An Act To Implement the Requirements of the Federal Patient Protection and Affordable Care Act
Maine Legislature, Session 125, LD 1554
Committee Amendment CA_A_H545 (House)
Amends: 24-A MRSA §2735-A, 24-A MRSA §2736-A, 24-A MRSA §2736-C, 24-A MRSA §2, 24-A MRSA §2808-B, 24-A MRSA §2850, 24-A MRSA §4218-A, 24-A MRSA §4301-A, 24-A MRSA §4302, 24-A MRSA §4303, 24-A MRSA §4306, 24-A MRSA §4309-A, 24-A MRSA §4312, 24-A MRSA §4318, 24-A MRSA §6451-A

COMMITTEE AMENDMENT "P" to H.P. 1140, L.D. 1554, Bill, "An Act To 
Implement the Requirements of the Federal Patient Protection and Affordable Care Act" 
Amend the bill by striking out everything after the enacting clause and before the 
summary and inserting the following: 
'Sec. 1. 24-A MRSA §2735-A, sub-§l, as amended by PL 2009, c. 244, Pt. C, 
§4, is further amended to read: 
1. Notice of rate filing or rate increase on existing policies. An insurer offering 
individual health plans as defined in section 2736-C must provide written notice by first 
class mail of a rate filing to all affected policyholders at least 60 days before the effective 
date of any proposed increase in premium rates or any proposed rating formula, 
classification of risks or modification of any formula or classification of risks. 
+he 
Except as otherwise provided in section 2736-C, subsection 2-B, the notice must also 
inform policyholders of their right to request a hearing pursuant to section 229. The 
notice must show the proposed rate and, unless otherwise provided in section 2736-C, 
subsection 2-B, state that the rate is subject to regulatory approval. 
+he Except as 
otherwise provided in section 2736-C, subsection 2-B, the superintendent may not take 
final action on a rate filing until 40 days after the date notice is mailed by an insurer. An 
increase in premium rates may not be implemented until 60 days after the notice is 
provided or until the effective date under section 2736, whichever is later. 
Sec. 2. 24-A MRSA §2736-A, first ~, as amended by PL 2009, c. 439, Pt. C, §3, 
is further amended to read: 
If at any time the superintendent has reason to believe that a filing does not meet the 
requirements that rates not be excessive, inadequate, or unfairly discriminatory or not in 
compliance with section 6913 or that the filing violates any of the provisions of chapter 
23, the superintendent shall cause a hearing to be held. If a filing proposes an increase in 
rates in an individual health plan as defined in section 2736-C, the superintendent shall 
cause a hearing to be held at the request of the Attorney General. In any hearing 
conducted under this section, the insurer has the burden of proving rates are not 
excessive, inadequate or unfairly discriminatory and in compliance vlith section 6913. 
Page J - 125LR0443(02)-1 
COMMITTEE AMENDMENT 
~ 
~~~ 
COMMITTEE AMENDMENT"R"to H.P. 1140, L.D.1554 
Sec. 3. 24-A MRSA §2736-C, sub-§2, ~C, as amended by PL 2011, c. 90, Pt. A, 
§ 1, is further amended to read: 
C. A carrier may vary the premium rate due to family membership to the extent 
permitted by the federal Affordable Care Act. 
Sec.4. 24-A MRSA §2736-C, sub-§2,~, as amended by PL 2011, c. 90, Pt. A, 
§3, is further amended to read: 
D. A carrier may vary the premium rate due to age and smokiRg status tobacco use in 
accordance with the limitations set out in this paragraph. 
(1) For all policies, contracts or certificates that are executed, delivered, issue'd 
for delivery, continued or renewed in this State between December 1, 1993 and 
July 14, 1994, the premium rate may not deviate above or below the community 
rate filed by the carrier by more than 50%. 
(2) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State between July 15, 1994 and July 
14, 1995, the premium rate may not deviate above or below the community rate 
filed by the carrier by more than 33%. 
(3) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State between July 15, 1995 and June 
30, 2012, the premium rate may not deviate above or below the community rate 
filed by the carrier by more than 20%. 
(5) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State between July 1, 2012 and 
December 31, 2013, the maximum rate differential due to age filed by the carrier 
as determined by ratio is 3 to 1. The limitation does not apply for determining 
rates for an attained age of less than 19 years of age or more than 65 years of age. 
(6) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued· or renewed in this State between January 1, 2014 and 
December 31,2014, the maximum rate differential due to age filed by the carrier 
as determined by ratio is 4 to 1 to the extent permitted by the federal Affordable 
Care Act. The limitation does not apply for determining rates for an attained age 
of less than 19 years of age or more than 65 years of age. 
(7) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State on or after January 1, 2015, the 
maximum rate differential due to age filed by the carrier as determined by ratio is 
to 1 to the extent permitted by the federal Affordable Care Act. The limitation 
does not apply for determining rates for an attained age of less than 19 years of 
age or more than 65 years of age. 
(8) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State on or after July 1, 2012, the 
maximum rate differential due to smekiRg s~atus tobacco use filed by the carrier 
as determined by ratio is 1.5 to 1. 
COMMITTEE AMENDMENT 
~' 
~ " 
~.~ 
COMMITTEE AMENDMENT "ft .. to H.P. 1140, L.D. 1554 
Sec. 5. 24-A MRSA §2736-C, sub-§2,~, as enacted by PL 2011, c. 90, Pt. A, 
§5, is amended to read: 
I. A carrier that offered individual health plans prior to July 1, 2012 may close its 
individual book of business sold prior to July 1, 2012 and may establish a separate 
community rate for individuals applying for coverage under an individual health plan 
on or after July 1, 2012. 
If a carrier closes its individual book of business as 
permitted under this paragraph, the carrier may vary the premium rate for individuals 
in that closed book of business only as permitted in this paragraph and paragraphs C 
and C-l. 
(1) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State between July 1, 2012 and 
December 31, 2012, the maximum rate differential due to age filed by the carrier 
as determined by ratio is 2 to 1. The limitation does not apply for determining 
rates for an attained age of less than 19 years of age or more than 65 years of age. 
(2) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State between January 1, 2013 and 
December 31, 2013, the maximum rate differential due to age filed by the carrier 
as determined by ratio is 2.5 to 1. The limitation does not apply for determining 
rates for an attained age of less than 19 years of age or more than 65 years of age. 
(3) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State between January 1, 2014 and 
December 31, 2014, the maximum rate differential due to age filed by the carrier 
as determined by ratio is 3 to 1. The limitation does not apply for determining 
rates for an attained age of less than 19 years of age or more than 65 years of age. 
(4) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State between January 1, 2015 and 
December 31, 2015, the maximum rate differential due to age filed by the carrier 
as determined by ratio is 4 to 1 to the extent permitted by the federal Affordable 
Care Act. The limitation does not apply for determining rates for an attained age 
of less than 19 years of age or more than 65 years of age. 
(5) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State on or after January 1, 2016, the 
maximum rate differential due to age filed by the carrier as determined by ratio is 
to 1 to the extent permitted by the federal Affordable Care Act. The limitation 
does not apply for determining rates for an attained age of less than 19 years of 
age or more than 65 years of age. 
(6) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State on or after July 1, 2012, the 
maximum rate differential due to smokiBg status tobacco use filed by the carrier 
as determined by ratio is 1.5 to 1. 
The sN~eriBteBdeBt shall establish by rule ~roeed\:lFes and ~olieies that faeilitate the 
i~lemeBtatioB of this ~,*agraph, iBelNdiBg, aNt Hot limited to, Botiee requiremeBts 
for ~olieyholders and e*~erieBee ~OOliBg reqNiremeBts of iBdividHal health ~rodH6ts. 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT"~" to H.P. 1140, L.D. 1554 
WheH 
establishiHg 
rules 
regardiHg 
experieHce 
pooliHg 
requiremeHts, 
the 
s'l:lperiHteHdeHt shall eHsme, to the greatest eJfteHt possible, the availability of 
affordaele optioHs for iHdivid'l:lals traHsitioHiHg from the closed book of busiHess. 
Rules adopted JffiTsuaHt to this paragraph are reutill:e teooll:ical rules as defined in 
Title 5, chapter 375, s'l:lbchapter 2 A. The superintendent shall direct the Consumer 
Health Care Division, established in section 4321, to work with carriers and health 
advocacy organizations to provide information about comparable alternative 
insurance options to individuals in a carrier's closed book of business and upon 
request to assist iHdivid'l:lals to facilitate the transition to an iHdivid'l:lal health plan iH 
that carrior's or aHother carrier's open book ofb'l:lsiness. 
Sec. 6. 24-A MRSA §2736-C, sub-§2, ~J is enacted to read: 
J. Except for enrollees in grandfathered health plans under the federal Affordable 
Care Act, beginning January 1, 2014, a carrier shall consider all enrollees in all 
individual health plans offered by the carrier to be members of a single risk pool to 
the extent required by the federal Affordable Care Act. 
Sec. 7. 24-A MRSA §2736-C, sub-§2-B, as enacted by PL 2011, c. 90, Pt. D, 
§2, is amended to read: 
2-B. Optional guaranteed loss ratio. Notwithstanding section 2736, subsection 1 
and section 2736-A, at the carrier's option, rate filings for a carrier's credible block of 
individual health plans may be filed in accordance with this subsection. Rates filed in 
accordance with this subsection are filed for informational purposes unless rate review is 
required pursuant to the federal Affordable Care Act. 
A. 
A carrier's individual health plans are considered credible if the anticipated 
average number of members during the period for which the rates will be in effect is 
at least 1,000 iH the aggFegate or if the iHdivid'l:lal health plaHS ill: the aggregate meet 
credibility meets standards adopted by the S'I:lperiRteHdeHt by rule for full or partial 
credibility pursuant to the federal Affordable Care Act. The rate filing must state the 
anticipated average number of members during the period for which the rates will be 
in effect and the basis for the estimate. If the superintendent determines that the 
number of members is likely to be less than 1,000 and the carrier does HOt satisfy any 
altemati'<'e credibility standards adopted by the S'I:lperiHteHdeHt by rule needed to meet 
the credibility standard, the filing is subject to section 2736, subsection 1 and section 
2736-A. 
B. On an annual schedule as determined by the superintendent, the carrier shall file a 
report with the superintendent showing aggregate eamed premiums and iHcarred 
olaims for the period the rates were iH effect. IRCliTFOd claims must iHclude claims 
paid to a date after the eHd of the amnial reportiHg period aHd all: estimate of lHlflaid 
claims. The report must state how the URflaid claims estimate was determiHed. The 
superiHteHdeHt shall detenniae the reportiag period aad the paid to date; begiIlfling 
January 1, 2011, both the reportiHg period and the paid to date must be cOHsisteHt 
with those for the rebates reE):l:lired purSl:laHt to the federal Affordable Care Act aHd 
federal reg'l:llatioHs adopted the calculation of rebates as required pursuant to the 
federal Affordable Care Act, except that the calculation must be based on a minimum 
medical loss ratio of 80% if the applicable federal minimum for the individual market 
in this State is lower. If the calculation indicates that rebates must be paid, the carrier 
COMMITTEE AMENDMENT 
~<o~ 
~.<:S 
COMMITTEE AMENDMENT"~' to H.P. 1140, L.D. 1554 
must pay the rebates in the same manner as is required for rebates pursuant to the 
federal Affordable Care Act. 
Sec. s. 24-A MRSA §2736-C, sub-§9, as enacted by PL 1995, c. 570, §7, is 
amended to read: 
9. Exemption for certain associations. The superintendent may exempt a group 
health insurance policy or group nonprofit hospital or medical service corporation 
contract issued to an association group, organized pursuant to section 2805-A, from the 
requirements of subsection 3, paragraph A; subsection 6, paragraph A; and subsection 8 
if: 
A. Issuance and renewal of coverage under the policy or contract is guaranteed to all 
members of the association who are residents of this State and to their dependents; 
B. 
Rates for the association comply with the premium rate requirements of 
subsection 2 or are established on a nationwide basis and substantially comply with 
the purposes of this section, except that exempted associations may be rated 
separately from the carrier's other individual health plans, if any; 
C. The group's anticipated loss ratio, as defined in subsection 5, is at least 75%; 
D. The association's membership criteria do not include age, health status, medical 
utilization history or any other factor with a similar purpose or effect; 
E. The association's group health plan is not marketed to the general public; 
F. The association does not allow insurance agents or brokers to market association 
memberships, accept applications for memberships or enroll members, except when 
the association is an association of insurance agents or brokers organized under 
section 2805-A; 
G. Insurance is provided as an incidental benefit of association membership and the 
primary purposes of the association do not include group buying or mass marketing 
of insurance or other goods and services; and 
H. Granting an exemption to the association does not conflict with the purposes of 
this section. 
Except for individuals with grandfathered health plans under the federal Affordable Care 
Act, this subsection does not apply to policies, contracts or certificates that are executed, 
delivered, issued for delivery, continued or renewed in this State on or after January 1, 
2014. 
Sec. 9. 24-A MRSA §2S0S-B, sub-§l, ~, as repealed and replaced by PL 2003, 
c. 428, Pt. H, §5, is amended to read: 
D. "Eligible group" means any person, firm, corporation, partnership, association or 
subgroup engaged actively in a business that employed an average of 50 or fewer 
eligible employees during the preceding calendar year. 
(1) If an employer was not in existence throughout the preceding calendar year, 
the determination must be based on the average number of employees that the 
employer is reasonably expected to employ on business days in the current 
calendar year. 
COMMITTEE AMENDMENT 
~;()\co. 
COMMIITEE AMENDMENT" R" to H.P. 1140, L.D. 1554 
(2) 
In determining the number of eligible employees, companies that are 
affiliated companies or that are eligible to file a combined tax return for purposes 
of state taxation are considered one employer. 
(3) A group is not an eligible group if there is anyone other state where there are 
more eligible employees than are employed within this State and the group had 
coverage in that state or is eligible for guaranteed issuance of coverage in that 
state. 
(4) An employer qualifies as an eligible group for 2-person coverage if the 
employer provides a carrier with the following information demonstrating that 
the employer's business and employees meet the minimum qualifications for 
group coverage in paragraph C: 
(a) A copy of the most recent quarterly combined filing for income tax 
withholding and unemployment contributions, Form 9411CI-ME; 
(b) For an employee claimed to be an employee eligible for group coverage 
whose name is not listed on Form 9411CI-ME, a copy of the employer's 
payroll records for the most recent 3 months showing tax withholding or a 
wage report from a payroll company showing wages paid to that employee 
for the most recent quarter with tax withholding; 
(c) 
If an employer is exempt from filing Form 9411CI-ME for group 
coverage, documentation of that exemption and a copy of the employer's 
payroll records for the most recent 3 months showing tax withholding or a 
wage report from a payroll company showing wages paid to that employee 
for the most recent quarter with tax withholding; or 
(d) If the name of the business owner or employee does not appear on Form 
9411C I-ME, a copy of one of the following: 
(i) Federal income tax Form Schedule C or Schedule F; 
(ii) Federal income tax Form 1120S, Schedule K-I; 
(iii) Federal income tax Form 1065, Schedule K-l; 
(iv) A workers' compensation insurance audit or evidence of a waiver of 
benefits under Title 39-A; 
(v) 
A description of operations in a commercial general liability 
insurance policy or equivalent insurance policy providing coverage for 
the business; or 
(vi) 
A signature card from a financial institution or credit union 
authorizing the employee to sign checks on a business checking or share 
draft account that is at least 6 months old; a notarized affidavit from the 
employer describing the duties of the employee and the average number 
of hours worked by the employee and attesting that the employer is not 
defrauding the carrier and is aware of the consequences of committing 
fraud or making a material misrepresentation to the carrier, including a 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT 1')-" to H.P. 1140, L.D. 1554 
loss of coverage and benefits; and, if the group coverage is purchased 
through a producer, a notarized affidavit from the producer affirming the 
producer's belief that the employer qualifies as an eligible group for 
coverage. 
In determining if a new business or a business that adds an owner or a new 
employee to payroll during the course of a year qualifies as an eligible group for 
2-person coverage under this subparagraph, the employer must submit an 
affidavit stating that all employees meet the criteria in this subparagraph and that 
the documentation and forms required under this subparagraph will be provided 
to the carrier when payroll records become available, when ownership 
distribution forms become available or the first renewal date of the coverage, 
whichever date is earlier. A false affidavit or misrepresentation on an affidavit 
submitted by an employer may result in the loss of group coverage and 
repayment of claims paid. This subparagraph may not be construed to prohibit a 
carrier from recognizing an employer as an eligible group if the employer has not 
produced the documentation required in this subparagraph. 
This subparagraph applies only to an employer applying for group health 
insurance coverage as a 2-person group 01'1 or after from October 1, 2001 to 
December 31, 2013. 
Sec. 10. 24-A MRSA §2S0S-B, sub-§2, ~C, as amended by PL 2011, c. 90, Pt. 
A, §6, is further amended to read: 
C. A carrier may vary the premium rate due to occupation and industry, family 
membership, participation in wellness programs and group size to the extent 
permitted by the federal Affordable Care Act. The superintendent may adopt rules 
setting forth appropriate methodologies regarding rate discounts for participation in 
wellness programs and rating for occupation and industry and group size pursuant to 
this paragraph. Rules adopted pursuant to this paragraph are routine technical rules 
as defined in Title 5, chapter 375, subchapter 2-A. 
Sec. 11. 24-A MRSA §2S0S-B, sub-§2, ~, as amended by PL 2011, c. 90, Pt. 
A, §8, is further amended to read: 
D. A carrier may vary the premium rate due to age and smoki1'1g states tobacco use 
only under the following schedule and within the listed percentage bands. 
(1) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State between July 15, 1993 and July 
14, 1994, the premium rate may not deviate above or below the community rate 
filed by the carrier by more than 50%. 
(2) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State between July 15, 1994 and July 
14, 1995, the premium rate may not deviate above or below the community rate 
filed by the carrier by more than 33%. 
(3) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State between July 15, 1995 and 
COMMITTEE AMENDMENT 
.()\~. 
~. 
COMMITfEE AMENDMENT "~" to H.P. 1140, L.D. 155' 
September 30, 2011, the premium rate may not deviate above or below the 
community rate filed by the carrier by more than 20%. 
(4) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State between October 1, 2011 and 
December 31, 2012, the maximum rate differential due to age filed by the carrier 
as determined by ratio is 2 to 1. The limitation does not apply for determining 
rates for an attained age of less than 19 years of age or more than 65 years of age. 
(5) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State between January 1, 2013 and 
December 31, 2013, the maximum rate differential due to age filed by the carrier 
as determined by ratio is 2.5 to 1. The limitation does not apply for determining 
rates for an attained age of less than 19 years of age or more than 65 years of age. 
(6) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State between January 1, 2014 and 
December 31, 2014, the maximum rate differential due to age filed by the carrier 
as determined by ratio is 3 to 1. The limitation does not apply for determining 
rates for an attained age of less than 19 years of age or more than 65 years of age. 
(7) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State between January 1, 2015 and 
December 31, 2015, the maximum rate differential due to age filed by the carrier 
as determined by ratio is 4 to 1 to the extent permitted by the federal Affordable 
Care Act. The limitation does not apply for determining rates for an attained age 
of less than 19 years of age or more than 65 years of age. 
(8) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State on or after January 1, 2016, the 
maximum rate differential due to age filed by the carrier as determined by ratio is 
to 1 to the extent permitted by the federal Affordable Care Act. The limitation 
does not apply for determining rates for an attained age of less than 19 years of 
age or more than 65 years of age. 
. 
(9) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State on or after October 1,2011, the 
maximum rate differential due to smoking status tobacco use filed by the carrier 
as determined by ratio is 1.5 to 1. 
Sec. 12. 24-A MRSA §2S0S-B, sub-§2, ~, as amended by PL 2001, c. 258, Pt. 
E, §4, is further amended to read: 
E. The superintendent may authorize a carrier to establish a separate community rate 
for an association group organized pursuant to section 2805-A or a trustee group 
organized pursuant to section 2806, as long as association group membership or 
eligibility for participation in the trustee group is not conditional on health status, 
claims experience or other risk selection criteria and all small group health plans 
offered by the carrier through that association or trustee group: 
COMMITTEE AMENDMENT 
~;o\CO. 
COMMITIEE AMENDMENT.f) "to H.P. 1140, L.D. 1554 
(1) Are otherwise in compliance with the premium rate requirements of this 
subsection; and 
(2) Are offered on a guaranteed issue basis to all eligible employers that are 
members of the association or are eligible to participate in the trustee group 
except that a professional association may require that a minimum percentage of 
the eligible professionals employed by a subgroup be members of the association 
in order for the subgroup to be eligible for issuance or renewal of coverage 
through the association. The minimum percentage must not exceed 90%. For 
purposes of this subparagraph, "professional association" means an association 
that: 
(a) Serves a single profession that requires a significant amount of education, 
training or experience or a license or certificate from a state authority to 
practice that profession; 
(b) Has been actively in existence for 5 years; 
(c) Has a constitution and bylaws or other analogous governing documents; 
(d) Has been formed and maintained in good faith for purposes other than 
obtaining insurance; 
(e) Is not owned or controlled by a carrier or affiliated with a carrier; 
(g) Has a least 1,000 members if it is a national association; 200 members if 
it is a state or local association; 
(h) 
All members and dependents of members are eligible for coverage 
regardless of health status or claims experience; and 
(i) Is governed by a board of directors and sponsors annual meetings of its 
members. 
Producers may only market association memberships, accept applications for 
membership or sign up members in the professional association where the individuals 
are actively engaged in or directly related to the profession represented by the 
professional association. 
Except for employers with plans that have grandfathered status under the federal 
Affordable Care Act, this paragraph does not apply to policies, contracts or 
certificates that are executed, delivered, issued for delivery, continued or renewed in 
this State on or after January 1, 2014. 
Sec. 13. 24-A MRSA §2S0S-B, sub-§2,~, as enacted by PL 2011, c. 90, Pt. A, 
§ 10, is amended to read: 
H. A carrier that offered small group health plans prior to October 1, 2011 may close 
its small group book of business sold prior to October I, 2011 and may establish a 
separate community rate for eligible groups applying for coverage under a small 
group health plan on or after October 1, 2011. If a carrier closes its small group book 
of business as permitted under this paragraph, the carrier may vary the premium rate 
COMMITTEE AMENDMENT 
.~\<O. 
\\. 
COMMITTEE AMENDMENT" R" to H.P. 1140, L.D. 1554 
for that closed book of business only as permitted in this paragraph and paragraphs C 
and C-l. 
(1) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State between October 1, 2011 and 
December 31, 2012, the maximum rate differential due to age filed by the carrier 
as determined by ratio is 2 to 1. The limitation does not apply for determining 
rates for an attained age of less than 19 years of age or more than 65 years of age. 
(2) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State between January 1, 2013 and 
December 31,2013, the maximum rate differential due to age filed by the carrier 
as determined by ratio is 2.5 to 1. The limitation does not apply for determining 
rates for an attained age of less than 19 years of age or more than 65 years of age. 
(3) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State between January 1, 2014 and 
December 31, 2014, the maximum rate differential due to age filed by the carrier 
as determined by ratio is 3 to 1. The limitation does not apply for determining 
rates for an attained age of less than 19 years of age or more than 65 years of age. 
(4) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State between January 1, 2015 and 
December 31,2015, the maximum rate differential due to age filed by the carrier 
as determined by ratio is 4 to 1 to the extent permitted by the federal Affordable 
Care Act. The limitation does not apply for determining rates for an attained age 
of less than 19 years of age or more than 65 years of age. 
(5) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State on or after January 1, 2016, the 
maximum rate differential due to age filed by the carrier as determined by ratio is 
to 1 to the extent permitted by the federal Affordable Care Act. The limitation 
does not apply for determining rates for an attained age of less than 19 years of 
age or more than 65 years of age. 
(6) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State on or after October 1, 2011, the 
maximum rate differential due to smoking status tobacco use filed by the carrier 
as determined by ratio is 1.5 to 1. 
Sec. 14. 24-A MRSA §2S0S-B, sub-§2, ~ is enacted to read: 
I. Except for plans that have grandfathered status under the federal Affordable Care 
Act, beginning January 1, 2014, a carrier shall consider all enrollees in all small 
group health plans offered by the carrier to be members of a single risk pool to the 
extent required by the federal Affordable Care Act. 
Sec. 15. 24-A MRSA §2S08-B, sub-§2-B, ~C, as enacted by PL 2003, c. 469, 
Pt. E, § 16, is amended to read: 
C. When a filing is not accompanied by the information upon which the carrier 
supports the filing or the superintendent does not have sufficient information to 
COMMITTEE AMENDMENT 
~;()\~. 
COMMITTEE AMENDMENT " ~" to H.P. 1140, L.D. 1554 
determine whether the filing meets the requirements that rates not be excessive, 
inadequate; or unfairly discriminatory or HOt ia eoHtf'liaaee with seetioa 6913, the 
superintendent shall require the carrier to furnish the information upon which it 
supports the filing. 
Sec. 16. 24-A MRSA §2S0S-B, sub-§2-C, as amended by PL 2011, c. 90, Pt. D, 
§4, is further amended to read: 
2-C. Guaranteed loss ratio. Notwithstanding subsection 2-B, at tHe earrier's of'tioa, 
rate filings for a credible block of small group health plans may be filed in accordance 
with this subsection instead of subsection 2-B. 
Rates filed in accordance with this 
subsection are filed for informational purposes. 
A. A block of small group health plans is considered credible if the anticipated 
average number of members during the period for which the rates will be in effect is 
at least 1,000 or ifit meets eredieility standards adof'ted e,. tHe superiateadeat ey mle 
for full or partial credibility pursuant to the federal Affordable Care Act. The rate 
filing must state the anticipated average number of members during the period for 
which the rates will be in effect and the basis for the estimate. If the superintendent 
determines that the number of members is likely to be less than 1,000 aad tHe bloek 
does Hot satisfy aay altemative eredibility staadards adof'ted by mle needed to meet 
the credibility standard, the filing is subject to subsection 2-B, eKeOJ)t as f'ro:vided ia 
paragrapH A 1. 
A 1. A earrier tHat eleeted to file rates ia aeeordaaee '.llitH this sueseetioa prior to 
80J)teHtber 1, 2004 Hta,. eoatiooe to file rates ia aeeordaaee witH tHis subseetioa as 
loag as the aatieif'ated aUfHber of HteHtber Htoaths for a 12 Htoath period is at least 
-l-,()OO-: 
B. Oa aft aaaual sehedule as deteffHiaed by the superiateadeat, the earrier SHall file a 
ref'ort witH tHe superiateadeBt SHo\viBg aggregate eamed premiwns aad iael:lITed 
elaiHts for tHe period the rates were ia effeet. Iaeurred elaims must iaelude elaims 
paid to a date after the ead of tHe aHOOal ref'ortiBg f'eriod aad aft estiHtate of l:lHpaid 
elaiHts. THe report must state HO'N tHe unpaid elaiHts estiHtate was determiaed. The 
superiBteadeat shall determiae tHe rOJ)ortiag period aad the f'aid to date; begilHliBg 
Jaooary 1, 2011, both tHe rOJ)ortiag period aad tHe paid to date must be eoasisteat 
with those for the rebates required purSUaftt to seetioa 4319 aad to the federal 
Affordable Care Aet aftd federal regulatioas adof'ted f'ursl:laat to the federal 
Affordable Care Act. 
C. If iacl:lITedclaiHts were less thaa 78% of aggregate earned f'remfUfHS over a 
eoatiauous 36 HtOatH period, the earrier SHall refuBd a pereeatage of the premiUHt to 
the eurreat ia foree polieyholder. 
For the f'lH'floses of caleulatiag tHis loss ratio 
pereentage, aay paymeats paid pursuant to foffHer seetioa 6913 must ee treated as 
iaeurred elaims. THe eKeess premiuHt is the aHtOl:lHt of preHtiuHt a9o:ve that araouat 
aeeessary to aeHieve a 78% loss ratio for all of tHe carrier's sHtall group polieies 
duriag the SarRe 36 Htoath f'eriod. The refufld must ee distriel:lted to polieYHolders ia 
aft araouat reasoRably ealculated to eorrespoRd to the aggregate eKf'erieRee of all 
f'olieyholders HoldiRg polieies HaviRg siHtilar eeaefits. THe total of all refuRds must 
eQl:lal the eKeess premiums. 
COMMITTEE AMENDMENT 
Vo.;()\ ~. 
COMMITfEEAMENDMENT"~"tOH.P.1140'L.D.1554 
(1) FOf deteffftination of loss ratio percentages in 2.005, acmal aggregate in6t:lITed 
claims e~~enses include expenses ineurred in 2.005 afld projected expenses fer 
2006 afld 2007. 
Fer deteffftination of less ratio percentages in 2006, acmal 
inctHTed claims expenses include e~Epenses in 2.005 and 2006 and projected 
expenses fer 2.007. 
(2.) The saperiRfeedeet may 'Naive the reql:liremeRf fer refueds dl:l£ieg the first 3 
years after the effective date of this saesectioe. 
D. The superieteedeet may require further SllfJport fer the uepaid claims estimate 
and may reqaire refueds to be recalculated if the estimate is feued to be unreasoeably 
~ 
B. 
The saperieteeaeet may adept Riles settieg ferth appropriate methodolegies 
regarding reports, refunds aed credibility standards pursaaet to this saesectioe. Rales 
adopted parsuam to this subsectioe are foatiee techeical rules as defieed ie Title 5, 
ehapter 375, saechapter 2. A. 
Sec. 17. 24-A MRSA §2808-B, sub-§6,~, as enacted by PL 1993, c. 477, Pt. B, 
§ 3 and affected by Pt. F, § 1, is amended to read: 
I. Notwithstanding any other provision of this section, prior to January 1, 2014, a 
carrier may choose whether it will offer to groups having only one member coverage 
under the carrier's individual health policies offered to other individuals in this State 
in accordance with section 2736-C or coverage under a small group health plan in 
accordance with this section, or both, but the carrier need not offer to groups of one 
both small group and individual health coverage. 
Sec. 18. 24-A MRSA §2850, sub-§2, V is enacted to read: 
F. 
Except for individual health plans in effect on March 23, 2010 that have 
grandfathered status under the federal Affordable Care Act, a carrier as defined in 
section 4301-A, subsection 3 offering a health plan as defined in section 4301-A, 
subsection 7 may not apply a preexisting condition exclusion to any enrollee under 19 
years of age. A preexisting condition exclusion may not be imposed on any enrollee 
after January 1, 2014 to the extent prohibited by the federal Affordable Care Act. 
Sec. 19. 24-A MRSA §4218-A is enacted to read: 
§4218-A. Compliance with the Affordable Care Act 
The superintendent may adopt and amend rules, establish standards and enforce 
federal statutes and regulations in order to carry out the purposes of the federal 
Affordable Care Act. Rules or amendments to rules adopted pursuant to this section, 
including amendments to major substantive rules, are routine technical rules as defined in 
Title 5, chapter 375, subchapter 2-A. 
Sec. 20. 24-A MRSA §4301-A, sub-§I, as amended by PL 2007, c. 199, Pt. B, 
§ 1, is further amended to read: 
1. 
Adverse health care treatment decision. 
"Adverse health care treatment 
decision" means a health care treatment decision made by or on behalf of a carrier 
offering or renewing a health plan denying in whole or in part payment for or provision of 
COMMITTEE AMENDMENT 
.()\~. 
v... 
COMMIITEE AMENDMENT .. R 
.. to H.P. tl4<l, L.D. 1554 
otherwise covered services requested by or on behalf of an enrollee. "Adverse health care 
treatment decision" includes a rescission determination and an initial coverage eligibility 
determination, consistent with the requirements of the federal Affordable Care Act. 
Sec. 21. 24-A MRSA §4301-A, sub-§3, ~~F and G, as enacted by PL 1999, c. 
742, §3, are further amended to read: 
F. A multiple-employer welfare arrangement licensed pursuant to chapter 81; ef 
G. 
A self-insured employer subject to state regulation as described in section 
2848-A~; or 
Sec. 22. 24-A MRSA §4301-A, sub-§3, ~ 
is enacted to read: 
H. Notwithstanding any other provision of this Title, an entity offering coverage in 
this State that is subject to the requirements of the federal Affordable Care Act. 
Sec. 23. 24-A MRSA §4301-A, sub-§7, as enacted by PL 1999, c. 742, §3, is 
amended to read: 
7. Health plan. "Health plan" means a plan offered or administered by a carrier that 
provides for the financing or delivery of health care services to persons enrolled in the 
plan, other than a plan that provides only accidental injury, specified disease, hospital 
indemnity, Medicare supplement, disability income, long-term care or other limited 
benefit coverage not subject to the requirements of the federal Affordable Care Act. A 
plan that is subject to the requirements of the federal Affordable Care Act and offered in 
this State by a carrier, including, but not limited to, a qualified health plan offered on an 
American Health Benefit Exchange or a SHOP Exchange established pursuant to the 
federal Affordable Care Act, is a health plan for purposes of this chapter. 
Sec. 24. 24-A MRSA §4302, sub-§6 is enacted to read: 
6. Reporting required pursuant to the Affordable Care Act. Notwithstanding 
any other requirements of this Title, a carrier shall provide to the Secretary of the United 
States Department of Health and Human Services, and make available to the public when 
required by federal law, any information required by the federal Affordable Care Act. 
Carriers shall provide the information to the superintendent upon request. 
Sec. 25. 24-A MRSA §4303, sub-§4, ~ 
is enacted to read: 
E. Health plans subject to the requirements of the federal Affordable Care Act must 
comply with federal claims and appeal requirements, including, but not limited to, the 
requirement that benefits for an ongoing course of treatment may not be reduced or 
terminated without advance notice and an opportunity for advance review, consistent 
with the requirements of the federal Affordable Care Act. 
Sec. 26. 24-A MRSA §4303, sub-§15 is enacted to read: 
15. Uniform explanation of coverage documents and standardized definitions. 
A carrier offering a health plan in this State shall: 
A. 
Provide to applicants, enrollees and policyholders or certificate holders a 
summary of benefits and an explanation of coverage that accurately describe the 
benefits and coverage under the applicable plan or coverage. A summary of benefits 
COMMITTEE AMENDMENT 
~;()\ <0. 
COMMITTEE AMENDMENT ,,~ .. to H.P. 1140, L.D. 1554 
and an explanation of coverage must conform with the requirements of the federal 
Affordable Care Act; and 
B. 
Use standard definitions of insurance-related and medical-related terms in 
connection with health insurance coverage as required by the federal Affordable Care 
Act. 
Sec. 27. 24-A MRSA §4303, sub-§16 is enacted to read: 
16. Language and culture. All notices to applicants, enrollees and policyholders or 
certificate holders subject to the requirements of the federal Affordable Care Act must be 
provided in a culturally and linguistically appropriate manner consistent with the 
requirements of the federal Affordable Care Act. 
Sec. 28. 24-A MRSA §4306, as amended by PL 2007, c. 199, Pt. B, §15, is 
further amended to read: 
§4306. Enrollee choice of primary care provider 
A carrier offering or renewing a managed care plan shall allow enrollees to choose 
their own primary care providers, as allowed under the managed care plan's rules, from 
among the panel of participating providers made available to enrollees under the managed 
care plan's rules. 
A carrier shall allow physicians, including, but not limited to, 
pediatricians and physicians who specialize in obstetrics and gynecology, and certified 
nurse practitioners who have been approved by the State Board of Nursing to practice 
advanced practice registered nursing without the supervision of a physician pursuant to 
Title 32, section 2102, subsection 2-A, to serve as primary care providers for managed 
care plans. A carrier is not required to contract with certified nurse practitioners or 
physicians as primary care providers in any manner that exceeds the access and provider 
network standards required in this chapter or chapter 56, or any rules adopted pursuant to 
those chapters. A carrier shall allow enrollees in a managed care plan to change primary 
care providers without good cause at least once annually and to change with good cause 
as necessary. When an enrollee fails to choose a primary care provider, the carrier may 
assign the enrollee a primary care provider located in the same geographic area in which 
the enrollee resides. 
Sec. 29. 24-A MRS A §4306-A is enacted to read: 
§4306-A. Patient access to obstetrical and gynecological care 
Notwithstanding any other requirements of this Title, a carrier offering a health plan 
in this State subject to the requirements of the federal Affordable Care Act: 
1. Authorization or referral not required. May not require authorization or 
referral by the carrier or any other person, including a primary care provider, in the case 
of a female enrollee who seeks coverage for obstetrical or gynecological care provided by 
a participating health care professional as described in the federal Affordable Care Act 
who specializes in obstetrics or gynecology. The health care professional shall agree to 
otherwise adhere to the health plan's or carrier's policies and procedures, including 
procedures regarding referrals and obtaining prior authorization and providing services 
pursuant to a treatment plan, if any, approved by the carrier; and 
COMMITTEE AMENDMENT 
.~\~. 
~. 
COMMITIEE AMENDMENT"~ , to H.P. 1140, L.D. 1554 
2. 
Treated as primary care. 
Shall treat the provIsIon of obstetrical and 
gynecological care by a participating health care professional as described in the federal 
Affordable Care Act who specializes in obstetrics or gynecology, pursuant to subsection 
1, as authorized by the primary care provider and the authorization of related obstetrical 
and gynecological items and services by that professional as the authorization of the 
primary care provider. 
Sec. 30. 24-A MRSA §4309-A is enacted to read: 
§4309-A. Compliance with the Affordable Care Act 
1. Carriers. A carrier shall comply with all applicable requirements of the federal 
Affordable Care Act. 
2. Superintendent. The superintendent may enforce and administer this section 
through all powers provided under this Title and Title 24. The superintendent may adopt 
and amend rules, establish standards and enforce federal statutes and regulations in order 
to carry out the purposes of the federal Affordable Care Act. Rules or amendments 
adopted pursuant to this subsection, including amendments to major substantive rules, are 
routine tec~nical rules as defined in Title 5, chapter 375, subchapter 2-A. 
Sec. 31. 24-A MRSA §4312, sub-§l, as enacted by PL 1999, c. 742, § 19, is 
amended to read: 
1. 
Request for external review. 
An enrollee or the enrollee's authorized 
representative shall make a written request for external review of an adverse health care 
treatment decision to the bureau. Except as provided in subsection 2, an enrollee may not 
make a request for external review under a group plan until the enrollee has exhausted all 
levels of a carrier's internal grievance procedure and may not make a request for external 
review under an individual plan until the enrollee has exhausted one level of a carrier's 
internal grievance procedure. A request for external review must be made within 12 
months of the date an enrollee has received a final adverse health care treatment decision 
under a carrier's internal grievance procedure. An enrollee may not be required to pay 
any filing fee as a condition of processing a request for external review. 
Sec. 32. 24-A MRSA §4312, sub-§2, as enacted by PL 1999, c. 742, §19, is 
amended to read: 
2. Expedited request for external review. An enrollee or an enrollee's authorized 
representative is not required to exhaust all levels of a carrier's internal grievance 
procedure in accordance with subsection I before filing a request for external review if: 
A. The carrier has failed to make a decision on an internal grievance within the time 
period required or has otherwise failed to adhere to all the requirements applicable to 
the appeal pursuant to state and federal law or the enrollee has applied for expedited 
external review at the same time as applying for an expedited internal appeal; 
B. 
The carrier and the enrollee mutually agree to bypass the internal grievance 
procedure; 
C. The life or health of the enrollee is in serious jeopardy; 6f 
D. The enrollee has died,.;...Q! 
COMMITTEE AMENDMENT 
COMMTITEE AMENDMENT .. fl" to Hl'. 1140, L.D. 1554 
E. The adverse health care treatment decision to be reviewed concerns an admission, 
availability of care. a continued stay or health care services when the claimant has 
received emergency services but has not been discharged from the facility that 
provided the emergency services. 
Sec. 33. 24-A MRSA §4318, sub-§4, as reallocated by RR 2009, c. 2, §70, is 
amended to read: 
4. Disclosure. A health plan issued after the effective date of this section that 
includes an annual or lifetime maximum aggregate benefit limit as permitted under 
subsection 3 and under section 4320 must include a disclosure of the applicable limit on 
the face page of the individual policy or group certificate. The disclosure must be printed 
in a font that is larger or bolder than the font used in the body of the face page. 
Sec. 34. 24-A MRSA §§4320 to 4320-G are enacted to read: 
§4320. No lifetime or annual limits on health plans subject to the Affordable Care 
Act 
Notwithstanding the requirements of section 4318. a carrier offering a health plan 
subject to the federal Affordable Care Act may not: 
1. Establish lifetime limits. Establish lifetime limits on the dollar value of benefits 
for any participant or beneficiary; or 
2. Establish annual limits. Establish annual limits on the dollar value of essential 
benefits, except that, prior to January 1, 2014, health plans may include restricted annual 
limits on essential benefits consistent with the requirements of the federal Affordable 
Care Act and may establish annual limits consistent with waivers granted by the 
Secretary of the United States Department of Health and Human Services. 
§4320-A. Coverage of preventive health services 
Notwithstanding any other requirements of this Title, a carrier offering a health plan 
subject to the federal Affordable Care Act shall. at a minimum. provide coverage for and 
may not impose cost-sharing requirements for preventive services as required by the 
federal Affordable Care Act. 
§4320-B. Extension of dependent coverage 
A carrier offering a health plan subject to the requirements of the federal Affordable 
Care Act that provides dependent coverage of children shall continue to make such 
coverage available for an adult child until the child turns 26 years of age. consistent with 
the federal Affordable Care Act. 
§4320-C. Emergency services 
If a carrier offering a health plan subject to the requirements of the federal Affordable 
Care Act urovides or covers any benefits with respect to services in an emergency 
department of a hospital, the plan must cover emergency services in accordance with the 
requirements of the federal Affordable Care Act. including requirements that emergency 
services be covered without prior authorization and that cost-sharing reguirements, 
COMMITTEE AMENDMENT 
~~()\<o. 
CDMMITIEE AMENDMENT .p"", H.P. 1140. L.D. 1554 
expressed as a copayment amount or coinsurance rate, for out-of-network services are the 
same as requirements that would apply if such services were provided in network. 
§4320-D. C;omprehensive health coverage 
Notwithstanding any other requirements of this Title, a carrier offering a health plan 
subject to the requirements of the federal Affordable Care Act shall, at a minimum, 
provide coverage that incorporates essential benefits and cost-sharing limitations 
consistent with the requirements of the federal Affordable Care Act. 
§4320-E. Reinsurance, risk corridors and risk adjustment 
1. 
Transitional reinsurance nro!!ram. 
The superintendent shall establish a 
transitional reinsurance program for calendar years 2014, 2015 and 2016 as required by 
Section 1341 of the federal Affordable Care Act. 
2. Risk corridors. A carrier shall make any payments required under the risk 
corridors program established by the Secretary of the United States Department of Health 
and Human Services for calendar years 2014, 2015 and 2016 as required by Section 1342 
of the federal Affordable Care Act. 
3. Risk adjustment. The superintendent shall establish a risk adjustment program as 
required by Section 1343 of the federal Affordable Care Act. 
§4320-F. Oversight of plans offered on the American Health Benefit Exchange and 
the SHOP Exchange 
1. Superintendent's authority preserved. Except as otherwise expressly provided 
by applicable law, the requirements established by this Title, Title 24 and rules adopted 
by the superintendent continue to apply to carriers and health plans and are not 
extinguished or modified in any way by: 
A. Certification of a health plan as a qualified health plan or any other determination 
made by the American Health Benefit Exchange or the SHOP Exchange pursuant to 
the federal Affordable Care Act; or 
B. Recognition by the applicable federal agency of a carrier as a qualified nonprofit 
health insurance issuer or as an issuer of multi state qualified health plans, or of a 
health plan as a multi state qualified health plan, pursuant to the federal Affordable 
Care Act. 
2. Coordination with exchanges. The superintendent has all additional powers and 
duties conferred upon a state insurance regulator with respect to the American Health 
Benefit Exchange and the SHOP Exchange by the federal Affordable Care Act. The 
superintendent may enter into agreements with the American Health Benefit Exchange 
and the SHOP Exchange relating to coordination of responsibilities, and such agreements 
may provide for the superintendent to assume additional authority relating to the 
certification of qualified health plans or the authorization of a carrier to participate in the 
American Health Benefit Exchange or the SHOP Exchange. 
COMMITTEE AMENDMENT 
.a\~: 
~. 
. 
COMMITTEE AMENOMENf .. p 
.. to H.P. 1140,1.0. 1554 
§4320-G. Applicability to health plans grandfathered under the Mfordable Care 
Act 
A health plan that is exempt from certain requirements of the federal Affordable Care 
Act because it has grandfathered status is also exempt. to the same extent. from 
substantially similar provisions in this Title and Title 24 enacted after January 1, 2011, 
except to the extent that those provisions state that they apply to grandfathered health 
plans. 
Sec. 35. 24-A MRSA §6451-A, sub-§3-A is enacted to read: 
3-A. Qualified nonprofit health insurance issuers. Qualified nonprofit health 
insurance issuers as defined in Section 1322 of the federal Affordable Care Act are 
considered health organizations for purposes of this chapter. 
Sec. 36. 
Review of transitional reinsurance, risk corridors and risk 
adjustment programs. No later than January 1,2013, the Department of Professional 
and Financial Regulation, Bureau of Insurance shall submit the bureau's proposed 
transitional reinsurance program and risk adjustment program established pursuant to the 
Maine Revised Statutes, Title 24-A, section 4320-E and any information related to the 
risk corridors program established pursuant to Section 1342 of the federal Affordable 
Care Act for review by the joint standing committee of the Legislature having jurisdiction 
over insurance and financial services matters. The joint standing committee may report 
out a bill to the First Regular Session of the 126th Legislature based on the bureau's 
proposed transitional reinsurance program or risk adjustment program.' 
SUMMARY 
This amendment replaces the bill and does the following. 
1. It retains provisions in the bill that amend the health insurance laws to incorporate 
changes to implement the requirements of the federal Patient Protection and Affordable 
Care Act. 
2. It removes the provisions in the bill that are inconsistent with changes made in 
Public Law 2011, chapter 90 related to rating for individual and small group health plans. 
3. 
It removes the provisions in the bill that define "Affordable Care Act" and 
conform state law to federal law relating to minimum medical loss ratios as these 
provisions are included in Public Law 2011, chapter 90. 
4. It makes technical changes and adds cross-references. 
5. It requires the Department of Professional and Financial Regulation, Bureau of 
Insurance to submit its proposed transitional reinsurance program and risk adjustment 
program and information related to the federal risk corridors program to the Legislature 
for review no later than January 1,2013. 
FISCAL NOTE REQUlRED 
(See Attached) 
COMMITTEE AMENDMENT 
Approved: 06/03111 
fraC!. 
LD 1554 
LR443(02) 
An Act To Implement the Requirements of the Federal Patient Protection and Affordable Care Act 
Fiscal Note for Bill as Amended by Committee Amendment 'it' 
Committee: Insurance and Financial Services 
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - Other Special Revenue Funds 
Fiscal Detail and Notes 
Additional costs to the Department of Professional and Financial Regulation can be absorbed utilizing existing 
budgeted resources. 
LR0443(02) - Fiscal Note - Page 1 of 1