An Act Regulating Employee Benefit Excess Insu'.rance
Maine Legislature, Session 129, LD 0598
Committee Amendment CA_A_S404 (Senate)
Amends: 24-A MRSA §2452-A

COMMITTEE AMENDMENT " A·" to S.P. 185, L.D. 598, Bill, "An Act 
Regulating Employee Benefit Excess Insu'.rance" 
Amend the bill by striking out everything after the enacting clause and inserting the 
following: 
'Sec. 1. 24-A MRSA §2452-A is enacted to read: 
§2452-A. Employee benefit excess insurance for small groups; rating practices 
1. Definitions. As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings. 
A. "Carrier" means an entity authorized to issue employee benefit excess insurance 
in this State. 
B. "Eligible employee" means an employee who is eligible for a small employer's 
sponsored health benefit plan and includes a sole proprietor, a partner of a partnership 
and an independent contractor, if these individuals are included as employees under 
the small employer's health benefit plan. 
C. 
"Employee" means an employee as defined under the federal Employee 
Retirement Income Security Act of 1974. 
D. "Enrolled employee" means an eligible employee who has elected coverage in the 
small employer's sponsored health benefit plan. 
E. "Premium rate" means the total amount due from a small employer to a carrier for 
the provision of employee benefit excess insurance. 
F. "Small employer" means an employer eligible for a small group health plan under 
section 2808-B or under the federal Affordable Care Act. 
2. Rating practices. The following requirements apply to the rating practices of 
carriers providing employee benefit excess insurance to small employers. 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT" ft "to S.P. 185, L.D. 598 
A. A carrier may not vary the premium rate due to the gender, health status, claims 
experience or policy duration of the group of eligible employees or members of the 
group or any other rating factor not specified in this section. 
B. 
A carrier may vary the premium rate by using the following allowable case 
characteristics: 
(1) The attained ages of the covered population; 
(2) The geographic area of the small employer; and 
(3) The family status of the enrolled employees. 
C. 
For purposes of paragraph B, a carrier may use approximations to calculate 
allowable case characteristics as long as any approximation method used by a carrier 
is applied uniformly among all small employers. An acceptable approximation 
method includes using the attained ages of enrolled employees with tier-based 
membership factors to approximate the attained ages of the covered population or 
using a prior census to estimate the actual enrollment. 
D. The premium rates calculated at issue, or at renewal, may not change during the 
policy year if the allowable case characteristics of a small employer group change. 
3. Reporting. Beginning March 15, 2021, and annually thereafter, a carrier offering 
employee benefit excess insurance to small employers shall file a report with the 
superintendent detailing for the prior calendar year any instances in which the carrier 
declined to offer coverage as applied for and any instances in which the carrier's quoted 
renewal premium rate represented an increase larger than 20% to a small employer. The 
report must be provided in a form and manner determined by the superintendent and 
include the following information, at a minimum: the identification number for the 
policyholder; the number of enrolled employees in both the calendar year for which the 
report is made and the prior calendar year, if known; and the reason the carrier declined 
to offer coverage to the small employer or the reason for the carrier's premium increase 
for the small employer.' 
Amend the bill by relettering or renumbering any nonconsecutive Part letter or 
section number to read consecutively. 
SUMMARY 
This amendment is the minority report of the committee and replaces the bill. The 
amendment sets forth requirements for rating of employee benefit excess insurance 
offered to small employers and for reporting information related to employee benefit 
excess insurance for small employers to the Superintendent of Insurance. 
COMMITTEE AMENDMENT