An Act To Authorize the Health Care Choice Compact To Permit the Purchase of Health Insurance from New Hampshire
Maine Legislature, Session 125, LD 1200
Committee: Insurance and Financial Services
Sponsors: McKANE, SNOWE-MELLO, FITZPATRICK, KNAPP, MORISSETTE, PICCHIOTTI, RICHARDSON, WHITTEMORE
Amends: 24-A MRSA §405, 24-A MRSA §405-A

Legislative Document 
No. 1200 
H.P. 891 
House of Representatives, March 21, 2011 
An Act To Authorize the Health Care Choice Compact To Permit 
the Purchase of Health Insurance from New Hampshire 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed. 
HEATHER J.R. PRIEST 
Clerk 
Presented by Representative McKANE of Newcastle. 
Cosponsored by Senator SNOWE-MELLO of Androscoggin and 
Representatives: FITZPATRICK of Houlton, KNAPP of Gorham, MORISSETTE of Winslow, 
PICCHIOTTI of Fairfield, RICHARDSON of Warren, Senator: WHITTEMORE of Somerset. 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1.  24-A MRSA §405, sub-§6, as enacted by PL 1969, c. 132, §1, is amended 
to read: 
6.    Any suit or action by the duly constituted receiver, rehabilitator or liquidator of 
the insurer, or of the insurer's assignee or successor, under laws similar to those contained 
in chapter 57 (delinquency proceedings; rehabilitation and liquidation).; or 
Sec. 2.  24-A MRSA §405, sub-§7 is enacted to read: 
7.  Transactions pursuant to individual health insurance covering residents of this 
State written by a New Hampshire insurer or health maintenance organization pursuant to 
the Health Care Choice Compact established in section 405-A if the superintendent 
certifies that the New Hampshire insurer or health maintenance organization meets the 
requirements of section 405-A. 
Sec. 3.  24-A MRSA §405-A is enacted to read: 
§405-A.  Health Care Choice Compact for individual health insurance 
1.  Health Care Choice Compact established. Pursuant to the federal Patient 
Protection and Affordable Care Act, Public Law 111-148, Section 1333, the State is 
authorized to join with New Hampshire to establish the Health Care Choice Compact to 
permit the sale of individual health insurance in this State by a New Hampshire insurer or 
health maintenance organization in accordance with the requirements of this section.  As 
used in this section, "New Hampshire insurer or health maintenance organization" means 
an insurer or health maintenance organization that holds a valid certificate of authority to 
transact individual health insurance in New Hampshire. 
2.  Certification of New Hampshire insurers or health maintenance 
organizations.   A New Hampshire insurer or health maintenance organization may not 
transact individual health insurance in this State by mail, the Internet or otherwise unless 
the superintendent has issued a certification that the New Hampshire insurer or health 
maintenance organization has met the requirements of this subsection. The superintendent 
shall issue a certification or deny certification within 30 days of a request. 
A.  A policy, contract or certificate of individual health insurance offered for sale in 
this State by a New Hampshire insurer or health maintenance organization must 
comply with the applicable individual health insurance laws in New Hampshire and 
must be actively marketed in that state. 
B.  A New Hampshire insurer or health maintenance organization shall meet the 
requirements of section 4302 for reporting plan information with respect to individual 
health plans offered for sale in this State and disclose to prospective enrollees how 
the health plans differ from individual health plans offered by domestic insurers in a 
format approved by the superintendent within 90 days of the effective date of this 
section. Health plan policies and applications for coverage must contain the following 
disclosure statement or a substantially similar statement: "This policy is issued by a 
New Hampshire insurer or health maintenance organization and is governed by the 
laws and rules of (New Hampshire insurer's or health maintenance organization's 
state of domicile). This policy may not be subject to all the insurance laws and rules 
of the State of Maine, including coverage of certain health care services or benefits 
mandated by Maine law. Before purchasing this policy, you should carefully review 
the terms and conditions of coverage under this policy, including any exclusions or 
limitations of coverage." 
C.  A New Hampshire insurer or health maintenance organization shall meet the 
requirements of section 4303, subsection 4 for grievance procedures with respect to 
health plans offered for sale in this State. 
D.  A New Hampshire insurer or health maintenance organization shall meet the 
requirements of chapter 56-A for provider network adequacy with respect to health 
plans offered for sale in this State. 
E.  A New Hampshire insurer or health maintenance organization shall meet the 
requirements of chapter 27 with respect to rates for individual health plans offered for 
sale in this State. 
F.  A New Hampshire insurer or health maintenance organization shall designate an 
agent for receiving service of legal documents and process in the manner provided in 
this title. 
G.  A New Hampshire insurer or health maintenance organization shall meet the 
requirements of this Title with respect to allowing the superintendent access to 
records of the New Hampshire insurer or health maintenance organization. 
3.  Unfair trade practices.  The provisions of chapter 23 apply to a New Hampshire 
insurer or health maintenance organization permitted to transact individual health 
insurance under this section or section 405. 
4.  Compliance with court orders.  A New Hampshire insurer or health maintenance 
organization shall comply with lawful orders from courts of competent jurisdiction issued 
in a voluntary dissolution proceeding or in response to a petition for an injunction by the 
superintendent asserting that the New Hampshire insurer or health maintenance 
organization is in a hazardous financial condition. 
5.  Exemption from other requirements. Except as expressly provided in this 
section, the requirements of this Title do not apply to a New Hampshire insurer or health 
maintenance organization permitted to transact individual health insurance under this 
section. 
6.  Effective date. The Health Care Choice Compact under subsection 1 becomes 
effective and binding upon the approval of the Secretary of the United States Department 
of Health and Human Services after legislative enactment by this State and New 
Hampshire except that an individual health insurance policy, contract or certificate may 
not be offered for sale in this State pursuant to this section before January 1, 2016. 
SUMMARY 
This bill authorizes the Health Care Choice Compact with New Hampshire pursuant 
to the federal Patient Protection and Affordable Care Act to allow insurers and health 
maintenance organizations authorized to transact individual health insurance in New 
Hampshire to offer their individual health plans for sale in this State. The bill requires 
New Hampshire insurers and health maintenance organizations to meet certain 
requirements of Maine law, including requirements for rating, provider network 
adequacy, disclosure, reporting and grievance procedures. The bill provides that the 
Health Care Choice Compact becomes effective and binding upon the approval of the 
Secretary of the United States Department of Health and Human Services after legislative 
enactment in New Hampshire and this State except that individual health insurance 
policies, contracts and certificates may not be offered for sale pursuant to the compact 
before January 1, 2016.