An Act To Enact the Health Insurance Consumer Assistance Program
Maine Legislature, Session 129, LD 1274
Committee: Health Coverage, Insurance and Financial Services
Sponsors: GRAMLICH, CLAXTON, FOLEY, GRATWICK, MOORE, KESCHL, MEYER, STOVER

Legislative Document
No. 1274
S.P. 394
In Senate, March 14, 2019
An Act To Enact the Health Insurance Consumer Assistance 
Program
Reference to the Committee on Health Coverage, Insurance and Financial Services 
suggested and ordered printed.
DAREK M. GRANT
Secretary of the Senate
Presented by Senator SANBORN, L. of Cumberland.
Cosponsored by Representative GRAMLICH of Old Orchard Beach and
Senators: CLAXTON of Androscoggin, FOLEY of York, GRATWICK of Penobscot, 
MOORE of Washington, SANBORN, H. of Cumberland, Representatives: KESCHL of 
Belgrade, MEYER of Eliot, STOVER of Boothbay.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  24-A MRSA c. 56-A, sub-c. 2-A is enacted to read:
SUBCHAPTER 2-A
HEALTH INSURANCE CONSUMER ASSISTANCE PROGRAM
§4326.  Health Insurance Consumer Assistance Program
1.  Establishment.  The Health Insurance Consumer Assistance Program, referred to 
in this section as "the consumer assistance program," is established in and administered 
by the bureau to provide support for consumers, including prospective consumers, of 
health insurance, referred to in this section as "consumers," and to customer assistance 
programs and health insurance ombudsman programs.  The superintendent shall contract 
with a nonprofit, independent health insurance consumer assistance entity, which may not 
be an insurer, to operate the consumer assistance program.
2.  Consumer assistance program services.  The services provided by the consumer 
assistance program may include:
A.  Assisting consumers with filing complaints and appeals with a group health plan, 
health insurance carrier or independent review organization and providing 
information about the internal and external appeal and grievance processes of a group 
health plan, health insurance carrier or independent review organization;
B.  Collecting, tracking and quantifying inquiries regarding health insurance and 
problems encountered by consumers;
C.  Educating consumers on their rights and responsibilities with respect to health 
insurance coverage;
D.  Assisting consumers with obtaining health insurance coverage by providing 
information, referrals or other assistance;
E.  Assisting with obtaining federal health insurance premium tax credits under 
Section 36B of the United States Internal Revenue Code of 1986, as amended; and
F.  Providing information to the public about the services of the consumer assistance 
program through a comprehensive outreach program and a toll-free telephone 
number.
3.  Report.  The operator of the consumer assistance program shall report to the 
superintendent, according to the requirements of the contract under subsection 1, on 
aggregate data relevant to the services provided by and activities of the consumer 
assistance program, and annually, by January 15th, the superintendent shall report to the 
joint standing committee of the Legislature having jurisdiction over health insurance 
matters on the aggregate data.
Sec. 2.  Appropriations and allocations.  The following appropriations and 
allocations are made.
PROFESSIONAL AND FINANCIAL REGULATION, DEPARTMENT OF 
Insurance - Bureau of 0092
Initiative: Provides ongoing funds to the Bureau of Insurance to contract with a 
designated nonprofit and independent health insurance consumer assistance entity to 
operate the Health Insurance Consumer Assistance Program.
SUMMARY
This bill establishes the Health Insurance Consumer Assistance Program in the 
Department of Professional and Financial Regulation, Bureau of Insurance to provide 
support for consumers, including prospective consumers, of health insurance and to 
health insurance customer assistance programs and health insurance ombudsman 
programs.  Some of the services the new program may provide include assisting with 
filing complaints and appeals regarding decisions made by a group health plan, health 
insurance carrier or independent review organization and obtaining health insurance 
premium tax credits on behalf of consumers.  The Superintendent of Insurance is required 
to contract with a nonprofit, independent health insurance consumer assistance entity that 
is not an insurer to operate the consumer assistance program, and funding is provided for 
that requirement.
GENERAL FUND
2019-20
2020-21
All Other
$200,000
$200,000
GENERAL FUND TOTAL
$200,000
$200,000