An Act To Provide Health Care Insurance to Volunteer Public Safety Personnel
Maine Legislature, Session 123, LD 0911
Committee: Insurance and Financial Services
Sponsors: BURNS, STRIMLING, CANAVAN, CARTER, GROSE, MARLEY, RAND, RINES, WHEELER
Amends: 24-A MRSA §6903, 24-A MRSA §6912, 24-A MRSA §6913

Legislative Document 
No. 911 
H.P.686 
House of Representatives, March 1, 2007 
An Act To Provide Health Care Insurance to Volunteer Public 
Safety Personnel 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed. 
Presented by Representative BURNS of Berwick. 
Cosponsored by Senator STRIMLING of Cumberland and 
'-7J'l~ 1J?17!d£~ 
MILLICENT M. MacFARLAND 
Clerk 
Representatives: CANAVAN of Waterville, CARTER of Bethel, GROSE of Woolwich, 
MARLEY of Portland, RAND of Portland, RINES of Wiscasset, WHEELER of Kittery. 
Printed on recyded paper 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 24-A MRSA §6903, sub-§7, as enacted by PL 2003, c. 469, Pt. A, §8, is 
amended to read: 
7. Eligible individual. "Eligible individual" means: 
A. 
A self-employed individual who: 
( 1) Works and resides in the State; and 
(2) 
Is organized as a sole proprietorship or in any other legally recognized 
manner in which a self-employed individual may organize, a substantial part of 
whose income derives from a trade or business through which the individual has 
attempted to earn taxable income; 
B. 
An unemployed individual who resides in this State; ef 
C. 
An individual employed in an eligible business that does not offer health 
insurance~~ 
D. An individual who acts as a volunteer firefighter or who voluntarily provides 
emergency services or police services for a county, municipality or other local unit of 
government and who is not eligible for MaineCare or employer-sponsored health 
insurance. 
Sec. 2. 24-A MRSA §6912, as amended by PL 2005, c. 400, Pt. A, §§7 to 9, is 
further amended to read: 
§6912. Subsidies 
Dirigo Health may establish sliding-scale subsidies for the purchase of Dirigo Health 
Program coverage paid by eligible individuals or employees whose income is under 
300% of the federal poverty level. 
Dirigo Health may also establish sliding-scale 
subsidies for the purchase of employer-sponsored health coverage paid by employees of 
businesses with more than 50 employees, whose income is under 300% of the federal 
poverty level. Dirigo Health shall provide subsidies for the purchase of Dirigo Health 
Program coverage for eligible individuals pursuant to subsection 4-A. 
1. Administration. Dirigo Health shall, by rule, establish procedures to administer 
this section. 
2. Eligibility for subsidy. To be eligible for a subsidy an individual or employee 
must: 
A. 
Be enrolled in the Dirigo Health Program, have an income under 300% of the 
federal poverty level and be a resident of the State; or 
B. 
Be enrolled in a health plan of an employer with more than 50 employees and 
have an income under 300% of the federal poverty level. The health plan must meet 
any criteria established by Dirigo Health. The individual must meet other eligibility 
criteria established by Dirigo Health. 
rage: - nJLR0191(Ol)-1 
3. Limitation of subsidies. Dirigo Health shall limit the availability of subsidies to 
reflect limitations of available funds. 
4. 
Limitation on amount subsidized. 
Dirigo Health may limit the amount 
subsidized of the payment made by individual plan enrollees under section 6910, 
subsection 4, paragraph C to 40% of the payment to more closely parallel the subsidy 
received by employees except as provided in subsection 4-A. In no case may the subsidy 
granted to eligible individuals in accordance with subsection 2, paragraph A exceed the 
maximum subsidy level available to other eligible individuals. 
4-A. Subsidy for volunteer firefighters and volunteer emergency services and 
police personnel. Notwithstanding the income eligibility requirements of subsection 2 
II 
and the limitation on subsidy amount in subsection 4, Dirigo Health shall provide a 
subsidy for 100% of the purchase of Dirigo Health Program coverage for individual plan 
enrollees eligible pursuant to section 6903, subsection 7, paragraph D. 
5. Notification of subsidy. Dirigo Health shall notify applicants and their employers 
in writing of their eligibility and approved level of subsidy. 
6. 
Report. 
Within 30 days after any subsidies are established pursuant to this 
section, the board shall report on the amount of the subsidies, the funding required for the 
subsidies and the estimated number of Dirigo Health Program enrollees eligible for the 
subsidies and submit the report to the joint standing committee of the Legislature having 
jurisdiction over appropriations and financial affairs, the joint standing committee of the 
Legislature having jurisdiction over insurance and financial services matters and the joint 
standing committee of the Legislature having jurisdiction over health and human services 
matters. 
Sec. 3. 24-A MRSA §6913, sub-§2, as amended by PL 2007, c. I, Pt. XX, §2 and 
affected by §3, is further amended to read: 
2. Determination of savings offset amount. The board shall determine annually a 
savings offset amount to be paid by health insurance carriers, employee benefit excess 
insurance carriers and 3rd-party administrators, not including carriers and 3rd-party 
administrators with respect to accidental injury, specified disease, hospital indemnity, 
dental, vision, disability income, long-term care, Medicare supplement or other limited 
benefit health insurance. 
The board shall determine the savings offset amount in 
accordance with the following: 
A. Not later than January 1 st of each year, the board shall prospectively determine 
the savings offset amount to be applied during the 12-month period beginning the 
immediately following July 1 st; 
B. 
To determine the savings offset amount, the board shall use the criteria and 
reports described in subsections 7 and 8; 
C. The savings offset amount must reflect and may not exceed aggregate measurable 
cost savings, as determined by the board pursuant to subsection 1 except as provided 
.i!!...R-aragraph E; ami 
D. The savings offset amount calculation is limited to the amount of funds necessary 
to provide subsidies pursuant to section 6912 and to support the Maine Quality 
Forum established in section 6951 and may not include general administrative 
expenses of Dirigo Health, except for general administrative expenses of the Maine 
Quality Forum~; and 
E. In the event the amount of aggregate measurable cost savings as determined by 
the board pursuant to subsection I exceeds the amount determined by the board to be 
necessary to provide subsidies as required under section 6912, subsection 4-A, the 
board may increase the amount of the savings offset, but in no case may the savings 
offset amount exceed the limits established in subsection 3. 
II 
The savings offset amount determined by the board in accordance with this subsection is 
the determining factor for inclusion of savings offset payments in premiums through rate 
setting review by the bureau. 
SUMMARY 
IS 
This bill makes persons who act as volunteer firefighters or volunteer emergency 
services and police personnel for a county, municipality or local government eligible for 
health care coverage through the Dirigo Health Program. The bill also requires that the 
Dirigo Health Program pay a subsidy for 100% of the costs of that coverage. The bill 
gives authority to the Board of Directors of Dirigo Health to increase the amount of the 
savings offset payment used to fund subsidies for the program if necessary but prohibits 
the amount from exceeding 4.0% of annual paid claims.