An Act To Protect Employees if Their Employer Fails To Pay Premiums for Employer-sponsored Health Insurance
Maine Legislature, Session 121, LD 0905
Committee: Insurance and Financial Services
Sponsors: STANLEY, CLARK, HATCH, CLOUGH, DUNLAP
Amends: 24-A MRSA §2809-A

Legislative Document 
No. 905 
S.P.301 
In Senate, February 20, 2003 
An Act To Protect Employees if Their Employer Fails To Pay 
Premiums for Employer-sponsored Health Insurance 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed. 
Presented by Senator STANLEY of Penobscot. 
Cosponsored by Representative CLARK of Millinocket and 
JOY J. O'BRIEN 
Secretary of the Senate 
Senator: HATCH of Somerset, Representatives: CLOUGH of Scarborough, DUNLAP of Old 
Town. 
Printed on recycled papt:r 
Be it enacted by the People of the State of Maine as follows: 
Sec. I. 24-A MRSA §2809-A, sub-§I-A, ,B, as 
repealed 
and 
replaced by PL 1995, c. 625, Pt. A, §25, is repealed. 
Sec. 2. 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. The notice must also include information to 
the certificate holder about the availability of individual 
coverage as described in subsection I-B. 
Sec. 3. 24-A MRSA §2809-A, sub-§I-B, as enacted by PL 1997, c. 
604, Pt. B, §3, is amended to read: 
I-B. 
Notification of availability of individual coverage. 
An 
insurer 
must 
provide 
forms 
to 
group 
policyholders 
QP~ 
certificate holders as reguired 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 II-A 
2-A. 
The form must include at least the following: 
A. 
A statement that 0.11 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 
individual 
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. 
SUMMARY 
This bill requires insurers to notify employees 
who 
are 
certificate 
holders 
under 
a 
group 
health 
insurance 
policy 
directly prior to cancellation of their group coverage. 
Under 
current law, 
insurers have the option of notifying either the 
certificate holders or the office of the group policyholder. 
The 
bill also requires that the notice include information on the 
availability of individual coverage after the group policy is 
cancelled.