An Act To Allow the Purchase of Health Insurance across State Lines
Maine Legislature, Session 130, LD 0713
Committee: Health Coverage, Insurance and Financial Services
Sponsors: STEWART
Amends: 24-A MRSA §405, 24-A MRSA §405-A, 24-A MRSA §405-B, 24-A MRSA §405-C

Legislative Document
No. 713
S.P. 278
In Senate, March 5, 2021
An Act To Allow the Purchase of Health Insurance across State 
Lines
Received by the Secretary of the Senate on March 3, 2021.  Referred to the Committee on 
Health Coverage, Insurance and Financial Services pursuant to Joint Rule 308.2 and ordered 
printed.
DAREK M. GRANT
Secretary of the Senate
Presented by Senator STEWART of Aroostook.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  24-A MRSA §405, sub-§7, as enacted by PL 2011, c. 90, Pt. C, §2, is 
amended to read:
7.   Transactions pursuant to individual health insurance covering residents of this State 
written by a regional an out-of-state insurer or health maintenance organization, as defined 
in section 405‑A, duly authorized or qualified to transact individual health insurance in the 
state or country of its domicile if the superintendent certifies that the regional out-of-state 
insurer or health maintenance organization meets the requirements of section 405‑A.
Sec. 2.  24-A MRSA §405-A, as amended by PL 2013, c. 388, Pt. B, §§1 and 2, is 
further amended to read:
§405-A.  Certification of regional out-of-state insurers or health maintenance 
organizations to transact individual health insurance
1.  Regional Out-of-state insurer or health maintenance organization defined.  As 
used in this section, "regional out-of-state insurer or health maintenance organization" 
means an insurer or health maintenance organization that holds a valid certificate of 
authority to transact individual health insurance in Connecticut, Massachusetts, New 
Hampshire, Rhode Island or Vermont another state.
2.  Certification of regional out-of-state insurers or health maintenance 
organizations.  A regional An out-of-state insurer or health maintenance organization may 
not transact individual health insurance in this State by mail, the Internet or otherwise 
unless the superintendent has issued a certification that the regional out-of-state insurer or 
health maintenance organization has met the requirements of this subsection. The 
superintendent shall issue a certification or deny certification within 30 days of a request.
A.  A policy, contract or certificate of individual health insurance offered for sale in 
this State by a regional an out-of-state insurer or health maintenance organization must 
comply with the applicable individual health insurance laws in the state of domicile of 
that regional out-of-state insurer and must be actively marketed in that state.
B.  A regional An out-of-state insurer or health maintenance organization shall meet 
the requirements of section 4302 for reporting plan information with respect to 
individual health plans offered for sale in this State and disclose to prospective 
enrollees how the health plans differ from individual health plans offered by domestic 
insurers in a format approved by the superintendent.  Health plan policies and 
applications for coverage must contain the following disclosure statement or a 
substantially similar statement on the face page of the policy or application in a type 
size of at least 14 points and font that is easily readable by a person with average 
eyesight:  "This policy is issued by a regional an out-of-state insurer or health 
maintenance organization and is governed by the laws and rules of (regional out-of-
state insurer's or health maintenance organization's state of domicile).  This policy may 
not be subject to all the insurance laws and rules of the State of Maine, including 
coverage of certain health care services or benefits mandated by Maine law.  Before 
purchasing this policy, you should carefully review the terms and conditions of 
coverage under this policy, including any exclusions or limitations of coverage."
C.  A regional An out-of-state insurer or health maintenance organization shall meet 
the requirements of section 4303, subsection 4 for grievance procedures with respect 
to health plans offered for sale in this State.
D.  A regional An out-of-state insurer or health maintenance organization shall meet 
the requirements of chapter 56‑A for provider network adequacy with respect to health 
plans offered for sale in this State.
E.  A regional An out-of-state insurer or health maintenance organization shall meet 
the requirements of chapter 33 with respect to rates for individual health plans offered 
for sale in this State.
F.  A regional An out-of-state insurer or health maintenance organization shall 
designate an agent for receiving service of legal documents or process in the manner 
provided in this Title.
G.  A regional An out-of-state insurer or health maintenance organization shall meet 
the requirements of this Title with respect to allowing the superintendent access to 
records of the regional out-of-state insurer or health maintenance organization.
3.  Unfair trade practices.  The provisions of chapter 23 apply to a regional an out-
of-state insurer or health maintenance organization permitted to transact individual health 
insurance under this section or section 405.
4.  Taxes; assessments.  A regional An out-of-state insurer or health maintenance 
organization transacting individual health insurance in this State under this section is 
subject to applicable taxes or assessments imposed on insurers transacting individual health 
insurance in this State pursuant to this Title and Title 36.
5.  Compliance with court orders.  A regional An out-of-state insurer or health 
maintenance organization transacting individual health insurance in this State under this 
section shall comply with lawful orders from courts of competent jurisdiction issued in a 
voluntary dissolution proceeding or in response to a petition for an injunction by the 
superintendent asserting that the regional out-of-state insurer or health maintenance 
organization is in a hazardous financial condition.
6.  Exemption from other requirements.  Except as expressly provided in this 
section, the requirements of this Title do not apply to a regional an out-of-state insurer or 
health maintenance organization permitted to transact individual health insurance under 
this section.
7.  Agreement with insurance regulators in other state.  The superintendent shall 
enter into a memorandum of understanding or other agreement with the insurance 
department of the state of domicile of a regional an out-of-state insurer or health 
maintenance organization permitted to transact individual health insurance in this State 
under this section with respect to enforcement of the provisions of this section.
8.  Sale of policies.  An individual health insurance policy, contract or certificate may 
not be offered for sale in this State pursuant to this section before January 1, 2014.
Sec. 3.  24-A MRSA §405-B, first ¶, as amended by PL 2013, c. 388, Pt. B, §3, is 
further amended to read:
Notwithstanding any other provision of this Title, a domestic insurer or licensed health 
maintenance organization authorized to transact individual health insurance in this State 
may offer for sale in this State an individual health plan duly authorized for sale in 
Connecticut, Massachusetts, New Hampshire, Rhode Island or Vermont another state by a 
parent or corporate affiliate of the domestic insurer or licensed health maintenance 
organization if the following requirements are met.
Sec. 4.  24-A MRSA §405-C, as enacted by PL 2011, c. 90, Pt. C, §5, is amended 
to read:
§405-C.  Domestic insurers or licensed health maintenance organizations; parity with 
regional out-of-state insurers
Notwithstanding any other provision of this Title, a domestic insurer or licensed health 
maintenance organization authorized to transact individual health insurance in this State 
may offer for sale in this State an individual health plan equivalent to any plan offered for 
sale in this State by a regional an out-of-state insurer or health maintenance organization 
pursuant to section 405-A.  An individual health plan may not be offered for sale pursuant 
to this section before January 1, 2014.
SUMMARY
This bill authorizes the sale of individual health insurance policies in the State by out-
of-state health insurers.  The bill removes the restriction on the sale of policies by only 
insurers authorized to transact individual health insurance in New England.