reglab/housing_qa huggingface dataset:
24-A ME Rev Stat § 2774 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 34: LICENSURE OF MEDICAL UTILIZATION REVIEW ENTITIES|24-A §2774. Enforcement

 §2774. Enforcement The following provisions govern enforcement of this chapter.   [PL 1989, c. 556, Pt. C, §2 (NEW).]1.  Periodic reviews.  The superintendent may conduct periodic reviews of the operations of the entities licensed pursuant to this chapter to ensure that they continue to meet the minimum standards set forth in section 2772 and any applicable rules adopted by the superintendent. The superintendent may perform periodic telephone audits of licensees to determine if representatives of the licensee are reasonably accessible, as required by section 2772.   [PL 1989, c. 556, Pt. C, §2 (NEW).] 2.  Action against licensee.  The superintendent is authorized to take appropriate action against a licensee which fails to meet the standards of this chapter or any rules adopted by the superintendent, or who fails to respond in a timely manner to corrective actions ordered by the superintendent. The superintendent may impose a civil penalty not to exceed $1,000 for each violation, as permitted by section 12‑A, or may deny, suspend or revoke the license.   [PL 1989, c. 556, Pt. C, §2 (NEW).] 3.  Opportunity to provide information and request hearing.  Before taking the actions authorized by this section to deny, suspend or revoke the license, the superintendent shall provide the licensee with reasonable time to supply additional information demonstrating compliance with the requirements of this chapter and the opportunity to request a hearing to be held consistent with the provisions of the Maine Administrative Procedure Act, Title 5, chapter 375.   [PL 1989, c. 556, Pt. C, §2 (NEW).] 4.  Authority to adopt rules.  The superintendent may adopt rules necessary to implement the provisions of this chapter.   [PL 1989, c. 556, Pt. C, §2 (NEW).] 5.  Rulings on appropriateness of medical judgments not authorized.  Nothing in this chapter requires or authorizes the superintendent to rule on the appropriateness of medical decisions or judgments rendered by review entities and their agents.   [PL 1989, c. 556, Pt. C, §2 (NEW).] SECTION HISTORY PL 1989, c. 556, §C2 (NEW).
24-A ME Rev Stat § 2781 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 34-A: STATE-FEDERAL HEALTH COVERAGE PARTNERSHIPS|24-A §2781. State-federal health coverage partnerships

 §2781. State-federal health coverage partnerships 1.  Partnerships authorized.  The State may enter into state-federal health coverage partnerships that support the availability of affordable health coverage in the State in accordance with this section. As used in this chapter, "state-federal health coverage partnership" means a program established or authorized under federal law that provides or reallocates federal funding or that provides for the waiver or modification of otherwise applicable provisions of federal laws governing health insurance. "State-federal health coverage partnership" includes, but is not limited to, innovation waivers under Section 1332 of the federal Affordable Care Act.   [PL 2019, c. 653, Pt. B, §1 (NEW).] 2.  Application.  Unless the applicable federal laws, regulations or administrative guidelines require a different state official to be the applicant, the superintendent may apply to the appropriate federal agency or agencies to establish or participate in a state-federal health coverage partnership or to modify the terms and conditions of an existing partnership if the superintendent determines that the application, if approved, is likely to improve the affordability, availability or quality of health coverage in this State and the Governor approves the submission of the application.   [PL 2019, c. 653, Pt. B, §1 (NEW).] 3.  Notice and consultation.  The superintendent shall ensure that all federally required notices and opportunities for consultation with respect to a state-federal health coverage partnership or proposed partnership are provided. The superintendent shall take any additional measures that may be necessary to identify persons and constituencies likely to be materially affected by a state-federal health coverage partnership or proposed partnership and to provide such persons and constituencies with reasonable notice and opportunity for input.   [PL 2019, c. 653, Pt. B, §1 (NEW).] 4.  MaineCare program and Maine Health Insurance Marketplace.  A state-federal health coverage partnership may coordinate with the MaineCare program or the Maine Health Insurance Marketplace established in Title 22, chapter 1479 and incorporate provisions affecting these programs, including but not limited to a joint Medicaid Section 1115 demonstration waiver and state innovation waiver, with the approval or joint application of the Commissioner of Health and Human Services.   [PL 2019, c. 653, Pt. B, §1 (NEW).] SECTION HISTORY PL 2019, c. 653, Pt. B, §1 (NEW).
24-A ME Rev Stat § 2791 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 34-B: POOLED MARKET AND CLEAR CHOICE DESIGN|24-A §2791. Definitions

 §2791. Definitions As used in this chapter, unless the context otherwise indicates, the following terms have the following meanings.   [PL 2019, c. 653, Pt. B, §2 (NEW).]1.  Individual health plan.  "Individual health plan" has the same meaning as in section 2736‑C, subsection 1, paragraph C.   [PL 2019, c. 653, Pt. B, §2 (NEW).] 2.  Small group health plan.  "Small group health plan" has the same meaning as in section 2808‑B, subsection 1, paragraph G.   [PL 2019, c. 653, Pt. B, §2 (NEW).] SECTION HISTORY PL 2019, c. 653, Pt. B, §2 (NEW).
24-A ME Rev Stat § 2801 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2801. Scope of chapter -- short title

 §2801. Scope of chapter -- short title 1.  This chapter applies only to group health insurance contracts and to blanket health insurance contracts as herein provided. Nothing in this chapter pertains to legal services insurance as described in chapter 38, except to the extent expressly permitted in that chapter.   [PL 1983, c. 801, §10 (AMD).] 2.  This chapter may be cited as the "Group or Blanket Health Insurance Law."   [PL 1969, c. 132, §1 (NEW).] SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1983, c. 801, §10 (AMD).
24-A ME Rev Stat § 2802 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2802. Group insurance defined

 §2802. Group insurance defined 1.  Any policy or contract of insurance against death or injury resulting from accident or from accidental means which covers more than one person, except blanket accident policies as defined in section 2813 and family accident and sickness policies conforming to section 2703, shall be deemed a group accident insurance policy.   [PL 1969, c. 177, §48 (AMD).] 2.  Any policy or contract which insures against disablement, disease or sickness of the insured, excluding disablement which results from accident or from accidental means, and which covers more than one person, except blanket sickness insurance policies as defined in section 2813 and family accident and sickness policies conforming to section 2703, shall be deemed a group sickness insurance policy or contract.   [PL 1969, c. 132, §1 (NEW).] 3.  Any policy or contract of insurance which combines the coverage of group accident insurance and of group sickness insurance shall be deemed a group accident and sickness insurance policy.   [PL 1969, c. 132, §1 (NEW).] 4.  Any reference hereinafter to group health insurance shall mean group accident, group sickness and group accident and sickness insurance as herein defined.   [PL 1969, c. 132, §1 (NEW).] SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1969, c. 177, §48 (AMD).
24-A ME Rev Stat § 2803 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2803. Requirements

 §2803. Requirements A policy of group health insurance may not be delivered in this State, nor may any certificate of group health insurance that derives from a policy issued in another state be delivered in this State unless the group policyholder conforms to one of the descriptions set forth in sections 2804 to 2808.   [PL 2011, c. 238, Pt. G, §1 (AMD).]SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1981, c. 147, §1 (RPR). PL 1993, c. 171, §C2 (AMD). PL 2011, c. 238, Pt. G, §1 (AMD).
24-A ME Rev Stat § 2803-A (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2803-A. Loss information

 §2803-A. Loss information 1.  Definitions.  As used in this section, unless the context otherwise indicates, the following terms have the following meanings.   A. "Insurance policy" means the insurance policy relating to the loss information requested pursuant to this section.   [PL 1995, c. 71, §2 (NEW).]B. "Loss information" means the aggregate claims experience of the group insurance policy or contract. "Loss information" includes the amount of premium received, the amount of claims paid and the loss ratio. "Loss information" does not include any information or data pertaining to the medical diagnosis, treatment or health status that identifies an individual covered under the group contract or policy.   [PL 1995, c. 71, §2 (NEW).]C. "Loss ratio" means the ratio between the amount of premium received and the amount of claims paid by the insurer under the group insurance contract or policy.   [PL 1995, c. 71, §2 (NEW).][PL 1995, c. 71, §2 (NEW).] 2.  Disclosure of basic loss information.  Upon written request, every insurer shall provide loss information concerning a group policy or contract to its policyholder, to a former policyholder or to a school administrative unit pursuant to Title 20‑A, section 1001, subsection 14, paragraph E within 21 business days of the date of the request. This subsection does not apply to a former policyholder whose coverage terminated more than 18 months prior to the date of a request. For the purposes of this subsection, "school administrative unit" has the same meaning as in Title 20-A, section 1, subsection 26.   [PL 2015, c. 420, §2 (AMD).] 3.  Transmittal of request.  An insurance producer or other authorized representative who receives a request for loss information in accordance with this section shall transmit the request for loss information to the insurer within 4 business days.   [PL 2001, c. 410, Pt. B, §1 (AMD).] 4.  Exception.  An insurer is not required to provide the loss information described in this section for a group that is eligible for small group coverage pursuant to section 2808‑B.   [PL 2001, c. 410, Pt. B, §2 (AMD).] SECTION HISTORY PL 1995, c. 71, §2 (NEW). PL 1997, c. 370, §E5 (AMD). PL 2001, c. 410, §§B1,2 (AMD). PL 2003, c. 428, §D1 (AMD). RR 2011, c. 1, §39 (COR). PL 2011, c. 395, §4 (AMD). PL 2015, c. 420, §2 (AMD).
24-A ME Rev Stat § 2804 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2804. Employee groups

 §2804. Employee groups A group of individuals may be insured under a policy issued to an employer or to the trustees of a fund established by an employer, which employer or trustees shall be deemed the policyholder, to insure employees of the employer for the benefit of persons other than the employer, subject to the following requirements.   [PL 1981, c. 147, §2 (RPR).]1.  The employees eligible for insurance under the policy must be all of the employees of the employer, or all of any class or classes thereof. The policy may provide that the term "employees" includes the employees of one or more subsidiary corporations and the employees, individual proprietors, and partners of one or more affiliated corporations, proprietorships or partnerships if the business of the employer and of the affiliated corporations, proprietorships or partnerships is under common control. The policy may provide that the term "employees" includes the individual proprietor or partners if the employer is an individual proprietorship or partnership. The policy may provide that the term "employees" includes retired employees and directors of a corporate employer. A policy issued to insure the employees of a public body may provide that the term "employees" includes elected or appointed officials. If authorized by the school boards of the alternative organizational structure's member school administrative units pursuant to Title 20‑A, section 1001, an alternative organizational structure established pursuant to Title 20‑A, section 1461‑B may contract for group health insurance that is offered to all eligible employees and retirees of the alternative organizational structure and its member school administrative units and their dependents in one or more employment classifications.   [PL 2015, c. 420, §3 (AMD).] 2.  The premium for the policy shall be paid either from the employer's funds or from funds contributed by the insured employees, or from both. Except as provided in subsection 3, a policy on which no part of the premium is to be derived from funds contributed by the insured employees must insure all eligible employees, except those who reject such coverage in writing.   [PL 1981, c. 147, §2 (RPR).] 3.  Except as provided in section 2736‑C, section 2808‑B and chapter 36, an insurer may exclude or limit the coverage on any person as to whom evidence of individual insurability is not satisfactory to the insurer.   [PL 1999, c. 256, Pt. G, §1 (AMD).] 4.   [PL 1981, c. 147, §2 (RP).] SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1969, c. 177, §49 (AMD). PL 1981, c. 147, §2 (RPR). PL 1989, c. 867, §§2,10 (AMD). PL 1999, c. 256, §G1 (AMD). PL 2015, c. 420, §3 (AMD).
24-A ME Rev Stat § 2804-A (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2804-A. Private purchasing alliances

 §2804-A. Private purchasing alliances A group of individuals may be insured under a policy issued to a private purchasing alliance meeting the requirements of chapter 18‑A.   [PL 1995, c. 673, Pt. A, §4 (NEW).]SECTION HISTORY PL 1995, c. 673, §A4 (NEW).
24-A ME Rev Stat § 2804-B (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2804-B. Group disability income protection plan

 §2804-B. Group disability income protection plan An employer may offer its employees an employer-sponsored group disability income protection plan in accordance with the requirements of section 2804. As used in this section, "disability income protection plan" means a group short-term disability policy or a group long-term disability policy instituted by an employer that provides income benefits to an employee who is unable to work for an extended period of time because of sickness or an accident. For the purpose of Title 26, section 629, subsection 1, the premium paid by an employee for an employer-sponsored group disability income protection plan issued pursuant to this section is considered a premium that the employee has agreed to pay if the group disability income protection plan provides for appropriate disclosure regarding the plan chosen by the employer, a method of enrollment that allows employees to opt out of coverage and an appropriate time period for employees to voluntarily terminate coverage. An employee must be provided information regarding the employer-sponsored group disability income protection plan at least 30 days prior and a 2nd time at least 10 days prior to the initial payroll deduction of that employee's premiums. The information provided must include a statement of the employee's right to opt out of coverage, the process by which the employee may exercise the right to opt out of coverage and any deadline to opt out of coverage.   [PL 2015, c. 490, §1 (NEW).]SECTION HISTORY PL 2015, c. 490, §1 (NEW).
24-A ME Rev Stat § 2805 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2805. Labor union groups

 §2805. Labor union groups A group of individuals may be insured under a policy issued to a labor union or similar employee organization, which shall be deemed to be the policyholder, to insure members of that union or organization for the benefit of persons other than the union or organization or any of its officials, representatives or agents, subject to the following requirements.   [PL 1981, c. 147, §3 (RPR).]1.  The members eligible for insurance under the policy shall be all of the members of the union or organization or all of any class or classes thereof.   [PL 1981, c. 147, §3 (RPR).] 2.  The premium for the policy shall be paid either from funds of the union or organization, or from funds contributed by the insured members specifically for their insurance, or from both. Except as provided in subsection 3, a policy on which no part of the premium is to be derived from funds contributed by the insured members specifically for their insurance must insure all eligible members, except those who reject such coverage in writing.   [PL 1981, c. 147, §3 (RPR).] 3.  Except as provided in section 2736‑C, section 2808‑B and chapter 36, an insurer may exclude or limit the coverage on any person as to whom evidence of individual insurability is not satisfactory to the insurer.   [PL 1999, c. 256, Pt. G, §2 (AMD).] 4.   [PL 1981, c. 147, §3 (RP).] SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1981, c. 147, §3 (RPR). PL 1989, c. 867, §§3,10 (AMD). PL 1999, c. 256, §G2 (AMD).
24-A ME Rev Stat § 2805-A (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2805-A. Association groups

 §2805-A. Association groups A group of individuals may be insured under a policy issued to an association or to a trust or to the trustees of a fund established, created or maintained for the benefit of members of one or more associations. The association or associations shall have at the outset a minimum of 50 persons; shall have been organized and maintained in good faith for purposes other than that of obtaining insurance; shall have been in active existence for at least 2 years; and shall have a constitution and bylaws which provides that: The association or associations hold regular meetings not less than annually to further purposes of the members; except for credit unions, the association or associations collect dues or solicit contributions from members; and the members have voting privileges and representation on the governing board and committees. The policy is subject to the following requirements.   [PL 1981, c. 147, §4 (NEW).]1.  The policy may insure members of the association or associations, employees thereof or employees of members or one or more of the preceding or all of any class or classes thereof for the benefit of persons other than the employees' employer.   [PL 1981, c. 147, §4 (NEW).] 2.  The premium for the policy shall be paid from funds contributed by the association or associations or by employer members, or by both, or from funds contributed by the covered persons or from both the covered persons and the association, associations or employer members.   [PL 1981, c. 147, §4 (NEW).] 3.  Except as provided in subsection 4, a policy on which no part of the premium is to be derived from funds contributed by the covered persons specifically for their insurance must insure all eligible persons, except those who reject that coverage in writing.   [PL 1981, c. 147, §4 (NEW).] 4.  Except as provided in section 2736‑C, section 2808‑B and chapter 36, an insurer may exclude or limit the coverage on any person as to whom evidence of individual insurability is not satisfactory to the insurer.   [PL 1999, c. 256, Pt. G, §3 (AMD).] SECTION HISTORY PL 1981, c. 147, §4 (NEW). PL 1989, c. 867, §§4,10 (AMD). PL 1999, c. 256, §G3 (AMD).
24-A ME Rev Stat § 2806 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2806. Trustee groups

 §2806. Trustee groups A group of individuals may be insured under a policy issued to a trust or to the trustee or trustees of a fund established by 2 or more employers, or by one or more labor unions or similar employee organizations, or by one or more employers and one or more labor unions or similar employee organizations, which trust or trustee or trustees shall be deemed the policyholder, to insure employees of the employers or members of the unions or organizations for the benefit of persons other than the employers or the unions or organizations, subject to the following requirements.   [PL 1981, c. 147, §5 (RPR).]1.  The persons eligible for insurance shall be all of the employees of the employers or all of the members of the unions or organizations, or all of any class or classes thereof. The policy may provide that the term "employees" includes retired employees, the individual proprietor or partners if an employer is an individual proprietorship or a partnership and directors of a corporate employer. The policy may provide that the term "employees" includes the trustees or their employees, or both, if their duties are principally connected with that trusteeship.   [PL 1981, c. 147, §5 (RPR).] 2.  The premium for the policy shall be paid from funds contributed by the employer or employers of the insured persons or by the union or unions or similar employee organizations, or by both, or from funds contributed by the insured persons or from both the insured persons and the employer or union or similar employee organization. Except as provided in subsection 3, a policy on which no part of the premium is to be derived from funds contributed by the insured persons specifically for their insurance must insure all eligible persons, except those who reject such coverage in writing.   [PL 1981, c. 147, §5 (RPR).] 3.  Except as provided in section 2736‑C, section 2808‑B and chapter 36, an insurer may exclude or limit the coverage on any person as to whom evidence of individual insurability is not satisfactory to the insurer.   [PL 1999, c. 256, Pt. G, §4 (AMD).] 4.   [PL 1981, c. 147, §5 (RP).] SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1969, c. 177, §§50,51 (AMD). PL 1977, c. 655, §2 (AMD). PL 1981, c. 147, §5 (RPR). PL 1989, c. 867, §§5,10 (AMD). PL 1999, c. 256, §G4 (AMD).
24-A ME Rev Stat § 2807 (2021)
2021 Maine Revised Statutes|TITLE 24-A: MAINE INSURANCE CODE|Chapter 35: GROUP AND BLANKET HEALTH INSURANCE|24-A §2807. Debtor groups

 §2807. Debtor groups A group of individuals may be insured under a policy issued to a creditor, or its parent holding company or to a trustee or trustees or agent designated by 2 or more creditors, which creditor, holding company, affiliate, trustee, trustees or agent shall be deemed the policyholder, to insure debtors of the creditor or creditors, as the case may be, all as defined and set forth under section 2604‑A, provided that the amount of indemnity payable with respect to any person insured thereunder shall not at any time exceed the aggregate of the periodic scheduled unpaid installments, including, with respect to mortgage indebtedness, such real estate taxes and insurance costs incident to the mortgaged property as may become due during the scheduled period and provided that nothing in this paragraph may be construed or deemed to apply to or affect disability benefit provisions in group credit life insurance policies as authorized under section 2604‑A.   [PL 1981, c. 698, §109 (AMD).]SECTION HISTORY PL 1969, c. 132, §1 (NEW). PL 1979, c. 127, §§156-A (AMD). PL 1981, c. 147, §6 (AMD). PL 1981, c. 698, §109 (AMD).