An Act To Extend the Scope of the Maine Guaranteed Access Reinsurance Association
Maine Legislature, Session 125, LD 1670
Committee: Insurance and Financial Services
Sponsors: COURTNEY, LANGLEY, PLOWMAN, RAYE, SNOWE-MELLO, WHITTEMORE, McKANE, MORISSETTE
Amends: 24-A MRSA §3952, 24-A MRSA §3958

Legislative Document 
No. 1670 
S.P. 569 
In Senate, December 21, 2011 
An Act To Extend the Scope of the Maine Guaranteed Access 
Reinsurance Association 
Approved for introduction by a majority of the Legislative Council pursuant to Joint Rule 
203. 
Received by the Secretary of the Senate on December 19, 2011.  Referred to the Committee 
on Insurance and Financial Services pursuant to Joint Rule 308.2 and ordered printed pursuant 
to Joint Rule 218. 
JOSEPH G. CARLETON, JR. 
Secretary of the Senate 
Presented by Senator COURTNEY of York. 
Cosponsored by Senators: LANGLEY of Hancock, PLOWMAN of Penobscot, President 
RAYE of Washington, SNOWE-MELLO of Androscoggin, WHITTEMORE of Somerset, 
Representatives: McKANE of Newcastle, MORISSETTE of Winslow. 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1.  24-A MRSA §3952, sub-§9, as enacted by PL 2011, c. 90, Pt. B, §8, is 
amended to read: 
9.  Member insurer.  "Member insurer" means an insurer that offers individual 
health plans and is actively marketing individual health plans in this State, or that offers 
small group health plans to groups of 10 or fewer members and is actively marketing 
small group health plans to groups of 10 or fewer members in this State. 
Sec. 2.  24-A MRSA §3958, sub-§1, as enacted by PL 2011, c. 90, Pt. B, §8, is 
amended to read: 
1.  Reinsurance amount.  A member insurer offering an individual health plan must 
be reinsured by the association to the level of coverage provided in this subsection and is 
liable to the association for the reinsurance premium rate established in accordance with 
subsection 2. 
A.  The association may not reimburse a member insurer with respect to claims of a 
person designated for reinsurance by the member insurer pursuant to section 3959 
until the insurer has incurred an initial level of claims for that person of $7,500 for 
covered benefits in a calendar year.  In addition, the insurer is responsible for 10% of 
the next $25,000 of claims paid during a calendar year.  The association shall 
reimburse insurers for claims paid in excess of $32,500.  The association may 
annually adjust the initial level of claims and the maximum limit to be retained by the 
insurer to reflect increases in costs and utilization within the standard market for 
individual health plans within in the State.  The adjustments may not be less than the 
annual change in the Consumer Price Index for medical care services unless the 
superintendent approves a lower adjustment factor as requested by the association. 
B.  An insurer shall apply all managed care, utilization review, case management, 
preferred provider arrangements, claims processing and other methods of operation 
without regard to whether claims paid for coverage are reinsured under this 
subsection. 
SUMMARY 
This bill extends the provisions of the law governing the Maine Guaranteed Access 
Reinsurance Association to insurers that offer small group health plans to groups of 10 or 
fewer members.