An Act To Provide Continued Access to Health Insurance for Small Business Employees
Maine Legislature, Session 121, LD 1043
Committee: Insurance and Financial Services
Sponsors: BREAULT, MAYO, CANAVAN, DUPLESSIE, O'NEIL, PERRY, WOODBURY, YOUNG, LaFOUNTAIN
Amends: 24-A MRSA §2809, 24-A MRSA §4222-B

12lst MAINE LEGISLATURE 
Legislative Document 
No. 1043 
H.P.760 
House of Representatives, February 26,2003 
An Act To Provide Continued Access to Health Insurance for Small 
Business Employees 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed. 
Presented by Representative BREAULT of Buxton. 
Cosponsored by Senator MAYO of Sagadahoc and 
!r/~ 
frJ.11!dC~ 
MILLICENT M. MacFARLAND 
Clerk 
Representatives: CANAVAN of Waterville, DUPLESSIE of Westbrook, O'NEIL of Saco, 
PERRY of Calais, PERRY of Bangor, WOODBURY of Yarmouth, YOUNG of Limestone, 
Senator: LaFOUNTAIN of York. 
Prinled on fe(,;ycled paper 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 24-A MRSA §2809.A, sub-§II-A is enacted to read: 
ll-A. 
Continued group coverage; groups with fewer than 20 
employees. 
Notwithstanding any other provision of this section, 
upon the termination of coverage for a member or employee covered 
under a group policy with 20 or fewer members or employees, the 
insurer shall allow the member or employee to elect, within the 
time period prescribed by paragraph B, to continue coverage under 
the aroup policy at no higher level than the level of benefits or 
coverage received by the member or employee immediately before 
.termination of coverage and at the member's or employee's expense 
or, at the member's or employee's option, to convert to a policy 
of 
individual 
coverage 
without 
evidence 
of 
insurability 
in 
accordance with this section. 
A. 
For 
the 
purposes 
of 
this 
subsection, 
"member 
or 
employee" includes only those persons who have been a member 
or employee for at least 6 months. 
B. 
The member or employee has 31 days from the termination 
of coverage in which to elect continued coverage and make 
the initial payment under this subsection. 
c. 
An insurer is not reguired to continue coverage under a 
group policy if the member or employee meets the conditions 
set out in subsection 3, paragraph A. 
D. 
The payment amount fQr continyeg group coverage under 
this §ubsection may not exceed 102% Qf the group rate 
ll1 
effect 
for 
a 
group 
memQgr, 
including 
an 
employer s 
contriQytiQn, if any. 
E. 
At the option Qf the member or employgg, the continued 
group covgrage may cover the member or employee, the member 
or employee and any depgndgnt§ or Qnly the depgndents of the 
member Qr gmplQyge; provided that. in the latter 2 cases, 
the dependents have been covered for a pgriQg of at least 3 
months under the group policy, unless the dependents were 
not eligible for coverage until after the Qeginning of the 
3-month pgriod. 
f. 
Excgpt as provided in paragraph G, 
coverage provided 
under this subsection cQntinygs for 18 months. 
G. 
Coverage 
provided 
undgr 
thi§ 
sUQsection 
may 
be 
terminatgg sooner than providgg ynggr paragraph F if: 
(1) The mgmber or emplQyeg fails to make timely payment 
Qf a reguired premium amQynt; or 
Page l-LRI604(1) 
(2) 
The 
member 
or 
employee 
becomes 
eligible 
for 
coverage under another group policy. 
H. 
At 
the 
expiration of 
any 
continued 
group 
coverage 
obtained under this subsection, the member or employee has 
the same conversion privileges as otherwise granted under 
this section. 
I. 
This subsection may not be construed to: 
J. 
(1) Prevent members or employees from negotiating for 
or 
receivinQ 
greater 
c9ntinued 
coverage 
of 
group 
insurance than is provided in this subsection; 
(2) 
Require 
coverage 
beyond 
the 
time limit set in 
paragraph Fj or 
( 3) Permit a member or employee to increase the level 
of benefits or coverage that the member or employee 
received 
immediately before 
the 
termination 
of 
the 
employee's coverage. 
This 
SU&ls~ction does not apply tQ 
any group policy 
subje!;;t to the United St,at,gs CQnQQlidateg Omnibus Budget 
Reconciliation Act, 
Publi!;; 
Law 
92-272 , 
Title 
X , 
Private 
Health Insurance Coverage, Sections 10QOl to 10Q03. 
Sec. 2. 24-A MRSA §4222-B, sub-§l8, as enacted by PL 200L c. 
410, Pt. B, §3, is amended to read: 
18. 
The 
FeEIy.iFemeBto 
requirements 
of 
section 
2809-A, 
sy.BseetoieB subsections 11 and ll-A to continue group coverage 
under certain circumstances applies ~ 
to health maintenance 
organizations. 
SUMMARY 
This bill gives 
employees 
whose 
coverage 
under 
a 
group 
policy is terminated the right to maintain coverage under that 
group policy at the employee's expense for 18 months. 
The bill 
applies to group policies covering fewer than 20 employees.