An Act To Eliminate Insurance Rating Based on [g~, Geographic Location or Smoking History and To Reduce Rate Variability Due to Group Size
Maine Legislature, Session 128, LD 0769
Committee Amendment CA_A_H143 (House)

COMMITTEE AMENDMENT "{j" to H.P. 549, L.D. 769, Bill, "An Act To 
Eliminate Insurance Rating Based on [g~, Geographic Location or Smoking History and 
To Reduce Rate Variability Due to Group Size" 
Amend the bill by striking out the title and substituting the following: 
'An Act To Reduce Insurance Rate Variability Due to Geographic Location or 
Tobacco Use and To Maintain Current Rating Based on Age and Group Size' 
Amend the bill in section 1 by striking out all of paragraph C-1 (page 1, lines 4 to 11 
in L.D,) and inserting the following: 
'C-1. A carrier may vary the premium rate due to geographic area in accordance with 
the limitation set out in this paragraph. For all policies, contracts or certificates that 
are executed, delivered, issued for delivery, continued or renewed in this State eH--ei' 
a:fteF between July 1, 2012 and December 31, 2018, the rating factor used by a carrier 
for geographic area may not exceed 1.5. For all policies, contracts or certificates that 
are executed, delivered, issued for delive1y, continued or renewed in this State on or 
after Januruy 1, 2019, the rating factor used by a cruTier for geographic area may not 
exceed 1.2.' 
Amend the bill in section 2 in paragraph D by striking out all of subparagraphs (7) 
and (8) (page 1, lines 39 to 41 and page 2, lines 1 to 13 in L.D.) and inserting the 
following: 
'(7) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State on or after between January 1, 
2015 and December 31, 2018, the maximum rate differential due to age filed by 
the carrier as determined by ratio is 5 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. For all 
policies, contracts or certificates that are executed, delivered, issued for delivery, 
continued or renewed in this State on or after January 1, 2019, the maximum rate 
differential due to age filed by the carrier as determined by ratio is 3 to 1. The 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT «A" to H.P. 549, L.D. 769 
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 ce1tificates that are executed, delivered, issued 
for delivery, continued or renewed in this State on or after between July 1, 2012 
and December 31, 2018, the maximum rate differential due to tobacco use filed 
by the carrier as determined by ratio is 1.5 to 1. For all policies, contracts or 
certificates that are executed, delivered, issued for delivery, continued or renewed 
in this State on or after January 1, 2019, the maximum rate differential due to 
tobacco use filed by the carrier as determined by ratio is 1.2 to 1.' 
Amend the bill in section 3 in paragraph I by striking out all of subparagraphs (5) and 
( 6) (page 3, lines 1 to 16 in L.D.) and inserting the following: 
'(5) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State on or after between January 1, 
2016 and December 31, 2018, the maximum rate differential due to age filed by 
the carrier as determined by ratio is 5 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. For all 
policies, contracts or certificates that are executed, delivered, issued for delivery, 
continued or renewed in this State on or after January 1, 2019, the maximum rate 
differential due to age filed by the canier 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 on or after between July 1, 2012 
and December 31, 2018, the maximum rate differential due to tobacco use filed 
by the canier as determined by ratio is 1.5 to 1. For all policies, contracts or 
ce1tificates that are executed, delivered, issued for delivery, continued or renewed 
in this State on or after January 1, 2019, the maximum rate differential due to 
tobacco use filed by the carrier as determined by ratio is 1.2 to 1.' 
Amend the bill in section 4 by striking out all of paragraph C-1 (page 3, lines 23 to 30 
in L.D.) and inserting the following: 
'C-1. A carrier may vary the premium rate due to geographic area in accordance with 
the limitation set out in this paragraph. For all policies, contracts or ce1tificates that 
are executed, delivered, issued for delivery, continued or renewed in this State en-er 
after between October 1, 2011 and December 31, 2018, the rating factor used by a 
carrier for geographic area may not exceed 1.5. 
For all policies, contracts or 
ce1tificates that are executed, delivered, issued for delivery, continued or renewed in 
this State on or after January 1, 2019. the rating factor used by a carrier for 
geographic area may not exceed 1.2.' 
Amend the bill in section 5 in paragraph D in subparagraph (8) in the 3rd line (page 
4, line 30 in L.D.) by striking out the following: "2017" and inserting the following: 
'2018' 
COMMITTEE AMENDMENT 
COMMIITEE AMENDMENT"~,, to H.P. 549, L.D. 769 
Amend the bill in section 5 in paragraph D by striking out all of subparagraphs (9) to 
(13) (page 4, lines 3 5 to 44 and page 5, lines 1 to 12 in L.D.) and inserting the following: 
'(9) For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State on or after between October 1, 
2011 and December 31, 2018, the maximum rate differential due to tobacco use 
filed by the carrier as determined by ratio is 1.5 to 1. For all policies, contracts or 
certificates that are executed, delivered, issued for delivery, continued or renewed 
in this State on or after January 1, 2019, the maximum rate differential due to 
tobacco use filed by the carrier as determined by ratio is 1.2 to 1. 
(10) For all policies, contracts or ce1tificates that are executed, delivered, issued 
for delivery, continued or renewed in this State on or after January 1, 2019, the 
maximum rate differential due to age and group size 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.' 
Amend the bill in section 6 in paragraph H in subparagraph (5) in the 3rd line (page 
6, line 5 in L.D .) by striking out the following: "2017 '1 and inserting the following: '2018' 
Amend the bill in section 6 in paragraph H by striking out all of subparagraphs ( 6) to 
(10) (page 6, lines 10 to 31 in L.D.) and inserting the following: 
'(6) Fm all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State on or after between October 1, 
2011 and December 31, 2018, the maximum rate differential due to tobacco use 
filed by the carrier as determined by ratio is 1.5 to 1. For all policies, contracts or 
certificates that are executed, delivered, issued for delivery, continued or renewed 
in this State on or after Janua1y 1, 2019, the maximum rate differential due to 
tobacco use filed by the carrier as determined by ratio is 1.2 to 1. 
(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, 2019, the 
maximum rate differential due to age and group size filed by the carrier as 
determined by ratio is 3 to 1. The limitation does not apply for dete1mining rates 
for an attained age of less than 19 years of age or more than 65 years of age.' 
SUMMARY 
This amendment is the minority report of the committee. The amendment reduces 
the maximum rate differential in premium rates for individual and small group health 
insurance policies on or after January 1, 2019 on the basis of geographic area from 1.5 to 
1.2 and tobacco use as dete1mined by ratio from 1.5 to 1 to 1.2 to 1 and maintains the rate 
differential due to age and group size at 3 to 1. The bill prohibits insurance carriers 
providing individual health plans or small group health plans from varying premium rates 
based on age, geographic location or tobacco use on or after January 1, 2018. 
COMMITTEE AMENDMENT