Maine Legislature, Session 121, LD 0905
Committee Amendment CA_A_S57 (Senate)
Amends: 24 MRSA §2317-B, 24-A MRSA §2809-A, 24-A MRSA §4209

COMMITTEE AMENDMENT "A" to s . P . 
301, L. D • 
Act To Protect Employees if Their Employer Fails 
for Employer-sponsored Health Insurance" 
5 , Bill, " An 
To Pay Premiums 
Amend the bill by striking out everything after the enacting 
clause and before the summary and inserting in its place the 
following: 
I Sec. 1. 24 MRSA §2317-B, sub-§15-A is enacted to read: 
15-A. 
Tit1e 24-A. sectioD 28Q9-A, subsectioDs 1-A and 1-B. 
Notice of cancellation and availability of individual coverage, 
Title 24-A, section 2809-A, subsections I-A and l-Bi 
Sec. 2. 24-A MRSA §2809-A, sub-§I-A, tB, 
as 
repealed and 
replaced by PL 1995, c. 625, Pt. A, §25, is repealed. 
Sec. 3. 24-A MRSA §2809-A, sub-§I-A, 'B-1 is enacted to read: 
B-1. 
At the time of notification under paragraph A, notice 
must be mailed to the certificate holder at the last address 
provided by the subgroup sponsor or the group policyholder 
to the insurer unless the insurer does not have an address 
on file for the certificate holder. 
The notice must also 
include information to the certificate holder 
about the 
availability 
of 
individual 
coverage 
as 
described 
in 
subsection I-B. 
Sec. 4. 24-A MRSA §2809-A, sub-§I-B, as enacted by PL 1997, c. 
604, Pt. B, §3, is amended to read: 
Page l-LR1598(2) 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT .. A 
.. to S.P. 301, L.D. 905 
I-B. 
Rotification of availability of individual coverage. 
An 
insurer 
must 
provide 
forms 
to 
group 
policyholders 
and 
certificate holders as required in subsection I-A for the purpose 
of informing terminating group members of their right to purchase 
any individual health plan available in this State. 
An adequate 
supply of forms must be provided to each group policyholder when 
the policy is issued and at least annually thereafter. 
The 
superintendent may prescribe the content of the form by routine 
technical rule pursuant to Title 5, chapter 375, subchapter ±±-A 
2-A. 
The form must include at least the following: 
A. 
A statement that all state residents not eligible for 
Medicare have a right to purchase any individual health plan 
available in this State; 
B. 
A statement that in order to avoid a gap in coverage, 
the individual should apply for individual coverage prior to 
termination of group coverage; 
C. A statement that if more than 90 days pass between the 
time 
the 
group 
coverage 
ends 
and 
the 
time 
individual 
coverage 
begins, 
the 
indi vidual 
coverage 
may 
exclude 
preexisting conditions for one year; and 
D. 
A 
statement 
that 
information 
concerning 
individual 
coverage is available from the Bureau of Insurance. 
The 
bureau's toll-free telephone number must also be provided. 
Sec. 5. 24-A MRSA §4209, sub-§6, as enacted by PL 1995, c. 
189, §3 and affected by §4, is amended to read: 
6. 
Rotification of cancellation. 
A health maintenance 
organization must provide by first class mail at least 10 days' 
prior notification of cancellation for nonpayment of enrollment 
charges according to this section. 
The notice must include the 
date 
of 
cancellation of 
coverage 
and 
the 
time 
period 
for 
exercising 
contract 
conversion 
rights. 
Notification 
is 
not 
required when the insurer has received written notice from the 
group contract holder that replacement coverage has been obtained. 
A. 
Notice must be mailed to the group contract holder or 
subgroup sponsor. 
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COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT "it" to S.P. 301, L.D. 905 
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B-1. 
At the time of notification under paragraph A, notice 
must 
be 
mailed to 
the 
individual enrollee at the last 
address provided by the subgroup sponsor or group contract 
holder to the health maintenance organization unless the 
health maintenance organization does not have an address on 
file for the individual enrollee. 
The notice must also 
include information to the individual enrollee about the 
availability of individual coverage as described in section 
2809-A. subsection I-B. 
C. 
Notice must be mailed to the Bureau of Insurance aRQ-~e 
~Re-8aFeaa-ef-~aaeF-S~aRQaFQs. ' 
SUMMARY 
This amendment replaces the bill. The amendment makes the 
provisions applicable to nonprofit hospital and medical service 
organizations, 
nonprofit health plans 
and health maintenance 
organizations as well as insurers. 
The 
amendment retains the 
requirement that employees who are certificate holders under a 
group health insurance policy be notified directly at least 10 
days prior to cancellation of their group coverage but clarifies 
that 
the 
notice 
is 
only 
required if the 
insurer 
has 
the 
employee's address on file. 
COMMITTEE AMENDMENT