An Act To Amend the Laws Pertaining to Employee Health Insurance
Maine Legislature, Session 126, LD 1495
Committee: Insurance and Financial Services
Sponsors: POULIOT, ALFOND, BERRY, EVES, VOLK, WILSON, KATZ
Amends: 5 MRSA §285

Legislative Document 
No. 1495 
H.P. 1072 
House of Representatives, May 2, 2013 
An Act To Amend the Laws Pertaining to Employee Health 
Insurance 
(AFTER DEADLINE) 
Approved for introduction by a majority of the Legislative Council pursuant to Joint Rule 
205. 
Reference to the Committee on Insurance and Financial Services suggested and ordered 
printed. 
MILLICENT M. MacFARLAND 
Clerk 
Presented by Representative POULIOT of Augusta. 
Cosponsored by President ALFOND of Cumberland and 
Representatives: BERRY of Bowdoinham, Speaker EVES of North Berwick, McCABE of 
Skowhegan, VOLK of Scarborough, WILSON of Augusta, Senator: KATZ of Kennebec. 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1.  5 MRSA §285, sub-§7, ¶C, as enacted by PL 2009, c. 213, Pt. GG, §1, is 
amended to read: 
C.  Beginning July 1, 2010, except as provided in subsection 7-A, the State, through 
the commission, shall pay a share of the individual premium for the standard plan 
identified and offered by the commission as follows. 
(1)  For an employee whose base annual rate of pay is projected to be less than or 
equal to $30,000 on July 1st of the state fiscal year for which the premium 
contribution is being determined, the State shall pay 95% of the individual 
premium for the standard plan identified and offered by the commission and 
available to the employee as authorized by the commission. 
(2)  For an employee whose base annual rate of pay is projected to be greater than 
$30,000 and less than $80,000 on July 1st of the state fiscal year for which the 
premium contribution is being determined, the State shall pay 90% of the 
individual premium for the standard plan identified and offered by the 
commission and available to the employee as authorized by the commission. 
(3)  For an employee whose base annual rate of pay is projected to be $80,000 or 
greater on July 1st of the state fiscal year for which the premium contribution is 
being determined, the State shall pay 85% of the individual premium for the 
standard plan identified and offered by the commission and available to the 
employee as authorized by the commission. 
Sec. 2.  5 MRSA §285, sub-§7-A, as amended by PL 2011, c. 1, Pt. FF, §1, is 
further amended to read: 
7-A.  Health credit premium program.  Notwithstanding subsection 7, paragraph 
C,  the State may pay a greater proportion of the total cost of the individual premium for 
the standard plan identified and offered by the commission and available to the employee 
as authorized by the commission. The commission shall develop a health credit premium 
program whereby employees are provided incentives to engage in healthy behaviors in an 
effort to improve the health status of the state employee population and to help reduce 
costs to the state employee health insurance program.  The commission shall define 
benchmarks for healthy behaviors that, if met by an individual employee, result in the 
State's paying a greater share of the individual premium. Adjustments to the state share of 
the individual premium must be applied once each year in advance of the beginning of 
the plan year. 
The benchmarks developed by the commission must provide 2 discrete levels for the state 
share of the individual premium as follows. 
A.  For employees whose base annual rate of pay is projected to be less than or equal 
to $30,000 on July 1st of the state fiscal year for which the premium contribution is 
being determined, the health credit premium program must provide the individual 
employee meeting the specified benchmarks with the opportunity to have the state 
share of the individual premium paid at 100% or 95%. The state share is determined 
by the specific benchmarks met by the employee. 
B.  For employees whose base annual rate of pay is projected to be greater than 
$30,000 and less than $80,000 on July 1st of the state fiscal year for which the 
premium contribution is being determined, the health credit premium program must 
provide the individual employee meeting the specified benchmarks with the 
opportunity to have the state share of the individual premium paid at 95% or 90%. 
The state share is determined by the specific benchmarks met by the employee. 
C.  For employees whose base annual rate of pay is projected to be $80,000 or greater 
on July 1st of the state fiscal year for which the premium contribution is being 
determined, the health credit premium program must provide the individual employee 
meeting the specified benchmarks with the opportunity to have the state share of the 
individual premium paid at 90% or 85%. The state share is determined by the specific 
benchmarks met by the employee. 
SUMMARY 
This bill provides that state employee contributions to the cost of the individual 
health insurance premium and credits for healthy behaviors are based on actual rate of 
pay rather than projected rate of pay.