An Act To Protect Consumers against Inadequate Health Care Coverage
Maine Legislature, Session 123, LD 1230
Committee: Insurance and Financial Services
Sponsors: CONOVER, HARLOW, PERRY, BRAUTIGAM, FAIRCLOTH, PRIEST
Amends: 24-A MRSA §4202-A, 24-A MRSA §4303

Legislative Document 
No. 1230 
H.P.872 
House of Representatives, March 8, 2007 
An Act To Protect Consumers against Inadequate Health Care 
Coverage 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed. 
Presented by Representative CONOVER of Oakland. 
'-7Y/~~ m· 7l/0£~ 
MILLICENT M. MacFARLAND 
Clerk 
Cosponsored by Representative HARLOW of Portland, Senator PERRY of Penobscot and 
Representatives: BRAUTIGAM of Falmouth, FAIRCLOTH of Bangor, PRIEST of Brunswick. 
Prinlt'J Pil rec)dcJ ra~r 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 24-A MRSA §4202-A, sub-§l, as amended by PL 2001, c. 218, §1, is 
further amended to read: 
1. 
Basic health care services. 
"Basic health care services" means health care 
services that an enrolled population might reasonably require in order to be maintained in 
good health and includes, at a minimum, emergency care, inpatient hospital care, 
inpatient physician services, outpatient physician services, ancillary services such as x-
ray services and laboratory services and all benefits mandated by statute and mandated by 
rule applicable to health maintenance organizations. The superintendent may adopt rules 
defining "basic health care services" to be provided by health maintenance organizations. 
In adopting such rules, the superintendent shall consider the coverages that have 
traditionally been provided by health maintenance organizations; the need for flexibility 
in the marketplace; and the importance of providing multiple options to employers and 
consumers. The superintendent may not require that all health benefit plans offered by 
health maintenance organizations meet or exceed each of the particular requirements of 
standard or basic health plans specified in Bureau of Insurance Rule, Chapter 750. The 
superintendent may select required services from among those set forth in Bureau of 
Insurance Rule, Chapter 750 and shall permit reasonable, but not excessive or unfairly 
discriminatory, variations in the copa)'ment, coinsurance, deductible and other features of 
such coverage, except that these features must meet or exceed those required in benefits 
mandated by statute. Rules adopted pursuant to this subsection are major substantive 
rules as defined in Title 5, chapter 375, subchapter II A. 
Sec. 2. 24-A MRSA §4303, sub-§12 is enacted to read: 
12. 
Certain high deductible health plans prohibited. 
For policies issued or 
renewed on or after October 1, 2007, a carrier may not offer a health plan that imposes an 
annual deductible of $1 ,500 or higher. 
Sec. 3. Bureau of Insurance rulemaking. By October 1, 2007, the Department 
of Professional and Financial Regulation, Bureau of Insurance shall amend its Rule 
Chapter 750: Standardized Health Plans to repeal Part II of the rule. 
Rules adopted 
pursuant to this section are routine technical rules as defined in Title 5, chapter 375, 
subchapter 2-A. 
SUMMARY 
This bill prohibits health insurance carriers from offering health plans with 
deductibles of $1 ,500 or higher. The bill applies to all health plans issued or renewed on 
or after October 1, 2007. The bill also removes the authority of the Department of 
Professional and financial Regulation, Bureau of Insurance to adopt rules that give 
carriers flexibility with regard to deductible and requires the Bureau of Insurance to 
repeal Part II of Rule Chapter 750: Standardized Health Plans.