An Act To Eliminate Insurance Rating Based on Age, Geographic Location or Smoking History and To Reduce Rate Variability Due to Group Size
Maine Legislature, Session 130, LD 1150
Committee: Health Coverage, Insurance and Financial Services
Sponsors: BROOKS, ARFORD, CRAVEN, EVANS, BRENNER, LIBBY
Amends: 24-A MRSA §2736-C, 24-A MRSA §2808-B

Legislative Document
No. 1150
H.P. 828
House of Representatives, March 22, 2021
An Act To Eliminate Insurance Rating Based on Age, Geographic 
Location or Smoking History and To Reduce Rate Variability Due 
to Group Size
Received by the Clerk of the House on March 18, 2021.  Referred to the Committee on 
Health Coverage, Insurance and Financial Services pursuant to Joint Rule 308.2 and ordered 
printed pursuant to Joint Rule 401.
ROBERT B. HUNT
Clerk
Presented by Representative BROOKS of Lewiston.
Cosponsored by Representatives: ARFORD of Brunswick, CRAVEN of Lewiston, EVANS of 
Dover-Foxcroft, Senators: BRENNER of Cumberland, LIBBY of Androscoggin.
Be it enacted by the People of the State of Maine as follows:
Sec. 1.  24-A MRSA §2736-C, sub-§2, ¶C-1, as enacted by PL 2011, c. 90, Pt. A, 
§2, is amended to read:
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 on or 
after between July 1, 2012 and December 31, 2021, 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 delivery, continued or renewed in this State on or 
after January 1, 2022, a carrier may not vary the premium rate due to geographic area.
Sec. 2.  24-A MRSA §2736-C, sub-§2, ¶D, as amended by PL 2019, c. 5, Pt. A, 
§3, is further amended by amending subparagraph (7) to read:
(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, 2021, except as provided in subparagraph (9), 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 
years of age.
Sec. 3.  24-A MRSA §2736-C, sub-§2, ¶D, as amended by PL 2019, c. 5, Pt. A, 
§3, is further amended by amending subparagraph (8) to read:
(8)  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, 2021, the maximum rate differential due to tobacco use filed by the 
carrier as determined by ratio is 1.5 to 1, except that the carrier may not apply a 
rate differential pursuant to this subparagraph when the covered individual is 
participating in an evidence-based tobacco cessation strategy approved by the 
United States Department of Health and Human Services, Food and Drug 
Administration.  For all policies, contracts or certificates that are executed, 
delivered, issued for delivery, continued or renewed in this State on or after January 
1, 2022, a carrier may not vary the premium rate due to tobacco use.
Sec. 4.  24-A MRSA §2736-C, sub-§2, ¶D, as amended by PL 2019, c. 5, Pt. A, 
§3, is further amended by amending subparagraph (9) to read:
(9)  For all policies, contracts or certificates that are executed, delivered, issued for 
delivery, continued or renewed in this State on or after the effective date of this 
subparagraph between March 19, 2019 and December 31, 2021, the maximum rate 
differential due to age filed by the carrier as determined by ratio is 3 to 1 for 
individuals 21 years of age and older on the first day of coverage under the policy, 
contract or certificate.  The variation in rate due to age must be actuarially justified 
for individuals under 21 years of age consistent with the uniform age rating curve 
adopted under this paragraph.  For all policies, contracts or certificates that are 
executed, delivered, issued for delivery, continued or renewed in this State on or 
after January 1, 2022, a carrier may not vary the premium rate due to age.
Sec. 5.  24-A MRSA §2808-B, sub-§2, ¶C-1, as enacted by PL 2011, c. 90, Pt. A, 
§7, is amended to read:
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 on or 
after between October 1, 2011 and December 31, 2021, 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 delivery, continued or renewed in this State on 
or after January 1, 2022, a carrier may not vary the premium rate due to geographic 
area.
Sec. 6.  24-A MRSA §2808-B, sub-§2, ¶D, as amended by PL 2019, c. 5, Pt. A, 
§11, is further amended by amending subparagraph (8) to read:
(8)  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, 2021, except as provided in subparagraph (10), the maximum 
rate differential due to age and group size 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, 2022, a carrier may not vary the premium rate due to age.
Sec. 7.  24-A MRSA §2808-B, sub-§2, ¶D, as amended by PL 2019, c. 5, Pt. A, 
§11, is further amended by amending subparagraph (9) to read:
(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, 2021, the maximum rate differential due to tobacco use filed by 
the carrier as determined by ratio is 1.5 to 1, except that the carrier may not apply 
a rate differential pursuant to this subparagraph when the covered individual is 
participating in an evidence-based tobacco cessation strategy approved by the 
United States Department of Health and Human Services, Food and Drug 
Administration.  For all policies, contracts or certificates that are executed, 
delivered, issued for delivery, continued or renewed in this State on or after January 
1, 2022, a carrier may not vary the premium rate due to tobacco use.
Sec. 8.  24-A MRSA §2808-B, sub-§2, ¶D, as amended by PL 2019, c. 5, Pt. A, 
§11, is further amended by amending subparagraph (10) to read:
(10)  For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State on or after the effective date of this 
Act between March 19, 2019 and December 31, 2021, the maximum rate 
differential due to age filed by the carrier as determined by ratio is 3 to 1 for 
individuals 21 years of age and older on the first day of coverage under the policy, 
contract or certificate.  The variation in rate due to age must be actuarially justified 
for individuals under 21 years of age consistent with the uniform age rating curve 
adopted under this paragraph.  For all policies, contracts or certificates that are 
executed, delivered, issued for delivery, continued or renewed in this State on or 
after January 1, 2022, a carrier may not vary the premium rate due to age.
Sec. 9.  24-A MRSA §2808-B, sub-§2, ¶D, as amended by PL 2019, c. 5, Pt. A, 
§11, is further amended by enacting a new subparagraph (11) to read:
(11)  For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State between January 1, 2022 and 
December 31, 2022, the maximum rate differential due to group size filed by the 
carrier as determined by ratio is 3 to 1.
Sec. 10.  24-A MRSA §2808-B, sub-§2, ¶D, as amended by PL 2019, c. 5, Pt. A, 
§11, is further amended by enacting a new subparagraph (12) to read:
(12)  For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State between January 1, 2023 and 
December 31, 2023, the maximum rate differential due to group size filed by the 
carrier as determined by ratio is 2 to 1.
Sec. 11.  24-A MRSA §2808-B, sub-§2, ¶D, as amended by PL 2019, c. 5, Pt. A, 
§11, is further amended by enacting a new subparagraph (13) to read:
(13)  For all policies, contracts or certificates that are executed, delivered, issued 
for delivery, continued or renewed in this State on or after January 1, 2024, the 
maximum rate differential due to group size filed by the carrier as determined by 
ratio is 1.5 to 1.
SUMMARY
This 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, 2022.  The bill also reduces the permitted variation based on group 
size to 1.5 to 1 for small group plans over time.