An Act Concerning Universal Health Insurance
Maine Legislature, Session 121, LD 1239
Committee: Insurance and Financial Services
Sponsors: O'NEIL, LaFOUNTAIN, COLWELL, DUPLESSIE, RICHARDSON, DAGGETT, GAGNON, MA YO, TREAT

12lst MAINE LEGISLATURE 
Legislative Document 
No. 1239 
H.P.913 
. House of Representatives, March 6, 2003 
An Act Concerning Universal Health Insurance 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed. 
Presented by Representative O'NEIL of Saco. 
Cosponsored by Senator LaFOUNTAIN of York and 
'7rJ~'frl.~ 
MILLICENT M. MacFARLAND 
Clerk 
Representatives: Speaker COLWELL of Gardiner, DUPLESSIE of Westbrook, 
RICHARDSON of Brunswick, Senators: President DAGGETT of Kennebec, GAGNON of 
Kennebec, MA YO of Sagadahoc, TREAT of Kennebec. 
Printed on recycled paper 
Be it enacted by the People of the State of Maine as follows: 
PART A 
Sec. A·I. 24·A MRSA §2736·C, sub·§8·A is enacted to read: 
8-A. 
Primary bealth care policy. 
All carriers offering 
individual health plans in this State shall offer 
a 
primary 
health care policy, 
referred to 
in this subsection as 
"the 
policy." 
The superintendent shall adopt rules that define the 
benefit design for the policy in accordance with the following. 
A. The policy must provide coverage that emphasizes primary 
and 
preventive 
care, 
including, 
but 
not 
limited 
to, 
well-adult and well-child visits and health screenings. 
B. The annual maximum limit payable on the policy must be 
determined as follows: 
(1) 
For an individual whose income is between 100% and 
200% 
of the federal 
nonfarm 
income 
federal 
poverty 
leveL the annual maximum limit payable on the policy 
is $2,000 per individual covered under the policy; 
(2) 
For an individual whose income is between 200% and 
300% 
of the federal 
nonfarm 
income 
federal 
poverty 
level, the annual maximum limit payable on the policy 
is $5,000 per individual covered under the policy; 
(3) 
For an individual whose income is between 300% and 
400% 
of the federal 
nonfarm 
income 
federal 
poverty 
level, the annual maximum limit payable on the policy 
is $10,000 per individual covered under the policy; and 
(4) 
For an individual whose income is above 400°" of 
the federal nonfarm income federal poverty level, the 
annual maximum limit payable on the policy is $20,000 
per individual covered under the policy. 
c. 
The 
policy must 
meet 
the 
reguirements 
for 
mandated 
benefits under this Title applicable to individual health 
plans. 
D. 
Notwithstanding subsection 2, paragraph D, a carrier may 
offer an additional discount of up to 
20'1-0 of the premium 
rate for the policy based on an individual's weight or 
adherence to a recommended schedule for regular physicals. 
With respect to weight and regular physicals, the discount 
must 
be 
based 
on 
the 
individual's 
compliance 
with 
the 
Page l-LR0186(1) 
Centers for Disease Control and Prevention guidelines in 
effect on the year of issuance or renewal of the policy. 
E. 
If 
approved 
by 
the 
superintendent, 
the 
policy 
may 
include provisions with financial incentives encouraging a 
policyholder to receive health care services at a center of 
excellence or other high quality provider designated by the 
carrier based on objective quality indicators. 
Rules adopted pursuant to this subsection are routine technical 
rules as defined in Title 5, chapter 375, subchapter 2-A. 
Sec. A-2. 24-A MRS A §2808-B, sub-§8-A is enacted to read: 
8-A. 
Prima~ health care policy. 
All carriers offering 
small group health plans in this State shall offer a primary 
heal th care policy, 
referred to 
in this 
subsection as 
"the 
policy". 
The superintendent shall adopt rules that define the 
benefit design for the policy in accordance with the following. 
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A. The policy must provide coverage that emphasizes primary 
and 
preventive 
care, 
inCluding, 
but 
not 
limited 
to, 
well-adult and well-child visits and health screenings. 
B. 
The 
annual 
maximum 
limit payable 
on 
the policy per 
member covered under the small group health plan, including 
dependents, must be determined as follows: 
(l) 
For a member whose income is between 100% and 200% 
of the federal nonfarm income federal poverty level, 
the 
annual 
maximum 
limit payable 
on 
the 
policy is 
$2,000 per member covered under the policy; 
(2) 
For a member whose income is between 200% and 300% 
of the federal nonfarm income federal poverty level, 
the 
annual 
maximum 
limit payable 
on 
the 
policy is 
$5,000 per member covered under the policy; 
(3) 
For a member whose income is between 300% and 400% 
of the federal nonfarm income federal poverty level, 
the 
annual 
maximum 
limit payable on the policy 
~s 
$10,000 per member covered under the policy; and 
(4) 
For a member whose income is above 400% of the 
federal 
nonfarm 
income 
federal 
poverty 
level, 
the 
annual maximum limit payable on the policy is $25,000 
per member covered under the policy. 
C. 
The 
policy must 
meet 
the 
requirements 
for 
mandated 
benefits under this Title applicable to small group health 
plans. 
D. 
Notwithstanding subsection 2. paragraph D. a carrier may 
offer an additional discount of up to 20 0b of the premium 
rate for 
the policy based on an individual's weight or 
adherence to a recommended schedule for regular physicals. 
With respect to weight and regular physicals, the discount 
must 
be 
based 
on 
the 
individual's 
compliance 
with 
the 
Centers for Disease Control 
and Prevention guidelines in 
effect on the year of issuance or renewal of the policy. 
E. 
If 
approved 
by 
the 
superintendent, 
the 
policy 
may 
include provisions with financial incentives encouraging a 
policyholder to receive health care services at a center of 
excellence or other high-quality provider designated by the 
carrier based on objective quality indicators. 
Rules adopted pursuant to this subsection are routine technical 
rules as defined in Title 5, chapter 375, subchapter 2-A. 
Sec. A·3. 24·A MRSA §4315 is enacted to read: 
§4315. 
Primary health care policy 
1. 
Mandatory offer. 
A carrier offering a health plan in 
this State shall offer and actively market a primary health care 
policy, 
referred 
to 
in 
this 
section 
as 
"the 
policy," 
to 
individuals and groups regardless of size. 
The superintendent 
shall adopt rules that define the benefit design for the policy 
in accordance with the following. 
A. The policy must provide coverage that emphasizes primary 
and 
preventive 
care, 
including, 
but 
not 
limited 
to, 
well-adult and well-child visits and health screenings. 
B. 
The 
annual 
maximum limit payable 
on 
the policy per 
individual 
covered 
under 
the 
health 
plan, 
including 
dependents, must be determined as follows: 
(1) 
For an individual whose income is between 100% and 
200% 
of 
the 
federal 
nonfarm 
income 
federal 
poverty 
level, the annual maximum limit payable on the policy 
is $2,000 per individual covered under the policy; 
(2) 
For an individual whose income is between 200% and 
300% 
of the federal 
nonfarm 
income 
federal poverty 
level, the annual maximum limit payable on the policy 
is $5,000 per individual covered under the policy; 
l4 
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(3) 
For an individual whose income is between 300% and 
400% 
of 
the 
federal 
nonfarm income 
federal 
poverty 
level, the annual maximum limit payable on the policy 
is $10,000 per individual covered under the policy; and 
(4) 
For an individual whose income is above 400°", of 
the federal nonfarm income federal poverty level, the 
annual maximum limit payable on the policy is $20,000 
per individual covered under the policy. 
C. 
The 
policy must 
meet 
the 
requirements 
for 
mandated 
benefits under this Title applicable to the policyholder. 
D. 
A carrier may offer an additional discount of up to 20% 
of the premium rate for the policy based on an individual's 
weight or adherence to a 
recommended schedule for regular 
physicals. With respect to weight and regular physicals, the 
discount must be based on the individual's compliance with 
the Centers for Disease Control and Prevention guidelines in 
effect on the year of issuance or renewal of the policy. 
E. 
If 
approved 
by 
the 
superintendent, 
the 
policy 
may 
include provisions with financial incentives encouraging a 
policyholder to receive health care services at a center of 
excellence or other high-quality provider designated by the 
carrier based on objective quality indicators. 
Notwithstanding section 4309, 
rules 
adopted pursuant to this 
section are 
routine technical rules 
as 
defined in Title 
5, 
chapter 375, subchapter 2-A. 
Sec. A-4. 24-A MRSA c. 55-A is enacted to read: 
CHAPTER 55-A 
MAINE UNIVERSAL HEALTH CARE COVERAGE ACT 
§4l6l. 
Short title 
This chapter may be known and cited as "the Maine Universal 
'12 
Heal th Care Coverage Act. " 
'14 
§4l62. 
Definitions 
1b 
As 
used 
in this 
chapter, 
unless 
the 
context 
otherwise 
indicates, the following terms have the following meanings. 
1. 
Agency. 
"Agency" means the Maine Universal Health Care 
')0 
Agency established in section 4164. 
2. 
Carrier. 
"Carrier" has the same meaning as in section 
4301, subsection 1. 
3. 
Enrollee. 
"Enrollee" means 
a person enrolled in the 
4. 
Fund. 
"Fund" means the Maine Universal Health Care Fund. 
LO 
5. 
Plan. 
"Plan" means the Maine Universal Health Care Plan. 
6. 
Provider. 
"Provider" means 
any person, organization, 
corporation or association that provides health care services and 
products and is authorized to provide those services and products 
under the laws of this State. 
7. 
Resident. 
"Resident" means a person who resides within 
the State. 
§4163. 
Maine Universal Health Care Plan established 
The 
Maine 
Universal Health Care 
Plan is established to 
provide universal access to high-quality, affordable health care 
for the people of this State. 
The plan must offer health care 
coverage 
beginning 
January 
1, 
2004 
and 
be 
administered 
and 
overseen by the 
agency in accordance with this chapter that 
includes the purchase of reinsurance or stop loss coverage from a 
reinsurer licensed to do business in this State. 
The plan may be 
administered through 
a 
self-insured arrangement or 
through 
a 
contract with a carrier licensed to do business in this State. 
1. Eligibility. 
Residents of the State are eligible to 
receive covered health care services under the plan in accordance 
with the requirements of this section. The agency shall adopt 
rules 
regarding 
certification 
of 
eligibility 
for 
the 
plan, 
application for a plan card and membership in the plan. 
The 
rules must provide for at least the following. 
A. 
Each resident of the State is eligible and may become an 
enrollee if the 
agency certifies that the 
resident has 
provided evidence of coverage under a primary health care 
policy offered pursuant to section 2736-C, subsection 8-A, 
section 2808-B, subsection 8-A and section 4315 and approved 
by the superintendent or under a medical savings account 
established pursuant to federal or state law. 
B. 
Eligibility may 
extend to 
an enrollee's 
spouse 
and 
dependents if the 
evidence of 
coverage 
under 
a 
primary 
health care policy demonstrates coverage for the enrollee's 
spouse and dependents. 
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c. 
Eligibility may not be extended to an enrollee unless 
the evidence of coverage demonstrates that the enrollee has 
had coverage under a primary health care policy or other 
approved health insurance policy within 180 days before the 
date the enrollee applies for eligibility under the plan. 
2. 
Plan benefits. 
As provided in this subsection, the plan 
must provide coverage to enrollees through one standard benefit 
plan. 
Benefits 
for 
covered health care services 
may 
not be 
provided to 
an enrollee until the enrollee has 
reached the 
maximum amount payable for coverage under that enrollee's primary 
health 
care 
policy. 
Covered 
health 
care 
services 
must 
be 
provided if those services are medically necessary or appropriate 
for the prevention, diagnosis or treatment of, or maintenance or 
rehabilitation following, injury, disability or disease. 
Covered 
heal th care must include all services and providers for which 
coverage is mandated under this Title. 
After consultation with 
the bureau, the agency shall adopt rules regarding the standard 
benefi t design for the plan. This subsection does not preclude 
supplementary 
benefit 
insurance 
for 
services 
that 
are 
not 
medically necessary. 
3. 
Delivery of health care services. 
This 
subsection 
governs the delivery of covered health care services. 
A. 
Covered 
health 
care 
services 
must 
be 
provided 
to 
enrollees by participating providers who are located wi thin 
the State and who are chosen by the enrollees. 
B. 
The plan must pay for health care services provided to 
an enrollee while the enrollee is temporarily outside the 
State. 
The 
maximum 
period of 
time 
an enrollee 
may 
be 
covered and receive services while out-of-state is 90 days 
per year. 
An enrollee may qualify to begin services outside 
the State but, in order to receive continued treatment, may 
be required to receive treatment within the State. 
C. 
A participating provider may not charge enrollees or 3rd 
parties for covered health care services in excess of the 
amount reimbursed to that provider by the plan. 
D. 
A participating provider 
may 
not 
refuse to provide 
services to an enrollee on the basis of health status, 
medical condition, previous insurance status, race, color, 
creed, 
age, 
national origin, 
citizenship status, 
gender, 
sexual orientation, disability or marital status. 
4. Participating carriers: contracts. 
The plan may contract 
wi th one or more participating carriers to provide coverage to 
enrollees. 
The plan shall develop objective criteria for the 
;2 
selection of participating carriers and provide adequate notice 
of the application process to permit all carriers a reasonable 
and 
fair 
opportunity 
to 
participate. 
The 
selection 
of 
participating carriers must be based on the criteria developed by 
C, 
the plan. 
5. 
Reinsurance: contracts. 
The plan may contract with one 
or more carriers to provide reinsurance or stop loss insurance 
for 
coverage provided to eligible enrollees. 
The plan shall 
develop objective criteria for the selection of participating 
reinsurers or stop loss insurers and provide adeg:uate notice of 
the application process to permit all reinsurers a reasonable and 
fair opportunity to participate. 
The selection of participating 
carriers must be based on the criteria developed by the plan. 
6. Coordination with Medicaid. The plan shall maximize the 
use of federal funds available through the Medicaid program to 
provide health care coverage to all individuals enrolled in the 
~o 
plan who are or could become eligible for Medicaid pursuant to 42 
United States Code, Section 1396a(r)(2), 1396u-l or 1397bb. for 
~ 2 
enrollees and dependents eligible for Medicaid, health services 
provided by Medicaid must continue to be provided in coordination 
with health services covered under the plan. 
The Department of 
Human Services shall apply for any necessary federal Medicaid 
7.6 
waivers to provide health care coverage through the plan under 
this section. 
7. Licensing: regulation. 
Carriers, including reinsurance 
carriers, that contract with the plan must be licensed pursuant 
to this Title. 
Health plans offered by participating carriers 
l2 
must comply with all applicable provisions of this Title and 
rules adopted pursuant to this Title. 
Hl 
§4164. 
Maine Universal Health Care Agency 
1. Administration. 
The Maine Universal Health Care Agency 
is established to administer and oversee the Maine 
Univer~~l 
Health 
Care 
Plan 
established 
in 
section 
4163. 
The 
agency 
operates 
as 
an 
independent 
agency 
of 
the 
State within 
the 
Executive Department. 
2. Executive Director. 
The Executive Director of the Maine 
Universal 
Health 
Care 
Agency 
1S 
appointed 
by 
the 
Governor L 
subject 
to 
review 
by 
the 
joint 
standing 
committee 
of 
the 
Legislature having jurisdiction over health insurance matters and 
to confirmation by the Legislature, and serves at the pleasure of 
the Governor. 
The executive director must have experience in the 
organization, financing and delivery of health care. 
')0 
.. 
3. 
Powers of agency. 
In addition to the powers granted to 
G 
the agency elsewhere in this chapter, the agency is authorized to 
act as necessary to carry out the purposes of this chapter, 
including, but not limited to, the following. 
(, 
A. 
The agency may employ necessary staff to administer this 
chapter, subject to the Civil Service Law. 
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B. 
The agency may enter into contracts with qualified 3rd 
parties for any service necessary to carry out the purposes 
of this chapter. 
c. The agency may solicit, receive and accept gifts, grants, 
payments and other funds and advances from any person and 
enter into agreements wi th respect to those grants, gifts, 
payments and other funds and advances, including agreements 
that 
involve 
the 
undertaking 
of 
studies, 
plans, 
demonstrations 
and projects. 
The 
agency 
may 
charge 
and 
retain fees 
to 
recover the 
reasonable costs incurred in 
reproducing 
and 
distributing 
reports, 
studies 
and 
other 
publications and in responding to requests for information. 
D. 
The 
agency may borrow any necessary funds to support 
initial operating expenses in administering this chapter. 
E. 
The agency may conduct studies and analyses related to 
the provision of health care, health care costs and matters 
the agency considers appropriate. 
F. 
The 
agency 
may 
establish 
a 
financial 
relationship 
directly with producers licensed pursuant to chapter 16 to 
market 
and 
service 
health 
coverage 
offered 
through 
the 
agency. 
4. 
Rulemaking. 
The 
agency may 
adopt, 
amend and repeal 
rules as necessary for the proper administration and enforcement 
of this chapter, subject to the Maine Administrative Procedure 
Act. 
Rules 
adopted -LUl£suant 
to 
this 
chapter 
are 
routine 
technical rules as defined in Title 5, chapter 375, subchapter 
£:::fu 
5. 
Funding. 
The 
agency 
shall 
determine 
the 
level 
of 
funding required to carD'_~ the purposes of this chapter. 
The 
agency shall submit biennially to the Legislature for approval a 
proposed budget with levels of adequate premiums and assessments 
and taxes under Title 36, section 4365. 
Funding for the agency 
l:>uo.g:~L~IProY~~lQy_th~_J,.f2gj,~J.~t\lJ:~_is paid from the fund. 
6. 
Technical. assistance _.from 
bureau. 
The 
agency. shalJ 
\,,1 
coordinate its a!=tivities to the extent possible with the bureau. 
The bureau shall provide technical assistance and expertise to 
the 
agency 
in 
the 
development 
of 
the 
agency's 
rules 
for 
eligibility, benefit plan design and other aspects of the plan. 
1. 
Coordination with federal. state and local health care 
systems. 
The agency shall institute a system to coordinate the 
activities of the agency and the plan with the health care 
programs 
of 
the 
Federal 
Government 
and 
state 
and 
municipal 
governments. 
8. 
Reports. 
On or before January 1st of each year, the 
agency shall submit to the Governor and the Legislature an annual 
report of its operations 
and activities during 
the 
previous 
year. 
This report must include facts, 
suggestions and policy 
recommendations 
that 
the 
agency 
considers 
necessary. 
As 
it 
determines appropriate, the agency shall publish and disseminate 
information helpful to the citizens of this State in making 
L8 
informed choices in obtaining health care, including the results 
of studies or analyses undertaken by the agency. 
9. 
Advisory committees. 
The agency may appoint advisory 
committees 
to 
advise 
and assist the 
agency. 
Members 
of 
an 
advisory 
committee 
serve 
without 
compensation 
but 
may 
b~ 
reimbursed by the agency for necessary expenses while on official 
business of the committee. 
10. 
Headgyarters. 
The agency's central office must be ln 
the Augusta area, but the agency may hold hearings and sessions 
at any place in the State . 
.30 
11. 
Seal. 
The agency may have a seal bearing the words 
"Maine Universal Health Care Agency. " 
\4 
§4l65. 
Maine Universal Health Care Fund 
1. 
Fund established. 
The Maine Universal Health Care Fund 
--+4 
is established to finance the plan. 
A. 
Deposits into the fund and expenditures from the fund 
must be made pursuant to this section and to rules adopted 
by the agency to carry out the purposes of this chapter ._ 
Payments 
into the 
fund 
may 
include 
payments 
from other 
governmental units, payments from 3rd-party payors, payments 
under 
agreements 
of 
cooperation 
and 
coordination 
for 
enrollees in other insurance or health benefit programs and 
payments under any system of revenue or taxation imposed by 
the Legislature to fund the plan. 
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B. 
All income generated pursuant to this chapter must be 
deposited into the fund, which may not lapse but must be 
carried forward from one fiscal year to the next. 
C. 
All funds remaining in the fund at the end of the fiscal 
year must be reported to the Legislature by January 1st of 
the 
following 
year 
and 
may 
be 
used, 
by 
vote 
of 
the 
Legislature, to expand the coverage of services paid for by 
the plan. 
D. 
Expenditures from the fund are authorized for payments 
to 
participating 
providers 
for 
health 
care 
services 
rendered, payments to enrollees from the Enrollee Hardship 
Fund 
established 
in 
subsection 
and 
payments 
for 
administration of the fund, the plan and the agency. 
2. Enrollee Hardship Fund. 
The Enrollee Hardship Fund is 
established as part of the fund to provide financial assistance 
to enrollees for whom 
the premium for 
a 
primary health care 
policy is a hardship based on income. 
The agency shall adopt 
rules 
for 
income 
eligibility 
of 
enrollees, 
the 
amount 
of 
financial assistance available and the application process for 
enrollees. 
3. 
Budget. 
The annual administrative costs for the agency 
,~" 
and for all administrative aspects of the plan may not exceed 5
of the total 
annual 
budget for 
the 
fund. 
The 
agency shall 
,:8 
implement cost-control measures 
to reduce administrative costs 
and eliminate unnecessary health care. 
Cost-control measures may 
U) 
not be implemented to limit necessary health care. 
PARTB 
Sec. B·1. 24 MRSA c. 19·A is enacted to read: 
CHAPTER 19-A 
MAINE NONPROFIT HEALTH INSURANCE C<:»O?ANY 
+ 
(I 
§238L 
Purpose 
The Maine Nonprofit Health Insurance Company, referred to in 
-l4 
this chapter as "the company," is established to provide health 
insurance coverage to residents of this State and to promote 
4h 
competition in the State's health insurance marketplace. 
n 
§2382. 
Establishment 
Page IO-LR0186(1) 
1. 
Nonprofit hospital and medical service organization. 
The 
Maine Nonprofit Health Insurance 
Company 
is 
a 
nonprofit 
hospital and medical service organization subject to all the 
requirements and standards of this Title and Title 24-A that are 
applicable 
to 
health 
insurers 
and 
health 
maintenance 
f) 
organizations. 
The 
company shall offer individual 
and 
group 
health insurance coverage beginning January 1, 2004. 
2. 
Health 
care 
coverage. 
The 
company 
shall 
provide 
individual and group health insurance to residents and employers 
in this State, including primary health care policies as required 
by Title 24-A, section 2736-c' subsection 8-A; section 2808-B, 
subsection 8-A; and section 4315. 
The company may not provide 
health insurance to out-of-state residents or employers. 
3. 
Incorp<>.ration. 
The 
company 
mus t 
be 
inco rpo r a ted 
pursuant to the provisions of chapter 19. 
The incorporators must 
be appointed by the Governor subject to review and approval by 
the 
joint 
standing 
committee 
of 
the 
Legislature 
having 
~o 
jurisdiction over health insurance matters. 
The 
appointments 
must be made within 10 days after the effective date of this 
subsection. 
The 
joint standing 
committee 
shall 
complete 
its 
review and vote on the 
approval 
of the appointments of the 
,~4 
Governor within 10 days of the Governor' s written notice of the 
appointments. 
If the 
joint standing committee fails 
to act 
within the required 10 days, then the appointees put forward by 
the Governor become the required incorporators. Upon appointment, 
the incorporators shall execute a certificate of organization as 
required by this Title and immediately pursue a certificate of 
authority 
for 
a 
nonprofit 
hospital 
and 
medical 
service 
organization. 
4. 
Composition of board. 
The 
company is governed by a 
l4 
board of directors that consists of at least 
members. 
Nine 
members 
must 
be 
policyholders 
who 
purchase 
health 
insurance 
coverage from the company, except that the initial appointment 
may 
include 
members 
who 
have 
purchased 
coverage 
from 
other 
l8 
carriers licensed in this State. 
Three members must be persons 
who represent the public interest of the company. 
Members who 
'clO 
are policyholders and members who represent the public interest 
must be appointed by the Governor within 30 days after a 
new 
board member is authorized or a vacancy occurs, subject to review 
and approval by the joint standing committee of the Legislature 
having jurisdiction over health insurance matters. 
The joint 
standing committee shall complete its review and vote on approval 
of 
the 
appointments 
of 
the 
Governor within 
days 
of 
the 
Governor's written notice of appointment. 
If the joint standing 
commi ttee fails to act within the required 15 days, 
then the 
appointees put forward by the Governor become the required board 
SO 
members. 
One 
member 
must 
be 
an at-large policyholder 
member 
Page ll-LR0186(1) 
elected 
b:l 
the 
board. 
The 
remaining 
bQard 
member 
is 
the 
12resident and chief executive officer, who shall serve on the 
board 
of 
directors 
while 
em121o:led 
as 
12resigent 
and 
chief 
executive officer. 
() 
5. 
Terms. 
Of the initial 12olic:lholder board members, 
serve 3-year terms, 
serve 2 -year terms and 3 serve one-year 
terms. 
Of the initial 12ublic interest members, 
one serves 
a 
3-year term, one serves a 2-:lear term and one serves a one-year 
term. 
A full term is 3 :lears. 
An individual may not serve more 
than 2 full terms as a director. All members shall serve for the 
terms 
12rovided 
and 
until 
their 
successors 
are 
a12120inted 
or 
elected and gualified. 
L6 
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6. 
Corporate governance. 
The initial board of directors 
shall, at the organizational meeting of the com12any to com121ete 
organization, ado12t b:llaws. 
The bylaws must provide a schedule 
of meetings and rules s12ecificall:l relating to the conduct of 
meetings and voting 12rocedures. 
7. 
Annual 
report. 
In 
addition 
to 
any 
other 
re120rts 
~2 
reguired b:l this Title, the com12any shall submit an annual re120rt 
to 
the 
Governor 
and to the joint standing committee of 
the 
?4 
Legislature having jurisdiction over health insurance matters 
that discloses the business transacted by the com12any during the 
,~() 
12revious :lear and states the resources and liabilities of the 
com12any 
together 
with 
other 
12ertinent 
information 
considered 
a1212ro12riate b:l the board. 
The re120rt must contain, at a minimum, 
a summary of the latest annual statement filing reguired to be 
~o 
filed 
under 
this Title with the 
SU12erintendent 
of 
Insurance 
12re12ared 
on 
a 
basis 
of 
statutor:l 
accounting 
12rece12ts. 
Any 
var iations between the annual statement and the annual 
re120rt 
must be reconciled to clearl:l show variances and the basis for 
an:l different values. 
lG 
§2383. 
Authority of board: povers and duties 
1. 
General 
authority. 
The 
board 
may 
12erform all acts 
necessary or convenient in the exercise of any 12ower. authority 
-l0 
or jurisdiction over the com12any, either in the administration of 
the com12an:l or in connection with the business of the com12an:l to 
fulfill the 12ur12oses of this cha12ter and cha12ter 19. The com12any 
has the 120wers otherwise granted to 
a 
non12rofit hos12ital 
and 
medical service organization. 
2. 
Standard of performance. 
The board shall discharge its 
duties with the same care, skill, 12rudence and diligence as that 
of 12rudent directors acting in a similar enter12rise and with a 
similar 12ur12ose. 
')0 
3. 
Personal liability. 
The 
members 
of 
the 
board 
and 
officers or employees of the company are not liable personally, 
either jointly or severally, for any debt or obligation created 
or incurred by the company. 
G 
§2384. 
Plan of operation 
1. Plan of operation. 
The company shall develop and file 
with the Superintendent of Insurance for review and approval a 
plan of operation and any amendments to 
a plan of operation 
necessary 
or 
sui table 
to 
ensure 
the 
fair, 
reasonable 
and 
equitable administration of the company. 
2. Initial funding. The company may obtain initial start-up 
7.4 
funds by: 
A. Borrowing from any public or private source; and 
B. The sale of private activity bonds through an allocation 
of 
the state ceiling on private activity bonds 
to 
the 
company pursuant to Title 10, section 363. 
§2385. President and chief executive officer 
1. 
Appointment. 
The board shall appoint a president who 
serves as chief executive officer and who is responsible for the 
operation of the company. 
The president must be qualified by 
education and experience to manage an organization with financial 
and operational obligations to its policyholders and claimants. 
2. 
Term. 
The president serves at the will of the board. 
3. 
Compensation. 
The president is entitled to compensation 
as established by the board and is subject to any reasonable 
requirements, including bonding, established by the board. 
4. 
Board member. 
The president is a member of the board 
but may not be the chair of the board. 
5. 
Duties. 
The board, as part of its plan of operation, 
shall designate the powers and duties of the president. 
The 
president may, 
with direction from the board, 
assist in the 
development of the plan of operation and other start-up functions. 
§2386. Honstate agency 
The 
company 
is 
not 
considered 
a 
state 
agency 
or 
4R 
instrumentality of the State for any purpose. 
The State may not 
borrow or otherwise appropriate funds from the company. 
• 
If) 
,2 (l 
, , 
. ~ 
~~ 4 
\(1 
\2 
\4 
\6 
J8 
4(1 
PARTC 
Sec. C-l. 36 MRSA c. 370-A is enacted to read: 
CHAPTER 370-A 
PAYROLL TAX 
§283l. 
Payroll tax on wages and earnings 
1. Tax levied. 
Every taxpayer constituting an employing 
unit in this State shall pay a tax of 5% on all gross earnings of 
that 
employing 
unit's 
employees. 
Every 
taxpayer 
who 
is 
self-employed shall pay a tax of 5% on all gross earnings of that 
taxpayer's wages and earnings. 
2. Payment of tax; returns. 
Every taxpayer subject to the 
tax imposed by this section shall, on or before the last day of 
each Apr iI, the last day of each June and the last day of each 
October, 
file with the 
assessor 
on 
forms 
prescribed by 
the 
assessor a return for the quarter ending the last day of the 
preceding month, except for the month of June, which is for the 
quarter ending June 30th. The final return and payment must be 
filed on or before March 15th covering the prior calendar year. 
At the time of filing such returns, each taxpayer shall pay to 
the assessor the amount of tax shown due. A taxpayer with annual 
tax 
liability not 
exceeding 
$500 
may 
with 
approval 
of 
the 
assessor file an annual return with payment on or before March 
15th covering the prior calendar year. 
3. Maine Universal Health Care Fund. 
The assessor shall pay 
taxes collected under this section to the Maine Universal Health 
Care Fund established in Title 24-A, section 4165. 
SUMMARY 
In Part A, this bill establishes the Maine Universal Health 
Care Plan. It establishes the Maine Universal Health Care Agency 
as an independent agency to administer the plan. 
Under the plan, 
enrollees are provided health care coverage after the policy 
limits of their primary health care policy have been reached. 
Coverage under the plan is contingent upon the enrollee's having 
secured 
coverage 
for 
primary 
and 
preventive 
care 
either 
individually or 
through the enrollee's employer. 
The 
primary 
health care policy must be approved by the Bureau of Insurance. 
Page l4-LR0186(1) 
In Part B, the bill establishes a new nonprofit hospital and 
medical service organization to compete with other carriers in 
Maine's health insurance market. 
The bill requires that the 
organization be organized in accordance with the Maine Revised 
Statutes, Title 24. 
In Part C, the bill establishes a 
5°-1> payroll tax on wages 
and earnings, 
including self-employed earnings, 
and dedicates 
that tax revenue to the Maine Universal Health Care Fund.