reglab/housing_qa huggingface dataset:
24-A ME Rev Stat § 4338 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 56-A: HEALTH PLAN IMPROVEMENT ACT|Subchapter 3: DOWNSTREAM RISK|24-A §4338. Downstream risk arrangements that exceed risk threshold described in section 4334

 §4338. Downstream risk arrangements that exceed risk threshold described in section 4334 The superintendent may waive downstream risk arrangements from licensure requirements that exceed the risk threshold described in section 4334 if the downstream risk arrangement meets the contractual and disclosure requirements established under section 4332 and the criteria set forth in sections 4339 to 4342 and is determined by the superintendent not to prejudice enrollee interests.   [PL 1999, c. 609, §20 (NEW).]SECTION HISTORY PL 1999, c. 609, §20 (NEW).
24-A ME Rev Stat § 4339 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 56-A: HEALTH PLAN IMPROVEMENT ACT|Subchapter 3: DOWNSTREAM RISK|24-A §4339. Contractual provisions to demonstrate financial viability

 §4339. Contractual provisions to demonstrate financial viability If a carrier applies for a waiver under section 4332, subsection 2, the carrier may demonstrate the financial viability and condition of the downstream entity through the terms of the contract, including one or more of the following:   [PL 1999, c. 609, §20 (NEW).]1.  Books, accounts and records.  A contractual provision authorizing the carrier to access the downstream entity's books, accounts and records according to terms and conditions on which the carrier and the downstream entity agree;   [PL 1999, c. 609, §20 (NEW).] 2.  Financial statements.  A contractual provision requiring the downstream entity to provide to the carrier interim unaudited financial statements on a regular and ongoing basis as well as an annual financial statement, accompanied by a certified public accountant's opinion, appropriate to the magnitude of risk involved;   [PL 1999, c. 609, §20 (NEW).] 3.  Reserves.  A contractual provision authorizing the carrier to receive information regarding the downstream entity's reserves;   [PL 1999, c. 609, §20 (NEW).] 4.  Letter of credit.  A contractual provision requiring the downstream entity to post a letter of credit or other acceptable financial security;   [PL 1999, c. 609, §20 (NEW).] 5.  Fees.  A contractual provision under which the carrier withholds fees payable to the downstream entity or to the providers for which it acts;   [PL 1999, c. 609, §20 (NEW).] 6.  General liability insurance.  A contractual provision requiring the downstream entity to carry general liability insurance and requiring participating providers to carry professional liability insurance in an amount and from an insurer mutually acceptable to the carrier and the downstream entity;   [PL 1999, c. 609, §20 (NEW).] 7.  Surety bond.  A contractual provision requiring the downstream entity to secure a surety bond to cover the downstream entity's performance under the contract; or   [PL 1999, c. 609, §20 (NEW).] 8.  Excess of loss insurance.  A contractual provision requiring the downstream entity to secure excess of loss insurance or reinsurance in an amount and from an insurer mutually acceptable to the carrier and the downstream entity.   [PL 1999, c. 609, §20 (NEW).] SECTION HISTORY PL 1999, c. 609, §20 (NEW).
24-A ME Rev Stat § 4340 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 56-A: HEALTH PLAN IMPROVEMENT ACT|Subchapter 3: DOWNSTREAM RISK|24-A §4340. Financial viability

 §4340. Financial viability Each carrier and downstream entity requesting a waiver shall file with the superintendent a plan for managing financial exposure under those downstream risk arrangement contracts and thereafter operate in substantial conformance with the terms of that plan and of the corresponding waiver. At least 60 days before any material change in a filed and approved exposure management plan, the carrier and downstream entity shall file for the superintendent's review and approval a modified plan, along with any changes in related contracts.   [PL 1999, c. 609, §20 (NEW).]SECTION HISTORY PL 1999, c. 609, §20 (NEW).
24-A ME Rev Stat § 4341 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 56-A: HEALTH PLAN IMPROVEMENT ACT|Subchapter 3: DOWNSTREAM RISK|24-A §4341. Limitations on premium transfer

 §4341. Limitations on premium transfer The superintendent may deny a request for waiver based on any of the following characteristics:   [PL 1999, c. 609, §20 (NEW).]1.  Transfer of 30% of annual aggregate premium.  A contract by which 30% or more of the carrier's annual aggregate premium with respect to a contract, plan or product is transferred to a single downstream entity. This transfer is the sum of capitated payments plus the sum of amounts returnable to the carrier through incentive payments or other risk adjustments; or   [PL 1999, c. 609, §20 (NEW).] 2.  Transfer of 75% of annual aggregate premium.  Multiple contracts by which 75% or more of the carrier's annual aggregate premium with respect to a contract, plan or product is transferred to one or more downstream entities. This transfer is the sum of capitated payments plus the sum of amounts returnable to the carrier through incentive payments or other risk adjustments.   [PL 1999, c. 609, §20 (NEW).] SECTION HISTORY PL 1999, c. 609, §20 (NEW).
24-A ME Rev Stat § 4342 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 56-A: HEALTH PLAN IMPROVEMENT ACT|Subchapter 3: DOWNSTREAM RISK|24-A §4342. Related provisions

 §4342. Related provisions The superintendent may deny a request for waiver based on any of the following characteristics:   [PL 1999, c. 609, §20 (NEW).]1.  Carrier controlled.  An arrangement with a downstream entity that has control of the carrier. "Control" has the same meaning as defined in section 222, subsection 2, paragraph B;   [PL 1999, c. 609, §20 (NEW).] 2.  Transfer of claims processing, payment or adjudication.  An arrangement by which the claims processing, claims payment or claims adjudication functions are transferred to the downstream entity from the carrier. This section may not be construed to authorize the superintendent to deny a request based on the transfer of utilization review functions from the carrier to the downstream entity;   [PL 1999, c. 609, §20 (NEW).] 3.  Transfer of managerial control.  An arrangement by which managerial control of the carrier's information system is transferred to the downstream entity;   [PL 1999, c. 609, §20 (NEW).] 4.  Overlap between officers or directors.  An arrangement in which there is overlap between the officers or directors of the downstream entity and the carrier; or   [PL 1999, c. 609, §20 (NEW).] 5.  Transfer of more than 1/12 of annual capitated payments.  An arrangement that transfers more than 1/12 of the annual capitated payments at one time to the downstream entity.   [PL 1999, c. 609, §20 (NEW).] SECTION HISTORY PL 1999, c. 609, §20 (NEW).
24-A ME Rev Stat § 4343 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 56-A: HEALTH PLAN IMPROVEMENT ACT|Subchapter 3: DOWNSTREAM RISK|24-A §4343. Rules

 §4343. Rules The superintendent may adopt rules establishing application procedures and specific standards for meeting the requirements pursuant to this subchapter. Rules adopted pursuant to this subchapter are routine technical rules pursuant to Title 5, chapter 375, subchapter II-A.   [PL 1999, c. 609, §20 (NEW).]SECTION HISTORY PL 1999, c. 609, §20 (NEW).
24-A ME Rev Stat § 4351 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 57: DELINQUENT INSURERS|Subchapter 1: REHABILITATION AND LIQUIDATION|24-A §4351. Scope of provisions

 §4351. Scope of provisions The applicable provisions of this chapter shall apply as to:   [PL 1969, c. 132, §1 (NEW).]1.  All insurers authorized to transact insurance in this State;   [PL 1969, c. 132, §1 (NEW).] 2.  All insurers having policyholders resident in this State;   [PL 1969, c. 132, §1 (NEW).] 3.  All insurers against whom a claim under an insurance contract may arise in this State;   [PL 1969, c. 132, §1 (NEW).] 4.  All persons in process of organization, or holding themselves out as organizing, or proposing to organize in this State for the purpose of becoming an insurer;   [PL 2001, c. 88, §10 (AMD).] 5.  All other persons as to whom such provisions are otherwise expressly made applicable by law; and   [PL 2001, c. 88, §10 (AMD).] 6.  Health maintenance organizations, which are considered insurers for the purposes of this subchapter and subchapter II.   [PL 2001, c. 88, §11 (NEW).] SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 2001, c. 88, §§10,11 (AMD).
24-A ME Rev Stat § 4352 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 57: DELINQUENT INSURERS|Subchapter 1: REHABILITATION AND LIQUIDATION|24-A §4352. Short title

 §4352. Short title This chapter constitutes and may be cited as the "Insurance Rehabilitation and Liquidation Law."   [PL 1969, c. 132, §1 (NEW).]SECTION HISTORY PL 1969, c. 132, §1 (NEW).
24-A ME Rev Stat § 4354 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 57: DELINQUENT INSURERS|Subchapter 1: REHABILITATION AND LIQUIDATION|24-A §4354. Jurisdiction of delinquency proceedings; venue; exclusiveness of remedy; appeal

 §4354. Jurisdiction of delinquency proceedings; venue; exclusiveness of remedy; appeal 1.  The Superior Court has original jurisdiction of delinquency proceedings under this chapter, and any court with jurisdiction is authorized to make all necessary or proper orders to carry out the purposes of this chapter. A delinquency proceeding may not be commenced under this chapter by anyone other than the superintendent.   [PL 1991, c. 828, §26 (AMD).] 2.  The venue of delinquency proceedings against a domestic insurer shall be in the county in this State of the insurer's principal place of business; or, if the principal place of business is located in another state, in any county in this State selected by the superintendent for the purpose. The venue of proceedings against foreign insurers shall be in any county in this State selected by the superintendent for the purpose.   [PL 1973, c. 585, §12 (AMD).] 3.  At any time after commencement of a proceeding the superintendent or any other party may apply to the court for an order changing the venue of, and removing, the proceeding to any other county of this State in which the proceeding may most conveniently, economically and efficiently be conducted.   [PL 1973, c. 585, §12 (AMD).] 4.  No court shall have jurisdiction to entertain, hear or determine any petition or complaint praying for the dissolution, liquidation, rehabilitation, sequestration, conservation or receivership of any insurer, or for an injunction or restraining order or other relief preliminary, incidental or relating to such proceedings, other than in accordance with this chapter.   [PL 1969, c. 132, §1 (NEW).] 5.  An appeal shall lie to the Supreme Judicial Court from any court granting or refusing rehabilitation, liquidation, conservation or receivership and from every order in delinquency proceedings having the character of a final order as to the particular portion of the proceedings embraced therein.   [PL 1969, c. 132, §1 (NEW).] SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1973, c. 585, §12 (AMD). PL 1991, c. 828, §26 (AMD).
24-A ME Rev Stat § 4355 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 57: DELINQUENT INSURERS|Subchapter 1: REHABILITATION AND LIQUIDATION|24-A §4355. Jurisdiction over related persons and transactions

 §4355. Jurisdiction over related persons and transactions 1.  A court of this State, in which an order of rehabilitation or liquidation has been entered in delinquency proceedings against a domestic insurer or alien insurer domiciled in this State, has jurisdiction also over persons, served as provided in subsection 2, in an action brought by the insurer's receiver on or arising out of such obligation or relationship, as follows:   A. Persons obligated to the insurer as a result of agency or brokerage or transactions between such persons and the insurer;   [PL 1969, c. 132, §1 (NEW).]B. Reinsurers of the insurer, and their representatives;   [PL 1991, c. 828, §27 (AMD).]C. Past or present officers, managers, trustees, directors, organizers and promoters of the insurer, and other persons in positions of similar responsibility with the insurer;   [PL 1991, c. 828, §27 (AMD).]D. Persons served who are or were at the time of the institution of the delinquency proceeding against the insurer holding assets in which the receiver claims an interest on behalf of the insurer, in any action concerning the assets; and   [PL 1991, c. 828, §28 (NEW).]E. Persons served who are obligated to the insurer in any way whatsoever, in any action on or incident to the obligation.   [PL 1991, c. 828, §28 (NEW).][PL 1991, c. 828, §§27, 28 (AMD).] 2.  As to those of such persons who are in this State, personal service of process shall be made as in other civil actions. As to those of such persons who cannot be found in this State at the time process is to be served, personal service of process shall be made thereon by a public officer of the jurisdiction in which such person may be found, in the same manner as personal service of process is required to be made within this State under the laws of this State; and the affidavit or certificate under oath setting forth the facts of such service shall be filed in the court in this State in which the action is pending.   [PL 1969, c. 132, §1 (NEW).] SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1991, c. 828, §27 (AMD). PL 1991, c. 828, §28 (AMD).
24-A ME Rev Stat § 4357 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 57: DELINQUENT INSURERS|Subchapter 1: REHABILITATION AND LIQUIDATION|24-A §4357. Grounds for liquidation of domestic insurer or domiciled alien insurer

 §4357. Grounds for liquidation of domestic insurer or domiciled alien insurer The superintendent may apply to the court for an order appointing the superintendent as receiver, if the superintendent's appointment as receiver is not then in effect, and directing the superintendent to liquidate the business of a domestic insurer or of the United States branch of an alien insurer having trusteed assets in this State, whether or not there has been a prior order directing the superintendent to rehabilitate the insurer, upon any one or more of the following grounds:   [RR 2021, c. 1, Pt. B, §353 (COR).]1.  That the insurer has failed to cure an impairment of surplus or capital or assets within the time allowed therefor by any lawful order of the superintendent;   [PL 1973, c. 585, §12 (AMD).] 2.  That the insurer is insolvent, or has commenced voluntary liquidation or dissolution, or attempts to commence or prosecute or is the object, in this State or elsewhere, of any action of proceeding to liquidate its business or affairs or to dissolve its corporate charter or to procure the appointment of a receiver, trustee, custodian or sequestrator under any law except this Title. This provision shall not apply as to the conversion of a stock insurer to an ordinary business corporation as authorized under section 3473 or to voluntary dissolution of the insurer pursuant to section 3484;   [PL 1969, c. 132, §1 (NEW).] 3.  That the insurer has ceased for a period of one year to transact insurance business;   [PL 1969, c. 132, §1 (NEW).] 4.  If a proposed insurer has not completed its organization and obtained a certificate of authority as an insurer within the time allowed therefor under any applicable law;   [PL 1969, c. 132, §1 (NEW).] 5.  That efforts to rehabilitate the insurer and remove the causes or adverse effects thereof for which rehabilitation was instituted have failed despite all reasonable efforts by the superintendent, or cannot be continued without material increase of risk of loss to the insurer's creditors or policyholders; or   [PL 1973, c. 585, §12 (AMD).] 6.  If the insurer has requested or consented to liquidation by vote or written authorization of a majority of its directors or stockholders, or members if a mutual insurer.   [PL 1969, c. 132, §1 (NEW).] SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1973, c. 585, §12 (AMD). RR 2021, c. 1, Pt. B, §353 (COR).
24-A ME Rev Stat § 4358 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 57: DELINQUENT INSURERS|Subchapter 1: REHABILITATION AND LIQUIDATION|24-A §4358. Ground for conservation, foreign and alien insurers

 §4358. Ground for conservation, foreign and alien insurers The superintendent may apply to the court for an order appointing the superintendent as receiver or ancillary receiver, and directing the superintendent to conserve the assets within this State, of a foreign or alien insurer upon any of the applicable ground specified in sections 4356 or 4357, or upon the ground that the insurer's property has been sequestrated in its domiciliary sovereignty or in any other sovereignty; or, in the case of an alien insurer that the insurer has failed to make good an impairment of its trusteed funds within the time required therefor by order of the superintendent.   [RR 2021, c. 1, Pt. B, §354 (COR).]SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1973, c. 585, §12 (AMD). RR 2021, c. 1, Pt. B, §354 (COR).
24-A ME Rev Stat § 4359 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 57: DELINQUENT INSURERS|Subchapter 1: REHABILITATION AND LIQUIDATION|24-A §4359. Grounds for ancillary liquidation, foreign and alien insurers

 §4359. Grounds for ancillary liquidation, foreign and alien insurers The superintendent may apply to the court for an order appointing the superintendent to liquidate the business of a foreign or alien insurer having assets, business or claims in this State upon the appointment in the domiciliary sovereignty of such insurer of a receiver, liquidator, conservator, rehabilitator or other officer by whatever name called for the purpose of liquidating the business of the insurer.   [RR 2021, c. 1, Pt. B, §355 (COR).]SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1973, c. 585, §12 (AMD). RR 2021, c. 1, Pt. B, §355 (COR).
24-A ME Rev Stat § 4360 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 57: DELINQUENT INSURERS|Subchapter 1: REHABILITATION AND LIQUIDATION|24-A §4360. Commencement of proceeding

 §4360. Commencement of proceeding 1.  The superintendent shall commence a delinquency proceeding authorized under this chapter, the Attorney General representing him, by filing a petition in a court of proper jurisdiction praying for appointment of the superintendent as receiver of the insurer.   [PL 1973, c. 585, §12 (AMD).] 2.  Upon the filing of the petition, the court shall issue an order directing the insurer to appear in court on the day fixed in the order and show cause why the petition should not be granted. Unless good cause is shown for a shorter period, the order shall require the insurer to so show cause not less than 15 or more than 30 days from date of the order.   [PL 1969, c. 132, §1 (NEW).] 3.  The order to show cause and service thereof on the insurer shall constitute due and legal process and shall be in lieu of any other process otherwise provided by law.   [PL 1969, c. 132, §1 (NEW).] SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1973, c. 585, §12 (AMD).
24-A ME Rev Stat § 4361 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 57: DELINQUENT INSURERS|Subchapter 1: REHABILITATION AND LIQUIDATION|24-A §4361. Service of process

 §4361. Service of process A certified copy of any order to show cause issued under section 4360, and a copy of the petition upon which the same is made, must be served upon the insurer by delivering the same to its president, vice-president, secretary, treasurer, director or to its managing agent or attorney in fact, if a reciprocal insurer; or if no such officer or functionary can readily be found in this State, then such process may be served upon the insurer by service thereof upon the superintendent pursuant to section 421.   [PL 1997, c. 457, §51 (AMD).]SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1973, c. 585, §12 (AMD). PL 1997, c. 457, §51 (AMD).
24-A ME Rev Stat § 4362 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 57: DELINQUENT INSURERS|Subchapter 1: REHABILITATION AND LIQUIDATION|24-A §4362. Injunctions

 §4362. Injunctions 1.  Upon application by the superintendent for such an order to show cause, or at any time thereafter, the court may without notice issue an injunction restraining the insurer, its officers, directors, stockholders, members, subscribers, agents and all other persons from the transaction of its business or the waste or disposition of its property until the further order of the court.   [PL 1973, c. 585, §12 (AMD).] 2.  The court may at any time during a proceeding under this chapter issue such other injunctions or orders as may be deemed necessary to prevent interference with the superintendent or the proceeding, or waste of the assets of the insurer, or the commencement or prosecution of any actions, or the obtaining of preferences, judgments, attachments or other liens, or the making of any levy against the insurer or against its assets or any part thereof.   [PL 1973, c. 585, §12 (AMD).] 3.  Notwithstanding any other provision of law, no bond shall be required of the superintendent as a prerequisite for the issuance of any injunction or restraining order pursuant to this section.   [PL 1973, c. 585, §12 (AMD).] SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1973, c. 585, §12 (AMD).
24-A ME Rev Stat § 4362-A (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 57: DELINQUENT INSURERS|Subchapter 1: REHABILITATION AND LIQUIDATION|24-A §4362-A. Dissolution of domestic insurer

 §4362-A. Dissolution of domestic insurer The superintendent, upon application for an order of liquidation of a domestic insurer for any of the reasons specified in section 4357 or at any time thereafter, may apply for an order of dissolution of the domestic insurer. Upon the filing of the application, the court shall issue an order directing the insurer to appear in court on the day fixed in the order and show cause why the application should not be granted. The order to show cause and notice thereof shall conform to the requirements applicable to an order to show cause set forth in section 4360, subsections 2 and 3, and section 4361. Unless cause is shown why the application should not be granted, the court, after hearing, shall order that the corporate existence of such domestic insurer be dissolved.   [PL 1983, c. 603, §1 (NEW).]SECTION HISTORY PL 1983, c. 603, §1 (NEW).
24-A ME Rev Stat § 4363 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 57: DELINQUENT INSURERS|Subchapter 1: REHABILITATION AND LIQUIDATION|24-A §4363. Uniform Insurers Liquidation Act; severability; interpretation

 §4363. Uniform Insurers Liquidation Act; severability; interpretation 1.  This section, section 4353 (definitions), and sections 4364 to 4369 comprise and may be cited as the Uniform Insurers Liquidation Act.   [PL 1969, c. 132, §1 (NEW).] 2.  If any provision of the Uniform Insurers Liquidation Act or the application thereof to any person or circumstances is held invalid, such invalidity shall not affect other provisions or applications of the Act which can be given effect without the invalid provision or application, and to this end the provisions of the Act are declared to be severable.   [PL 1969, c. 132, §1 (NEW).] 3.  This Uniform Insurers Liquidation Act shall be so interpreted as to effectuate its general purpose to make uniform the laws of those states which enact it. To the extent that its provisions, when applicable, conflict with other provisions of this Title, the Uniform Insurers Liquidation Act shall control.   [PL 1969, c. 132, §1 (NEW).] SECTION HISTORY PL 1969, c. 132, §1 (NEW).