An Act to Exempt
Maine Legislature, Session 132, LD 0893
Committee Amendment CA_A_S59 (Senate)
Amends: 24-A MRSA §704

COMMITTEE AMENDMENT "A » to S.P. 381, L.D, 893, "An Act to Exempt
Nonprofit Agricultural Membership Organizations from Insurance Requirements"
Amend the bill by striking out all of section 2 and inserting the following:
'See. 2. 24-A MRSA §704, sub-§4 is enacted to read:
4. Nonprofit aericultural membership oreanization^^^^^ Title
24. the use of "health insurance" and related terms such as "accident and health insurance,"
"accident and sickness insurance." "carrier." "health." "health benefit plan." "health care. "
"health insurer" or "insurer" do not include, unless speoificallv orovided otherwise in the
law. a nonprofit aericultural membership oreatuzation providine health care benefits in
accordance with this subsection, and a nonprofit agricultural membership organization
providing health care benefits in accordance with this subsection may not be considered to
be engaged in the business of insurance for the purposes of this Title.
A. For the purposes of this subsection, "nonprofit aericultural membership
organization" means a statewide nonprofit agricultural meinbership oreanization that
is exempt from taxation under the federal Internal Revenue Code of 1986 and that;
fl) Has been in eKistence contiuuouslv since December 31.1951:
(2} Provides health care benefits coverage for the payment of medical expenses to
or for members of the oreanization. their dependents and others who provide
documentation of one of the followine;
(a) That the farm owned or operated bv the member meets the United States
Department ofAericulture. National Aericultural Statistics Seivice. Census of
Aericulture definition of a farm in the most recent census year;
(b) The filing of Schedule F or a substantially similar form withthe federal
Internal Revenue Service for the most recent tax year;
3 Cc) The filing of Schedule C or a substantially similar form witli the federal
Internal Revenue Service for the most recent tax year if the m'incipal business
5 or professional activity reported is agriculture-related ;
Page I - 132LR1569(02)
COMMITTEE AMENDMENT
COMMITTEE AMENDMENT"^ "to S.P. 381, L.D, 893 LS'^
fd) Is employed by an agricultural or aericulture-related business; or
(e) Is emoloved by a statewide nonprofit aRricultural membership
oreanization: and
f3) Files an annual certified actuarial statement of plan reserves with the
syperintendent in a form and manner determined by the superintendent.
B. At the time an initial aoolication for coverage for health care benefits is taken with
respect to new applicants and upon renewal of coveraee with respect to persons
previously covered, the nonprofit agricultural membership organization, or a 3rd earty
actine on behalf of the oreanization. shall provide to the applicant or covered person a
written notice stating that;.
H) The coveraee is not provided by an insurance comoanv:
(2} The plan is not subject to the laws and rules relatine to insurance companies;
(3} The plan isnotynderthejurisdictionofthe superintendent: and
(4) Iftlie plan does not oav medical expenses that are elieible for payment under
the plan for any reason, the individuals covered by the plan may be liable for such
expenses.
C. A nonprofit aericultural membership organization, or a 3rd party acting on behalf
of the oreanization, offering coverage for health care benefits shall require all new
applicants to complete a navieation process with the nonprofit aericultural membershio
organization or the organization's desienee to explore other health coverage options
prior to enrolling in coveraee offered by the organization.
D. A nonprofit aerioultural membei'sliip oreanization. or a 3rd oartv acting on behalf
of the oreanization. offering coveraee for health care benefits shall establish a
complaint procedure for resolvine disputes related to coveraee that is substantially
similar to the process for resolvine disputes related to coverage sub]ect_tQ the
requirements of this Title,'
Amend the bill by relettering or renumbering any nonconsecutive Part letter or section
number to read consecutively.
SUMMARY
This amendment, which is the minority report, adds certain requirements that statewide
nonprofit agricultural membership organizations must meet in order to be exempt from the
definition of "health insurance," including requirements for eligibility for coverage as a
farmer; requirements for financial documentation; requirements for education about other
health coverage options and for disclosure prior to a farmer's enrolling in coverage; and
requirements for a complaint mechanism to resolve disputes.
COMMITTEE AMENDMENT