit society, nonprofit hospital or medical service organization, viatical settlement provider or risk retention group $70; Biennial fee for appointment, each insurer, health maintenance organization, fraternal benefit society, nonprofit hospital or medical service organization, viatical settlement provider or risk retention group $70; [PL 2017, c. 115, §2 (AMD).] F. Issuance fee for resident agency license, $30; Biennial fee, $30; Biennial fee for appointment, each insurer, health maintenance organization, fraternal benefit society, nonprofit hospital or medical service organization, viatical settlement provider or risk retention group, $30; and [PL 2011, c. 238, Pt. H, §1 (AMD).] G. Issuance fee for nonresident agency license, $70; Biennial fee, $70; Biennial fee for appointment, each insurer, health maintenance organization, fraternal benefit society, nonprofit hospital or medical service organization, viatical settlement provider or risk retention group, $70. [PL 2011, c. 238, Pt. H, §2 (AMD).] H. [PL 2011, c. 238, Pt. H, §3 (RP).] [PL 2017, c. 115, §2 (AMD).]

6. Brokers. [PL 1997, c. 457, §19 (RP); PL 1997, c. 457, §55 (AFF).]

7. Consultants. Consultant license fees may not exceed: A. Issuance fee for original resident consultant license $50; Biennial fee $50; [PL 1997, c. 592, §17 (AMD).] B. Issuance fee for original nonresident consultant license $100; Biennial fee $100; [PL 1997, c. 592, §17 (AMD).] C. Issuance fee for resident consultant agency license $50; Biennial fee $50; and [PL 1997, c. 592, §17 (AMD).] D. Issuance fee for nonresident consultant agency license $100; Biennial fee $100. [PL 1997, c. 592, §17 (AMD).] [PL 2003, c. 203, §1 (AMD).]

8. Adjusters. Adjuster license fees may not exceed: A. Issuance fee for original resident adjuster license $30; Biennial fee $30; [PL 1997, c. 592, §18 (AMD).] B. Issuance fee for original nonresident adjuster license $60; Biennial fee $60; [PL 1997, c. 592, §18 (AMD).] C. Temporary license $50; [PL 1993, c. 637, §8 (AMD).] D. Issuance fee for resident adjuster agency license $30; Biennial fee $30; and [PL 1997, c. 592, §18 (AMD).] E. Issuance fee for nonresident adjuster agency license $60; Biennial fee $60. [PL 1997, c. 592, §18 (AMD).] [PL 2003, c. 203, §1 (AMD).]

9. Examination. [PL 1993, c. 221, §1 (RP).]

9-A. Application. Application for license fees may not exceed: A. Application filing fee, other than consultants $15; and [PL 1993, c. 221, §2 (NEW).] B. Consultant application filing fee $25. [PL 1993, c. 221, §2 (NEW).] [PL 2003, c. 203, §1 (AMD).]

10. Vending machines. Insurance vending machines fees may not exceed: Issuance fee for license, each machine $100; and Biennial continuation of license, each machine $100. [PL 2003, c. 203, §1 (AMD).]

11. Rating organizations and advisory organizations. Rating organizations and advisory organizations fees may not exceed: Original license issuance fee $200; and Biennial continuation of license $200. [PL 2003, c. 203, §1 (AMD).]

12. Road or tourist service. [PL 1997, c. 457, §20 (RP).]

13. Copies of certificates. Certified copy of insurer certificate of authority or other license issued under this Title may not exceed $10. [PL 2003, c. 203, §1 (AMD).]

14. Copies of other documents. Copies of other documents on file in the bureau: reasonable charge as fixed by the superintendent; and for certifying and fixing official seal may not exceed $10. [PL 2003, c. 203, §1 (AMD).]

15. [PL 1975, c. 767, §15 (RP).]

16. Self-insurance authorization. Fees applicable to each self-insurer, individual or group, seeking authorization or authorized to operate a workers' compensation self-insurance plan, and each self-insurance reinsurance account and each protected cell of a self-insurance reinsurance account, may not exceed: A. For filing application for initial authorization, including all documents submitted as part of the application, $1,000; [PL 2009, c. 232, §1 (AMD).] A-1. For filing application for authority to self-insure under Title 39‑A, section 403, subsection 16 , including all documents submitted as part of the application, $500; and [PL 2025, c. 348, §8 (AMD).] B. For authorization and each annual continuation, $400. [PL 2025, c. 348, §9 (AMD).] C. [PL 2025, c. 348, §10 (RP).] If a self-insurer terminates the plan or otherwise does not continue to self-insure, the fee applicable to filing of yearly reports must apply to that period in which the making of these reports is mandated. [PL 2025, c. 348, §§8-10 (AMD).]

17. Rules, rates and forms filings. Rate filings, rating rules filings, insurance policy, forms, riders, endorsements and certificate filings may not exceed $20. [PL 2003, c. 203, §1 (AMD).]

18. Third-party administrators. Third-party administrators license fees may not exceed: A. Original issuance fee $100; and [PL 1993, c. 637, §12 (AMD).] B. Annual renewal fee $100. [PL 1993, c. 637, §12 (AMD).] [PL 2003, c. 203, §1 (AMD).]

19. Purchasing group registrations. Purchasing group registration fees may not exceed: A. Original issuance fee $100; and [PL 1993, c. 637, §13 (AMD).] B. Annual renewal fee $100. [PL 1993, c. 637, §13 (AMD).] [PL 2003, c. 203, §1 (AMD).]

20. Preferred provider arrangement administrator. Preferred provider arrangement administrator fees may not exceed: A. Original registration issuance fee $100; and [PL 1993, c. 637, §13 (AMD).] B. Annual renewal fee $100. [PL 1993, c. 637, §13 (AMD).] [PL 2003, c. 203, §1 (AMD).]

21. Reinsurance intermediary. Reinsurance intermediary issuance fees and renewal fees may not exceed: A. Original license issuance fee $50; and [PL 1993, c. 637, §14 (RPR).] B. Annual continuation $50. [PL 1997, c. 457, §21 (AMD).] [PL 2003, c. 203, §1 (AMD).]

22. Managing general agents. Managing general agents fees may not exceed: A. Original registration fee $100; and [PL 1993, c. 221, §4 (NEW).] B. Annual continuation of registration fee $100. [PL 1993, c. 221, §4 (NEW).] [PL 2003, c. 203, §1 (AMD).]

23. Continuing education vendors and courses. Filing fees for continuing education courses and vendors may not exceed: A. Filing fee for each continuing education vendor $100; [PL 1993, c. 637, §15 (NEW).] B. Biennial continuation of approval $100; and [PL 1993, c. 637, §15 (NEW).] C. Filing fee for original approval of each continuing education course $20. [PL 1993, c. 637, §15 (NEW).] [PL 2003, c. 203, §1 (AMD).]

24. Multiple-employer welfare arrangements. Applications for authorization may not exceed $500. [PL 2003, c. 203, §1 (AMD).]

25. Transferees of structured settlement payment rights. Transferees of structured settlement payment rights registration fees may not exceed: A. Original issuance fee $100; and [PL 1999, c. 268, §1 (NEW).] B. Annual renewal fee $100. [PL 1999, c. 268, §1 (NEW).] [PL 2003, c. 203, §1 (AMD).]

26. Accredited reinsurers. Application fees for accreditation of reinsurers may not exceed $500. [PL 2013, c. 238, Pt. B, §1 (AMD).]

26-A. Certified reinsurers. Application fees for certification of reinsurers may not exceed $1,000. [PL 2013, c. 238, Pt. B, §2 (NEW).]

27. Viatical or life settlement provider. Settlement provider license issuance fees and renewal fees may not exceed: A. Original license issuance fee $400; and [PL 2003, c. 636, §1 (NEW).] B. Annual renewal fee $400. [RR 2003, c. 2, §85 (COR).] [RR 2003, c. 2, §85 (COR).]

28. Pharmacy benefits manager. [PL 2019, c. 469, §3 (RP); PL 2019, c. 469, §9 (AFF).]

28-A. Pharmacy benefits manager. Pharmacy benefits manager licensing fees may not exceed: A. Original issuance fee, $100; and [PL 2019, c. 469, §4 (NEW); PL 2019, c. 469, §9 (AFF).] B. Renewal fee, $100. [PL 2019, c. 469, §4 (NEW); PL 2019, c. 469, §9 (AFF).] [PL 2019, c. 469, §4 (NEW); PL 2019, c. 469, §9 (AFF).]

29. Portable electronic device insurance vendor. Portable electronic device insurance vendor licensing fees may not exceed: A. Original license issuance fee, $1,000; and [PL 2011, c. 297, §1 (NEW).] B. Annual renewal fee, $500. [PL 2011, c. 297, §1 (NEW).] [PL 2011, c. 297, §1 (NEW).] Revisor's Note: (Subsection 29 as enacted by PL 2011, c. 345, §3 and affected by §7 is REALLOCATED TO TITLE 24-A, SECTION 601, SUBSECTION 30)

30. (REALLOCATED FROM T. 24-A, §601, sub-§29) Service contract providers and administrators. Service contract provider or administrator annual registration fees may not exceed $200. [RR 2011, c. 1, §37 (RAL).]

31. Supervising travel insurance producer. Supervising travel insurance producer licensing fees may not exceed: A. Original license issuance fee, $500; and [PL 2015, c. 133, §1 (NEW).] B. Annual renewal fee, $300. [PL 2015, c. 133, §1 (NEW).] [PL 2015, c. 133, §1 (NEW).]

32. Surplus lines. Surplus lines authority fees may not exceed: A. Issuance fee for surplus lines authority, $150. [PL 2019, c. 382, §1 (NEW).] [PL 2019, c. 382, §1 (NEW).]

33. Self-storage insurance provider. Self-storage insurance provider fees may not exceed: A. Issuance of license for self-storage insurance provider, $100; and [PL 2021, c. 218, §1 (NEW).] B. Annual renewal fee, $50. [PL 2021, c. 218, §1 (NEW).] [PL 2021, c. 218, §1 (NEW).]
24-A M.R.S. § 4320-P — ME Code / Title 24-A / Chapter 56-A / Section 4320-P
24-A §4320-P. Coverage for health care services for COVID-19
Status: in_force

Notwithstanding any requirements of this Title to the contrary, a carrier offering a health plan in this State shall provide, at a minimum, coverage as required by this section for screening, testing and immunization for COVID-19. [PL 2021, c. 28, Pt. A, §3 (NEW).]

1. Definitions. For the purposes of this section, unless the context otherwise indicates, the following terms have the following meanings. A. "COVID-19" means the coronavirus disease 2019 resulting from SARS-CoV-2, severe acute respiratory syndrome coronavirus 2, and any virus mutating from that virus. [PL 2021, c. 28, Pt. A, §3 (NEW).] B. "Surveillance testing program" means a structured program of asymptomatic testing at a community or population level to understand the incidence or prevalence of COVID-19 in a group. "Surveillance testing program" does not include a program of testing that occurs less often than once per month per individual. [PL 2021, c. 28, Pt. A, §3 (NEW).] [PL 2021, c. 28, Pt. A, §3 (NEW).]

2. Testing. A carrier shall provide coverage for screening and testing for COVID-19 as follows. A. A carrier shall provide coverage for screening and testing for COVID-19, except when such screening and testing is part of a surveillance testing program. [PL 2021, c. 28, Pt. A, §3 (NEW).] B. A carrier may not impose any deductible, copayment, coinsurance or other cost-sharing requirement for the costs of COVID-19 screening and testing, including all associated costs of administration. [PL 2021, c. 28, Pt. A, §3 (NEW).] C. A carrier may not make coverage without cost sharing as required by paragraph B dependent on any prior authorization requirement. [PL 2021, c. 28, Pt. A, §3 (NEW).] D. A carrier may not make coverage without cost sharing as required by paragraph B dependent on the use of a provider in a carrier's network unless an enrollee is offered screening and testing by a network provider without additional delay and the enrollee chooses instead to obtain screening from an out-of-network provider or to be tested by an out-of-network laboratory. [PL 2021, c. 28, Pt. A, §3 (NEW).] E. For the purposes of this subsection, with respect to COVID-19 screening and testing rendered by an out-of-network provider, a carrier shall reimburse the out-of-network provider in accordance with section 4303‑C, subsection 2, paragraph B . [PL 2021, c. 28, Pt. A, §3 (NEW).] [PL 2021, c. 28, Pt. A, §3 (NEW).]

3. Immunization; COVID-19 vaccines. A carrier shall provide coverage for COVID-19 vaccines as follows. A. A carrier shall provide coverage for any COVID-19 vaccine licensed or authorized under an emergency use authorization by the United States Food and Drug Administration that is recommended by the United States Centers for Disease Control and Prevention Advisory Committee on Immunization Practices, or successor organization, for administration to an enrollee. [PL 2021, c. 28, Pt. A, §3 (NEW).] B. A carrier may not impose any deductible, copayment, coinsurance or other cost-sharing requirement for the cost of COVID-19 vaccines, including all associated costs of administration. [PL 2021, c. 28, Pt. A, §3 (NEW).] C. A carrier may not make coverage without cost sharing as required by paragraph B dependent on any prior authorization requirement. [PL 2021, c. 28, Pt. A, §3 (NEW).] D. A carrier may not make coverage without cost sharing as required by paragraph B dependent on the use of a provider in a carrier's network unless an enrollee is offered immunization by a network provider without additional delay and the enrollee chooses instead to obtain immunization from an out-of-network provider. [PL 2021, c. 28, Pt. A, §3 (NEW).] [PL 2021, c. 28, Pt. A, §3 (NEW).]

4. Rules. The superintendent may adopt rules to implement and administer this section to align with any applicable federal requirements. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2‑A . [PL 2021, c. 28, Pt. A, §3 (NEW).]

Revisor's Note: §4320-P. Coverage for services provided by a certified registered nurse anesthetist (As enacted by PL 2021, c. 39, §1 is REALLOCATED TO TITLE 24-A, SECTION 4320-Q)
24-A M.R.S. § 2393 — ME Code / Title 24-A / Chapter 26 / Section 2393
24-A §2393. Initial funding of pool
Status: in_force

1. Payments by insurers. Insurers shall pay to the pool on or before January 1, 1996 the amount of $65,000,000, as follows. A. Major insurers shall pay to the pool 90% of the $65,000,000 payment, which is $58,500,000. Each major insurer shall pay to the pool that major insurer's allocated share of the payment required by this paragraph as determined in accordance with the following: (1) If the major insurer's percentage of the total net direct written premium in the voluntary workers' compensation market in the State for the calendar years 1989 and 1990 was less than 3.4% according to data compiled by the National Council on Compensation Insurance, then the major insurer must pay to the pool $4,906,000; (2) If the major insurer's percentage of the total net direct written premium in the voluntary workers' compensation market in the State for the calendar years 1989 and 1990 was equal to or greater than 3.4%, according to data compiled by the National Council on Compensation Insurance, then the major insurer must pay $4,906,000 less one of the following credits: (a) If the major insurer's percentage of total net direct written premium in the voluntary market exceeded 25% for each of the calendar years 1989 and 1990, then $1,811,000; (b) If the major insurer's percentage of total net direct written premium in the voluntary market exceeded 10% for each of the calendar years 1989 and 1990, then $1,772,000; (c) If the major insurer's percentage of total net direct written premium in the voluntary market exceeded 10% for either calendar year 1989 or 1990, then $807,000; (d) If the major insurer's percentage of total net direct written premium in the voluntary market exceeded 7.5% for each of the calendar years 1989 and 1990, then $596,000; or (e) For any other major insurer that qualifies for credit under this subparagraph, $289,000; (3) One or more major insurers may agree in writing to pay more or less than the amount of their allocated share under subparagraph (1) or (2); except that: (a) A major insurer may not pay less than the allocated share under subparagraph (1) or (2), unless the written agreement is executed by all major insurers that have timely paid or agreed in writing to timely pay in full at least their allocated share; (b) The total amount of timely payments to the pool by major insurers is equal to or greater than $58,500,000; (c) The pool is made a 3rd-party beneficiary to a written agreement among certain major insurers that provides for: (i) Timely payments to the pool by major insurers that are equal to $58,500,000; and (ii) An express right of the pool to enforce the payments required by that agreement; and (d) Timely payment of any share agreed upon in writing pursuant to this subparagraph in an amount less than the allocated share under subparagraph (1) or (2) constitutes timely payment in full of an allocated share for purposes only of subsection 1, paragraph C or section 2396, subsection 1 . (4) If the total amount paid according to the requirements of subparagraphs (1), (2) and (3) exceeds $58,500,000, the pool must disburse within 30 days the excess amount by refunding to each major insurer that has timely paid in full at least its allocated share under subparagraph (1) or (2) in direct proportion to the amount that each major insurer paid to the pool as part of the total major insurers' payment required by this paragraph. [PL 1995, c. 289, §11 (NEW).] B. Minor insurers shall pay to the pool 10% of the $65,000,000 payment, which is $6,500,000. Each minor insurer shall pay to the pool an allocated share of the payment required by this paragraph as determined in accordance with the following. (1) Except as provided in subparagraph (2), an allocated share equal to the sum of the amounts described in divisions (a) to (c) must be paid to the pool. (a) Minor insurers authorized to provide workers' compensation insurance in the State at any time during 1989 pay 59% of the $6,500,000 payment, with each minor insurer paying a per capita share. (b) Minor insurers authorized to provide workers' compensation insurance in the State at any time during 1990 pay 38% of the $6,500,000 payment, with each minor insurer paying a per capita share. (c) Minor insurers authorized to provide workers' compensation insurance in the State at any time during 1991 pay 3% of the $6,500,000 payment, with each minor insurer paying a per capita share. (2) A minor insurer that qualifies for a partial exemption under this subparagraph shall pay to the pool the greater of $10,000 or 2% of the minor insurer's average annual after-tax adjusted earnings for the 3 calendar years immediately prior to enactment of this chapter as reported in the minor insurer's annual statement filed with the superintendent. A minor insurer qualifies for a partial exemption from the per capita share payment required by this paragraph if, for the 3 calendar years immediately prior to enactment of this chapter, as reported in the minor insurer's annual statement filed with the superintendent, the minor insurer's: (a) Average annual after-tax adjusted earnings were less than $2,000,000; and (b) Surplus as to policyholders did not exceed $12,500,000. (3) A minor insurer that has not received a partial exemption under subparagraph (2) is entitled to participation credits determined as follows. (a) For any policy year beginning on or after January 1, 1989, the share for each minor insurer authorized to write workers' compensation insurance in the year to which the calculation in this division pertains is reduced by .05% for each .10% that its participation ratio for the year to which the assessment relates exceeds its participation ratio for the base period as calculated by dividing the minor insurer's net direct written premium for the base period by the total minor insurer's net direct written premium for the base period. For purposes of this division, "base period" means the calendar years 1983 to 1986. The participation ratio for the year to which the assessment relates is calculated by dividing the minor insurer's net direct written premium in that calendar year by the total net direct written premium of minor insurers that were authorized at any time during that year; (b) Credits earned by a minor insurer may not result in a minor insurer's participation ratio being adjusted to less than 1/2 of its otherwise allocated share; (c) For a minor insurer not authorized to write workers' compensation insurance in 1986, its adjusted participation ratio is 1/2 of its participation ratio in the year to which the calculation applies; (d) Any deficiency must be distributed among all minor insurers in proportion to the adjusted participation ratio, after credit adjustments; and (e) For purposes of this subparagraph, "adjusted participation ratio" means a minor insurer's participation ratio as calculated in accordance with this subparagraph and after application of any credits. For purposes of this subparagraph, net direct written premium does not include premiums for residual market risks reinsured by the pool or retrospective rating plan adjustments on policies effective prior to January 1, 1988. (4) The total amount of the differences between the following must be paid by those minor insurers that actually paid their allocated share as of January 1, 1996 by allocating the difference to those minor insurers in the same proportion as each such minor insurer's payment bears to the total aggregate amount actually paid by minor insurers as of January 1, 1996: (a) The otherwise allocated share payments under subparagraph (1); and (b) The payments made by minor insurers that qualify for a partial exemption as provided in subparagraph (2) and any participation credits under subparagraph (3). (5) In the event a minor insurer for any reason fails to pay its allocated share, as described in this paragraph, by January 1, 1996, then the pool may charge the deficiency resulting from those uncollected amounts to all minor insurers that actually pay their allocated share as of January 1, 1996 by allocating that deficiency to those minor insurers in the same proportion as each such minor insurer's payment bears to the total aggregate amount actually paid by minor insurers as of January 1, 1996. Those minor insurers are subrogated to the pool's right to collect such amounts from the delinquent minor insurer. (6) One or more minor insurers may agree in writing to pay more or less than the amount of their allocated share under subparagraphs (1) to (4), except that: (a) A minor insurer may not pay less than the allocated shares under subparagraphs (1) to (4) unless the written agreement is executed by all minor insurers that have timely paid or agreed in writing to timely pay in full at least their allocated share; (b) The total amount of timely payments to the pool by minor insurers is equal to or greater than $6,500,000; (c) The pool is made a 3rd-party beneficiary to a written agreement among certain minor insurers that provides for: (i) Timely payments to the pool by minor insurers that are equal to $6,500,000; and (ii) An express right of the pool to enforce the payments required by that agreement; and (d) Timely payment of any share agreed upon in writing pursuant to this subparagraph in an amount less than the allocated share under subparagraphs (1) to (4) constitutes timely payment in full of an allocated share for purposes only of subsection 1, paragraph C or section 2396, subsection 1 . (7) If the total amount paid according to the requirements of subparagraphs (1) to (6) exceeds $6,500,000, the pool must disburse within 30 days the excess amount by refunding to each minor insurer that has timely paid in full at least its allocated share under subparagraphs (1) to (4) in direct proportion to the amount that each minor insurer paid to the pool as part of the total minor insurers' payment required by this paragraph. [PL 1995, c. 289, §11 (NEW).] C. The pool shall bill and collect from each insurer the allocated share established by paragraphs A and B . If an insurer has not timely paid its allocated share in full to the pool on or before January 1, 1996, then the insurer is considered delinquent and the following applies. (1) The pool has all the rights, powers and authority to take all necessary and appropriate action, as determined in the pool's discretion, against the delinquent insurer to collect any amounts not paid as and when due, and any deficiency is assessed interest at the rate of 10% per annum from January 1, 1996 until full payment from the insurer is received by the pool. The pool is entitled to an award of and reimbursement from any delinquent insurer of the costs of enforcement and collection of any amounts not paid as and when due, including all costs and expenses, reasonable attorney's and paralegal's fees and any other professional fees and expenses associated with the pool's enforcement and collection efforts. (2) If the pool has received $58,500,000 from major insurers or $6,500,000 from minor insurers, valued as of January 1, 1996, the pool shall provide prompt written notice of this fact to insurers in the same category, either major or minor. Within 90 days following a request, the pool shall assign all such rights, powers and authority, including the entitlement to costs and expenses, to any insurers in the same category of the delinquent insurer that have requested an assignment and timely paid in full at least the allocated share established by paragraphs A and B . (3) The pool has the right to set off any amounts due under this chapter to the pool from a delinquent insurer against any sums credited by or due from the pool to the delinquent insurer and against any other property of the delinquent insurer in the possession or under the control of the pool. (4) Regardless of whether any action is taken pursuant to subparagraphs (1) to (3), the superintendent is authorized to exercise all authority as may be provided by and in accordance with law to take appropriate action against any delinquent insurer. In addition to any other authority the superintendent may possess under law, the superintendent upon notice and hearing may suspend a delinquent insurer's authority to transact the business of insurance in the State for so long as the insurer remains delinquent. The authority granted to the superintendent under this paragraph and jurisdiction vested in the bureau are concurrent with other actions by other parties authorized in this paragraph. (5) Any collection by or on behalf of the pool, or amounts obtained by setoff with respect to a delinquent insurer, are retained by the pool, until the insurers in the same category as the delinquent insurer have paid the total amount required for that category, plus interest pursuant to subparagraph (1) and costs and expenses of the pool for collection in an amount not to exceed the delinquent share, valued as of January 1, 1996, to the pool. Any excess must be distributed within 90 days among the insurers in the same category as the delinquent insurer that have timely paid in full at least the allocated share established by paragraphs A and B in direct proportion to that insurer's payment to the pool as part of the total payments required by paragraph A or B , except that any collection on behalf of the pool as the result of an assignment pursuant to subparagraph (2) must be distributed as agreed among the insurers that receive the assignment from the pool. (6) No defense or substantive argument that could have been raised or asserted related to an insurer's status as a major insurer or minor insurer or any purported contractual rights under prior or existing law is extinguished or otherwise abridged in any proceeding against a delinquent insurer instituted under subparagraphs (1) to (5). [PL 1995, c. 289, §11 (NEW).] [PL 1995, c. 289, §11 (NEW).]

2. Payments by employers. Employers shall pay to the pool the following amounts. A. Employers shall pay initial surcharges, in the manner described in this subsection, in an aggregate amount equal to $110,000,000, calculated on a net present value basis using January 1, 1995 as the valuation date, a discount rate of 5% and the midpoint of each calendar quarter as the date of actual receipt of surcharge proceeds remitted to the pool for each calendar quarter. Proceeds included in determining when the $110,000,000 initial surcharge is fully paid consist of: (1) All proceeds from surcharges under this chapter on policies with effective dates on or after July 1, 1995 and surcharges under this chapter on self-insured employers with plan years commencing on or after July 1, 1995; and (2) All proceeds from surcharges actually received in immediately available funds by the pool after 5:00 p.m., September 30, 1995, whether the proceeds result from a surcharge under this chapter or under laws existing prior to enactment of this chapter. [PL 1995, c. 289, §11 (NEW).] B. Proceeds from surcharges under existing laws actually received in immediately available funds by the pool on or before 5:00 p.m., September 30, 1995 may not be credited against the initial surcharge requirement. [PL 1995, c. 289, §11 (NEW).] C. The pool shall maintain records reflecting actual dates of receipt of proceeds from surcharges sufficient to enable the net present value calculation. [PL 1995, c. 289, §11 (NEW).] D. The initial surcharges must be paid in accordance with the following provisions. (1) Beginning July 1, 1995 every insurer writing workers' compensation insurance in the State shall collect from workers' compensation insurance policyholders and pay to the pool a surcharge on all surchargeable premiums received by the insurer for those policies. During the initial surcharge period, the surcharge is at a fixed rate of 6.32% of the surchargeable premium. The surcharge may be applied only to policies with an effective date on or after 12:01 a.m., July 1, 1995. All surcharges received by each insurer during the preceding calendar quarter must be remitted to the pool within 15 days following the end of each calendar quarter, except that servicing carriers shall remit on February 15th, May 15th, August 15th and November 15th of each year. Any surcharge proceeds not remitted on a timely basis accrue interest at the rate of 10% per annum from the due date until paid in full. The pool is entitled to reimbursement from any insurer failing to remit surcharge proceeds on a timely basis for the pool's costs of collection of those amounts, including all collection costs and fees, reasonable attorney's and paralegal's fees and any other professional fees and expenses associated with the pool's collection efforts. The surcharges described in this subparagraph do not apply to reinsurance recognized by the superintendent pursuant to Chapter 250, section 2, paragraph G or section 3, paragraph G, procured by an individual self-insured employer or a self-insured employer group. (2) Self-insured employers that secured their obligation to provide workers' compensation benefits under the Workers' Compensation Act through issuance or renewal at any point during the fresh start period of an insurance policy for any portion of any of the policy years 1988 to 1992 are subject to a surcharge as provided in the following. (a) During the initial surcharge period the rate of surcharge is 6.32% of the surchargeable premium as adjusted pursuant to this paragraph for the self-insured employer's current plan year utilizing estimated payroll as submitted with the self-insured employer's renewal application for authority to self-insure, in accordance with Chapter 250, section 2, paragraph C, subparagraph 1, division c or Chapter 250, section 3, paragraph C, subparagraph 1, division g as applicable, subject to audit pursuant to division (d), subdivision (iii). If the plan year in which a surcharge is collected or a credit is distributed is shorter than 12 months, due to a change in accounting period or termination of self-insurance authorization, the surcharge or credit for that plan year must be based upon the final audited payroll for the short plan year. (b) All surcharges must be collected or distributed on a plan year basis. In each plan year, the percentage of the surchargeable premium to be surcharged is the same percentage as is applied to an insured employer whose policy period coincided with the plan year. (c) Except for a successor self-insured employer, each self-insured employer shall pay surcharges relating to only that portion of the policy years 1988 to 1992 in which the self-insured employer insured its workers' compensation obligations. The surcharge factor, as determined by the board under this chapter, must be adjusted to take into consideration the policy years or portions of policy years 1988 to 1992 in which a self-insured employer was self-insured. The self-insured employer adjustment is determined as follows. The surcharge factor must be multiplied by the factor attributed to each of the years 1988 to 1992, as set forth in the table below. If a self-insured employer was insured only during a portion of a policy year, then the factor for that year is prorated based on the ratio of the number of days in the policy year during which the self-insured employer was insured to 365 days. Policy Year Factor 1988 28.48% 1989 30.70% 1990 23.26% 1991 11.55% 1992 6.01% (d) The board shall administer the surcharges on self-insured employers as follows. (i) The board shall issue surcharge billings to self-insured employers, pursue collection of all invoiced surcharges, initiate legal proceedings as necessary to collect surcharges and maintain records adequate to administer the surcharge process. The records of the board and of the bureau form the basis for identifying self-insured employers who are subject to this paragraph. (ii) Annual surcharges may be paid in a single lump sum within 30 days of the receipt of the pool's invoice or in quarterly installments at the self-insured employer's option. The board shall issue a yearly invoice as soon as practicable after the self-insured employer's plan approval or renewal date and receipt of all necessary supporting information from the superintendent. Each invoice must contain a schedule of dates when quarterly installments are due and clearly state the policy year or years for which the surcharge is imposed, the surcharge percentage multiplied by the factor applicable to each policy year and the amount of the surchargeable premium. (iii) Each individual self-insured employer shall report final audited payrolls to the pool not later than 60 days after the end of each plan year and each self-insured employer that is a member of a self-insured group or the group's administrator, as the group may select, shall report final audited payrolls to the pool not later than 120 days after the end of each plan year and shall remit with the audit information any additional surcharges resulting from the audit. (iv) Upon the request of a self-insured employer, including a successor self-insured employer or an administrator of a self-insurance group, the board may determine whether there was a factual inaccuracy in the information underlying a surcharge billing issued by the board for the fresh start period or whether the surcharge calculated by the board is consistent with the provisions of this subparagraph. The request must be filed within 180 days from the date on which the final payment is due and must be in writing, including a statement of the reason for the request and the amount, if known, of the alleged overcharge. If an appeal based upon an alleged overcharge is sustained, the board shall refund the overcharge, together with any investment earnings on those amounts. If a self-insured employer is aggrieved by the final action or decision of the board, or if the board does not act on the written request within 60 days, the self-insured employer may appeal to the superintendent within 60 days of such action or decision of the board. Notwithstanding a pending appeal, a self-insured employer must pay any surcharge billing issued by the board. (e) Self-insured employers have the following obligations with respect to the surcharge process. (i) As a condition of continuing authorization to self-insure, each self-insured employer and each group self-insurance administrator shall assist the board and the superintendent in the calculation, billing and collection of any applicable surcharge. The required assistance includes maintaining and providing, upon request of the board or the superintendent, actual premium history and all payroll and experience information necessary to calculate self-insured employer premiums, as specified in this subparagraph. Information provided by the self-insured employer is subject to audit by the pool and the superintendent at any time and self-insured employers shall provide to the pool, or its designee, and to the superintendent full and complete access to all books and records relating in any way to the audit. Group self-insurance administrators shall give prompt notice to the superintendent of any changes in group membership. (ii) Information provided by self-insured employers to the board pursuant to this paragraph is confidential. The board shall protect the confidentiality of all self-insured employer information in its possession, whether the information is obtained directly from the self-insured employer or from the superintendent or a group administrator. All information relating to a self-insured employer provided pursuant to this paragraph and in the possession of the board or superintendent continues to be confidential until that information is destroyed. (iii) A self-insurance group may act as the collection agent for its members. Any group so electing shall notify the board. The board shall bill the group on a consolidated basis. The group shall remit its entire quarterly payment to the board within 30 days after receiving the invoice, whether or not any members remain in default and notify the board and the superintendent of any delinquency. (iv) Each self-insured employer shall make provisions for possible surcharges in the normal course of operations and pay the full amount of any surcharge installment within 30 days after receiving an invoice from the board or the self-insured employer's self-insurance group. Late payments are subject to interest at the rate of 10% per annum. (v) The failure of any self-insured employer or self-insurance group to comply with its duties under this paragraph constitutes grounds for suspension, revocation, termination of the option to self-insure, expulsion from a self-insurance group or other appropriate sanctions authorized under section 12‑A , in addition to all procedures for the collection of past-due accounts otherwise available by law to the board or the governing body of the self-insurance group. (f) The superintendent has the following responsibilities with respect to the surcharge process. (i) The superintendent shall furnish to the board, on a monthly basis, a list of all self-insurance plan approvals, renewals and anniversaries that have occurred since the last report or for any other reason were not included in any previous report, including all approvals, terminations and membership changes for group self-insurers. For each employer listed, the superintendent shall provide all available information necessary for the board's imputed calculations under this paragraph, including: the date the new plan year began; the self-insurance group, if any, to which the self-insured employer belongs; the dates of coverage under each policy issued or renewed in policy years 1988 to 1992; the rating information for the current plan year, including estimated payroll by classification, premium rate for each classification, experience modification and other applicable rating adjustments; information relating to changes of ownership or control, changes of operations, changes of name or organizational structure; and other information necessary to determine successorship. (ii) The superintendent shall supplement promptly the initial report as necessary, including any revision to the self-insured employer's rating information on audit, any other additions or corrections to incomplete or inaccurate information provided in the initial report and the length of the plan year, if shorter than 12 months. (g) A successor self-insured employer is subject to surcharge on the same basis as the predecessor employer would be if still actively doing business and self-insured. If a self-insured employer is the successor to more than one employer, then the successor employer's self-insured employer adjustment is the sum of each predecessor employer's self-insured employer adjustment multiplied by the ratio of the employer's surchargeable premium for the 12-month period immediately preceding the succession transaction to the combined surchargeable premium of all predecessor employers for that 12-month period. (i) If one or more of the predecessor employers was insured at the time of the succession transaction, its self-insured employer adjustment is calculated pursuant to division (c), (h) or (i) as if it had become self-insured at the time of the succession transaction. (ii) If business operations that were covered under a single workers' compensation policy or certificate of self-insurance authority are subsequently separately owned by virtue of any succession transaction, dissolution, reincorporation or other transaction or series of transactions, for purposes of this subparagraph each business is treated as a distinct employer, subject to surcharge as either an insured employer or a self-insured employer. (iii) If substantial changes in operations during the 12-month period immediately preceding the succession transaction make the 12-month surchargeable premium an inappropriate measure of a predecessor employer's workers' compensation exposure prior to the transaction, the board may adopt procedures for calculating an annualized premium in a manner consistent with the intent of this subparagraph. (h) A self-insured employer that secured its obligation to provide workers' compensation benefits under the Workers' Compensation Act through a self-insurance program approved by the superintendent for the entirety of that self-insured employer's policy years 1988 to 1992, in which the self-insured employer actually had an obligation to secure benefits under the Workers' Compensation Act is not subject to the surcharge. (i) Except for any successor self-insured employer, self-insured employers that commence operations in the State on or after July 1, 1995 are subject to surcharge under this subparagraph on the same basis as self-insured employers that secured compensation under the Workers' Compensation Act by the purchase of an insurance policy throughout the entire fresh start period. (3) An employer may, as specified in this subparagraph, prepay all of its surcharges for a period of 10 consecutive policy years or plan years. The 10-year period starts with the employer's first renewal date or plan year following July 1, 1995. Within 30 days after the inception of the first plan year or first policy renewal date following July 1, 1995, if the employer intends to exercise this option, the employer must file with the pool written notice electing to make a lump-sum payment of surcharges and shall include with the notice the employer's full lump-sum payment. If the election is not made within 30 days after the first day of the first plan year or policy year following July 1, 1995, the option expires and is no longer available. The pool shall implement such procedures for administering this option as the board determines necessary. An employer that elects this option shall reimburse the pool for its expenses of administering this option for that employer, including the cost of individually allocating those costs to individual employers, in accordance with billing procedures developed and implemented by the board. This subparagraph does not eliminate or limit the employer's liability to pay adjusted surcharges or supplemental surcharges pursuant to paragraph E or section 2394 . For purposes of this subparagraph, "lump-sum payment" is the surcharge for the first year multiplied by 10 and discounted to net present value using: (a) A 5% discount rate; (b) The first day of the first plan year or policy year starting on or after July 1, 1995; and (c) An assumption that the surcharge for each of the 10 plan years or policy years would have been paid on the first day of each subsequent plan year or policy year. [PL 2011, c. 524, §11 (AMD).] E. The initial surcharge percentage may be adjusted by the pool in accordance with the following provisions. (1) Each July 1st beginning in 2003, the board shall establish a surcharge percentage to be imposed on all workers' compensation insurance policies issued or renewed on or after that date until the effective date of any subsequent adjustment in the surcharge percentage established by the board; except that, if supplemental surcharges and assessments have commenced under section 2394 , no further adjustments may be made under this subparagraph. The surcharge must be at a level determined by the board to be sufficient to produce cash receipts over the ensuing 24 months that, together with all other funds reasonably anticipated by the board to be available on a cash basis over that period, produce an amount not less than the pool's projected cash requirements to meet its obligations over that period. In making that determination, the board shall employ and rely upon the advice of professional and consulting services, including services available through the pool's internal staff, as the board determines necessary. (2) If the surcharge percentage established under this subparagraph exceeds 6.32%, then a prepaid employer shall pay surcharges for that future assessment period at the same rate as those employers who paid annually, based upon the employer's surchargeable premium for the policy year or plan year to which the increased surcharge percentage applies. A prepaid employer may take a credit for the surcharges prepaid for that assessment period pursuant to section 2393, subsection 2, paragraph D , subparagraph (3) in an amount equal to the net present value calculated on a basis consistent with paragraph D, subparagraph (2), division (d), subdivision (ii). If the surcharge percentage is less than 6.32% for that future assessment period, then the pool shall refund to a prepaid employer an amount equal to the difference between the value of the lump-sum surcharge paid for the future assessment period calculated on a basis consistent with paragraph D, subparagraph (2), division (d), subdivision (ii) and the amount of surcharge due based upon the adjusted surcharge percentage and applicable surchargeable premium. For purposes of this subparagraph, "prepaid employer" means an employer who has elected to pay surcharges on a lump-sum basis pursuant to paragraph D, subparagraph (3). (3) The board has authority to make interim adjustments in the surcharge percentage on or after July 1, 2003, to be effective on dates other than July 1st as specified by the board, to the extent considered necessary by the board to produce sufficient cash receipts from surcharges over the ensuing 24 months that, together with all other funds reasonably anticipated by the board to be available on a cash basis to the pool over the ensuing 24 months, will be sufficient to meet the pool's anticipated cash requirements over that period. (4) In projecting the pool's anticipated cash requirements, the board shall maintain a reserve equal to 25% of the cash expenditures of the pool over the immediately preceding 12-month period. [PL 1995, c. 289, §11 (NEW).] F. The surcharges required by this subsection are considered premium for cancellation and nonrenewal purposes only and are not subject to premium tax, Maine Insurance Guaranty Association assessments, agents' commissions or other payments required on insurance policy premiums. [PL 1995, c. 289, §11 (NEW).] G. Employer surcharges required by this chapter are suspended if: (1) The board determines that the pool's assets are adequate to satisfy all remaining obligations, including any necessary repayment to insurers that satisfy the requirements of subparagraph (2); and (2) The insurers and employers have been repaid by the pool in amounts necessary to produce a ratio of actual surcharges under this subsection paid by employers calculated on a net present value basis using January 1, 1995 as a valuation date and a discount rate of 5% to actual payments by insurers to the pool under subsection 1 , valued as of January 1, 1996, not including employer surcharges remitted to the pool by insurers, that is the same as 11 to 6.5, for employers and insurers respectively. [PL 1995, c. 289, §11 (NEW).] H. If the board suspends initial surcharges and the pool subsequently requires additional assets to satisfy remaining obligations, the board shall order additional initial surcharges consistent with this subsection. The board shall review the relationship between the pool's assets and liabilities as often as determined necessary by the board, but at least annually. Projections of assets and liabilities contained in any quarterly or annual statements of operation prepared by or at the direction of the board do not constitute a determination under this subsection. [PL 1995, c. 289, §11 (NEW).] [PL 2011, c. 524, §11 (AMD).]

3. Payments by Maine Insurance Guaranty Association. The association shall pay to the pool $1,538,039 on or before February 15th, May 15th, August 15th, and November 15th of each year for 40 consecutive calendar quarters beginning August 15, 1996. A. Each payment made by the association to the pool under this subsection is treated as a covered claim pursuant to section 4435, subsection 4 , except that any provision or authority for the association to seek reimbursement or recoupment from any source other than by assessments to association member insurers does not apply. This section does not limit or impair a member insurer's right to recoupment under section 4447 . [PL 1995, c. 289, §11 (NEW).] B. The quarterly payments by the association to the pool as required by this subsection must be made regardless of the financial condition or actual or projected cash requirements of the pool. [PL 1995, c. 289, §11 (NEW).] [PL 1995, c. 289, §11 (NEW).]
24-A M.R.S. § 4113 — ME Code / Title 24-A / Chapter 55 / Section 4113
24-A §4113. No personal liability
Status: in_force

The officers and members of the supreme, grand or any subordinate body of a society shall not be personally liable for payment of any benefits provided by a society. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 6815-A — ME Code / Title 24-A / Chapter 85 / Section 6815-A
24-A §6815-A. Regulatory requirements under Maine Uniform Securities Act
Status: in_force

This chapter does not preempt the regulatory requirements set forth in the Maine Uniform Securities Act, as amended, including but not limited to the regulation of securities transactions in settlement contracts or viatical settlement contracts and the licensing of any person or entity engaged in the sale of securities. [PL 2005, c. 65, Pt. C, §15 (AMD).]
24-A M.R.S. § 704 — ME Code / Title 24-A / Chapter 9 / Section 704
24-A §704. "Health insurance" defined
Status: in_force

1. Health insurance. For purposes of this Title, except as provided in subsection 2 and subsection 3 , "health insurance" means insurance of human beings against bodily injury, disablement or death by accident or accidental means, or the expense thereof, or against disablement or expense resulting from sickness, and every insurance appertaining thereto, including provision for the mental and emotional welfare of human beings by defraying the costs of legal services only to the extent provided for in chapter 38 . [PL 2011, c. 192, §1 (AMD).]

2. Exceptions. As used in this Title and Title 24 in any law enacted after the effective date of this subsection that mandates medical benefits or coverage in individual or group health insurance policies under chapter 33 or chapter 35 for certain specific health services or diseases or certain providers of health care services or that mandates rights and obligations under chapter 56‑A , unless the context otherwise indicates, the use of "health insurance" and related terms such as "accident and health insurance," "accident and sickness insurance," "carrier," "health," "health benefit plan," "health care," "health insurer" or "insurer" does not include, unless specifically provided otherwise in the law, the following types of insurance or any combination of those types of insurance: accidental injury, specified disease, hospital indemnity, dental, vision, disability income, long-term care, Medicare supplement or other limited benefit health insurance. [PL 2001, c. 79, §1 (NEW).]

3. Health care sharing ministry. As used in this Title and Title 24 , the use of "health insurance" and related terms such as "accident and health insurance," "accident and sickness insurance," "carrier," "health," "health benefit plan," "health care," "health insurer" or "insurer" does not include, unless specifically provided otherwise in the law, a health care sharing ministry, and a health care sharing ministry may not be considered to be engaged in the business of insurance for the purposes of this Title. For the purposes of this section, "health care sharing ministry" means a faith-based, nonprofit organization that is exempt from taxation under the federal Internal Revenue Code and that: A. Has been in existence continuously since December 31, 1999 and has facilitated the sharing of medical expenses of participants without interruption since December 31, 1999; [PL 2011, c. 192, §2 (NEW).] B. Limits participation in the health care sharing ministry to individuals who have a particular religious affiliation; [PL 2011, c. 192, §2 (NEW).] C. Acts as a facilitator among participants who have financial and medical needs and matches those participants with other participants with the present ability to assist those with financial and medical needs in accordance with criteria established by the health care sharing ministry; [PL 2011, c. 192, §2 (NEW).] D. Provides for the financial and medical needs of a participant through monetary contributions from one participant to another; [PL 2011, c. 192, §2 (NEW).] E. Provides amounts that participants may contribute without any assumption of risk or promise to pay among the participants and requires no assumption of risk or promise to pay by the health care sharing ministry to the participants; [PL 2011, c. 192, §2 (NEW).] F. Provides a written monthly statement to all participants that lists the total dollar amount of qualified needs submitted to the health care sharing ministry, as well as the amount actually published or assigned to participants for their contribution; [PL 2011, c. 192, §2 (NEW).] G. Conducts an annual audit that is performed by an independent certified public accountant in accordance with generally accepted accounting principles and that is made available to the public upon request; and [PL 2011, c. 192, §2 (NEW).] H. Provides a written disclaimer on or accompanying all applications and guideline materials distributed by or on behalf of the organization that reads in substance: "Notice: The organization facilitating the sharing of medical expenses is not an insurance company and neither its guidelines nor plan of operation is an insurance policy. Whether anyone chooses to assist you with your medical bills will be totally voluntary because no other participant will be compelled by law to contribute toward your medical bills. Participation in the organization or a subscription to any of its documents should never be considered to be insurance. Regardless of whether you receive payment for medical expenses or whether this organization continues to operate, you are always personally responsible for the payment of your own medical bills." [PL 2011, c. 192, §2 (NEW).] [PL 2011, c. 192, §2 (NEW).]
24-A M.R.S. § 1953 — ME Code / Title 24-A / Chapter 18-A / Section 1953
24-A §1953. Powers
Status: in_force

In addition to the powers granted in Title 13‑B or Title 13‑C , an alliance may do any of the following: [RR 2001, c. 2, Pt. B, §43 (COR); RR 2001, c. 2, Pt. B, §58 (AFF).]

1. Membership fees. Set reasonable fees for membership in the alliance for financing reasonable and necessary costs incurred in administering the alliance; [PL 1995, c. 673, Pt. A, §3 (NEW).]

2. Premium collection. Provide premium collection services for health benefit plans offered through the alliance if the insurer or health maintenance organization offering the plan gives express written authorization to the alliance or any other person or entity acting on behalf of the alliance to act as the insurer's or the health maintenance organization's agent for that purpose; [PL 1995, c. 673, Pt. A, §3 (NEW).]

3. Contracts. Contract with qualified independent 3rd parties for any service necessary to carry out the powers and duties authorized or required by this chapter; [PL 1995, c. 673, Pt. A, §3 (NEW).]

4. Standards. Exclude a carrier or freeze enrollment in a carrier for failure to achieve established quality, access or information reporting standards of the alliance; [PL 1995, c. 673, Pt. A, §3 (NEW).]

5. Data collection. Develop uniform standards for data to be provided by participating carriers and providers. The alliance may collect data necessary for evaluation of the performance of participating carriers and their provider networks by consumers, providers, employers and the superintendent; [PL 1995, c. 673, Pt. A, §3 (NEW).]

6. Negotiation. Negotiate with participating carriers the premium rates charged for coverage offered through the alliance, consistent with rules adopted by the superintendent; or [PL 1995, c. 673, Pt. A, §3 (NEW).]

7. Risk adjustment. Establish procedures, subject to approval by the superintendent, for adjusting payments within each risk pool to participating carriers if the alliance finds that some carriers have a significantly disproportionate share of high-risk or low-risk enrollees. [PL 1995, c. 673, Pt. A, §3 (NEW).]
24-A M.R.S. § 6097 — ME Code / Title 24-A / Chapter 72-A / Section 6097
24-A §6097. Purchasing groups; exemption from certain laws relating to the group purchase of insurance
Status: in_force

Any purchasing group meeting the criteria established under the provisions of the federal Liability Risk Retention Amendments of 1986 is exempt from any law of this State relating to the creation of groups for the purchase of insurance, prohibition of group purchasing or any law that discriminates against a purchasing group or its members. In addition, an insurer is exempt from any law of this State that prohibits providing, or offering to provide, to a purchasing group or its members advantages based on their loss and expense experience not afforded to other persons with respect to rates, policy forms, coverages or other matters. A purchasing group and any insurer that provides coverage to a purchasing group with Maine members are subject to all other applicable laws of this State, including, but not limited to, chapters 25 , 27 and 39 . [RR 1991, c. 2, §93 (COR).]
24-A M.R.S. § 4317 — ME Code / Title 24-A / Chapter 56-A / Section 4317
24-A §4317. Pharmacy providers
Status: in_force

1. Contracts with pharmacy providers. Notwithstanding section 2672 , section 4307, subsection 3 and Title 32, chapter 117, subchapter 8 , a carrier that provides coverage for prescription drugs as part of a health plan may not refuse to contract with a pharmacy provider that is qualified and is willing to meet the terms and conditions of the carrier's criteria for pharmacy participation as stipulated in the carrier's contractual agreement with its pharmacy providers. This subsection may not be construed to limit a carrier's ability to offer an enrollee incentives, including variations in premiums, deductibles, copayments or coinsurance or variations in the quantities of medications available to the enrollee, to encourage the use of certain preferred pharmacy providers as long as the carrier makes the terms applicable to the preferred pharmacy providers available to all pharmacy providers. For purposes of this subsection, a preferred pharmacy provider is any pharmacy willing to meet the specified terms, conditions and price that the carrier may require for its preferred pharmacy providers. [PL 2009, c. 519, §1 (NEW); PL 2009, c. 519, §2 (AFF).]

2. Prompt payment of claims. Notwithstanding section 2436 , the following provisions apply to the payment of claims submitted to a carrier by a pharmacy provider. A. For purposes of this subsection, the following terms have the following meanings. (1) "Applicable number of calendar days" means: (a) With respect to claims submitted electronically, 21 days; and (b) With respect to claims submitted otherwise, 30 days. (2) "Clean claim" means a claim that has no defect or impropriety, including any lack of any required substantiating documentation, or particular circumstance requiring special treatment that prevents timely payment from being made on the claim under this section. [PL 2009, c. 519, §1 (NEW); PL 2009, c. 519, §2 (AFF).] B. A contract entered into by a carrier with a pharmacy provider with respect to a prescription drug plan offered by a carrier must provide that payment is issued, mailed or otherwise transmitted with respect to all clean claims submitted by a pharmacy provider, other than a pharmacy that dispenses drugs by mail order only or a pharmacy located in, or under contract with, a long-term care facility, within the applicable number of calendar days after the date on which the claim is received. For purposes of this subsection, a claim is considered to have been received: (1) With respect to claims submitted electronically, on the date on which the claim is transferred; and (2) With respect to claims submitted otherwise, on the 5th day after the postmark date of the claim or the date specified in the time stamp of the transmission of the claim. [PL 2009, c. 519, §1 (NEW); PL 2009, c. 519, §2 (AFF).] C. If payment is not issued, mailed or otherwise transmitted by the carrier within the applicable number of calendar days after a clean claim is received, the carrier shall pay interest to the pharmacy provider at the rate of 18% per annum. [PL 2009, c. 519, §1 (NEW); PL 2009, c. 519, §2 (AFF).] D. A claim is considered to be a clean claim if the carrier involved does not provide notice to the pharmacy provider of any deficiency in the claim within 10 days after the date on which an electronically submitted claim is received or within 15 days after the date on which a claim submitted otherwise is received. [PL 2009, c. 519, §1 (NEW); PL 2009, c. 519, §2 (AFF).] E. If a carrier determines that a submitted claim is not a clean claim, the carrier shall immediately notify the pharmacy provider of the determination. The notice must specify all defects or improprieties in the claim and list all additional information or documents necessary for the proper processing and payment of the claim. If a pharmacy provider receives notice from a carrier that a claim has been determined to not be a clean claim, the pharmacy provider shall take steps to correct that claim and then resubmit the claim to the carrier for payment. [PL 2009, c. 519, §1 (NEW); PL 2009, c. 519, §2 (AFF).] F. A claim resubmitted to a carrier with additional information pursuant to paragraph E is considered to be a clean claim if the carrier does not provide notice to the pharmacy provider of any defect or impropriety in the claim within 10 days of the date on which additional information is received if the claim is resubmitted electronically or within 15 days of the date on which additional information is received if the claim is resubmitted otherwise. [PL 2009, c. 519, §1 (NEW); PL 2009, c. 519, §2 (AFF).] G. A claim submitted to a carrier that is not paid by the carrier or contested by the plan sponsor within the applicable number of calendar days after the date on which the claim is received by the carrier is considered to be a clean claim and must be paid by the carrier. [PL 2009, c. 519, §1 (NEW); PL 2009, c. 519, §2 (AFF).] H. Payment of a clean claim under this subsection is considered to have been made on the date on which the payment is transferred with respect to claims paid electronically and on the date on which the payment is submitted to the United States Postal Service or common carrier for delivery with respect to claims paid otherwise. [PL 2009, c. 519, §1 (NEW); PL 2009, c. 519, §2 (AFF).] I. A carrier shall pay all clean claims submitted electronically by electronic transfer of funds if the pharmacy provider so requests or has so requested previously. In the case when the payment is made electronically, remittance may be made by the carrier electronically. [PL 2009, c. 519, §1 (NEW); PL 2009, c. 519, §2 (AFF).] J. For a contract entered into or renewed on or after January 1, 2021, the contract entered into by a carrier with a pharmacy provider with respect to a prescription drug plan offered by a carrier may not contain a provision that purports to directly or indirectly charge the pharmacy provider or hold the pharmacy provider responsible for any fee related to a clean claim: (1) That is not apparent at the time the carrier processes the claim; (2) That is not reported on the remittance advice of a claim adjudicated by the carrier; or (3) After the initial claim is adjudicated by the carrier. [PL 2019, c. 643, §1 (NEW).] For purposes of this subsection, a contract entered into by a carrier with a pharmacy provider with respect to a prescription drug plan offered by a carrier includes any contract with respect to a prescription drug plan offered by the carrier under which a pharmacy provider is legally obligated, either directly or through an intermediary. [PL 2019, c. 643, §1 (AMD).]

3. Exception. Subsections 1 and 2 do not apply to any medical assistance or public health programs administered by the Department of Health and Human Services, including, but not limited to, the Medicaid program and the elderly low-cost drug program under Title 22, section 254‑D . [PL 2011, c. 443, §5 (AMD).]

4. Participation in contracts. A pharmacy benefits manager may not require a pharmacist or pharmacy to participate in one network in order to participate in another network. The pharmacy benefits manager may not exclude an otherwise qualified pharmacist or pharmacy from participation in one network solely because the pharmacist or pharmacy declined to participate in another network managed by the pharmacy benefits manager. [PL 2011, c. 443, §6 (NEW).]

5. Prohibition. The written contract between a carrier and a pharmacy benefits manager may not provide that the pharmacist or pharmacy is responsible for the actions of the insurer or a pharmacy benefits manager. [PL 2011, c. 443, §6 (NEW).]

6. Pharmacy benefits manager duties. All contracts must provide that, when the pharmacy benefits manager receives payment for the services of a pharmacist or pharmacy, the pharmacy benefits manager shall distribute the funds in accordance with the time frames provided in this subchapter. [PL 2011, c. 691, Pt. A, §23 (AMD).]

7. Complaints, grievances and appeals. A pharmacy benefits manager may not terminate the contract of or penalize a pharmacist or pharmacy solely as a result of the pharmacist's or pharmacy's filing of a complaint, grievance or appeal. This subsection is not intended to restrict the pharmacy's and pharmacy benefits manager's ability to enter into agreements that allow for mutual termination without cause. [PL 2011, c. 443, §6 (NEW).]

8. Denial or limitation of benefits. A pharmacy's benefits manager may not terminate the contract of or penalize a pharmacist or pharmacy for expressing disagreement with a carrier's decision to deny or limit benefits to an enrollee or because the pharmacist or pharmacy assists the enrollee to seek reconsideration of the carrier's decision or because the pharmacist or pharmacy discusses alternative medications. [PL 2011, c. 443, §6 (NEW).]

9. Written notice required. At least 60 days before a pharmacy's benefits manager terminates a pharmacy's or pharmacist's participation in the pharmacy benefits manager's plan or network, the pharmacy benefits manager shall give the pharmacy or pharmacist a written explanation of the reason for the termination, unless the termination is based on: A. The loss of the pharmacy's license or the pharmacist's license to practice pharmacy or cancellation of professional liability insurance; or [PL 2011, c. 443, §6 (NEW).] B. A finding of fraud. [PL 2011, c. 443, §6 (NEW).] At least 60 days before a pharmacy or pharmacist terminates its participation in a pharmacy benefits manager's plan or network, the pharmacy or pharmacist shall give the pharmacy benefits manager a written explanation of the reason for the termination. [PL 2011, c. 443, §6 (NEW).]

10. Audits. Notwithstanding any other provision of law, when an on-site audit of the records of a pharmacy is conducted by a pharmacy benefits manager, the audit must be conducted in accordance with the following criteria. A. A finding of overpayment or underpayment must be based on the actual overpayment or underpayment and not a projection based on the number of patients served having a similar diagnosis or on the number of similar orders or refills for similar drugs, unless the projected overpayment or denial is a part of a settlement agreed to by the pharmacy or pharmacist. [PL 2011, c. 443, §6 (NEW).] B. The auditor may not use extrapolation in calculating recoupments or penalties. [PL 2011, c. 443, §6 (NEW).] C. Any audit that involves clinical or professional judgment must be conducted by or in consultation with a pharmacist. [PL 2011, c. 443, §6 (NEW).] D. Each entity conducting an audit shall establish an appeals process under which a pharmacy may appeal an unfavorable preliminary audit report to the entity. [PL 2011, c. 443, §6 (NEW).] E. This subsection does not apply to any audit, review or investigation that is initiated based on or involves suspected or alleged fraud, willful misrepresentation or abuse. [PL 2011, c. 443, §6 (NEW).] F. Prior to an audit, the entity conducting an audit shall give the pharmacy 10 days' advance written notice of the audit and the range of prescription numbers and the range of dates included in the audit. [PL 2013, c. 71, §1 (NEW).] G. A pharmacy has the right to request mediation by a private mediator, agreed upon by the pharmacy and the pharmacy benefits manager, to resolve any disagreements. A request for mediation does not waive any existing rights of appeal available to a pharmacy under this subsection or subsection 11 . [PL 2013, c. 71, §1 (NEW).] H. The requirements of section 4303, subsection 10 apply to claims audited under this subsection. [PL 2013, c. 71, §1 (NEW).] [PL 2013, c. 71, §1 (AMD).]

11. Audit information and reports. A preliminary audit report must be delivered to the pharmacy within 60 days after the conclusion of the audit under subsection 10 . A pharmacy must be allowed at least 30 days following receipt of the preliminary audit to provide documentation to address any discrepancy found in the audit. A final audit report must be delivered to the pharmacy within 90 days after receipt of the preliminary audit report or final appeal, whichever is later. A charge-back, recoupment or other penalty may not be assessed until the appeal process provided by the pharmacy benefits manager has been exhausted and the final report issued. Except as provided by state or federal law, audit information may not be shared. Auditors may have access only to previous audit reports on a particular pharmacy conducted by that same entity. [PL 2011, c. 443, §6 (NEW).]

12. Maximum allowable cost. [PL 2019, c. 469, §6 (RP); PL 2019, c. 469, §9 (AFF).]

13. Prohibition on excessive copayments or charges; disclosure not penalized. [PL 2019, c. 469, §7 (RP); PL 2019, c. 469, §9 (AFF).]

Revisor's Note: §4317. Prohibition against maximum aggregate benefit provisions (As enacted by PL 2009, c. 588, §1 and affected by §3 is REALLOCATED TO TITLE 24-A, SECTION 4318)
24-A M.R.S. § 5077 — ME Code / Title 24-A / Chapter 68-A / Section 5077
24-A §5077. Nonforfeiture benefits
Status: in_force

1. Offer required. Except as provided in subsection 2 , a long-term care insurance policy or certificate may not be delivered or issued for delivery in this State unless the policyholder or certificate holder has been offered the option of purchasing a policy or certificate that includes a nonforfeiture benefit. The offer of a nonforfeiture benefit may be in the form of a rider that is attached to the policy. If the policyholder or certificate holder declines the nonforfeiture benefit, the insurer shall provide a contingent benefit upon lapse that must be made available for a specified period of time following a substantial increase in premium rates. [PL 1999, c. 292, §2 (NEW).]

2. Group policyholders. When a group long-term care insurance policy is issued, the offer required in subsection 1 must be made to the group policyholder. If the group long-term care insurance policy is issued to a group described in section 2808 other than to a continuing care retirement community or other similar entity, the offer must be made to each proposed certificate holder. [PL 1999, c. 292, §2 (NEW).]

3. Rules. The superintendent shall adopt rules specifying the type or types of nonforfeiture benefits to be offered as part of long-term care insurance policies and certificates, the standards for nonforfeiture benefits and the standards regarding contingent benefit upon lapse, including a determination of the specified period of time during which a contingent benefit upon lapse is available and the substantial premium rate increase that triggers a contingent benefit upon lapse as described in subsection 1 . Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter II‑A . [PL 1999, c. 292, §2 (NEW).]
24-A M.R.S. § 4432 — ME Code / Title 24-A / Chapter 57 / Section 4432
24-A §4432. Purpose
Status: in_force

The purpose of this subchapter is to provide a mechanism for the payment of covered claims under certain insurance policies to avoid excessive delay in payment and to avoid financial loss to claimants or policyholders because of the insolvency of an insurer, to assist in the detection and prevention of insurer insolvencies, and to provide an association to assess the cost of such protection among insurers. [PL 1969, c. 561 (NEW).]
24-A M.R.S. § 6815 — ME Code / Title 24-A / Chapter 85 / Section 6815
24-A §6815. Assignment or resale of policies
Status: in_force

1. Prohibited transfers. A settlement provider may not sell, assign, transfer or pledge a policy acquired pursuant to a settlement contract except to a licensed settlement provider or a person exempt from licensing under section 6803 . [PL 2003, c. 636, §15 (AMD).]

2. Securities registration. Any sale by a settlement provider of settlement contracts, policies acquired pursuant to settlement contracts or interests therein that constitute a "security" within the meaning of the United States Securities Act of 1933, as amended, or the Maine Uniform Securities Act, as amended, must be registered under those statutes unless there is an available exemption from registration under those statutes. [PL 2005, c. 65, Pt. C, §14 (AMD).]
24-A M.R.S. § 2303 — ME Code / Title 24-A / Chapter 25 / Section 2303
24-A §2303. Making of rates
Status: in_force

1. Rates shall be made in accordance with the following provisions. A. Manual, minimum, class rates, rating schedules or rating plans shall be made and adopted, except in the case of specific inland marine rates on risks specially rated. [PL 1969, c. 132, §1 (NEW).] B. Rates shall not be excessive, inadequate or unfairly discriminatory. [PL 1969, c. 132, §1 (NEW).] C. Due consideration must be given: (1) To past and prospective loss experience within and outside this State; (2) To the conflagration and catastrophe hazards; (3) To a reasonable margin for underwriting profit and contingencies; (4) To dividends, savings or unabsorbed premium deposits allowed or returned by insurers to their policyholders, members or subscribers; (5) To past and prospective expenses both countrywide and those specially applicable to this State; (6) To all other relevant factors within and outside this State; (7) In the case of fire insurance rates, to the experience of the fire insurance business during a period of not less than the most recent 5-year period for which such experience is available; and (8) In the case of title insurance rates, to the reasonableness of commission levels and other acquisition costs both countrywide and those specifically applicable to this State. [PL 1991, c. 885, Pt. B, §2 (AMD); PL 1991, c. 885, Pt. B, §13 (AFF).] D. [PL 1989, c. 797, §3 (RP); PL 1989, c. 797, §§37, 38 (AFF).] E. [PL 1989, c. 797, §3 (RP); PL 1989, c. 797, §§37, 38 (AFF).] F. [PL 1985, c. 372, Pt. B, §4 (RP).] G. Risks may be grouped by classifications for the establishment of rates and minimum premiums. Classification rates may be modified to produce rates for individual risks in accordance with rating plans that establish standards for measuring variations in hazards or expense provisions, or both. These standards may measure any differences among risks that may have a probable effect upon losses or expenses. No risk classification may be based upon race, religion, ancestry or national origin of the insured. [PL 2021, c. 553, §16 (AMD).] H. The expense provisions included in the rates to be used by an insurer must reflect the operating methods of the insurer and its anticipated expenses. [PL 1989, c. 797, §4 (NEW); PL 1989, c. 797, §§37, 38 (AFF).] I. Rates may contain a provision for contingencies and an allowance permitting a reasonable profit. In determining the reasonableness of the profit allowance, consideration must be given to investment income. [PL 1989, c. 797, §4 (NEW); PL 1989, c. 797, §§37, 38 (AFF).] [PL 2021, c. 553, §16 (AMD).]

2. Nothing in this section shall be taken to prohibit as unreasonable or unfairly discriminatory the establishment of classifications or modifications of classifications or risks based upon size, expense, management, individual experience, purpose of insurance, location or dispersion of hazard, or any other reasonable considerations, provided such classifications and modifications apply to all risks under the same or substantially similar circumstances or conditions. [PL 1969, c. 132, §1 (NEW).]

3. [PL 1989, c. 797, §5 (RP); PL 1989, c. 797, §§37, 38 (AFF).]

3-A. [PL 2007, c. 188, Pt. A, §1 (RP).]

4. Rates made in accordance with this section may be used subject to this chapter. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 210 — ME Code / Title 24-A / Chapter 3 / Section 210
24-A §210. Delegation of powers
Status: in_force

1. The superintendent may delegate to the superintendent's deputy, examiner or an employee of the bureau the exercise or discharge in the superintendent's name of any power, duty or function, whether ministerial, discretionary or of whatever character, vested in or imposed upon the superintendent. [RR 2021, c. 1, Pt. B, §154 (COR).]

2. The official act of any such person acting in the superintendent's name and by his authority shall be deemed an official act of the superintendent. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 2391 — ME Code / Title 24-A / Chapter 26 / Section 2391
24-A §2391. Title and scope of chapter
Status: in_force

1. Title. This chapter may be known and cited as "The Workers' Compensation Residual Market Deficit Resolution and Recovery Act." [PL 1995, c. 289, §11 (NEW).]

2. Scope. This chapter establishes an efficient and effective mechanism for funding the obligations of the residual market mechanism in the State arising from workers' compensation insurance policies with initial effective dates or renewal dates between January 1, 1988 and December 31, 1992. [PL 1995, c. 289, §11 (NEW).]
24-A M.R.S. § 2752 — ME Code / Title 24-A / Chapter 33 / Section 2752
24-A §2752. Mandated health legislation procedures
Status: in_force

1. Mandated health benefits proposals. For purposes of this section, a mandated health benefit proposal is one that mandates health insurance coverage for specific health services, specific diseases or certain providers of health care services as part of individual or group health insurance policies. A mandated option is not a mandated benefit for purposes of this section. [PL 1991, c. 701, §8 (NEW).]

2. Procedures before legislative committees. Whenever a legislative measure containing a mandated health benefit is proposed, the joint standing committee of the Legislature having jurisdiction over the proposal shall hold a public hearing and determine the level of support for the proposal among the members of the committee. If there is support for the proposed mandate among a majority of the members of the committee, the committee may refer the proposal to the Bureau of Insurance for review and evaluation pursuant to subsection 3 . Once a review and evaluation has been completed, the committee shall review the findings of the bureau. A proposed mandate may not be enacted into law unless review and evaluation pursuant to subsection 3 has been completed. [PL 1997, c. 616, §4 (AMD).]

3. Review and evaluation. Upon referral of a mandated health benefit proposal from the joint standing committee of the Legislature having jurisdiction over the proposal, the Bureau of Insurance shall conduct a review and evaluation of the mandated health benefit proposal and shall report to the committee in a timely manner. The report must include, at the minimum and to the extent that information is available, the following: A. The social impact of mandating the benefit, including: (1) The extent to which the treatment or service is utilized by a significant portion of the population; (2) The extent to which the treatment or service is available to the population; (3) The extent to which insurance coverage for this treatment or service is already available; (4) If coverage is not generally available, the extent to which the lack of coverage results in persons being unable to obtain necessary health care treatment; (5) If the coverage is not generally available, the extent to which the lack of coverage results in unreasonable financial hardship on those persons needing treatment; (6) The level of public demand and the level of demand from providers for the treatment or service; (7) The level of public demand and the level of demand from the providers for individual or group insurance coverage of the treatment or service; (8) The level of interest in and the extent to which collective bargaining organizations are negotiating privately for inclusion of this coverage in group contracts; (9) The likelihood of achieving the objectives of meeting a consumer need as evidenced by the experience of other states; (10) The relevant findings of the appropriate health system agency relating to the social impact of the mandated benefit; (11) The alternatives to meeting the identified need; (12) Whether the benefit is a medical or a broader social need and whether it is consistent with the role of health insurance and the concept of managed care; (13) The impact of any social stigma attached to the benefit upon the market; (14) The impact of this benefit on the availability of other benefits currently being offered; (15) The impact of the benefit as it relates to employers shifting to self-insured plans and the extent to which the benefit is currently being offered by employers with self-insured plans; and (16) The impact of making the benefit applicable to the state employee health insurance program; [PL 2011, c. 90, Pt. J, §21 (AMD).] B. The financial impact of mandating the benefit, including: (1) The extent to which the proposed insurance coverage would increase or decrease the cost of the treatment or service over the next 5 years; (2) The extent to which the proposed coverage might increase the appropriate or inappropriate use of the treatment or service over the next 5 years; (3) The extent to which the mandated treatment or service might serve as an alternative for more expensive or less expensive treatment or service; (4) The methods that will be instituted to manage the utilization and costs of the proposed mandate; (5) The extent to which the insurance coverage may affect the number and types of providers of the mandated treatment or service over the next 5 years; (6) The extent to which insurance coverage of the health care service or provider may be reasonably expected to increase or decrease the insurance premium and administrative expenses of policyholders; (7) The impact of indirect costs, which are costs other than premiums and administrative costs, on the question of the costs and benefits of coverage; (8) The impact of this coverage on the total cost of health care, including potential benefits and savings to insurers and employers because the proposed mandated treatment or service prevents disease or illness or leads to the early detection and treatment of disease or illness that is less costly than treatment or service for later stages of a disease or illness; (9) The effects of mandating the benefit on the cost of health care, particularly the premium and administrative expenses and indirect costs, to employers and employees, including the financial impact on small employers, medium-sized employers and large employers; and (10) The effect of the proposed mandate on cost-shifting between private and public payors of health care coverage and on the overall cost of the health care delivery system in this State. In order to enable the committee to assess the financial impact of the benefit, the report must include a comparison of the rate of increase in the Consumer Price Index for medical care services to the rate of increase in the Consumer Price Index for the previous year and the current year as reported by the United States Department of Labor, Bureau of Labor Statistics; [PL 2005, c. 125, §1 (AMD).] C. The medical efficacy of mandating the benefit, including: (1) The contribution of the benefit to the quality of patient care and the health status of the population, including the results of any research demonstrating the medical efficacy of the treatment or service compared to alternatives or not providing the treatment or service; and (2) If the legislation seeks to mandate coverage of an additional class of practitioners: (a) The results of any professionally acceptable research demonstrating the medical results achieved by the additional class of practitioners relative to those already covered; and (b) The methods of the appropriate professional organization that assure clinical proficiency; and [PL 1991, c. 701, §8 (NEW).] D. The effects of balancing the social, economic and medical efficacy considerations, including: (1) The extent to which the need for coverage outweighs the costs of mandating the benefit for all policyholders; (2) The extent to which the problem of coverage may be solved by mandating the availability of the coverage as an option for policyholders; and (3) The cumulative impact of mandating this benefit in combination with existing mandates on the costs and availability of coverage. [PL 1997, c. 616, §5 (AMD).] [PL 2011, c. 90, Pt. J, §21 (AMD).]
24-A M.R.S. § 6208 — ME Code / Title 24-A / Chapter 73 / Section 6208
24-A §6208. Continuing care agreement; consumer cooperative
Status: in_force

As part of the continuing care agreement, a subscriber may purchase or acquire or be the beneficiary of a purchase or acquisition of a membership interest or share or shares in an incorporated or unincorporated group organized on a cooperative basis subject to the requirements of Title 13, chapter 85, subchapter I , governing consumer cooperatives or Title 13, chapter 85, subchapter I‑A , governing cooperative affordable housing corporations. [PL 1995, c. 452, §25 (AMD).]

If a registration statement for the cooperative is filed with the Office of Securities, pursuant to the Maine Uniform Securities Act, Title 32, chapter 135 , a copy must be simultaneously filed with the superintendent and a copy must be given to every purchaser of a membership interest or share in the cooperative at least 10 days prior to the sale of the interest or share. Any information required to be filed with the superintendent pursuant to this chapter and contained in the referenced registration materials may be filed in that format with the superintendent and need not be submitted under separate cover. If a registration statement is not filed with the Office of Securities, a disclosure statement containing, to the extent applicable, all the information required to register a security by qualification, pursuant to Title 32, section 16304 , must be filed with the superintendent and given to every subscriber at least 10 days prior to the sale. In the alternative, a provider may elect to provide each subscriber a disclosure statement containing those provisions stated in section 6209 determined to be required by the superintendent. [PL 2005, c. 65, Pt. C, §13 (AMD).]
24-A M.R.S. § 4320 — ME Code / Title 24-A / Chapter 56-A / Section 4320
24-A §4320. No lifetime or annual limits on health plans
Status: in_force

A carrier offering a health plan in the individual, small group or large group market, as those markets are defined under applicable federal law, may not: [PL 2019, c. 5, Pt. A, §25 (AMD).]

1. Establish lifetime limits. Establish lifetime limits on the dollar value of benefits for any participant or beneficiary; or [PL 2011, c. 364, §34 (NEW).]

2. Establish annual limits. Establish annual limits on the dollar value of essential benefits. [PL 2019, c. 5, Pt. A, §25 (AMD).]

3. Application. This section applies to health plans offered or renewed in this State in the individual, small group and large group markets, as those markets are defined under applicable federal law. A health plan may contain annual dollar limits to the extent allowed under the federal Affordable Care Act as of January 1, 2019 if the plan has been continuously renewed since that date, but the plan may not impose any new limits or reduce any existing limit in effect as of January 1, 2019. [PL 2019, c. 5, Pt. A, §25 (NEW).]

Revisor's Note: §4320. Payment reform pilot projects (As enacted by PL 2011, c. 270, §2 is REALLOCATED TO TITLE 24-A, SECTION 4320-H)
24-A M.R.S. § 4259 — ME Code / Title 24-A / Chapter 56 / Section 4259
24-A §4259. Coverage for the diagnosis and treatment of autism spectrum disorders (REALLOCATED FROM TITLE 24-A, §4258)
Status: in_force

(REALLOCATED FROM TITLE 24-A, §4258)

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Applied behavior analysis" means the design, implementation and evaluation of environmental modifications using behavioral stimuli and consequences to produce socially significant improvement in human behavior, including the use of direct observation, measurement and functional analysis of the relations between environment and behavior. [PL 2011, c. 420, Pt. A, §27 (RAL).] B. "Autism spectrum disorders" means any of the pervasive developmental disorders as defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, published by the American Psychiatric Association, including autistic disorder, Asperger's disorder and pervasive developmental disorder not otherwise specified. [PL 2011, c. 420, Pt. A, §27 (RAL).] C. "Treatment of autism spectrum disorders" includes the following types of care prescribed, provided or ordered for an individual diagnosed with an autism spectrum disorder: (1) Habilitative or rehabilitative services, including applied behavior analysis or other professional or counseling services necessary to develop, maintain and restore the functioning of an individual to the extent possible. To be eligible for coverage, applied behavior analysis must be provided by a person professionally certified by a national board of behavior analysts or performed under the supervision of a person professionally certified by a national board of behavior analysts; (2) Counseling services provided by a licensed psychiatrist, psychologist, clinical professional counselor or clinical social worker; and (3) Therapy services provided by a licensed or certified speech therapist, occupational therapist or physical therapist. [PL 2011, c. 420, Pt. A, §27 (RAL).] [PL 2011, c. 420, Pt. A, §27 (RAL).]

2. Required coverage. All individual and group health maintenance organization contracts must provide coverage for autism spectrum disorders for an individual covered under a contract who is 10 years of age or under in accordance with the following. A. The contract must provide coverage for any assessments, evaluations or tests by a licensed physician or licensed psychologist to diagnose whether an individual has an autism spectrum disorder. [PL 2011, c. 420, Pt. A, §27 (RAL).] B. The contract must provide coverage for the treatment of autism spectrum disorders when it is determined by a licensed physician or licensed psychologist that the treatment is medically necessary health care as defined in section 4301‑A, subsection 10‑A . A licensed physician or licensed psychologist may be required to demonstrate ongoing medical necessity for coverage provided under this section at least annually. [PL 2011, c. 420, Pt. A, §27 (RAL).] C. The contract may not include any limits on the number of visits. [PL 2011, c. 420, Pt. A, §27 (RAL).] D. Notwithstanding section 4234‑A and to the extent allowed by federal law for group contracts, the contract may limit coverage for applied behavior analysis to $36,000 per year. A health maintenance organization may not apply payments for coverage unrelated to autism spectrum disorders to any maximum benefit established under this paragraph. [PL 2011, c. 420, Pt. A, §27 (RAL).] E. This subsection may not be construed to require coverage for prescription drugs if prescription drug coverage is not provided by the contract. Coverage for prescription drugs for the treatment of autism spectrum disorders must be determined in the same manner as coverage for prescription drugs for the treatment of any other illness or condition is determined under the contract. [PL 2011, c. 420, Pt. A, §27 (RAL).] [PL 2013, c. 597, §3 (AMD); PL 2013, c. 597, §4 (AFF).]

3. Limits; coinsurance; deductibles. Except as otherwise provided in this section, any contract that provides coverage for services under 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 2011, c. 420, Pt. A, §27 (RAL).]

4. Individualized education plan. This section may not be construed to affect any obligation to provide services to an individual with an autism spectrum disorder under an individualized education plan or an individualized family service plan. [PL 2011, c. 420, Pt. A, §27 (RAL).]
24-A M.R.S. § 3482 — ME Code / Title 24-A / Chapter 47 / Section 3482
24-A §3482. -- effective date of merger, consolidation; effect as to assets, liabilities, rights and power
Status: in_force

1. When the plan and agreement for merger or consolidation has been so signed, acknowledged, approved, authorized, certified, filed and recorded as provided in sections 3478 to 3481 , then the separate existence of all of the constituent corporations other than the surviving corporation into which the other corporation or corporations parties have merged or consolidated shall cease. [PL 1969, c. 132, §1 (NEW).]

2. The surviving corporation shall be the merged or consolidated corporation by the name provided for in the agreement; and shall thereby possess all the rights, privileges, powers, franchises and immunities as well of a public as of a private nature, and shall thereby be subject to all the liabilities, restrictions and duties, of each of the merged or consolidated corporations, and have all and singular the rights, privileges, powers, franchises and immunities of each of such corporations, together with all property, real, personal and mixed, wheresoever located, and all debts due to any of such constituent corporations on whatever account; and all other things in action of each of such corporations, are by virtue of such merger or consolidation automatically vested in such surviving corporation. [PL 1969, c. 132, §1 (NEW).]

3. All such property, rights, privileges, powers, franchises and immunities and all and every other such interest shall be thereafter as effectually the property of the surviving corporation as they were of the respective constituent corporations; and title to any real estate, whether by deed or otherwise, under the laws of this State, vested in any of such constituent corporations shall not revert or be in any way impaired by reason of such merger or consolidation. All rights of creditors and all liens upon the property of any of such constituent corporations shall be preserved unimpaired, limited to the property affected by such liens at the time of the merger or consolidation; and all debts, liabilities and duties of the respective constituent corporations shall thenceforth attach to the surviving corporation and may be enforced against it to the same extent as if such debts, liabilities and duties had been incurred or contracted by it. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 2415 — ME Code / Title 24-A / Chapter 27 / Section 2415
24-A §2415. Charter, bylaw provisions
Status: in_force

No policy shall contain any provision purporting to make any portion of the charter, bylaws or other constituent document of the insurer (other than the subscriber's agreement or power of attorney of a reciprocal insurer) a part of the contract unless such portion is set forth in full in the policy. Any policy provision in violation of this section shall be invalid. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 4501 — ME Code / Title 24-A / Chapter 59 / Section 4501
24-A §4501. Insurance, annuities, pensions for public employees; payment of premiums and charges
Status: in_force

1. The State, any county, city or town may make contracts of insurance with any insurer authorized to transact such business within the State insuring its employees or any class or classes thereof under a policy or policies of group insurance covering life, health or accident insurance and may contract with any such insurer granting annuities or pensions for the pensioning of such employees and for such purposes may agree to pay part or all of the premiums or charges for carrying such contract, raise money by taxation therefor and appropriate out of its treasury money necessary to pay such premiums or charges or portions thereof. [PL 1969, c. 132, §1 (NEW).]

2. Like authority to make contracts of insurance and appropriate out of its treasury, money necessary to pay such premiums or charges or portions thereof, is granted to any water district or other quasi-municipal corporation chartered and organized as such under the laws of this State. Any such water district or other quasi-municipal corporation may provide for the retirement and pensioning of its employees and for such purpose may create and set aside out of its treasury funds for a reserve or reserves, or it may contract with any insurer authorized to transact such business within the State and grant annuities for the retirement and pensioning of its employees, and for such purposes may agree to pay a part or all of the premiums or annual charges for carrying out such contracts or for creating such annuity reserves. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 4403 — ME Code / Title 24-A / Chapter 57 / Section 4403
24-A §4403. -- enforcement, penalty
Status: in_force

1. The superintendent may apply for and any Superior Court may grant such restraining orders, temporary and permanent injunctions and other orders as may be deemed necessary to enforce the superintendent's order. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

2. Violation of any order of the superintendent issued under section 4401 by any person as to whom the order is in effect shall subject such person to a penalty of not to exceed $10,000, to be collected in a civil action brought by the Attorney General in the name of the State of Maine. The Attorney General shall deposit all funds so collected with the Treasurer of State to the credit of the Insurance Division Regulatory Revolving Fund. [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]
24-A M.R.S. § 2169-B — ME Code / Title 24-A / Chapter 23 / Section 2169-B
24-A §2169-B. Use of consumer reports in insurance underwriting
Status: in_force

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Adverse action" means a denial or cancellation of, an increase in any charge for or a reduction or other adverse or unfavorable change in the terms of coverage or amount of any insurance, existing or applied for, in connection with the underwriting of personal insurance. [PL 2003, c. 223, §1 (NEW).] B. "Applicant" means an individual who has applied to be covered by a personal insurance policy with an insurer. [PL 2003, c. 223, §1 (NEW).] C. "Consumer" means an individual insured whose credit information is used or whose insurance score is calculated in the underwriting or rating of a personal insurance policy or an applicant for a personal insurance policy. [PL 2003, c. 223, §1 (NEW).] D. "Consumer report" has the same meaning as in 15 United States Code, Section 1681a(d). [PL 2013, c. 588, Pt. C, §7 (AMD).] E. "Consumer reporting agency" has the same meaning as in Title 10, section 1308, subsection 3 . [PL 2013, c. 588, Pt. C, §7 (AMD).] F. "Credit information" means any credit-related information derived from a consumer report, found on a consumer report itself or provided on an application for personal insurance. "Credit information" does not include information that is not credit-related regardless of whether it is contained in a credit report or application or used to calculate an insurance score. [PL 2003, c. 223, §1 (NEW).] G. "Insurance score" means a number or rating that is derived from an algorithm, computer application, model or other process that is based in whole or in part on credit information for the purposes of predicting the future loss exposure of an individual applicant or insured. [PL 2003, c. 223, §1 (NEW).] H. "Personal insurance" means private passenger automobile, homeowners, motorcycle, mobile home owners and noncommercial dwelling fire insurance policies and boat, personal watercraft, snowmobile and recreational vehicle policies that are individually underwritten for personal, family or household use. [PL 2003, c. 223, §1 (NEW).] [PL 2013, c. 588, Pt. C, §7 (AMD).]

2. Use of consumer reports. Notwithstanding this subsection, an insurer may use a consumer report as permitted under the Fair Credit Reporting Act pursuant to Title 10, chapter 209‑B and 15 United States Code, Chapter 41. An insurer may use information obtained from a consumer reporting agency to calculate an insurance score for underwriting and rating purposes, except that an insurer may not: A. Use an insurance score that is calculated using race, sex, sexual orientation, gender identity, religion, ancestry or national origin, income, address, zip code or marital status of a consumer as a factor; [PL 2021, c. 553, §15 (AMD).] B. Deny, cancel or refuse to renew a policy of personal insurance solely on the basis of credit information without consideration of any other applicable underwriting factor independent of credit information and not expressly prohibited by paragraph A ; [PL 2003, c. 223, §1 (NEW).] C. Base an insured's renewal rates for personal insurance solely upon credit information, without consideration of any other applicable factor independent of credit information; [PL 2003, c. 223, §1 (NEW).] D. Take an adverse action against a consumer solely because that consumer does not have a credit card account, without consideration of any other applicable factor independent of credit information; [PL 2003, c. 223, §1 (NEW).] E. Consider an absence of credit information, the number of inquiries or an inability to calculate an insurance score in underwriting or rating personal insurance unless the insurer has demonstrated to the superintendent that an absence of credit information, the number of inquiries or an inability to calculate an insurance score is a relevant factor to the risk underwritten or rated by the insurer and the insurer applies this factor in a manner approved by the superintendent; or [PL 2003, c. 223, §1 (NEW).] F. Take an adverse action against a consumer based on credit information unless an insurer obtains and uses a credit report issued or an insurance score calculated within 90 days before the date the policy is first written or renewal is issued. [PL 2003, c. 223, §1 (NEW).] [PL 2021, c. 553, §15 (AMD).]

3. Notice of use of credit information. If credit information is used by an insurer, an insurer shall disclose, either on the insurance application or at the time the insurance application is taken, that credit information may be obtained by the insurer in connection with the application. The disclosure must be written or provided to an applicant in the same medium as the application for insurance. The insurer is not required to provide the disclosure statement required under this subsection to any insured on a renewal policy if such consumer has previously been provided a disclosure statement. An insurer may demonstrate compliance with this subsection by using the following example disclosure statement: "In connection with this application for insurance, we may review your credit report or obtain or use a credit-based insurance score based on the information contained in that credit report. We may use a 3rd party in connection with the development of your insurance score." [PL 2003, c. 223, §1 (NEW).]

4. Notice of adverse action. If an insurer makes an adverse action based on credit information, the insurer shall provide the consumer with notice as required by this subsection. The insurer shall provide: A. Notice to the consumer that an adverse action has been taken in accordance with the requirements of the Fair Credit Reporting Act pursuant to Title 10, chapter 209‑B and 15 United States Code, Chapter 41; and [PL 2013, c. 588, Pt. C, §9 (AMD).] B. Notice to the consumer explaining the reason for the adverse action. The reason or reasons must be provided in sufficiently clear and specific language so that an individual can identify the basis for the insurer's decision to take an adverse action. The notice must include a description of up to 4 factors that were the primary influences of the adverse action. The use of a generalized term such as "poor credit history," "poor credit rating" or "poor insurance score" does not meet the explanation requirements of this paragraph. Standardized credit explanations provided by consumer reporting agencies or other 3rd-party vendors are deemed to comply with this paragraph. [PL 2003, c. 223, §1 (NEW).] [PL 2013, c. 588, Pt. C, §9 (AMD).]

5. Dispute resolution and error correction. If it is determined through the dispute resolution process set forth in 15 United States Code, Section 1681i(a)(5) that the credit information of a current insured was incorrect or incomplete and if the insurer receives notice of such determination from either the consumer reporting agency or from the insured, the insurer shall reunderwrite and rerate the consumer within 30 days of receiving the notice. After reunderwriting or rerating the insured, the insurer shall make any adjustments necessary, consistent with its underwriting and rating guidelines. If an insurer determines that the insured has overpaid premium, the insurer shall refund to the insured the amount of overpayment calculated back to the shorter of either the last 12 months of coverage or the actual policy period. [PL 2013, c. 588, Pt. C, §10 (AMD).]

5-A. Rescoring. An insurer that uses insurance scores to underwrite or rate risks, upon request of the insured but no more often than once every 12 months, shall obtain an updated credit report and recalculate the insurance score and shall reunderwrite and rerate the consumer within 30 days of receiving the request. After reunderwriting or rerating the insured, the insurer shall make any adjustments necessary, consistent with its underwriting and rating guidelines, on the anniversary date or the effective date of the renewal of the policy. [PL 2007, c. 74, §1 (NEW).]

6. Filing of insurance scoring models. An insurer that uses insurance scores to underwrite and rate risks shall file the scoring model or other scoring processes used by the insurer with the superintendent. A 3rd party may file scoring models on behalf of insurers. A filing that includes insurance scoring must include loss experience justifying the use of credit information if required by the superintendent. The insurance scoring model contained in a filing required under this subsection is confidential and not a public record within the meaning of Title 1, section 402, subsection 3 . [PL 2003, c. 223, §1 (NEW).]

7. Indemnification. An insurer shall indemnify, defend and hold agents harmless from and against all liability, fees and costs arising out of or relating to the actions, errors or omissions of a producer who obtains or uses credit information or insurance scores for an insurer, provided the producer, in the exercise of reasonable care, follows the instructions of or procedures established by the insurer and complies with any applicable law or regulation. This subsection may not be construed to provide a consumer or other insured with a cause of action that does not otherwise exist in the absence of this subsection. This subsection may not be construed to indemnify a producer for the producer's omission when a producer elects not to obtain a credit-related insurance score in connection with an application for personal insurance coverage from an insurer that the producer represents if that insurer uses credit information as permitted under this section to underwrite that coverage. [PL 2003, c. 223, §1 (NEW).]

8. Applicability. This section applies only to personal insurance. This section does not apply to commercial insurance. [PL 2003, c. 223, §1 (NEW).]
24-A M.R.S. § 2180 — ME Code / Title 24-A / Chapter 23 / Section 2180
24-A §2180. Unfair and coercive insurance requirements
Status: in_force

No officer or employee of this State, or of any political subdivisions or quasi-municipal corporations, or of any public authority, and no person acting or purporting to act on behalf of such officer, employee or public agency or authority, except a public agency or authority created pursuant to agreement or compact with another state, shall, with respect to any public building or construction contract which is about to be or which has been competitively bid, require the bidder to make application to, or furnish financial data to, or to obtain or procure any surety bond or contract of insurance specified in connection with such contract, or specified by any law, ordinance or regulation, from a particular surety or insurance company, agent or broker. No such officer or employee, or person, firm or corporation acting or purporting to act on behalf of such officer or employee, shall negotiate, make application for, obtain or procure any such surety bond or contract of insurance, except contracts of insurance for builder's risk or owner's protective liability, which can be obtained or procured by the bidder, contractor or subcontractor. [PL 1975, c. 623, §33 (AMD).]

The same prohibition shall extend to and include any and all construction projects which are wholly or in part financed by federal, state or municipal funds. [PL 1969, c. 504, §40-A (NEW).]

This section shall not apply to any project under design or construction on January 3, 1970, by or on behalf of a public agency or authority if such agency or authority was then engaged in insurance activity with respect to such project that otherwise would be prohibited by this section. [PL 1969, c. 504, §40-A (NEW).]
24-A M.R.S. § 221-A — ME Code / Title 24-A / Chapter 3 / Section 221-A
24-A §221-A. Financial audit requirements
Status: in_force

1. Purpose. The purpose of this section is to provide the superintendent with a means of improved financial monitoring of insurers doing business in this State. This mechanism of increased financial surveillance of insurers shall not be a substitute for financial examinations required or authorized by this Title generally. [PL 1985, c. 330, §1 (NEW).]

2. Definitions. As used in the section, unless the context indicates otherwise, the following terms have the following meanings. A. "Accountant" and "independent certified public accountant" mean an independent certified public accountant or firm licensed to practice in the State or in any state recognizing similar reciprocal licensing requirements and who is a member in good standing of the American Institute of Certified Public Accountants. It shall also mean, in the case of Canadian and British domiciled companies, a Canadian or British chartered accountant. [PL 1985, c. 330, §1 (NEW).] B. "Audited financial report" means a written report which meets the requirements of subsection 4 . [PL 1985, c. 330, §1 (NEW).] C. "Insurer" means any insurance company doing business in the State pursuant to this Title and includes, but is not limited to, all life, accident and health, property and casualty, title, direct writing reinsuring companies and surplus lines companies regulated by the Bureau of Insurance. [PL 1985, c. 330, §1 (NEW).] [PL 1985, c. 330, §1 (NEW).]

3. Audits required. All insurers, excepting insurers transacting business in this State pursuant to the terms of chapter 51 , shall cause to be conducted an annual audit by an independent certified public accountant. Each domestic insurer shall file an audited financial report with the superintendent on or before June 1st for the year ending December 31st preceding. An extension of the filing deadline may be granted by the superintendent upon a showing by the insurer or its accountant that there exists valid justification for such an extension. A foreign or alien insurer shall file an audited financial report upon the superintendent's request. A firm of independent certified public accountants engaged to perform an audit of an insurer shall substitute the appointed audit partner in charge with another audit partner in charge at least once every 5 years. An accountant substituted for pursuant to this subsection may not serve as a partner in charge of that audit until 5 years after the date of substitution, unless the superintendent waives this requirement on the basis of unusual circumstances upon application by the insurer. [PL 2009, c. 511, Pt. A, §1 (AMD).]

4. Content of annual audited financial reporting. Annual audited financial reporting must consist of the following. A. Financial statements furnished under this section must be examined by independent certified public accountants in accordance with generally accepted auditing standards as prescribed by the American Institute of Certified Public Accountants. The opinion of the accountant must cover all years for which a financial presentation is made. The opinion expressed concerning the financial statements filed under this section must conform with the accounting practices prescribed or permitted by the superintendent or the insurance supervisory official of the insurer's state of domicile. An insurer, with the approval of the superintendent, may file audited consolidated or combined financial statements in lieu of separate annual audited financial statements if the insurer is part of a group of insurance companies that uses a pooling agreement and such an insurer cedes all of its direct and assumed business to the pool or if the insurer has executed a 100% reinsurance agreement with one or more of the insurers in the group and the pooling or reinsurance agreement affects the solvency of the insurer or the integrity of the insurer's reserves. In those cases, a columnar consolidating or combining worksheet must be filed with the report. The opinion must be expressed to the insurer by the accountant on the accountant's letterhead and show the address of the office issuing that opinion, must be manually executed and dated. [PL 1993, c. 313, §6 (AMD).] B. Financial statements, as a minimum, must consist of: (1) Balance sheet; (2) Statement of gain or loss from operations; (3) Statement of cash flow; (4) Statement of change in capital paid-up, gross paid-in and contributed surplus and unassigned funds, surplus funds; and (5) Notes to financial statements. [PL 1993, c. 313, §6 (AMD).] C. The statement must include an independent certified public accountant's report respecting evaluation of internal controls. [PL 1993, c. 313, §6 (AMD).] D. The statement must include an independent certified public accountant's letter, in conformance with standards established by the National Association of Insurance Commissioners, attesting to that certified public accountant's qualifications, possession of license and subscription to the code of professional ethics and pronouncements issued by the American Institute of Certified Public Accountants. [PL 1999, c. 113, §6 (AMD).] [PL 1999, c. 113, §6 (AMD).]

5. Rules authorized. The superintendent shall promulgate such rules as shall be necessary to effectuate provisions of this section. [PL 1985, c. 330, §1 (NEW).]

6. Application and effective date. For those insurers doing business in this State that are subject to this section, the filing of the initial annual audited financial reports required under this section are due June 30, 1986, covering the calendar year December 31, 1985. Similar recurring reports are due each June 1st thereafter. [PL 1999, c. 113, §7 (AMD).]

7. Exemptions. Upon written application of any insurer subject to this section, the superintendent may grant an exemption of the filing requirements under this section if the superintendent finds upon review of the application that compliance would constitute a financial hardship upon the insurer. An insurer is exempt from the filing requirements of this section for any year in which the insurer’s annual statement reflects: A. Nationwide business in an amount less than $1,000,000 in written premium plus reinsurance assumed; and [PL 2009, c. 511, Pt. A, §2 (NEW).] B. Outstanding loss reserves in an amount less than $1,000,000. [PL 2009, c. 511, Pt. A, §2 (NEW).] [PL 2009, c. 511, Pt. A, §2 (RPR).]

8. Required notice concerning adverse financial condition. Each insurer retaining an independent certified public accountant to represent it with respect to the report which the insurer is required to file pursuant to this section shall, as a condition of its written terms of engagement of the accountant, require that: A. The accountant immediately notify in writing each member of the board of directors of the insurer and the superintendent upon any determination by the independent certified public accountant that the insurer has materially misstated its financial condition as reported in the annual statement required under section 423 for the year ending December 31st preceding; and [PL 1989, c. 846, Pt. C, §2 (AMD); PL 1989, c. 846, Pt. E, §4 (AFF).] B. If the accountant, subsequent to the date of the audited financial report required by this section, becomes aware of material subsequent facts that would have affected the accountant's report, the accountant shall provide the pertinent information upon the accountant's determination to the parties identified in this subsection. [RR 2021, c. 1, Pt. B, §165 (COR).] [RR 2021, c. 1, Pt. B, §165 (COR).]
24-A M.R.S. § 2169 — ME Code / Title 24-A / Chapter 23 / Section 2169
24-A §2169. Notice of free choice of agent or insurer
Status: in_force

The creditor or lender at the time of application for the loan or at the outset of negotiations regarding the loan or sale shall inform the purchaser or borrower of that person's right of free choice in the selection of the agent and insurer through or by which the insurance in connection with the loan is to be placed, including the right to choose an agent or broker whether or not that agent or broker is affiliated with a creditor or lender. For purposes of this section, "affiliated" has the same meaning as set forth in section 1443‑A, subsection 1, paragraph A , with respect to financial institutions and credit unions or in Title 9‑A, section 4‑403 with respect to supervised lenders. In conjunction with this notice, a creditor or lender shall inform its purchasers or borrowers that obtaining insurance products from a particular agent or broker does not affect credit decisions by the creditor or lender regarding the purchaser or borrower, unless the insurance product selected violates the terms of the extension of credit regarding adequacy of coverage or is otherwise not approved under section 2168, subsection 2 . Another person may not interfere either directly or indirectly with the borrower's, debtor's or purchaser's free choice of an agent and of an insurer that complies with the requirements set out in section 2168 and the creditor or lender may not refuse an adequate policy so tendered by the borrower, debtor or purchaser. A creditor or lender may not reject an insurance product selected by a purchaser or borrower because the product was not obtained from or through an insurance agent or broker affiliated with the institution. For purposes of this section, the term "policy" includes, but is not limited to, any temporary contract or binder, by whatever name known, under the terms of which insurance coverage commences at a specified time, and continues until a finished policy is issued or the risk is declined and coverage is terminated. Upon notice of any refusal of this tendered policy, the superintendent shall order the creditor or lender to accept the tendered policy, if the superintendent determines that the refusal is not in accordance with the requirements set out in section 2168. Failure to comply with such an order of the superintendent is a violation of this section. [PL 1999, c. 127, Pt. A, §41 (AMD).]

This section does not apply to group health and group life insurance to the extent authorized by chapters 31 and 35 when the insured is enrolled in the insurance policy, credit life and credit health insurance to the extent authorized by chapter 37 , credit property insurance, credit involuntary unemployment insurance, forced placed property insurance, a vendor's single interest policy or any other insurance product as determined by the superintendent. [PL 1997, c. 315, §26 (NEW).]
24-A M.R.S. § 6303 — ME Code / Title 24-A / Chapter 75 / Section 6303
24-A §6303. Definitions
Status: in_force

For purposes of this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 1989, c. 931, §5 (NEW).]

1. Insurer. "Insurer" means any insurer authorized to transact insurance in this State and any insurer authorized as a surplus lines insurer pursuant to chapter 19 . [PL 1989, c. 931, §5 (NEW).]

2. Physician's employer. "Physician's employer" means any hospital, health care facility, clinic or other entity that employs a physician and pays for or otherwise provides professional liability insurance for the physician. [PL 1989, c. 931, §5 (NEW).]

2-A. Program. "Program" means the Rural Medical Access Program. [PL 1991, c. 734, §3 (NEW).]

3. Self-insured. "Self-insured" means any physician, hospital or physician's employer insured against the physician's professional negligence or the hospital's professional liability through any entity other than an insurer as defined in subsection 1 . For purposes of this chapter, a physician, hospital or physician's employer that does not purchase insurance is considered self-insured. [PL 2005, c. 122, §1 (AMD).]
24-A M.R.S. § 2758 — ME Code / Title 24-A / Chapter 33 / Section 2758
24-A §2758. Coverage for services provided by registered nurse first assistants (REALLOCATED FROM TITLE 24-A, SECTION 2756)
Status: in_force

(REALLOCATED FROM TITLE 24-A, SECTION 2756)

1. Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings. A. "Perioperative nursing" means a practice of nursing in which the nurse provides preoperative, intraoperative and postoperative nursing care to surgical patients. [RR 1999, c. 1, §33 (RAL).] B. "Recognized program" means a program that addresses all content of the core curriculum for registered nurse first assistants as established by the Association of Operating Room Nurses or its successor organization. [RR 1999, c. 1, §33 (RAL).] C. "Registered nurse first assistant," or "RNFA," means a person who: (1) Is licensed as a registered nurse under Title 32, chapter 31 ; (2) Is experienced in perioperative nursing; and (3) Has successfully completed a recognized program. [RR 1999, c. 1, §33 (RAL).] [RR 1999, c. 1, §33 (RAL).]

2. Institutional powers. Each health care institution, as defined in Title 22, chapter 405 , may establish specific procedures for the appointment and reappointment of registered nurse first assistants and for granting, renewing and revising their clinical privileges. [RR 1999, c. 1, §33 (RAL).]

3. Required coverage for services. Notwithstanding any other provisions of this chapter, an insurer that issues individual health insurance policies and contracts that provide coverage for surgical first assisting benefits or services shall provide coverage and payment under those contracts to a registered nurse first assistant who performs services that are within the scope of a registered nurse first assistant's qualifications. The provisions of this subsection apply only if reimbursement for an assisting physician would be covered and a registered nurse first assistant who performed those services is used as a substitute. This section does not apply to policies or contracts that cover only specified diseases. [RR 1999, c. 1, §33 (RAL).]

4. Limits; coinsurance; deductibles. Any contract that provides coverage for the services required by this section may contain provisions for maximum benefits and coinsurance and reasonable limitations, deductibles and exclusions to the extent that these provisions are not inconsistent with the requirements of this section. [RR 1999, c. 1, §33 (RAL).]
24-A M.R.S. § 410 — ME Code / Title 24-A / Chapter 5 / Section 410
24-A §410. Minimum paid-in capital and surplus requirements
Status: in_force

1. To qualify for authority to transact any one kind of insurance, as defined in chapter 9 , or combination of kinds of insurance as shown below, an insurer must possess and thereafter maintain unimpaired paid-in capital stock, if a stock insurer, or unimpaired basic surplus, if a foreign mutual or a reciprocal insurer, and when first so authorized must possess initial free surplus, all in amounts not less than as determined from the following table. A health, life and health or multiple line (as described in section 409 ) insurer may qualify for a certificate of authority to transact a legal services insurance business, as described in chapter 38 , if it is otherwise qualified therefor and possesses and thereafter maintains, in addition to the amounts described in the following table, an additional amount of unimpaired paid-in capital stock, if a stock insurer, or unimpaired basic surplus, if a foreign mutual or reciprocal insurer, of not less than $500,000. An insurer may qualify for a certificate of authority to transact solely financial guaranty insurance as defined in section 709‑A , if it is otherwise qualified therefor and possesses and thereafter maintains paid-in capital stock in the amount of $2,500,000 and initial free surplus in an amount of $47,500,000 or, if the insurer is a foreign mutual or reciprocal insurer, minimum required basic surplus in an amount of $2,500,000 and initial free surplus in an amount of $47,500,000. Stock Insurers Foreign mutual, Reciprocal Insurers Kind or Kinds of Insurance Minimum Required Capital Stock Initial Free Surplus Minimum Required Basic Surplus Initial Free Surplus Life $1,500,000 $1,500,000 $1,500,000* $1,500,000* Health 1,000,000 1,000,000 1,000,000 1,000,000 Life and Health 2,500,000 2,500,000 2,500,000* 2,500,000* Casualty 1,500,000 1,500,000 1,500,000 1,500,000 Marine and Transportation 1,500,000 1,500,000 1,500,000 1,500,000 Property 1,000,000 1,000,000 1,000,000 1,000,000 Surety 1,500,000 1,500,000 1,500,000 1,500,000 Title 500,000 500,000 500,000 500,000 Multiple line (as defined in section 409) 2,500,000 2,500,000 2,500,000 2,500,000 All Line (as defined in section 409 5,000,000 5,000,000 5,000,000* 5,000,000* * Does not apply as to a reciprocal insurer. Except: A. An insurer holding a valid certificate of authority to transact insurance in this State on January 1, 1970 may, if otherwise qualified therefor until January 1, 1989, continue to be so authorized while possessing paid-in capital stock, if a stock insurer, or surplus, if a mutual or reciprocal insurer, as required for such authority immediately prior to January 1, 1970. [PL 1991, c. 385, §2 (AMD).] B. Prior to January 1, 1989, the superintendent may not authorize such an insurer to transact any other kinds of insurance unless it complies with the requirements as to capital stock, if a stock insurer, or basic surplus, if a mutual or reciprocal insurer, as applied to all kinds of insurance it proposes to transact, as provided in the table contained in this paragraph. A health, life and health or multiple line (as described in section 409 ) insurer may qualify for a certificate of authority to transact a legal services insurance business, as described in chapter 38 , if it is otherwise qualified therefor and possesses and thereafter maintains, in addition to the amounts described in the following table, an additional amount of unimpaired paid-in capital stock, if a stock insurer, or unimpaired basic surplus, if a foreign mutual or reciprocal insurer, of not less than $500,000. Stock Insurers Foreign mutual, Reciprocal Insurers Kind or Kinds of Insurance Minimum Required Capital Stock Initial Free Surplus Minimum Required Basic Surplus Initial Free Surplus Life $500,000 $1,000,000 $1,000,000* $1,000,000* Health 250,000 250,000 250,000 250,000 Life and Health 500,000 1,000,000 1,000,000* 1,000,000* Casualty 500,000 500,000 500,000 500,000 Marine and Transportation 500,000 500,000 500,000 500,000 Property 500,000 500,000 500,000 500,000 Surety 500,000 500,000 500,000 500,000 Title 150,000 150,000 150,000 150,000 Multiple line (as defined in section 409) 1,000,000 1,000,000 1,000,000 1,000,000 All Line (as defined in section 409 2,000,000 2,000,000 2,000,000* 2,000,000* *Does not apply as to a reciprocal insurer. [PL 1991, c. 385, §2 (AMD).] C. Until January 1, 1989, a domestic mutual insurer formed prior to January 1, 1968, and while possessing surplus of not less than $200,000 may be authorized to transact, in addition to the types of insurance it was transacting prior to July 24, 1984, any other additional kinds of insurance authorized by its charter; subject to those minimum required basic surplus amounts applicable as to foreign mutual insurers as contained in the table in paragraph B , if the insurer is to transact life insurance together with any one or more of property, casualty, surety or marine and transportation insurances. [PL 1987, c. 78, §1 (AMD).] D. Domestic mutual insurers holding a certificate of authority upon January 1, 1989, if otherwise qualified, and possessed of basic surplus in minimum required amounts as contained in the table in this paragraph may continue to be so authorized, provided those insurers continue to possess and maintain unimpaired basic surplus funds as determined in this paragraph and applicable to those lines or kinds of insurance permitted by its certificate of authority immediately prior to January 1, 1989. Upon application by any such insurer and written approval by the superintendent, the insurer's certificate of authority may be extended to permit the writing of other kinds or lines of insurance if the insurer is qualified and possessed of basic surplus funds in amounts contained in the table in this paragraph. A domestic mutual insurer holding a certificate of authority prior to January 1, 1989, but which does not possess and maintain basic surplus in the minimum required amounts contained in the table in this paragraph, may continue to be authorized to transact insurance in this State and to write other kinds or lines of insurance, subject to the approval of the superintendent, as long as it maintains 100% reinsurance and has no liabilities. For the purposes of this paragraph, any assuming reinsurer must be a corporation which possesses the ability to exercise control of the ceding insurer, must be an insurance company possessed of a certificate of authority to transact the same kinds of insurance in this State as those assumed and shall file a consolidated annual statement as required by section 423 . A health, life and health or multiple line (as described in section 409 ) insurer may qualify for a certificate of authority to transact a legal services insurance business, as described in chapter 38 , if it is otherwise qualified therefor and possesses and thereafter maintains, in addition to the amounts described in the following table, an additional amount of unimpaired paid-in capital stock, if a stock insurer, or unimpaired basic surplus, if a foreign mutual or reciprocal insurer, of not less than $500,000. Kind or Kinds of Insurance Domestic Mutual Insurers Life $1,000,000 Health 500,000 Life and Health 1,250,000 Casualty 750,000 Marine and Transportation 1,000,000 Property 500,000 Surety 1,000,000 Title 350,000 Multiple Line (as defined in section 409) 1,250,000 All line (as defined in section 409 ) 2,500,000 [PL 1991, c. 385, §2 (AMD).] E. An insurer that otherwise possesses funds as required under this subsection shall at all times maintain policyholders' surplus, combined paid-in capital stock, if any, and surplus, reasonable in amount, as determined by the superintendent, in relation to the kinds and amount of insurance it has in force, or being written and retained by it, net of applicable reinsurance. In making any such determination, the superintendent shall give due consideration to any applicable standards approved or adopted by the National Association of Insurance Commissioners and to the desirability of substantial uniformity as to such requirements among the respective states. [PL 1991, c. 385, §2 (AMD).] F. A health maintenance organization as a division or line of business is subject to this paragraph. (1) An insurer that operates a health maintenance organization as a division or a line of business shall possess and maintain policyholder's surplus, including paid-in capital stock if any, as otherwise required by this section and in addition shall meet the surplus requirements of section 4204‑A . (2) A nonprofit hospital or medical service organization that operates a health maintenance organization as a division or as a line of business shall possess and maintain subscriber reserves as defined in Title 24, section 2301, subsection 9‑A, paragraph H , subparagraph (2) and in an amount required by the superintendent and in addition shall meet the surplus requirements of section 4204‑A . [RR 2021, c. 2, Pt. A, §68 (COR).] [RR 2021, c. 2, Pt. A, §68 (COR).]

2. Capital and surplus requirements are based upon all the kinds of insurance transacted by the insurer in any and all areas in which it operates or proposes to operate, whether or not only a portion of such kinds are to be transacted in this State. [PL 1969, c. 132, §1 (NEW).]

3. As to surplus required for authority to transact one or more kinds of insurance and thereafter to be maintained, domestic mutual legal reserve insurers hereafter formed are governed by chapter 47 . [PL 1991, c. 385, §2 (AMD).]
24-A M.R.S. § 2694-A — ME Code / Title 24-A / Chapter 32-A / Section 2694-A
24-A §2694-A. Physician performance measurement, reporting and tiering programs
Status: in_force

1. Performance measurement, reporting and tiering programs. An insurer delivering or issuing for delivery within the State any individual health insurance policy or group health insurance policy or certificate shall annually file with the superintendent on or before October 1, 2010 and annually by October 1st in subsequent years a full and true statement of its criteria, standards, practices, procedures and programs that measure or tier health care provider performance with respect to quality, cost or cost-efficiency. The statement must be on a form prepared by the superintendent and may be supplemented by additional information required by the superintendent. The statement must be verified by the oath of the insurer's president or vice-president, and secretary or chief medical officer. A filing and supporting information are public records notwithstanding Title 1, section 402, subsection 3, paragraph B . [PL 2013, c. 383, §2 (AMD).]

2. Duties. The superintendent shall review the statements, if any, assemble the statements in one table using a side-by-side comparison format and provide an analysis identifying the commonalities and differences of the statements. Notwithstanding any provision of law to the contrary, the superintendent shall adopt by rule a program and performance measures designed to: A. Ensure transparency and fairness and promote the continued strengthening of measurement programs to meet patients' needs; [PL 2009, c. 350, Pt. B, §1 (NEW).] B. Promote the consistency, efficiency and fairness of physician performance measurement; and [PL 2009, c. 350, Pt. B, §1 (NEW).] C. Promote an appropriate balance between innovation and standardization. [PL 2009, c. 350, Pt. B, §1 (NEW).] [PL 2009, c. 350, Pt. B, §1 (NEW).]

3. Advisory panel. [PL 2011, c. 90, Pt. J, §20 (RP).]

4. Rulemaking. The superintendent may adopt rules 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 2009, c. 350, Pt. B, §1 (NEW).]
24-A M.R.S. § 1151-A — ME Code / Title 24-A / Chapter 13-A / Section 1151-A
24-A §1151-A. Definitions
Status: in_force

As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings. [PL 1999, c. 715, §8 (NEW).]

1. Acceptable collateral. "Acceptable collateral" means: A. As to securities lending transactions, repurchase transactions and reverse repurchase transactions and for the purpose of calculating counter-party exposure amount: cash, cash equivalents, letters of credit or direct obligations of, or securities that are fully guaranteed as to principal and interest by the government of the United States, by any agency of the United States, by the Federal National Mortgage Association or by the Federal Home Loan Mortgage Corporation; and [PL 1999, c. 715, §8 (NEW).] B. As to foreign securities lending transactions: sovereign debt rated "1" by the Securities Valuation Office of the National Association of Insurance Commissioners. [PL 1999, c. 715, §8 (NEW).] [PL 1999, c. 715, §8 (NEW).]

2. Admitted assets. "Admitted assets" means assets recognized by the superintendent pursuant to section 901‑A . [PL 2001, c. 72, §13 (AMD).]

3. Aggregate amount of investments. "Aggregate amount of investments" means the aggregate value of those investments, as determined in accordance with statutory accounting principles pursuant to section 901‑A and any rules adopted under that section, except as provided in section 1157, subsection 5 . [PL 2001, c. 72, §13 (AMD).]

4. Business entity. "Business entity" means a sole proprietorship, corporation, limited liability company, association, general or limited partnership, joint stock company, joint venture, mutual fund, bank, trust, real estate investment trust, joint tenancy or other similar form of business organization, whether organized as a for-profit or nonprofit organization. [PL 1999, c. 715, §8 (NEW).]

5. Cap. "Cap" means an agreement obligating the seller to make payments to the buyer with each payment based on the amount by which a reference price or level or the performance or value of one or more underlying interests exceeds a predetermined number, sometimes called the "strike rate" or "strike price." [PL 1999, c. 715, §8 (NEW).]

6. Cash equivalents. "Cash equivalents" means highly rated, highly liquid and readily marketable obligations that are readily convertible into known amounts of cash without a penalty and have a remaining term to maturity of one year or less. For purposes of this definition, "highly rated" means an investment rated "P-1" by Moody's Investors Service, Inc., "A-1" by the Standard and Poor's Division of The McGraw-Hill Companies, Inc., or an equivalent rating by a nationally recognized statistical rating organization recognized by the Securities Valuation Office of the National Association of Insurance Commissioners. [PL 1999, c. 715, §8 (NEW).]

7. Collar. "Collar" means an agreement to receive payments as the buyer of an option, cap or floor and to make payments as the seller of a different option, cap or floor. [PL 1999, c. 715, §8 (NEW).]

8. Counter-party. "Counter-party" means a business entity that is the other party to an investment practices transaction with an insurer or, as to a securities lending transaction, the custodian bank or agent, if any, acting on behalf of an insurer. [PL 1999, c. 715, §8 (NEW).]

9. Counter-party exposure; counter-party exposure amount. "Counter-party exposure" or "counter-party exposure amount" means: A. For an over-the-counter derivative instrument not entered into pursuant to a written master agreement that provides for netting of payments owed by the respective parties: (1) The market value of the over-the-counter derivative instrument if the liquidation of the derivative instrument would result in a final cash payment to the insurer; or (2) Zero if the liquidation of the derivative instrument would not result in a final cash payment to the insurer; and [PL 1999, c. 715, §8 (NEW).] B. For an over-the-counter derivative instrument entered into pursuant to a written master agreement that provides for netting of payments owed by the respective parties, if the domiciliary jurisdiction of the counter-party is either within the United States or within a foreign jurisdiction listed as eligible for netting in the purposes and procedures manual of the Securities Valuation Office of the National Association of Insurance Commissioners or its successor publication, the greater of zero or the net sum payable to the insurer in connection with all derivative instruments subject to the written master agreement upon their liquidation in the event of default by the counter-party pursuant to the master agreement, assuming there are no conditions precedent to the obligations of the counter-party to make such a payment and no setoff of amounts payable pursuant to any other instrument or agreement. [PL 1999, c. 715, §8 (NEW).] For purposes of this definition, "market value" or the "net sum payable" is determined at the end of the most recent quarter of the insurer's fiscal year and must be reduced by the market value of acceptable collateral held by the insurer or a custodian on the insurer's behalf. [PL 1999, c. 715, §8 (NEW).]

10. Derivative instrument. "Derivative instrument" means any agreement, option or instrument or any series or combination of those agreements, options or instruments: A. To make or take delivery of, assume or relinquish a specified amount of one or more underlying interests, or to make a cash settlement in lieu thereof; or [PL 1999, c. 715, §8 (NEW).] B. That has a price, performance, value or cash flow based primarily upon the actual or expected price, yield, level, performance, value or cash flow of one or more underlying interests. [PL 1999, c. 715, §8 (NEW).] For purposes of this definition, "derivative instrument" includes options, warrants not attached to another financial instrument purchased by the insurer, caps, floors, collars, swaps, forwards, futures and any other substantially similar agreements, options or instruments, or any series or combinations of those agreements, options or instruments. "Derivative instrument" does not include collateralized mortgage obligations, other asset-backed securities, principal-protected structured securities, floating rate securities or instruments in which an insurer is otherwise authorized to invest or that an insurer is otherwise authorized to receive under this chapter other than under section 1153, subsection 4 , and any debt obligations of the insurer. [PL 1999, c. 715, §8 (NEW).]

11. Derivative transaction. "Derivative transaction" means a transaction involving the use of one or more derivative instruments. For purposes of section 1153, subsection 4 , dollar roll transactions, repurchase transactions, reverse repurchase transactions and securities lending transactions are not considered derivative transactions. [PL 1999, c. 715, §8 (NEW).]

12. Dollar roll transaction. "Dollar roll transaction" means 2 simultaneous transactions with settlement dates no more than 96 days apart so that in one transaction an insurer sells to a counter-party and in the other transaction the insurer is obligated to purchase from the same counter-party substantially similar securities of the following types: A. Mortgage-backed securities issued, assumed or guaranteed by the Government National Mortgage Association, the Federal National Mortgage Association, the Federal Home Loan Mortgage Corporation or their respective successors; and [PL 1999, c. 715, §8 (NEW).] B. Other mortgage-backed securities referred to the Secondary Mortgage Market Enhancement Act of 1984, 15 United States Code, Section 77r‑1, as amended. [PL 1999, c. 715, §8 (NEW).] [PL 1999, c. 715, §8 (NEW).]

13. Domestic institution. "Domestic institution" means an institution created or existing under the laws of the United States or any state, district or territory. [PL 1999, c. 715, §8 (NEW).]

14. Floor. "Floor" means an agreement obligating the seller to make payments to the buyer in which each payment is based on the amount by which a predetermined number, sometimes called the "floor rate" or "price," exceeds a reference price, level, performance or value of one or more underlying interests. [PL 1999, c. 715, §8 (NEW).]

15. Foreign investment; foreign investment practice. "Foreign investment" or "foreign investment practice" means an investment or investment practice in a foreign jurisdiction, an investment practice with a person domiciled in a foreign jurisdiction or an investment in a person, real estate or asset domiciled in a foreign jurisdiction. An investment or investment practice is not considered a foreign investment or foreign investment practice if the issuing person, counter-party, qualified primary credit source or qualified guarantor is a domestic jurisdiction or a person domiciled in a domestic jurisdiction unless: A. The counter-party or the issuing person is a shell business entity; and [PL 1999, c. 715, §8 (NEW).] B. The investment or investment practice is not assumed, accepted, guaranteed, insured or otherwise backed by a domestic jurisdiction or a person that is not a shell business entity, domiciled in a domestic jurisdiction. [PL 1999, c. 715, §8 (NEW).] For purposes of this subsection, "shell business entity" means a business entity having no economic substance, except as a vehicle for owning interests in assets issued, owned or previously owned by a person domiciled in a foreign jurisdiction; "qualified guarantor" means a guarantor against which an insurer has a direct claim for full and timely payment, evidenced by a contractual right for which an enforcement action can be brought in a domestic jurisdiction; and "qualified primary credit source" means the credit source to which an insurer looks for payment as to an investment and against which an insurer has a direct claim for full and timely payment, evidenced by a contractual right for which an enforcement action can be brought in a domestic jurisdiction. [PL 1999, c. 715, §8 (NEW).]

16. Foreign jurisdiction. "Foreign jurisdiction" means a jurisdiction other than the United States, any state or any political subdivision of the United States or any state. [PL 1999, c. 715, §8 (NEW).]

17. Forward. "Forward" means an agreement other than a future to make or take delivery in the future of one or more underlying interests, or effect a cash settlement based on the actual or expected price, level, performance or value of such underlying interests. "Forward" does not mean spot transactions effected within customary settlement periods, when-issued purchases or other similar cash market transactions. [PL 1999, c. 715, §8 (NEW).]

18. Future. "Future" means an agreement traded on a futures exchange to make or take delivery of or effect a cash settlement based on the actual or expected price, level, performance or value of one or more underlying interests. [PL 1999, c. 715, §8 (NEW).]

19. Futures exchange. "Futures exchange" means a qualified foreign exchange or an exchange, contract market or board of trade on which trading in futures is conducted that has been authorized for futures trading in the United States by the Commodities Futures Trading Commission or its successor. [PL 1999, c. 715, §8 (NEW).]

20. Hedging transaction. "Hedging transaction" means a derivative transaction that is entered into and maintained to reduce: A. The risk of a change in the value, yield, price, cash flow or quantity of assets or liabilities or a portfolio of assets or liabilities that an insurer has acquired or incurred or anticipates acquiring or incurring; or [PL 1999, c. 715, §8 (NEW).] B. The currency exchange rate risk related to assets or liabilities or a portfolio of assets or liabilities that an insurer has acquired or incurred or anticipates acquiring or incurring. [PL 1999, c. 715, §8 (NEW).] [PL 1999, c. 715, §8 (NEW).]

21. High-yield obligations. "High-yield obligations" means obligations that are neither investment grade nor medium grade obligations. [PL 1999, c. 715, §8 (NEW).]

22. Income generation transaction. "Income generation transaction" means a derivative transaction that is entered into to generate income. A derivative transaction that is entered into as a hedging transaction or a replication or synthetic asset transaction is not considered an income generation transaction. [PL 1999, c. 715, §8 (NEW).]

23. Institution. "Institution" means a corporation, joint-stock association, business trust, business partnership, business joint venture or any other similar entity. [PL 1999, c. 715, §8 (NEW).]

24. Investment grade obligation. "Investment grade obligation" means an obligation that at the time of acquisition by the insurer is rated "1" or "2" by the Securities Valuation Office of the National Association of Insurance Commissioners. If not valued by the Securities Valuation Office of the National Association of Insurance Commissioners, "investment grade obligation" means an obligation that at the time of acquisition by the insurer is rated the equivalent of "1" or "2" by one of the following nationally recognized independent rating agencies: Moody's Investors Service, Inc., Standard and Poor's Division of The McGraw-Hill Companies, Inc., Fitch Investors Service, Inc. or Duff and Phelps Credit Rating Company. [PL 1999, c. 715, §8 (NEW).]

25. Investment practices. "Investment practices" means transactions of the types described in section 1153, subsection 4 and section 1160, subsection 6 . [PL 1999, c. 715, §8 (NEW).]

26. Market value. "Market value" means the price for the security or derivative instrument obtained from a generally recognized source or the most recent quotation from such a source or, to the extent no generally recognized source exists, the price for the security or derivative instrument as determined pursuant to the terms of the instrument or in good faith by the insurer as can be reasonably demonstrated to the superintendent upon request, plus accrued but unpaid income thereon to the extent not included in the price as of the date that market value is determined. [PL 1999, c. 715, §8 (NEW).]

27. Medium grade obligation. "Medium grade obligation" means an obligation that at the time of acquisition by the insurer is rated by the Securities Valuation Office of the National Association of Insurance Commissioners as Class "3" quality. If not valued by the Securities Valuation Office of the National Association of Insurance Commissioners, "medium grade obligation" means an obligation that at the time of acquisition by the insurer is rated the equivalent of "3" by Moody's Investors Service, Inc., Standard and Poor's Division of The McGraw-Hill Companies, Inc., Fitch Investors Service, Inc. or Duff and Phelps Credit Rating Company. [PL 1999, c. 715, §8 (NEW).]

28. Obligation. "Obligation" means a bond, note, debenture, trust certificate including an equipment certificate, production payment, negotiable bank certificate of deposit, banker's acceptance, credit tenant loan as that term is defined in the practices and procedures manual of the National Association of Insurance Commissioners or its successor publication, loan secured by financing net leases and other evidence of indebtedness for the payment of money, or participations, certificates or other evidence of an interest in any of the foregoing, whether constituting a general obligation of the issuer or payable only out of certain revenues or certain funds pledged or otherwise dedicated for payment. [PL 1999, c. 715, §8 (NEW).]

29. Option. "Option" means an agreement giving the buyer the right to buy or receive, sell or deliver, enter into, extend or terminate or effect a cash settlement based on the actual or expected price, spread, level, performance or value of one or more underlying interests, including, without limitation, an option to purchase or sell a swap at a given price and time or at a series of prices and times. [PL 1999, c. 715, §8 (NEW).]

30. Over-the-counter derivative instrument. "Over-the-counter derivative instrument" means a derivative instrument entered into with a counter-party other than through a qualified exchange or futures exchange or cleared through a qualified clearinghouse. [PL 1999, c. 715, §8 (NEW).]

31. Person. "Person" means an individual, business entity, multilateral development bank or a government or quasi-governmental body, such as a political subdivision or a government-sponsored enterprise. [PL 1999, c. 715, §8 (NEW).]

32. Potential exposure. "Potential exposure" means: A. As to a futures position, the amount of initial margin required for that position; or [PL 1999, c. 715, §8 (NEW).] B. As to swaps, collars and forwards, 0.5% times the notional amount times the square root of the remaining years to maturity. [PL 1999, c. 715, §8 (NEW).] [PL 1999, c. 715, §8 (NEW).]

33. Qualified bank. "Qualified bank" means: A. A national bank, state-chartered bank or trust company that is adequately capitalized at all times as determined by standards adopted by federal banking regulators and that either is regulated by state banking laws or is a member of the Federal Reserve System; or [PL 1999, c. 715, §8 (NEW).] B. A bank or trust company incorporated or organized under the laws of a country other than the United States that is regulated as a bank or trust company by that country's government or an agency of that country's government and that is adequately capitalized at all times as determined by standards adopted by international banking regulators. [PL 1999, c. 715, §8 (NEW).] [PL 1999, c. 715, §8 (NEW).]

34. Qualified broker or dealer. "Qualified broker or dealer" means a broker or dealer that is organized under the laws of a state, is registered under the United States Securities Exchange Act of 1934, 15 United States Code, Sections 78a to 78kk and has net capital in excess of $250,000,000. [PL 1999, c. 715, §8 (NEW).]

35. Qualified business entity. "Qualified business entity" means: A. An issuer of preferred stock or obligations that are rated "1" or "2" by the Securities Valuation Office of the National Association of Insurance Commissioners or an issuer of obligations, preferred stock or derivative instruments that are rated the equivalent of "1" or "2" by the Securities Valuation Office of the National Association of Insurance Commissioners or by a nationally recognized statistical rating organization recognized by the Securities Valuation Office of the National Association of Insurance Commissioners; or [PL 1999, c. 715, §8 (NEW).] B. A primary dealer in United States Government securities that is recognized by the Federal Reserve Bank of New York. [PL 1999, c. 715, §8 (NEW).] [PL 1999, c. 715, §8 (NEW).]

36. Qualified clearinghouse. "Qualified clearinghouse" means a clearinghouse subject to the rules of a qualified exchange or a futures exchange that provides clearing services, including acting as a counter-party to each of the parties to a transaction such that the parties no longer have credit risk to each other. [PL 1999, c. 715, §8 (NEW).]

37. Qualified exchange. "Qualified exchange" means: A. A securities exchange registered as a national securities exchange or a securities market regulated under the federal Securities Exchange Act of 1934, 15 United States Code, Section 78 et seq., as amended; [PL 1999, c. 715, §8 (NEW).] B. A board of trade or commodities exchange designated as a contract market by the Commodity Futures Trading Commission or any successor; [PL 1999, c. 715, §8 (NEW).] C. Any computerized or Internet-based market for private offerings, resales and trading of obligations or other securities that is maintained under the auspices of a federally regulated, self-governing securities dealers organization, registered as a securities exchange or regulated as a securities market under the federal Securities Exchange Act of 1934, 15 United States Code, Section 78 et seq., as amended; [PL 1999, c. 715, §8 (NEW).] D. A designated offshore securities market as defined in Securities Exchange Commission Regulation S, 17 Code of Federal Regulations, Part 230, as amended; or [PL 1999, c. 715, §8 (NEW).] E. A qualified foreign exchange. [PL 1999, c. 715, §8 (NEW).] [PL 1999, c. 715, §8 (NEW).]

38. Qualified foreign exchange. "Qualified foreign exchange" means a foreign exchange, board of trade or contract market located outside the United States, its territories or possessions: A. That has received regulatory comparability relief under Commodity Futures Trading Commission Rule 30.10 as set forth in Appendix C to Part 30 of the Commodity Futures Trading Commission's Regulations, 17 Code of Federal Regulations, Part 30, as amended; [PL 1999, c. 715, §8 (NEW).] B. That is, or its members are, subject to the jurisdiction of a foreign futures authority that has received regulatory comparability relief under Commodity Futures Trading Commission Rule 30.10, as set forth in Appendix C to Part 30 of the Commodity Futures Trading Commission's Regulations, 17 Code of Federal Regulations, Part 30, as amended, as to futures transactions in the jurisdiction where the exchange, board of trade or contract market is located; or [PL 1999, c. 715, §8 (NEW).] C. Upon which foreign stock index futures contracts are listed that are the subject of no-action relief issued by the Commodity Futures Trading Commission's Office of General Counsel; however, an exchange, board of trade or contract market that qualifies as a "qualified foreign exchange" only under this paragraph may only be a "qualified foreign exchange" as to foreign stock index futures contracts that are the subject of no-action relief. [PL 1999, c. 715, §8 (NEW).] [PL 1999, c. 715, §8 (NEW).]

39. Qualified for public sale. "Qualified for public sale" means registered under the United States Securities Act of 1933, 15 United States Code, Sections 77a to 77aa. [PL 1999, c. 715, §8 (NEW).]

40. Replication or synthetic asset transaction. "Replication or synthetic asset transaction" means a derivative transaction entered into in conjunction with other permissible investments held by the insurer in order to reproduce the investment characteristics of other permissible investments. A derivative transaction entered into by the insurer as a hedging transaction or an income generation transaction is not considered a replication or synthetic asset transaction. [PL 1999, c. 715, §8 (NEW).]

41. Repurchase transaction. "Repurchase transaction" means a transaction in which an insurer sells securities to a qualified bank or a qualified business entity or to a bank or a business entity whose obligations with respect to the transaction are guaranteed by a qualified bank or a qualified business entity and the insurer is obligated to repurchase the sold securities or equivalent securities from the bank or business entity at a specified price, either within a specified period of time or upon demand. [PL 2021, c. 16, §11 (AMD).]

42. Reverse repurchase transaction. "Reverse repurchase transaction" means a transaction in which an insurer purchases securities from a counter-party that is obligated to repurchase the purchased securities or equivalent securities from the insurer at a specified price, either within a specified period of time or upon demand. [PL 2021, c. 16, §12 (AMD).]

43. Securities lending transaction. "Securities lending transaction" means a transaction in which securities are loaned by an insurer to a qualified bank or a qualified business entity or a bank or a business entity whose obligations with respect to such transaction are guaranteed by a qualified bank or a qualified business entity that is obligated to return the loaned securities or equivalent securities to the insurer, either within a specified period of time or upon demand. [PL 1999, c. 715, §8 (NEW).]

44. Subsidiary. "Subsidiary" has the meaning as prescribed in section 222, subsection 2, paragraph F . The term "subsidiary" does not include a separate account established under section 2537 . [PL 1999, c. 715, §8 (NEW).]

45. Swap. "Swap" means an agreement to exchange or to net payments at one or more times based on the actual or expected price, yield, level, performance or value of one or more underlying interests. [PL 1999, c. 715, §8 (NEW).]

46. Underlying interest. "Underlying interest" means the assets, liabilities or other interests, or a combination of those assets, liabilities or interests, underlying a derivative instrument, such as any one or more securities, currencies, rates, indices, commodities or derivative instruments that are or relate to investments or investment practices that an insurer is permitted to acquire or engage in pursuant to this chapter. [PL 1999, c. 715, §8 (NEW).]

47. United States. "United States" when used to signify place means those lands and waters under the jurisdiction of the United States. [PL 1999, c. 715, §8 (NEW).]

48. Warrant. "Warrant" means an instrument that gives the holder the right to purchase or sell the underlying interest at a given price and time or at a series of prices and times outlined in the warrant agreement. [PL 1999, c. 715, §8 (NEW).]
24-A M.R.S. § 1496 — ME Code / Title 24-A / Chapter 16 / Section 1496
24-A §1496. Acts of MGA considered acts of insurer; examination authority
Status: in_force

The acts of the MGA are deemed to be the acts of the insurer on whose behalf it is acting. An MGA may be examined as if it were the insurer. [PL 1997, c. 573, §1 (NEW); PL 1997, c. 573, §2 (AFF).]
24-A M.R.S. § 788 — ME Code / Title 24-A / Chapter 9 / Section 788
24-A §788. Dividends
Status: in_force

The special purpose reinsurance vehicle may not declare or pay dividends in any form to its owners unless the dividends do not cause the reinsurance vehicle or any of its protected cells to become impaired and, after giving effect to the dividends, the assets of the reinsurance vehicle, including assets held in trust pursuant to the terms of the insurance securitization, must be sufficient to meet its obligations. Except for dividends specifically provided for in the approved plan of operation under section 782, subsection 2, paragraph H , the prior approval of the superintendent is required for any dividend paid during the term of coverage or while the reinsurance vehicle has undischarged obligations to the ceding insurer. The dividends may be declared by the board of directors of the reinsurance vehicle if the dividends would not violate the provisions of this subchapter or the approved plan of operation and would not jeopardize the fulfillment of the obligations of the reinsurance vehicle or the trustee pursuant to the special purpose reinsurance vehicle insurance securitization, the special purpose reinsurance vehicle contract or any related transaction. The provisions of section 222, subsection 11‑C do not apply to such dividends. [PL 2009, c. 511, Pt. A, §6 (AMD).]
24-A M.R.S. § 3408 — ME Code / Title 24-A / Chapter 47 / Section 3408
24-A §3408. Home office, records, assets to be in State; exceptions
Status: in_force

1. Every domestic insurer shall have and maintain its principal place of business and home office in this State, and shall keep therein accurate and complete accounts and records of its assets, transactions and affairs in accordance with the usual and accepted principles and practices of insurance accounting and record keeping as applicable to the kinds of insurance transacted by the insurer. [PL 1969, c. 132, §1 (NEW).]

2. Every domestic insurer shall have and maintain its assets in this State, except as to: A. Real property and personal property appurtenant thereto lawfully owned by the insurer and located outside this State; [RR 2015, c. 1, §29 (COR).] B. Such property of the insurer as may be customary, necessary and convenient to enable and facilitate the operation of its branch offices located outside this State as referred to in subsection 4 ; and [PL 1981, c. 501, §46 (AMD).] C. United States public obligations and other corporate securities for which definitive certificates have not been issued, but are issued through the book-entry systems of federal reserve banks or depository trust companies. Insurers investing in securities in book-entry form shall make available at the time of examination the following: (1) A copy of the custodial or safekeeping agreement entered into by the insurer and the custodian, a state-chartered bank, a member bank of the federal reserve system or a depository trust company if the deposit was made directly to the entity, which sets forth the provisions for the use of the book-entry securities on behalf of the insurer by the custodian. The agreement shall provide for a standard of responsibility on the part of the custodian which shall be the responsibility of a bailee for hire under the law of the jurisdiction of the custodian's state of domicile. The agreement shall provide that the securities held by the custodian are subject to the instructions of the insurer and may be withdrawn immediately upon demand of the insurer; and (2) Affidavits evidencing ownership of the book-entry securities signed by a responsible official of the custodian and stating that the custodian is holding the securities for the insurer pursuant to the terms of the custodial agreement. These book-entry securities shall be treated as "admitted assets" of the insurer on production of the affidavit. The required custodial agreement and affidavit shall conform to such standards as may be prescribed from time to time by the Superintendent of Insurance. [PL 1981, c. 501, §47 (NEW).] [RR 2015, c. 1, §29 (COR).]

3. No person shall remove all or a material part of the records or assets of a domestic insurer from this State, except pursuant to a plan of merger, consolidation or bulk reinsurance approved by the superintendent under this Title, or for such reasonable purposes and periods of time as may be approved by the superintendent in writing in advance of such removal, or conceal such records or assets or such material part thereof from the superintendent. Any person who removes or attempts to remove such records of assets or such material part thereof from the home office or other place of business or of safekeeping of the insurer in this State with the intent to remove the same from this State, or who conceals or attempts to conceal the same from the superintendent, in violation of this section, shall upon conviction thereof be guilty of a felony, punishable by a fine of not more than $10,000 or by imprisonment for not more than 5 years, or by both in the discretion of the court. Upon any removal or attempted removal of such records of assets, or upon retention of such records or assets or material part thereof outside this State, beyond the period therefor specified in the superintendent's consent under which the records were so removed thereat, or upon concealment of or attempt to conceal records or assets in violation of this section, the superintendent may institute delinquency proceedings against the insurer pursuant to chapter 57 . [PL 1969, c. 132, §1 (NEW); PL 1973, c. 585, §12 (AMD).]

4. This section shall not be deemed to prohibit or prevent an insurer from: A. Establishing and maintaining regional home offices or branch offices in other states or countries where necessary or convenient to the transaction of its business, and keeping therein the detailed records and assets customary and necessary for the servicing of its insurance in force and affairs in the territory served by such an office, as long as such records and assets are made readily available at such office for examination by the superintendent at the superintendent's request; [RR 2021, c. 1, Pt. B, §271 (COR).] B. Having, depositing or transmitting funds and assets of the insurer in or to jurisdictions outside of this State required by the law of such jurisdiction or as reasonably and customarily required or convenient in the regular course of its business. [PL 1969, c. 132, §1 (NEW).] [RR 2021, c. 1, Pt. B, §271 (COR).]
24-A M.R.S. § 2420 — ME Code / Title 24-A / Chapter 27 / Section 2420
24-A §2420. Assignability; rights of insurer, assignee
Status: in_force

1. A policy may be assignable or not assignable, as provided or permitted by its terms. [PL 1969, c. 132, §1 (NEW).]

2. Subject to its terms relating to assignability, a life or health insurance policy, whether heretofore or hereafter issued, under the terms of which the beneficiary may be changed upon the sole request of the insured or owner, may be assigned either by pledge or transfer of title, by an assignment executed by the insured or owner alone and delivered to the insurer, whether or not the pledgee or assignee is the insurer. [PL 1969, c. 132, §1 (NEW).]

3. Any assignment of a policy which is otherwise lawful and of which the insurer has received notice, shall entitle the insurer to deal with the assignee as the owner or pledgee of the policy in accordance with the terms of the assignment, until the insurer has received at its home office written notice of termination of the assignment or pledge, or written notice by or on behalf of some other person claiming some interest in the policy in conflict with the assignment. [PL 1969, c. 132, §1 (NEW).]

3-A. Upon receiving notice of a revocation of an assignment of a life insurance policy pursuant to this section, an insurer shall notify the assignee of the policy that the insured or owner has revoked the assignment. The insurer shall also notify the assignee if any cash value of the policy has been distributed at the time of revocation. Notice must be sent to the assignee within 30 days. An insurer is deemed to have complied with this subsection if that insurer has mailed notice by first class mail to the last known mailing address of the assignee. [PL 2003, c. 109, §1 (NEW).]

4. Any individual insured under a group insurance policy or group annuity contract has the right, unless expressly prohibited under the terms of the policy or contract, to assign to any other person the individual's rights and benefits under the policy or contract, including, but not limited to, the right to designate the beneficiary or beneficiaries and the rights as to conversion provided for in sections 2621 to 2625 , and, subject to the terms of the policy relating to assignments thereunder, any such assignment, made either before or after January 2, 1970, is valid for the purpose of vesting in the assignee all such rights and benefits so assigned. While the assignment is in effect, and whether heretofore or hereafter made, the insurer is entitled to deal with the assignee as the owner of such rights and benefits in accordance with the terms of the assignment; but without prejudice to the insurer on account of any lawful action taken or payment made by it prior to receipt by it at its home office of written notice of the assignment or of the termination thereof. [RR 2021, c. 1, Pt. B, §216 (COR).]
24-A M.R.S. § 2904 — ME Code / Title 24-A / Chapter 39 / Section 2904
24-A §2904. Judgment creditor may have insurance; exceptions
Status: in_force

Whenever any person, including an administrator, executor or guardian, recovers a final judgment against any other person for any loss or damage specified in section 2903 , the judgment creditor is entitled to have the insurance money applied to the satisfaction of the judgment by bringing a civil action, in the judgment creditor's own name, against the insurer to reach and apply the insurance money, if when the right of action accrued, the judgment debtor was insured against such liability and if before the recovery of the judgment the insurer had had notice of such accident, injury or damage. The insurer has the right to invoke the defenses described in this section in the proceedings. The provisions of this paragraph and section 2903 do not apply: [PL 2023, c. 405, Pt. A, §90 (AMD).]

1. Motor vehicle operated illegally or by one under age. When the insured automobile, motor vehicle or truck is being operated by any person contrary to law as to age or by any person under the age of 16 years where no statute restricts the age; or [PL 1969, c. 132, §1 (NEW).]

2. Motor vehicle used in race contest. When such automobile, motor vehicle or trust is being used in any race or speed contest; or [PL 1969, c. 132, §1 (NEW).]

3. Motor vehicle used for towing a trailer. When such automobile, motor vehicle or truck is being used for towing or propelling a trailer unless such privilege is indorsed on the policy or such trailer is also insured by the insurer; or [PL 1969, c. 132, §1 (NEW).]

4. Liability assumed. In the case of any liability assumed by the insured for others; or [PL 1969, c. 132, §1 (NEW).]

5. Liability under workers' compensation. In the case of any liability under any workers' compensation agreement, plan or law; or [PL 1989, c. 502, Pt. A, §98 (AMD).]

6. Fraud or collusion. When there is fraud or collusion between the judgment creditor and the insured. [PL 1969, c. 132, §1 (NEW).]

No civil action shall be brought against an insurer to reach and apply such insurance money until 20 days shall have elapsed from the time of the rendition of the final judgment against the judgment debtors. [PL 1969, c. 132, §1 (NEW).]
24-A M.R.S. § 1106 — ME Code / Title 24-A / Chapter 13 / Section 1106
24-A §1106. Diversification; property, casualty and other nonlife insurers
Status: in_force

The investments of an insurer are subject to the following diversification requirements and limitations. [PL 1993, c. 313, §21 (AMD).]

1. Not less than 30% of the insurer's assets in aggregate amount may consist of cash funds, agents' balances less than 90 days past due and investments eligible under the following sections: A. 1107 (public obligations); [PL 1969, c. 132, §1 (NEW).] B. 1108 (obligations, stock of certain federal and international agencies); [PL 1969, c. 132, §1 (NEW).] C. 1109 (investment grade corporate obligations); [PL 1989, c. 846, Pt. B, §3 (AMD); PL 1989, c. 846, Pt. E, §4 (AFF).] D. 1112 (preferred or guaranteed stocks); [PL 1969, c. 132, §1 (NEW).] E. 1116 (trustees' or receivers' obligations); [PL 1969, c. 132, §1 (NEW).] F. 1117 (equipment trust certificates); [PL 1969, c. 132, §1 (NEW).] G. 1118 (acceptances, bills of exchange); [PL 1969, c. 132, §1 (NEW).] H. 1119 (savings and loan institutions); [PL 1969, c. 177, §21 (AMD).] I. 1120 (common trust funds, mutual funds); [PL 1969, c. 132, §1 (NEW).] J. 1124 (mortgage loans); and [PL 1969, c. 132, §1 (NEW).] K. 1126 (housing developments). [PL 1969, c. 132, §1 (NEW).] [PL 1993, c. 313, §21 (AMD).]

2. The insurer may not invest in aggregate amount in excess of its surplus as to policyholders in all investments eligible under the following sections: A. 1113 (common stocks); [PL 1969, c. 132, §1 (NEW).] B. 1114 (insurance stocks); [PL 1969, c. 132, §1 (NEW).] C. 1115 (stocks of subsidiaries); and [PL 1993, c. 313, §21 (AMD).] D. 1120, subsection 2 (mutual funds). [PL 1993, c. 313, §21 (AMD).] E. [PL 1993, c. 313, §21 (RP).] [PL 1993, c. 313, §21 (AMD).]

3. The insurer may not invest in aggregate amount over 20% of its assets in all investments in real estate eligible under sections 1125 (real estate) and 1127 (leased property). [PL 1993, c. 313, §21 (AMD).]

4. Except as otherwise expressly provided, an insurer may not invest more than 10% of its assets in the securities of any one person, other than investments eligible under the following sections: A. 1107 (public obligations); [PL 2001, c. 524, §2 (AMD).] B. 1108 (obligations, stock of certain federal and international agencies); [PL 2023, c. 59, §2 (AMD).] C. 1120 (common trust funds, mutual funds), but as to this exception, only with the prior approval of the superintendent and only in index mutual funds in an amount up to 20% of the insurer's assets; and [PL 2023, c. 59, §2 (AMD).] D. 1115 (stocks of subsidiaries), but only with the prior approval of the superintendent unless, with respect to investments in subsidiaries engaged in or organized to engage in the kinds of business in which the insurer may engage, the investments would not result in the aggregate net cost of the insurer's investments in all such subsidiaries exceeding 50% of its surplus as to policyholders. For the purposes of this paragraph, "net cost of the insurer's investment" means the sum of the total money or other consideration expended and obligations assumed in the acquisition or formation of a subsidiary, including all organizational expenses and contributions to capital and surplus of that subsidiary, and all amounts expended in acquiring additional common stock, preferred stock, debt obligations and other securities, and all contributions to the capital or surplus, of a subsidiary subsequent to its acquisition or formation less any returns of capital, repayments of principal and any other payments that reduce the insurer's investment in the subsidiary. [PL 2023, c. 59, §2 (NEW).] [PL 2023, c. 59, §2 (AMD).]

5. The insurer's investments in common stock, preferred stock, debt obligations and other securities of subsidiaries other than insurance subsidiaries are limited to the lesser of 10% of the insurer's admitted assets or 50% of the insurer's surplus as to policyholders except in instances when a greater investment has been approved by the superintendent. [PL 1993, c. 313, §21 (NEW).]

6. The assets of an insurer may be invested in obligations issued, assumed, guaranteed or accepted by domestic institutions, or trustees or receivers of those institutions and preferred shares of any of those institutions, except that, without the prior approval of the superintendent, a domestic insurer may not acquire any high-yield or medium grade obligations of any institution if: A. The aggregate amount of all medium grade obligations and all high-yield obligations then held by the insurer exceeds the lesser of 20% of its admitted assets or its surplus as to policyholders; [PL 1993, c. 313, §21 (NEW).] B. The aggregate amount of all high-yield obligations then held by the insurer exceeds 10% of its admitted assets; [PL 1993, c. 313, §21 (NEW).] C. The aggregate amount of all high-yield obligations rated 5 or 6 by the Securities Valuation Office of the National Association of Insurance Commissioners or, if not rated by the National Association of Insurance Commissioners, rated at the equivalent of 5 or 6 by Moody's Investors Service, Inc., Standard and Poor's Corporation, Fitch Investors Service, Inc. or Duff and Phelps, Inc. exceeds 3% of admitted assets; [PL 1993, c. 313, §21 (NEW).] D. The aggregate amount of all high-yield obligations rated 6 by the Securities Valuation Office of the National Association of Insurance Commissioners or, if not rated by the National Association of Insurance Commissioners, rated the equivalent of 6 by Moody's Investors Service, Inc., Standard and Poor's Corporation, Fitch Investors Service, Inc. or Duff and Phelps, Inc., exceeds 1% of admitted assets; [PL 1993, c. 313, §21 (NEW).] E. The aggregate amount of medium grade obligations issued, guaranteed or insured by any one institution then held by the insurer exceeds 1% of its admitted assets; or [PL 1993, c. 680, Pt. C, §3 (AMD).] F. The aggregate amount of high-yield obligations issued, guaranteed, or insured by any one institution then held by the insurer would exceed 1/2 of 1% of its admitted assets. [PL 1993, c. 313, §21 (NEW).] [PL 1993, c. 680, Pt. C, §3 (AMD).]
24-A M.R.S. § 2395 — ME Code / Title 24-A / Chapter 26 / Section 2395
24-A §2395. Revisions to residual market mechanism plan of operation
Status: in_force

1. Plan manager. The board shall appoint a plan manager who reports to and serves at the pleasure, direction and control of the board. The board has the exclusive right to retain any individual or organization as plan manager and to terminate the plan manager. The board is exclusively responsible for establishing the terms and conditions, including compensation, under which the plan manager serves. [PL 1995, c. 289, §11 (NEW).]

2. Appointment of employer representatives. The 5 members of the board of governors serving as representatives of the business community of the State are appointed by the Governor for staggered 3-year terms, with at least one member appointed each year. All members whose terms have not expired on or before July 3, 1995 continue on the board until their terms expire. [PL 1995, c. 289, §11 (NEW).]

3. Staff and consultants. The board may employ, or otherwise retain, staff and consultants as the board considers necessary or appropriate to effect the purposes of this chapter and chapter 440 and to otherwise administer pool operations. The board or its designee is exclusively responsible for establishing the responsibilities and compensation of all staff employed by the pool and are exclusively responsible for establishing the terms and conditions, including compensation, of all consultants retained by the pool. [PL 1995, c. 289, §11 (NEW).]

4. Transfer of policies. An insurer may transfer any rights, obligations and liabilities of a workers' compensation insurance policy issued pursuant to the residual market mechanism. [PL 1995, c. 289, §11 (NEW).]

5. Authority to borrow money. The pool may, when directed by the board, borrow money and enter into financing transactions in the name of and on behalf of the pool and issue evidences of indebtedness in connection with those transactions. To secure the payment of any indebtedness incurred pursuant to this subsection, the pool may pledge and create a lien upon any or all of its receivables or revenues or grant such other security interests in its property as the board determines reasonable and proper for the security of the holders of indebtedness. The terms and conditions of any borrowing, including, but not limited to, dates, maturities, interest and rates, must be established by the board. [PL 1995, c. 289, §11 (NEW).]

6. Report required. Beginning in 1996, the board shall file an annual report on or before June 1st to the Governor, the superintendent, the President of the Senate and the Speaker of the House of Representatives and the joint standing committee of the Legislature having jurisdiction over banking and insurance matters. The report must identify the following information: A. The pool's most recent audited financial statements; [PL 1995, c. 400, §1 (NEW).] B. The total claims payments made by the pool in the preceding 12 months; [PL 1995, c. 400, §1 (NEW).] C. The most recent actuarial report, including cash flow and deficit projections for the pool; [PL 1995, c. 400, §1 (NEW).] D. A report of changes to the operations of the pool; [PL 1995, c. 400, §1 (NEW).] E. A summary of the number of open claims and aggregate reserves for each policy year; and [PL 1995, c. 400, §1 (NEW).] F. Any information required to be maintained by the pool pursuant to section 2393, subsection 2, paragraph E and section 2394, subsection 1 . [PL 1995, c. 400, §1 (NEW).] [PL 1995, c. 400, §1 (NEW).]
24-A M.R.S. § 2267 — ME Code / Title 24-A / Chapter 24-B / Section 2267
24-A §2267. Power of superintendent
Status: in_force

1. Investigate. The superintendent may examine and investigate the affairs of any licensee to determine whether the licensee has been or is engaged in any conduct in violation of this chapter. This power is in addition to the powers the superintendent has under sections 220 and 221 . Any such examination or investigation must be conducted pursuant to those sections. [PL 2021, c. 24, §1 (NEW).]

2. Enforcement. Whenever the superintendent has reason to believe that a licensee has been or is engaged in conduct in this State that violates this chapter, the superintendent may take action that is necessary or appropriate to enforce the provisions of this chapter. [PL 2021, c. 24, §1 (NEW).]
24-A M.R.S. § 5001-A — ME Code / Title 24-A / Chapter 67 / Section 5001-A
24-A §5001-A. Applicability and scope
Status: in_force

1. Application. Except as otherwise specifically provided in section 5013 , this chapter applies to: A. All Medicare supplement policies delivered or issued for delivery in this State on or after the effective date of this section; and [PL 1991, c. 740, §2 (NEW).] B. All certificates issued under group Medicare supplement policies, which certificates have been delivered or issued for delivery in this State. [PL 1991, c. 740, §2 (NEW).] [PL 1995, c. 332, Pt. E, §2 (AMD).]

2. Employers or labor organizations. This chapter does not apply to a policy of one or more employers or labor organizations, or of the trustees of a fund established by one or more employers or labor organizations, or combination thereof, for employees or former employees or a combination thereof, or for members or former members, or a combination thereof, of the labor organizations. [PL 1991, c. 740, §2 (NEW).]

3. Plans not marketed as Medicare supplements. Except as otherwise provided in section 5005, subsection 3‑A , the provisions of this chapter are not intended to prohibit or apply to insurance policies or health care benefit plans, including group conversion policies, provided to Medicare eligible persons that are not marketed or held to be Medicare supplement policies or benefit plans. [PL 1995, c. 332, Pt. E, §2 (AMD).]